First the executive summary:

1. Do NOT get vaccinated with any of the current COVID vaccines (as of Oct 25, 2021). We now have multiple peer-reviewed papers published in the scientific literature showing the 3 vaccines used in the US are unsafe. Over 150,000 Americans have been killed by the vaccines and the vaccines kill more people than they save for all age groups. See this article for details on the analysis and the peer-reviewed published papers that back up this extraordinary claim.

1. Early treatment is key. Treating the virus as soon as you know you are infected (ideally even before any symptoms) consistently gives amazing outcomes (i.e., the virus does nothing to you at all). So either test regularly or test as soon as you think you might have COVID. I use an Oura ring to alert me to a night time temperature rise since this is a clear early warning something is wrong. Sadly, many doctors will wait for symptoms before starting treatment to avoid treating you unnecessarily. This is a huge mistake. By the time you have symptoms in COVID, damage is done and it will be both harder to treat and may be difficult to impossible to fully repair. Would you want the fire department to wait until your home collapses before they turn the water on? In every case where these drugs fail to get you back to 100%, it was because the treatment was initiated too late. I don’t know of a single case where when the virus was treated early with a combo of FLV+IVM at the dosages recommended below where the person didn’t fully recover rapidly with no long-haul COVID symptoms. The ideal time to treat is IMMEDIATELY after you get a positive test result and before you have any symptoms. People often wait 5 or 6 days after start of symptoms before seeking treatment. These people will often have elevated D-dimer levels which means blood clots have already formed and significant damage may have already been sustained. If your doctor ever suggests delaying drug like ivermectin or fluvoxamine until you have symptoms, please ask her for evidence showing that delaying treatment leads to better outcomes. No such evidence exists.
2. Don’t underestimate the disease. Many people who think they don’t need any drugs to help them have come to regret that decision. It’s far better to treat the virus as life threatening at all stages. A third of COVID survivors suffer from neurological or mental disorders. Inadequate treatments do not offer protection, e.g., Dr. Drew was treated with the monoclonal and ivermectin and still suffers from mental difficulties months later. Treat early and hard. The failures we’ve seen are when the patient is dosed too late and/or with insufficient drug.
3. The two drugs to treat COVID early that are most readily available with the best evidence today are fluvoxamine and ivermectin. Fluvoxamine (50mg BID) has been shown to be 100% protective against hospitalization in two studies. In the Seftel study it was shown to be effective in preventing any long-haul COVID (PACS) symptoms which affect 27% of COVID patients vs. 60% rate in patients who refused treatment. Treated patients were free of PACS from 14 days after start of treatment and thereafter (4 months so far). One of the key reasons fluvoxamine is so effective (especially in resolving brain fog) is that fluvoxamine can pass through the blood-brain barrier and calm any inflammation in your brain that can lead to devastating effects, even for patients as young as 12 years old.
   
   As of April 10, 2021, there have been over 50 studies of Ivermectin in over 15,000 patients and in only one of those trials did the non-ivermectin arm show a superior outcome. Nobody is able to explain how that can happen if the drug doesn’t work. The NIH has a NEUTRAL recommendation on ivermectin even though there has never been a drug in the history of the world which has over 50 published studies showing positive effect sizes where the drug was later determined not to work.
   
   The combination of fluvoxamine and ivermectin has been shown to be extremely powerful. Every physician that I’m aware of who has tried the combination is pleased with the result. I highly recommend people consider treating with both drugs as soon as you know you are infected. Learn from the mistakes of others: Do not wait for symptoms before treating.
4. Ultimately, I believe that the combination of antiviral and anti-inflammatory will be the best combination therapy. COVID is very unlikely to be effectively treated with a single off-label drug. At a minimum, using a combo of an antiviral (like proxalutamide, bromhexine, camostat, ivermectin, etc.) plus an anti-inflammatory (such as fluvoxamine or ivermectin) should be extremely effective in preventing hospitalization and long haul COVID (aka PACS) as long as it is administered promptly after diagnosis and ideally before (or concurrent with) first symptoms. Drug combos that keep at least both CRP and D-dimer at normal levels are going to be the most successful.
5. Kids and already infected do not need to vaccinated. There is no trial showing a benefit and vaccines always have risks.
6. Viral spread: Spread of the virus by asymptomatic people is very rare. It is also extremely rare to spread the virus outdoors.

