The COVID Cure Is Here

  We now have a cheap, safe, over the counter cure for Covid. Taken monthly with Vitamin D - 109% protection from Covid. 

If you are exposed , over 90% effective

If you are sick in the hospital- miraculous results 

If you are in the ICU tremendous results.  Go here to see short testimony Dec 8 before the Senate.  https://youtu.be/CuHq12B_Tvk

 After you watch the video go to http://www.flccc.net to learn all about it. 

The “Crime Of The Masking Of America” and other Frauds by Fraud Fauci

What have we done to ourselves?    Why have we “masked America”?   We have world-renowned doctors that have been treating thousands and thousand of CO_V;ID 1’9 patients with unbelievable success.  Many of the docs are seeing zero ICU’s admittance and zero death.  

We have Dr. Bart’’lette using a simple inhaler ster.oid with 100% success.  He had a local hospital inquire of his protocol and he says on video- they emptied their ICU in South Texas- emptied of all CO;’;Vid patients.  They could not believe they ended the suffering in a matter of days. 

We have another doc;’;tor stating he can treat the entire population of the U.S for $24.00 and eliminate this situation in 3 weeks if the F’;’DA will let do[ctors use I’;’vermectin. (Safe for 50 years in the U.S. for headlice treatment and parasites- no side effects).   

The cu[res are here, waiting to be used along with h’ydro[xy_chlo=roquine which if used early with zinc is having micraculous results.  By the way- the successes are so good in places like Japan with 200 million people, they have only had -(are you ready this? 1001 deaths - through July 31.   They have had a recent “surge” in cases, but with Hyd——- and Cam-ostat Mesol’;ate,  ( a cheap old drug) they have literally cured virtually everyone that got the vi’;runs.    

This same story is in country after country- but not here.  Here, everything that can stop this madness has been stopped by Fauci, crazy governors and crazy administrators who willl not let doctors prescribe medicine that has been FDA approved for 50 years.  This is criminal, and this is killing America as we know it. 

Now- crooked Fauci, says he only takes double blinded placebo studies and refuses to accept thousands of reports of people being healed.   

So let the get this straight, we have a 79 year old career bureaucrat that has never had his own medical practice -stopping those who do from saving lives.  We have a man that really never has practiced medicine calling the shots.  He is a brilliant researcher, and I have read some of his writings in my medical books, but he has never really touched people.   He joined the NIH at age 28 and as far as my research goes back, he never really saw any real patients.  He lectured, did research, and has done so since he as 28.  He has a 100 year old understanding of the immune system and still preaches it.

So in a Congressional hearing when asked about these doctors having unbelievable success - on the front line - with real people that would have died- crooked Fauci says “none of that matters”.  All that matters is a double blinded placebo controlled study over a period of time.     So this crook - and actually murderer - in my humble but educated opinion is guiding national policy to kill people and drag this mess out.

Now we get to the mask insanity.  Fauci goes along with a new narrative- everyone needs a mask.    Where does he get his double-blind placebo controlled study to show masks will make a  positive difference?   Well, it just got published- hitting the shelves now on a huge study - just like Fauci wants- and gusss what?   Study shows that for the flu - which is virtually spread the same way as this v’;Irus, and almost the same size, spread by droplets and touch.  The study shows ZERO improvement of transmission to others.  Not 50%, not 25%, not 5% but ZERO improvement to have the general population wear surgical or cloth masks.  Study shows ZERO benefit to people at home, or out.  So, Fauci- you have your famous study out there, but you will not refer to it, because it goes against your narrative. 

Mark my words, not only will the masks rip America apart due to the anti-maskers vs the maskers, but we have not even seen the beginning of the death, pain, suffering, destruction, and mental anguish these masks will cause us.   There will be hundreds of thousands, if not millions, if not tens of millions of U.S. children who will have their lives ruined over this mask crime. Has no one thought of the emotional trauma instilled on 75 million children.  The “masking of America” will go down as one of the greatest frauds and crimes crimes against humanity in world history.  There will be untold books, and publications to cover this crime against humanity.    Sadly, the rest of the world is following our lead, so everything is being multiplied.   Believer me when I say the “masking of America” is a horrid indescribable crime.

