Édouard Manet Woman with a jug 1858-60
John Day is one of the “resident physicians” at the Automatic Earth, who posts on a very regular basis in our Comments section.
I asked him recently for an update of preferred treatments for Coronavirus/COVID19, because I noticed new treatments being discussed, in particular ivermectin/doxycycline, which appeared to be taking the place of hydroxychloroquine/azithromycin in some cases.
As per John, below, there doesn’t seem to be much difference; that is, both do fine, if and when applied in timely fashion. In combination with zinc, of course. Azithromycin and doxycycline are antibiotics.
We’ve been discussing HCQ for a long time here, and John’s been a fan since even before he started treating patients with it.
Did you notice that the first criticisms of HCQ in the US et al were all about the death risk, and now that’s totally gone, and people like Fauci only claim it’s ineffective?! And it probably is, if taken too late, or without zinc, but have you ever seen Fauci mention zinc in the discussion?
An estimated 200 million Africans were given chloroquine as a malaria drug since the 1960s, and there’s not one report I’ve seen of people dying from it. It’s still prescribed for rheumatoid arthritis and lupus, no reports of significant numbers of deaths there either.
John provides an overview here of recent developments, reports etc., which is of necessity always in transition. Keep on checking back. Delve in deep or just scan for essentials.
Even earlier than HCQ and ivermectin, and as John again repeats, you need vitamin D, which is essential for strenghtening the linings of blood vessels and lymphatic vessels, and is sort of your first defense against a potential infection with a virus that attacks exactly those, before it happens. Boost your vitamin D levels as a precaution; it’s cheap and effective.
But I’m not the doctor, John is:
John Day: This is a lot, folks, and I did not really delve into use of high dose steroids, ventilators and paralyzing medicines in hospital treatment. We should be avoiding that whole scenario. I remember when AIDS became a disease for outpatient treatment. That was dramatic. Pills that worked made it possible.
Roger Seheult MD Discusses the role of vitamin-D in helping the body fight the effects of SARS-CoV-2 virus, with special focus on the arterial lining, the endothelium, where the battle for life is fought. Recent paper has more vitamin-D data, and it’s all the same, just more. Take 5000 units per day, or whatever it takes to get your level above 60. He recommends 50,000U initial dose for all hospitalized patients.
Look at 11:30 to 13:30 (the last 2 minutes) for specifics on vitamin-D in hospital by this critical care pulmonologist. This COVID-19 update series is excellent!
JCEM paper cited in lecture: https://academic.oup.com/jcem/article/97/8/2792/2823373
Charoenngam/Holick paper cited in lecture: https://www.researchgate.net/publication/342970598_Immunologic_Effects_of_Vitamin_D_on_Human_Health_and_Disease
This is a comprehensive aggregation of papers relating directly to Vitamin-D levels and supplementation in COVID-19 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276229/
This much cited Indonesian study , reported in June, is included in the above analysis, and is worth its own link: https://emerginnova.com/patterns-of-covid19-mortality-and-vitamin-d-an-indonesian-study/
My general advice for people over 100# is to take 5000 units of vitamin-D daily, long term, unless you have not been taking it, in which case, take 10,000 units vitamin D3 daily until Thanksgiving or Christmas or New Years Day or something. If you weigh 80# take 4000 units per day, 60# gets 3000 units, etc.
This is the influential study from Bangladesh, reported in July, which prompted the Indian state of Uttar Pradesh to change from hydroxychloroquine/azithromycin to ivermectin/doxycycline. It explains the known antiviral mechanisms at work very well.
A Case Series of 100 COVID-19 Positive Patients Treated with Combination of Ivermectin and Doxycycline
Dr Alam’s randomized, controlled follow-up trial is approved and funded and underway
Dr. Alam Gets his Randomized Controlled Trial Approved by the Bangladesh Medical Research Council
This paper explains that ivermectin blocks a transport mechanism that viral RNA and proteins need to get from the cytoplasm, into the nucleus, where the machinery for viral replication exists. Ivermectin turns the nuclear-membrane into a wall against coronavirus, and some other viruses, too. The broad spectrum antiviral ivermectin targets the host nuclear transport importin ±/≤1 heterodimer
Ivermectin helped sick hospitalized patients in Florida survive, especially some of the sickest ones. Conclusions and Relevance: Ivermectin was associated with lower mortality during treatment of COVID-19, especially in patients who required higher inspired oxygen or ventilatory support. These findings should be further evaluated with randomized controlled trials.
More News on Dr. Borody’s Ivermectin proposal
Here is my essay on the sick husband and wife I treated with Ivermectin, zinc and doxycycline last week. She gets nauseated from the zinc, but they both got out of crisis right away. He still feels tired and coughs.
A randomized trial of ivermectin/doxycycline, vs hydroxychloroquine/azithromycin in COVID-19 patients (I see no reason not to use both ivermectin and hydroxychloroquine. Mechanisms of action would be complementary. It is being proposed and has been done.)
This trial found the treatments to be similarly well tolerated and similarly beneficial.(Ivermectin was better, not to statistical significance.)
A compilation of hydroxychloroquine studies treating COVID-19, and in-vitro studies, to date and summarized. Thanks Marc.
Hydroxychloroquine + azithromycin + zinc got more patients home from the hospital than hydroxychloroquine + azithromycin without zinc:
Dr Raoult’s large scale and successful study of hydroxychloroquine and azithromycin. (Not randomized with a placebo arm, since people were dying and placebo was already known to the investigators to lead to more deaths than treatment.) Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis.
Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11-0.27), decreased risk of hospitalization e”10 days (odds ratios 95% CI 0.38 0.27-0.54) and shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17-1.42). QTc prolongation (>60/ ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500/ ms. No cases of torsade de pointe or sudden death were observed.
Here is an ongoing prospective, randomized American study, which does assign people to HCQ/Azithromycin or clever placebo pills.
Zinc is not part of it.
Here is Gummi Bears’ “Deep Dive on Hydroxychloroquine” from last month. Scroll down 2/3 of the way and see the national responses to initiation of HCQ/Azithro treatment in Brazil, Algeria and Morocco. Deaths plateau in 10 days, while cases keep rising to a much later plateau.
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