I’m the Executive Director for the COVID-19 Early Treatment Fund (CETF), an organization that funds researchers from all over the world pursuing promising drugs against COVID. We’ve evaluated more than 60 grant proposals and funded 14. This gives me a bird’s eye view of many of the most promising treatments.

The advice you get from the CDC and Dr. Fauci is very conservative based on the most proven science. They will not recommend a drug unless it passes Phase 3 trials. They should be using the precautionary principle and “use all available evidence.” But they don’t because they want you to get vaccinated.

The net result of the current CDC advice is that in America about 100,000 people die from COVID each month. And even if you recover, a lot of people will be left with long-term to permanent impairments in neurological or lung function. A third of recovered patients from COVID will return to the hospital within 5 months and 1 in 8 die. It couldn’t be more obvious that the current advice isn’t working out very well.

But if our goal is simply to minimize the number of deaths per unit time, and we are OK about being wrong once in a while because saving lives is more important than our reputation, then we can look at drugs that are just shy of the Phase 3 bar and ask the question: “Based on a systematic review of the data on the table today, is the drug more likely to save lives or cost lives?”

When we change the problem we are trying to solve to minimize the number of deaths, we find that we have evidence-based treatments today that have a high probability to significantly reduce the hospitalization and death rates and reduce the chance of any long term impacts with virtually no incremental risk. It is an unnecessary loss of life, to “wait for more data” (such as a phase 3 trial) if the evidence on the table is statistically significant and impossible to explain with confounders.

What this means is if you are interested in maximizing your life expectancy, you must look outside the CDC guidelines.

Everyone has an opinion as to the best approach, so here’s mine: if you goal is to treat early to prevent hospitalization and death, the two most effective drugs that are available in the US today are fluvoxamine and ivermectin.

For example, Dr. Syed Haider has prescribed fluvoxamine+ivermectin for over 100 patients (as of March 14, 2021) and in every single case, the patients got better and recovered back to normal most within just a few days (takes longer if you wait longer before starting the meds). Side effects were minimal (just one person had to stop the fluvoxamine). No hospitalizations or deaths. He reports that the two drug combination works much better than ivermectin alone (which is what he used to prescribe).

What follows are details and dosages for these drugs, as well as other options.

Ivermectin has been strongly endorsed by an international panel of experts (see the BIRD report) and the the studies are consistently positive. Studies in Peru and Argentina show massive effect sizes and are inexplicable other than the drug works.

For fluvoxamine, a key opinion leader (KOL) panel, people from NIH, CDC, and top academic institutions, met on Jan 22 to review the fluvoxamine evidence. They voted afterward to support “shared decision making” TODAY (between doctor and patient) on fluvoxamine by more than a 2:1 margin (note only 20 of the 30 cast votes). So they were voting in their PERSONAL capacity, and NOT in their OFFICIAL capacity. So even though the guidelines panel will wait for a phase 3 trial because of the “public trust” issue in their recommendations, the doctors overwhelming agreed that the weight of the evidence merited a discussion today between doctors and patients (and NOT waiting for more data).

The confidence level in some of these drugs is quite high.

Waiting for “more data” (such as a phase 3 trial) before making a decision is sub-optimal because there are no good solutions today. If you were drowning and someone threw you a life preserver, would you avoid using it until the phase 3 trial completed? I wouldn’t! I’d request that they throw me the life preserver with the highest effect size.

Nearly all the drugs listed below are the most effective when used as soon as you know you are infected. Because tests can take a while to come back, if it were me, and I thought I was exposed to COVID and had one or more of the telltale symptoms, I would rush to get a fluvoxamine prescription ASAP.

These drugs can still be used at later stage, in the disease but:

1. you may have to use the drug longer than 14 days (one hospitalized patient took 9 weeks to fully recover on a fairly low dose of FLV)
2. you may have to increase the dose to that you can tolerate without side-effects (never exceed the FDA limits)
3. you may be too late to reverse permanent damage caused by the virus.