Fauci, you are a liar and a fraud.  I have your interview where in 2016 you told the interviewer you stayed safe around sick people by taking high dose vitamin C and Vitamin D.    Why have you never uttered this word - vitamin- or boost immune system in 8 months?   Because you do not want us to know your secret.   I would dare to have you prove you are not using Hyd’;droxy ... yourself.    You have committed a crime against this country.

You want to shut us down again, have everyone wear masks, googles and ear protection to keep others from getting the virus.    Well, guess what, everyone on planet earth gets to “encounter” this thing one way or the other.  Since death rates are still low- despite your best efforts to keep them high, this thing needs to run its course like Sweden did.  Now its over in Sweden, life is almost back to normal. 

Here are questions for the people of the U.S. and for you to explain.

1.  Why do you know tell us that there is a mathmatical algorithm to who has a bad reaction to this or not?  It’s math- below 20ng/ml you did of this. 20 to 25, you have sever reaction. 25 to 30, you have moderate outcome.  30 to 35, minor outcome, 35 to 40, almost no problems.  Over 40, almost zero chance of showing side effects.

2.  Why do you not show us the data on low glutathione levels which virtually coincide its the Vitamin D? Low glutathione, bad outcome.

3.  Why do you now tell every American we should be taking a supplement of 50mg of zinc?  Having low zinc- same math algorithm?

4.  Why do you not tell Americans that the protocol should not be , - get sick, got the ER, go home, come back when you are dearly ill is the opposite of what we should do?

5.  Why do you not tell us the “disease” has 2 phases in people that have bad outcomes due to low D and Zince, and that the second phase is what gets you later and is your immune system going crazy that kills people?

6.  Why do you not tell people to take high does vitamin C - up to 4 grams a day to put out the fire of the second phase?

7.  Why do you not tell Americans of any phrophelactic precautions Americans can take to more or less “immunize” themselves?

Why Dr. Fauci?

How can you sleep at night, knowing - you are the man killing America?

Fire Fauci

Defeat The Pandemic

Over the past 3 months, I have transitioned from fear of a supposed global virus which our body had no natural immunity to, (which was false) to somewhere between anger, frustration, joy, and grief.   As most of you, I first heard this virus came from a seafood market, was novel in nature, unknown to the human immune system, and had a high mortality rate which began with serious pneumonia.  So far, it is all proving to be a grand lie.    

I immediately began to learn that a lot of this solution would be based on math and the number of available beds/ventilators per state.   I listened to the argument that we could not overload the hospital system and we should work hard to “flattening the curve”.  Remember that?   

We were asked to “flatten the curve”  because the elderly are very susceptible to the disease, and we would need room in the hospitals for the elderly right?   

So I went along with the plan with millions of people throughout our state to help “flatten the curve”.    As we began to see our governors get very aggressive with shutting down small business, I soon saw we didn’t have a curve to flatten as all the hospitals were empty everywhere I looked.  They even shut down all the emergency hospitals in New York, Washington, and California.  Everywhere was pretty much empty right?  

But then the governors doubled down on everybody after their legislatures gave them emergency powers and the whole country started becoming a police state.  Most of it still is- as ridiculous as it sounds.  Now we have a bunch of idiot lawmakers demanding citizens wear masks to filter a virus that can literally pass through the mask without even knowing it hit a mask.  I heard a doctor specializing in virology today say wearing a mask right now is like building a chain link fence to keep out mosquitos.   There are governors having people arrested for not wearing a mask while our hospitals sit empty and staff laid off.  The fool of a mayor of New York City is considering building a fence to keep people off the beaches of New York during Memorial Day weekend.  He will be arresting people for going to the beach and getting sun, (which produces Vitamin D and is part of the cure by the way). think we should be asking the president to have the Justice Department arrest a few mayors and governors for violating the civil rights of millions of Americans and causing untold death, suicide and financial ruin to millions of Americans.  I am fortunate, this did not affect our family, but I hurt for the millions that are still having their rights stolen from them over a fraud.  Did you know they just released a report that 67% of 70 to 79 year olds do not even experience symptoms with this virus?   I am not saying it is not real, but I am demanding that we have been treating the wrong medical condition with the wrong protocols resulting in mass death. Did you know that doctors that provide patients high dose Vitamin C and keep their patients off respirators are seeing near zero that is ZERO mortality rates?  People wake up. You have been lied to.  Is there a virus? Yes, can it be very bad or lethal? Yes.  Can you stop it?   Almost exclusively yes with extremely high success with basic vitamins and natural ionophores like Quercetin and Zinc. The solutions to this are there. 

