Since appearing on the Rick and Bubba University podcast that was released on August 1, the number of requests I have received for Covid treatment and prophylaxis has grown exponentially.  I knew that would happen, of course, and I knew it was not possible for me to handle all such requests.  I also knew that God would provide help and lead others to help stem this plague by utilizing safe and effective early treatments.  A retired physician and and nurse practitioner have graciously joined the effort.  We will help as many as I can, but understand it is best to be treated as early as possible.  If you are able to find appropriate care, I strongly encourage you to not delay starting that care.  And, if this is a medical emergency,  dial 911.  In all seriousness, if you are having any respiratory issues or are uncomfortable with the current state of your health, seek immediate care.  At the moment, I am not able to get to requests for prophylaxis due to the volume of requests for treatment.

I will be adding additional information and resources to this page as I am able, but I wanted to get treatment options out as soon as possible. 

I will describe my treatment regimen here.  Although I hope to have time to elaborate on rationale and mechanisms soon, this will be a succinct summary of medications consistently prescribed along with potential additions.  It is based on recommendations of some of the most qualified physicians in the world with regard to Covid and many of these therapies have been utilized successfully since almost the start of the outbreak.  Drs. Peter McCullough and Pierre Kory are prominent examples of doctors who have fought tirelessly on our behalf to advocate for early treatment.

Saline nasal rinses.  The only reason you haven’t heard more about this is no one makes money off salt water.  Everyone everywhere should be rinsing their nose.  Four times a day for prophylaxis and eight to twelve times a day if you are sick.  The data shows it not only helps outpatients but reduces hospital and even ICU stays.

Gargle 30 seconds every night with Listerine.

Ivermectin – weight based at 0.2mg per kg per dose.  Simple calculation is weight in pounds divided by 11.  It comes in 3mg tablets and you round up.  So a 140 pound patient would receive 15mg per dose.  Currently using on days 1, 3, and 5.  So 48 hours separate the doses.  The FLCCC is using ivermectin daily for 5 days at 0.2-0.4mg/kg/dose but supply is currently strained and I have seen my patients do well with 48 hour dosing.  It is included on the WHO List of Essential Medicines.  Its’ safety has long been established, it has been studied at doses up to 120mg per day and interactions with commonly prescribed medications are rare.  Take with food.

Doxycycline or azithromycin.  The dose for doxycycline is 100mg twice a day and azithromycin can either be 500mg on day one with 250mg days 2-5 (the standard Zpack) or 500mg daily for 5 days depending on the patient's size and presence of pneumonia.

50mg of elemental zinc daily. 

Vit C 1g 4 times a day.

Vit D 5000-10000IU daily for 10 to 15 days.

Aspirin every day.

Monitor pulse oximetry is recommended.

Regeneron, or outpatient antibody treatment, is definitely an option.  Once I started utilizing ivermectin in late December last year my patients did so well I never really utilized them again.  However, patients are definitely sicker now and my general approach to Covid is if it may help I am all in favor.

Lung expansion and preservation is paramount with this disease.   We have used prone positioning in the hospital and for ventilated patients.  That is now extending to outpatient.  Patients with any hint of respiratory symptoms need to lay on their stomach as opposed to sitting in a recliner.  Sleep on your stomach or alternate every few hours.  Use an incentive spirometer.  Hydrate.  Prone, incentive spirometer, hydrate.

That is my initial treatment.  Most of the time, it will be adequate and the only treatment required but there are times other interventions are needed.  It should be noted other physicians have also been utilizing colchicine, fluvoxamine, quercetin, and/or melatonin in initial treatments.

Systemic steroids are generally avoided during the initial phase of the disease.  However, inhaled budesonide can be used early and should be added if respiratory symptoms are present.

With continued fatigue or certainly with respiratory symptoms, decadron 6mg daily for 7 days can be added around day 5 or 6.  I usually wait until day 6 unless breathing requires a little earlier.  Usage of a pulseox can help this determination.

With this round of Covid, especially the GI version, I have found if a patient has access to a bag of IV fluids, at an urgent care for instance, they feel significantly better after the IV.  I usually suggest the first dose of decadron be given IV (8mg) with the fluids and Zofran can be given as well if nauseated.

Another possibility for blocking histamine is the combination of Pepcid and Zyrtec.  Pepcid can also be useful for relief of GI symptoms.

I have heard from patients that getting outside has helped with symptoms, including fatigue.

One other note about the course of this disease.  It can be very stubborn.  Some people have very mild symptoms or recover quickly.  Others run fever, or feel as if they were hit by a truck, for two weeks or longer.  As long as you are able to avoid respiratory distress or a blood clot, outpatient treatment was highly successful.

David Williams, MD