If everyone in the world just did one thing differently, talking to their doctor about whether they should start fluvoxamine + ivermectin immediately after they learned they were COVID positive, our hospitals and ICUs would be nearly empty today and there would be very few “long haulers.”

There is an excellent op-ed in the WashPost by Dr. Jeffrey Klausner about using drugs like fluvoxamine off-label immediately using a process known as “shared decision making.”

You should always consult with your doctor before following taking any supplement or drug. There are a variety of options available below. You and you doctor may be more comfortable with some than others, so I’ve listed a range of options. If your doctor won’t prescribe the drug, certain online telehealth providers such as CityHealth Urgent Care are able to assist with getting a prescription. For hospitalized patients, court orders may be necessary.

The biggest mistake people make is underestimating this disease. I can’t tell you how many people will read this article and ignore the advice perhaps reasoning, “well if this is true, I’d be reading about it in the press.” OK, well fluvoxamine was featured on 60 Minutes, and there have been a huge number of stories on ivermectin.

The side effects of this disease can happen relatively quickly and be devastating and irreversible. If I got infected, I would, without hesitation, treat it as early as possible using the options below. I would not wait for first symptoms as your first symptoms could be irreversible. Would you play Russian roulette with your brain and body? I wouldn’t. If you lose the results can include limb amputation and permanent blindness.

A lot of physicians will consider these drugs only for patients who are most at risk of hospitalization. I think this is a huge mistake because it’s your life and nobody can tell you for certain how the virus will affect you. If there is no downside to the drug and it can reduce your chance of hospitalization by 90%, why wouldn’t you want the drug? For fluvoxamine and ivermectin, for example, the dosage is so low that any side effects are rare, minor, and go away when you stop the drug. A lot of this is simply fear of the unknown: their inexperience in prescribing the drug and trying anything new. Doctors who prescribe the drug on regular basis (psychiatrists) have no such fear.

Here’s a list of the options I would consider to treat the virus. This is not to say that these are your only good choices; these are simply the ones I believe are the most effective with the best scientific evidence. Whether or not to combine these options is something you should discuss with your doctor.

For me personally, I’m not on any drug for prevention. If I get COVID, I’ll take camostat, lactoferrin, metformin, and fluvoxamine. In the unlikely event I had worsening symptoms, I’d add in ivermectin, doxazosin, and fenofibrate.

Case 1: Drugs for prevention

Note that none of these options actually prevents you from getting COVID. If you are exposed with enough virus, you will get it. What these drugs will do is enable you to defeat the virus very quickly.

1. COVID vaccination: The current gene-based vaccines are unsafe. I recommend you avoid them. See this video.
2. Ivermectin (IVM): If I felt I was a high risk of getting COVID (e.g., a family member was diagnosed or I was more socially active), my first choice would be prophylaxis by taking .2mg/kg of Ivermectin every week, i.e., taking four 3mg tablets every Monday. This is the updated FLCCC recommendation. The Carvallo study is incredibly impressive (0 of 788 people got sick vs. 58% in the matched group) (Hoyt on Twitter). A recent study in Bangladesh found similar results (Can Ivermectin help prevent Covid-19?) (note that dosing in that study was once a month which was not sufficient to protect everyone). The prevention data for ivermectin is quite strong.

Case 2: Drugs for treatment once you are infected (the antivirals)

Every virologist would tell you that the best way to fight a virus is to treat it early with antiviral. For that reason, I have worn an Oura ring every night since the pandemic started because a night time temperature rise is often an early sign of infection (not a daytime temperature rise). If I see my temperature rise beyond my normal range, I’m going to pay extra get a same-day COVID test to verify. The virus doubles in size in vivo around every 10-12 hours (we think), so every hour is valuable for getting the best possible outcome.