Subsequently I learned the unthinkable; all conspiracy theories aside, I learned from digging deep that the virus was never from any kind of some wet market, but the end product of over a decade of very high level virological DNA and RNA engineering, gene sequencing and gene insertions into the earlier sequenced and propagated SARS-COV RNA Coronavirus.  These scientists in Wuhan with help from Americans (and Anthony Fauci) had genetically inserted 3 other  markers into the gene sequence of the original virus, one of which was HIV, another was apparently MERS virus.  Researchers Expose Fauci and Engineered Virus SequenceThis new cocktail was not particularly lethal, but it would accomplish an intended  economic/geopolitical  end.   

This new information set me on the path to research what top virologists and PHD’s in Molecular Biology had to say about how to protect yourself against this new “conconction” of a virus.  So then, I had to learn things about the immune I had forgotten since my college days of Chemistry and Biology.  I downloaded ebooks and actually downloaded and tried to speed read Harrison’s Principles of Internal Medicine Vol I and II.  I scooped up every video I could get on immune function and defeating the virus.  After taking all this in- I was actually joyful because I knew the world would make it, my family would be ok, and everyone that I had told about things like VItamin A, C, D, E, Zinc, Quercetin, cytokine storms, and all that stuff.  Natural Treatmenments for Covid 19.  

Then, I got angry because I then asked myself  - Why is Anthony Fauci never saying the word “Vitamin” and the phrase “immune support” to the American people?    Why is Fauci so opposed to the $2.00 per dose prescription drug “HydroxyChloroquine” which is really a supercharged version of the nutrients mentioned above, and why is he only saying Vaccine, (which we have never had in the world for a Coronavirus) and pushing lockdown?   All they needed to say was that Americans should boost their immune system, make sure they had high levels of Vitamins A, C, E, D, and Zinc, and they would be fine.  No one from the media or the President’s COVID Response Team ever said a single word about taking your vitamins.

Next, I started questioning “the narrative”.  Why the lies? Why block Facebook posts about vitamins being the key to defeat the virus?      Why were New York State Hospitals putting almost all their patients on Ventilators and running 88% to 100% mortality in New York Hospitals?  Why were hospitals not putting these patients on high dose Vitamin C which other doctors had learned had almost 0% mortality.  New York Hosptials/Ventilators killing all patients

So now, I transition to the anger of seeing there is in fact some type of “narrative” being pushed on us by the government.  Why was Fauci and this whistle blower guy so opposed to Hyrdroxychloriquine, and Vitamin therapy and only pushing Remdesevir at $1,600.00 per dose when it really didn’t save lives, it just shorted hospital duration by 3 days? Now I had a lot of “why’s”.

After experiencing anger, I started experiencing frustration over the over-zealous mayors, town councils and governors that decided to push to take away our rights, completely blew past the “flatten the curve” initiate and started pushing a lock down state following the Chinese and Korean model.  It’s never a good idea to follow a communist country’s approach to a medical emergency.   So now, I am seeing the full weight of the “Blue States” destroying freedoms and even Republican governors like Stitt in Oklahoma and the governor of Texas actually violating our state constitutions by using executive orders as enforceable laws. More anger, more frustration.  Why then do all the states go after the churches?  Have you noticed the all out war on churches in virtually every state in the U.S?    Have you noticed, that if there was ever a time when every church in America should have had their doors open not 1 day a week, but 24 hours a day- 7 days a week it was during this crisis.

Remember something- and I am not I going religious wacko here, but remember James 5:14-16?  It says “is any among you sick? Let him call for the elders of the church and let them pray over them anointing them with oil in the name of the Lord.     We should have been doing this during this time.  Open the churches, call for the elders of the churches to get inolved in this.  Why? Because this is over most doctor’s pay grades and we all need to work together as community. 