1. Approved monoclonals: Because I meet the eligibility criteria, I would try to get one of the two monoclonal antibody treatments approved by the FDA. Bamlanivimab is made by Lilly, casirivimab and imdevimab are made by Regeneron. They require a infusion (a 30 minute process or longer) which is done either in your home or the hospital. It is not yet known whether the monoclonals will be effective against virus mutations. Basically, it gives me an extra edge in fighting the virus. The FDA I think made an error in setting the dosage well below what was proven effective so this option gives you an “edge” rather than being 100% one and done.
2. Amantadine: This drug has been extremely effective in preventing hospitalization. This drug may be easier to get since it is less well known.
3. Colchicine: This drug is 25% effective in reducing hospitalization. See Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19. This drug hasn’t been widely adopted because the effect size is small and not statistically significant and the side effect profile is high. It’s rarely used.
4. Lactoferrin: Jonathan Sexton and colleagues at University of Michigan have demonstrated anti-viral effect of lactoferrin in vitro. The suggested dosing for treating the virus is 1g twice a day (i.e., a total of 2g/day). No prescription needed. Available on Amazon. Adding lactoferrin can’t hurt and may give you some additional protection.

Harder to get drugs:

1. Proxalutamide: This is an unapproved drug that has a stellar track record in clinical trials both for outpatients and hospitalized patients. See COVID-19 early treatment: real-time analysis of 542 studies.
2. Dutasteride: This is an extremely cheap generic drug (TMPRSS2 inhibitor) with very impressive results reported in a single trial in Brazil done by respected researchers.
3. SNG001: Only available in clinical trials, this inhaled interferon can reduce chance of getting serious COVID by 79% (see Synairgen's inhaled interferon for COVID-19 enhances short, harmless version of virus entry point: study).
4. Bromhexine: Bromhexine is available over the counter outside the US (e.g., in Brazil its a very commonly used cough syrup and you can buy a bottle for just $4). A large effect (5x or more improvement in ICU admission and fatality) was confirmed in an open label randomized trial of bromhexine (8mg TID + HCQ 200mg QD)x14 days. Bromhexine, even when given late in the disease, is complementary to fluvoxamine since bromhexine acts as an antiviral (TMPRSS2 inhibitor like camostat) whereas fluvoxamine is primarily a regulator of the immune response. It’s not clear HCQ adds anything to the mix; it was used in the trial because in the country doing the trials, it was standard of care so had to be used. It would be very interesting to see a trial with just bromhexine.
5. AZD7442: There is another promising monoclonal, AZD7442, that is long-lasting, but only available in clinical trials. See COVID-19 long-acting antibodies discovered by Vanderbilt University Medical Center move to phase 3 clinical trials.¶
6. Camostat: The antiviral with the next best track record so far is camostat. This is the drug that is the first choice for many of the world’s top coronavirus experts because it inhibits TMPRSS2, a key enzyme needed for the virus to replicate. Camostat is readily available via enrolling in a clinical trial out of Yale University. If you are in the New Haven area, please enroll in the Yale clinical trial. It will soon be open at more sites such as the University Hospital network in Ohio. Do not exceed 2.4g per day! Typical dosing is 200mg every 8 hours (i.e., 600mg per day), but if you can tolerate double that, you’ll likely give the virus a more difficult time (at the expense of some nausea).
7. Interferon lambda: This drug is only available in a clinical trial in certain locations. The virus basically turns off your immune system when it gets into your body, so by injecting exogenous interferon, it basically compensates for this and returns your immune system to normal. This drug is extremely safe with a very low side effect profile (so low it is unmeasurable). One study showed it is far more effective than any of the approved monoclonals. It’s also much easier to administer than a monoclonal; it is a single shot in the arm, ideally within 3 days of first symptoms (the earlier the better). But there were conflicting studies on this drug published just 9 days apart (Stanford vs. Toronto), so there will be a Phase 3 trial to resolve the conflict. If it validates the Toronto study, this drug could rise to be the most important single drug to get as soon as you know you are infected since it will likely work for all mutations of the virus (and can be useful for future pandemics as well).
8. GS-441524: This drug is a precursor drug in the manufacture of remdesivir. It has been shown to be safe in humans, cheap and easy to manufacture, and can be put in pill form. It is remarkably effective against all RNA viruses (including the coronavirus). This drug may be the most important discoveries in the fight against COVID and future viruses.
9. EXO-CD24: This drug just completed phase 1 trials where 29 of 30 patients with moderate to severe COVID recovered in 3–5 days.

Case 3: Drugs for use post-infection (anti-inflammatories)

Once I learned I was infected, I would ALSO immediately also start on an anti-inflammatory drug. The reason is simple: to reduce the chance of permanent brain damage that could disable me for the rest of my life.

I’ve listed the drugs in order of effect size. I wouldn’t have any qualms about taking any of these drugs/supplements.

1. Fluvoxamine (FLV): As soon as I found out I was COVID positive, I would immediately start taking 50mg twice a day since this was shown to be the minimum effective dose for a 100% effect size. However the numbers in the Seftel study at that dose were small (N=77 in the treatment group), so it is possible that a higher dose may provide even better protection (e.g., for elderly), but the side effect profile is higher. You can ramp up to 100mg twice a day safely and the psychotropic effects are minimal for a 14 day duration even at the higher dose. On average, at 50mg BID, it takes about 3 days to reverse COVID symptoms and return to normal. Even lower doses appear to work as well, e.g., 50mg once a day. I would avoid caffeine while on drug (FLV jacks up the intensity and duration). It is even safe to take the drug at this dose and duration if you are pregnant (that should tell you how safe it is!). I’ve not yet heard of a single case of someone taking the drug and not recovering. The retrospective data shows that some people on the drug still get hospitalized, but it isn’t yet clear if they got hospitalized because of the COVID or for some other reason. There are several reasons I prefer FLV to ivermectin: 1) I personally know and can vouch for the quality and integrity of researchers and the trial methodologies, 2) the trial was published in JAMA showing a 100% success rate and despite 120,000 views, nobody found any confounders, 3) it continued to be 100% successful as a monotherapy in a real-world study with a very challenging patient ethnicity mix, 4) in the opinion of mainstream docs at this point, FLV is the hands-down choice between the two because of the quality and consistency of the evidence and the clear mechanisms of action, 5) It’s really hard to argue with the 100% success record (compared to inconsistent readouts with IVM) 6) its effective at low dosing and has no side effects at that dose, 7) we know that it is safe long term for anyone who takes it, 8) it gets out of your system fast as soon as you stop taking it, 9) In the Seftel trial at Golden Gate fields, there were 0% hospitalization and 0% long haulers vs. 12.5% hospitalization and 60% long haulers in the no treatment group, 10) in general, doctors have less of a problem prescribing FLV than IVM, and 11) costs less than $10 for the entire treatment even if you don’t have insurance. The immediate release FLV (generic) is cheaper and more available and is actually preferable to the controlled release version (since it gets to work faster for you).
   
   Another option is to enroll in the fluvoxamine clinical trial. This is free and you can enroll from the comfort of your home. You must be over 30 and enroll within 7 days of first symptoms.
2. Ivermectin: Ivermectin comes in second for the drug I would take if I got COVID (for the five reasons cited in the previous paragraph). The dosing for IVM once you are sick with COVID is not the same as the dose for prevention. At this stage you are looking at 0.2 to 0.4 mg/kg per day for up to 5 days (vs. the 0.1mg/kg once a week for prevention). There is a wide body of evidence suggesting that ivermectin is effective against a wide range of both DNA and positive-sense single-stranded RNA viruses such as SARS-CoV-2 (Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen). Merck can put out a Company Statement saying that ivermectin is useless against COVID (Merck Statement on Ivermectin use During the COVID-19 Pandemic - Merck.com), but that doesn’t make it true. Merck said there was no evidence it works which is untrue (they could claim that there is no “high quality” evidence it works). I find the data to be extremely compelling. Ivermectin is nearly impossible to get in Canada. After Zimbabwe made ivermectin illegal in January 2021, deaths skyrocketed. Then they made it widely available again (just two weeks later), and now the death rate in Zimbabwe rapidly fell to near zero which is where it remains. It’s an impressive country wide large scale clinical trial.
3. Doxazosin: Doxazosin has a clear mechanism of action for lowering inflammation. Dosage is 2 mg taken once a day. I’ve got hypertension already (that isn’t fully controlled with the meds I take now), so there is no risk to me that it would lower my blood pressure too low. The researcher who discovered this is Bert Vogelstein, who is the most cited scientist of all time in any field. I know many top people at John Hopkins have stockpiled this drug after Bert discovered it. That pretty much tells you what you need to know. The effect size is around 50% in observational data (often the effect will be larger in an RCT) and there are no randomized trials or real world evidence prospective trials like with fluvoxamine, so that’s why this ranks a distant second to fluvoxamine. It should definitely be tested ASAP.
4. Statins. Statins have consistently shown a 50% benefit. See this paper an