 We could have brought together the leaders, the business owners, the scientists, the doctors, the chemists, and Chiropractors together, and as communities of faith, we could defeat the pandemic. But Oh No! We cannot allow the church to get involved, we have to push the church aside.  Imagine for a moment, if we had kept all churches open, and thousands of churches could have been used to bring together experts from various fields in each in community and attacked this from a spiritual perspective, a Biblical perspective , a scientific perspective, a medical perspective, a nutrition perspective, a small business perspective where we would be? 

Which leads me to frustration and grief.  Now we know that radical governors are trying to hijack this country and take away our freedoms.  I see that this is happening on global scale. Globally there is a concerted-coordinated effort to radially change the world order.  Forget conspiracies, you would have to be a fool not to see this.  There is something very big, very evil going on locally, in every state and every country in the world.  It is becoming a global war against freedom under the guise of a pandemic.   Remember where this started, in a communist country  that was likely desperate to attack America.  China was desperate to stop a wave of freedom that had started in the U.S, other countries including Taiwan, spread even to Wuhan China.

WARNING:   Below is my tin foil theory of “why”.  “Why” a pandemic?  This is just my thinking in a blog.  

All this leads me to the master plan I finally understand. I keep asking if this is truly a modified virus and the result of at least 10 years of research, and if Anthony Fauci is actually named on one the patents of how this virus operates (back in 2016 and 2017) why is the virus not more lethal?  What idiot country would unleash a virus as an act of war if it only did what it does?

The answer to that question is pure brilliant evil.   China took 3 of the worlds worst viruses, put them together into something we as a world had never seen.  The virus is unique in that it does not affect completely healthy people with proper Vitamin D levels. Since low Vitamin D is associated with numerous other diseases, this disease primarily affects people with low vitamin D.  See the link: COVID 19 Seems to only attack people with low level Vitamin D

1.  The virus leaves the lab.  I have my theory, but we can debate later.

2.  China knows it has to have a good story.  They need a story that will hold up, and it will have to affect a large of people in China in order for the world to believe it. With a population near 3 Billion, they will need 20 or 30,000 casualties to sell the scam to the world. 

3.  China’s elderly population is overhead, it costs them a lot of money and resources I n a communist technocracy they serve only to draw state resources. so, the elderly in China are sacrificed in large numbers to make the scam work.  

4.  Those who are obese, sickly, have weakened immune systems are no good whatsoever in a communist regime.  Again, they draw resources, cost money and do not produce.  Even 67% of 70-to 79 year olds will not even be symptomatic people.  Look it up.  I hope you realize from global stats that over half the people that encounter the virus, don’t even know they encountered it. Their immune system took it out before they got sick.  Look up the relation of Vitamin D to sickness.  Low vitamin D,- you get very ill and have a 99% chance of death.  Low normal D- you get sick, need vitamin C therapy like Cumo’s brother got at home.  Oh yea, he got high dose Vitamin C.   Normal level Vitamin D, very little chance of hospitalization even with co-morbidity.  China knew this.  So they cleared out their sickly and elderly in the Wuhan area.  

5.  You prepare a solution to your own Chinese pandemic that you can provide to the masses as soon as it starts to really spread out of Wuhan.  In this case, the “cure” was high dose Vitamin C and Vitamin D/Sunshine as the prophylaxis.   China stockpiled and delivered hundreds of tons of Vitamin C to Wuhan starting in late January. You wait for the right time to distribute.  Meanwhile, you pre-prepare the rest of your 3 billion population with the right nutrients so they’d really never get the virus.  If they did, they got a less lethal strain than was exported to New York or Milan. 

6.  You “seed” thousands of international travelers to New York and Milan, and a few selected International destinations. (See headlines from 5/18/2020 on Fox about this, or refer to my “Suppose” post from 2 months ago where I concluded this.   This seeding is possibly with a much more lethal strain than what you let out in Wuhan. 

7.  You tell the world it causes pneumonia and they must put patients on ventilators. (Which was the opposite of what we should have done).  It never really caused pneumonia , it actually was a thoracic blood clotting disorder treated without ventilators.  COVID Patients Do NOT get Pneumonia, they get something completely different, We usd all the wrong protocollsYou delay telling anyone, then you send out the wrong medical protocol to every hospital in the world which results in massive infection and begin to sickening the elderly just like it does.  

8.  You insist the only solution is social distancing and you insist each country must lock down all their people or as much as they can.  (This was you actually export a huge part of the communist model).    

9.  You cripple the U.S. economy, while the U.S. is in panic, you drop hundreds of tons of Vitamin C back in Wuhan, cure the people, and along with Vitamin D from the spring sun, you end the pandemic in China.  Meanwhile,, you keep put the cover, and let people like the globalists do their thing.   You know that with America’s respect for the elderly, that with misguided protocols and misinformation, many American cities would lock down our nursing homes which was exactly the opposite thing we should have done. Many thousand of our seniors were sacrificed in New York State over this misguided policy.  Sunshine and time with family would have saved thousands.  You assist American media to convince democrat leaders to ban beaches and parks which is in fact part of the prevention and cure.  This virus does not like sunlight at all. 

10.  You go on a fire sale of buying up U.S. assets like half the oil wells in Texas, theatre companies like AMC, home finance companiies like Wells Fargo, hundreds of other American corporations while you make sure America tears itself apart.

11.  American goes into a sort of self-destruct mode as the Democrats use this a chance to move America to a Socialist Technocracy.  They do not go all the way communist, but you destroy most small business in America, people are broken into smal groups wher they cannot fight police enforcement.    People turn on their neighbors to support the state while fall for the entire lie.

12.  American media continues to help perpetuate the hoax that this disease is unsolvable only by lockdown, contact tracing while we wait for a vaccine that will allow essentially give everyone in the U.S. a  serial number.   You help Google , Facebook and YouTube to be sure to remove all videos that teach the solution is immune support.   Any natural remedies that go against the World Health Organization communist based guidelines is removed.  RInse and repeat.  Silence the church.  Silence freedom, silence individual thinkers like this writer. Rinse and repeat.

13.  America goes into a severe recession while dealing with the essence of a political and class based civi war.  The citizens learn to hate their local leaders, and despise the police who they once admired and respected.   You, as China, move to the number 1 global leader.  Globalist like Bill Gates and Fauci win. America is led deceptively down the path that lockdown and an untested vaccine is a cure.   Massive sickness develops and mysteriously begins appearing in the U.S. while they war among themselves. You- China, won  the war you knew you could have never fought with conventional warfare.  But then again, you are not bound by rules.   China wins. 

Wake up people, go outside, get 15 minutes of sun, eat an orange or an apple, turn off CNN and FOX, take off the face mask, and resist lock down efforts.  It is time for the citizens of America to take this country back.    Stand for your rights and join together to end this lockdown and demand we be told the truth about how to protect our people. Enough is enough.

This Protocol Works To Treat COVID-19 Without Ventilators Using Massive Doses of Vitamin C in ICU

Please distribute this to every family member you know, have them copy this and present this procedure to their  admitting/treating physician 

This is from a document I just received.  It fully documents the procedures I have been recommending for some time.  This time, it is a highly respected Doctor in the midst of the fight against COVID-19.   For those of you that want the source article, click here and share to everyone you know.  Ventilators are killing almost 90% of patients who go on one.  The Doctors have been treating the wrong disease.   Click Here for Original Source:  E. VIrginia Medical School Protocol


Please note:  every single word beneath this line is from Doctor Marik’s protocol.

 EVMS CRITICAL CARE
COVID-19 MANAGEMENT PROTOCOL
Developed and updated by Paul Marik, MD Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School, Norfolk, VA April 2, 2020
URGENT! Please circulate as widely as possible. It is crucial that every pulmonologist, every critical care doctor and nurse, every hospital administrator, every public health official receive this information immediately.
This is our recommended approach to COVID-19 based on the best (and most recent) available literature including the Shanghai Management Guideline for COVID. We should not re-invent the wheel, but learn from the experience of others around the world. It is important to recognize that COVID-19 does not cause your “typical ARDS”... this disease must be treated differently and it is likely we are exacerbating this situation by causing ventilator induced lung injury. This is a very fluid situation; therefore, we will be updating the guideline as new information emerges. Please check on the EVMS website for updated versions of this protocol.
 EVMS COVID website: https://www.evms.edu/covid-19/medical_information_resources/ Short url: evms.edu/covidcare
Dr. AB (NYC).
“We have zero success for patients who were intubated. Our thinking is changing to postpone intubation to as long as possible, to prevent mechanical injury from the ventilator. These patients tolerate arterial hypoxia surprisingly well. Natural course seems to be the best.”
This is not your “typical ARDS”. Mechanical Ventilation may be doing harm. We need to think of alternative treatment strategies.
   Page 1 of 11 | EVMS Critical Care COVID-19 Management Protocol 04-02-2020 | evms.edu/covidcare

A few General thoughts:
 1. We are all inhabitants of the same planet and we are all in this together. The medical community needs to get off their “high pedestal” and act decisively and immediately; there is no time to lose. Patients are dying needlessly.
2. It is likely that 40-80% of the population across the world will become infected with this virus. It is therefore unrealistic for us to expect this will just go away. Our goal, therefore, should be to reduce the mortality in those who are at greatest risk of dying. This requires those at risk to diligently “socially distance” themselves. Once they become infected, we should treat aggressively to prevent disease progression.
3. The course of the disease is quite predictable. Acute respiratory failure occurs on day 6-8 concomitant with the cytokine storm and hypercoagulable state. In those patients requiring supplemental oxygen, we need to be very aggressive to prevent disease progression and mechanical ventilation. Once intubated, the mortality is high.
4. This is not your “typical” ARDS... but something else (weird). Chest CT shows bilateral, discreet, irregular, multilobar infiltrates and not the typical dependent air-space consolidation (“sponge lung”) characteristic of “typical” ARDS. Physiologically “COVID-19 ARDS” is different; our preliminary data suggests that lung water (EVLWI) is normal or only marginally increased (therefore by definition this is NOT ARDS). Furthermore, lung compliance is quite good yet there is severe hypoxia (due to shunting). This suggest microvascular and/or macrovascular disease... or some other alternative explanation. In addition, pulmonary embolism appears to be very common in these patients and may be the cause of sudden death.
5. It is important to stress that there is no known drug/treatment that has been proven to improve the outcome of COVID. This, however, does not mean we should adopt a nihilist approach. Furthermore, it is likely that there will not be a single “magic bullet” to cure COVID-19. Rather, we should be using multiple drugs/interventions that have synergistic and overlapping biological effects, that are safe, cheap and “readily” available. The impact of COVID-19 on middle- and low-income countries will be enormous; these countries will not be able to afford expensive designer molecules.
6. Preliminary data suggests that chloroquine and hydroxychloroquine decrease the duration of viral shedding. In addition, chloroquine has favorable immunomodulating properties including inhibition of PAI-1 expression. These agents are now FDA approved for the treatment of COVID- 19. These agents (if available) could be used to mitigate/curtail the spread of this virus and could be used in elderly patients with comorbidities at risk of progression and death.
7. Zinc (Zn++) inhibits viral RNA dependent RNA polymerase (replicase). Chloroquine and hydroxychloroquine are potent Zn ionophores that increase intracellular Zn concentrations.
8. Ascorbic acid has numerous proven biological properties (anti-inflammatory, anti-oxidant, immune enhancing, antiviral) that are likely to be of benefit in patients with COVID-19 disease. Furthermore, it is important to stress that ascorbic acid has proven synergistic effects when combined with corticosteroids. Therefore, steroids are recommended in patients with COVID-19 and respiratory failure. The benefit of ascorbic acid (without corticosteroids) in patients with severe respiratory failure appears to be limited. While the optimal dose of ascorbic acid is unknown, we suggest 3 g IV q 6 hourly. It should be noted that in the presence of free iron (released from ferritin) ascorbic acid may potentially have pro-oxidant effects. Therefore, the trends in CRP and ferritin need to be closely monitored; in those patients who ferritin AND CRP are increasing, reducing the dose to 1.5g q 6 hourly should be considered.
 Page 2 of 11 | EVMS Critical Care COVID-19 Management Protocol 04-02-2020 | evms.edu/covidcare

9. Very recent data suggests that in addition to being a potent anti-oxidant, melatonin may have direct antiviral effects against COVID-19. In healthy people, melatonin levels plummet after the age of 40 years. This may partly explain the increased risk of death in patients with COVID-19 who are over the age of 40. Melatonin may therefore have a role in both the prevention and treatment of COVID-19.
10. Vitamin D has important immune-enhancing effects. Much of the population, especially the elderly have sub-optimal vitamin D levels, particularly during the winter months. Low vitamin D levels have been shown to increase the risk of developing viral upper respiratory tract infections. Therefore, prophylactic vitamin D should be considered especially in the elderly.
11. Quercetin is a plant phytochemical. Experimental and early clinical data suggests that this compound has broad antiviral properties (including against coronavirus) and acting at various steps in the viral life cycle. Quercetin is a potent inhibitor of heat shock proteins (HSP 40 and 70) which are required for viral assembly. This readily available and cheap plant-derived compound may play a role in the prophylaxis of COVID-19 in high risk populations.


  Prophylaxis

While there is very limited data (and none specific for COVID-19), the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease, especially amongst the most vulnerable citizens in our community; i.e. those over the age of 60 years and those with medical comorbidities. While there is no high level evidence that this cocktail is effective; it is cheap, safe and should be readily available. So what is there to lose?

• Vitamin C 500 mg BID
• Zinc 75-100 mg/day (acetate, gluconate or picolinate; do not use for more than 2 months)
• Quercetin 500-1000 mg/day
• Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night
• Vitamin D3 1000-4000 u/day (optimal dose unknown; likely that those with baseline low 25-OH
vitamin D and those > 40o latitude will benefit the most)

 Mildly Symptomatic patients (on floor):

 • Vitamin C 500mg BID
• Zinc 75-100 mg/day
• Quercetin 500-1000 mg/day
• Melatonin 6-12 mg at night (the optimal dose is unknown)
• Vitamin D 1000- 4000 u/day
• Enoxaparin 40-60mg day (if not contraindicated; dose adjust with CrCl < 30ml/min)
• Observe closely.
• N/C 2L /min if required (max 6L/min; however, consider early t/f to ICU for escalation of care).
• Avoid Nebulization and Respiratory treatments. Use MDI if required.
• NO Bagging.
• Avoid non-invasive ventilation
• T/f EARLY to the ICU for increasing respiratory signs/symptoms.
  Page 3 of 11 | EVMS Critical Care COVID-19 Management Protocol 04-02-2020 | evms.edu/covidcare

Respiratory symptoms (SOB; hypoxia: admit to ICU):

1. Chloroquine 500 mg PO BID for 5 days or hydroxychloroquine 400mg BID day 1 followed by 200mg BID for 4 days.
2. Ascorbic acid (Vitamin C) 3g IV q 6 hourly until extubated and for at least 4 days and up to 7 days (see dosage adjustment above and caution with POC glucose testing).
3. Anticoagulation. COVID-19 results in a hypercoagulable state with pulmonary micro- and macrovascular disease playing a role in the hypoxia/pulmonary shunting. Unless contraindicated we suggest FULL anticoagulation (on admission to the ICU) with enoxaparin, i.e 1 mg kg s/c q 12 hourly (dose adjust with Cr Cl < 30mls/min). The use of half-dose rTPA has also been suggested: 25mg of tPA over 2 hours followed by a 25mg tPA infusion administered over the subsequent 22 hours, with a dose not to exceed 0.9 mg/kg followed by full anticoagulation.
4. Thiamine 200mg q 12 (PO or IV).
5. Azithromycin 500 mg day 1 then 250 mg for 4 days (has immunomodulating properties including
downregulating IL-6; in addition Rx of concomitant bacterial pneumonia).
6. Melatonin 6-12 mg at night (the optimal dose is unknown).
7. Zinc 75-100 mg daily.
8. Magnesium: 2 g stat IV. Keep Mg between 2.0 and 2.4 mmol/l. Prevent hypomagnesemia (which
increases the cytokine storm and prolongs Qtc).
9. Broad-spectrum antibiotics if superadded bacterial pneumonia is suspected based on
procalcitonin levels and resp. culture (no bronchoscopy).
Co-infection with other viruses appears to be uncommon, however a full respiratory viral panel is still recommended. Superadded bacterial infection is reported to be uncommon (however, this may not be correct).
10. Maintain EUVOLEMIA (this is not non-cardiogenic pulmonary edema).
11. Early norepinephrine for hypotension. While the angiotenin II agonist Giapreza TM has a limited
role in septic shock, this drug may uniquely be beneficial in patients with COVID-19
(downregulates ACE-2).
12. Optional: Atorvastatin 40-80 mg/day. Of theoretical but unproven benefit. Statins have been
demonstrated to reduce mortality in the hyper-inflammatory ARDS phenotype. Statins have pleotropic anti-inflammatory, immunomodulatory, antibacterial and antiviral effects. In addition, statins decrease expression of PAI-1.
13. Optional: Tocilizumab (if available) may have a role in cytokine storm (specific IL-6 inhibitor).
14. Steroids:
a. This topic is controversial. However, the only study on the use of corticosteroids and COVID (from Wuhan) demonstrates a marked mortality reduction with methylprednisolone (60mg daily). Steroids together with vitamin C maybe necessary to down-regulate the cytokine storm.
b. During the early viral replicative stage, best to avoid.
c. During the hyperimmune/hypercoagulable phase (day 6-8 onward) in patients with
hypoxia: Hydrocortisone 50mg IV q 6 for 4 days is recommended (together with ascorbic
acid)
d. Patients may evolve into an HLH/cytokine vortex phase, marked by increasing ferrin,
CRP, IL-6 and worsening oxygenation. These patients may benefit from high dose methylprednisolone. (dose ?? 200-500 mg q 12).
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15. Consider plasma exchange for cytokine storm/HLH picture (see steroids below). The use of CVVH filters that remove cytokines should also be considered.
16. Escalation of respiratory support (steps); Try to avoid intubation if at all possible
• Accept “permissive hypoxemia” (keep O2 Saturation > 86%)
• N/C 1-6 L/min
• High Flow Nasal canula (HFNC) up to 60-80 L/min
• Trial of inhaled Flolan (epoprostenol)
• Attempt proning (cooperative proning)
• Intubation ... by Expert intubator; Rapid sequence. No Bagging; Full PPE. Crash/emergency
intubations should be avoided.
• Volume protective ventilation; Lowest driving pressure and lowest PEEP as possible
• Moderate sedation to prevent self-extubation
• Trial of inhaled Flolan (epoprostenol)
• Prone positioning
• ?? ECMO < 60 yrs and no severe commodities/organ failure.
There is widespread concern that using HFNC could increase the risk of viral transmission. There is, however, no solid evidence to support this fear.
CPAP/BiPAP may be used in select patients, notably those with COPD exacerbation or heart failure.
17. Monitoring
• Daily: PCT, CRP, IL-6, BNP, Troponins, Ferritin, Neutrophil-Lymphocyte ratio, D-dimer, Mg, CRP and Ferritin are good biomarkers and track disease severity.
• In patients receiving IV vitamin C, the Accu-ChekTM POC glucose monitor will result in spuriously high blood glucose values. Therefore, a laboratory glucose is recommended to confirm the blood glucose levels.
• Monitor QTc interval if using chloroquine/hydrochloroquine and azithromycin and monitor Mg++ (torsades is uncommon in monitored ICU patients)
• No routine CT scans, follow CXR and chest ultrasound.
• Follow ECHO closely; Pts develop a severe cardiomyopathy.
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Typical CT scan of “COVID-9 ARDS”
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CTPA of 44 COVID + patient (with no risk factor for DVT/PE) presenting with severe tachycardia
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 Found on Internet, source unknown (thank you, author)
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   Page 10 of 11 | EVMS Critical Care COVID-19 Management Protocol 04-02-2020 | evms.edu/covidcare

Proposed mechanism of hypercoagulable state.
 Found on Internet, source unknown (thank you, author)
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