and

1. Fenofibrate: Like with Metformin, I would not hesitate to get a prescription for fenofibrate. This drug is cheap, widely available, and widely used. It has a very low side-effect profile and has been shown in human studies to be very protective against inflammation in the lungs. Used alone, gives you approximately a 6x better chance of escaping an ICU admission. Dosage is 145 mg/d, the same as in the clinical trial.
2. Budesonide: The findings from 146 people – of whom half took 800 micrograms of the medication twice a day and half were on usual care – suggests that inhaled budesonide reduced the relative risk of requiring urgent care or hospitalization by 90% in the 28-day study period. Participants allocated the budesonide inhaler also had a quicker resolution of fever, symptoms and fewer persistent symptoms after 28 days. See Common asthma treatment reduces need for hospitalisation in COVID-19 patients, study suggests. However, the Pre-print fails to distinguish between the reduction in urgent care, ER, and hospitalizations. It’s a composite endpoint (which is fair), but what’s the breakdown? example(s): A 90% reduction in hospitalizations = game changer. A 90% reduction in urgent care visits = underwhelming in an open-label, non-blinded trial What is it? (Unknown). So we really don’t know what to make of this drug!
3. ARB drugs (Losartan, …): Taking an ARB (commonly prescribed to lower blood pressure), results in a 30% risk reduction. So if you happen to be on an ARB for blood pressure, don’t stop it if you get COVID.
4. Metformin: If I wasn’t already on metformin, I’d get a prescription for it. Metformin has a very low side effect profile, it’s very safe (it’s safer than drinking orange juice, for example) and I was very impressed with the data showing it provides an extra margin of protection by reducing the chance of hospitalization by 40% according to observational data. So it’s a no-brainer addition to the mix even though fluvoxamine is already at 100%. According to Carolyn Bramante, who is running the metformin clinical trial at the University of Minnesota, the best dose is 500mg in AM and 1,000mg in PM. However, in the Together Trial, metformin was not found to be effective at all.
5. Melatonin could reduce your risk by 30%. This drug has not been studied yet in clinical trials, but there is no risk in trying it.

1. Hydroxychloroquine: This is highly controversial. There are respected physicians who swear by it and point to this meta-analysis which is not peer reviewed and has numerous flaws. That doesn’t mean it doesn’t work. It just means that the scientific evidence of its benefit is less clear cut. For example, the Marik Sepsis Protocol works, but it hasn’t been replicated in RCTs. That doesn’t mean it doesn’t work. Clearly some physicians are using HCQ and claiming to have excellent results while other physicians remain quite skeptical. The Skipper HCQ paper, which described the HCQ given as early treatment for COVID, showed a 50% reduction in hospitalizations, but it wasn’t statically significant (meaning the study was too small). There is a new paper out suggesting that combining HCQ with a TMPRSS2 inhibitor like bromhexine might be extremely effective. The paper states that “suppression of TMPRSS2 restores the antiviral efficiency of hydroxychloroquine.” That’s speculation because it could all be from the bromhexine. The speculation of a large effect (5x) was confirmed in an open label randomized trial. There is also a HCQ and bromhexine clinical trial.

Case 4: Drugs for use if you get hospitalized

All of the drugs mentioned above are likely to still work once someone has been hospitalized, with the caveat that the more serious the case, the less likely the above drugs are likely to work. Once you are hospitalized, the options are much more limited and the effect sizes are smaller.

1. Fluvoxamine: This hasn’t been formally studied in a hospitalized setting but every single anecdote we’ve heard (over 10) has shown that patients turn around quite quickly, even if they are hospitalized and are on high flow oxygen, in the ICU, or on a vent. A patient who was intubated took 300mg FLV per day. His CRP (a measure of inflammation) had been exponentially rising prior to the FLV. Immediately his CRP started declining and in only 14 days hit normal levels. Then, when the medication was removed, the CRP climbed be to higher than before in just 2 days and then he died. The FLV was keeping him alive. He would likely have fully recovered if they weren’t forced to remove the drug. They key point here is that it can take more than a week for people to see improvement if they start on FLV at a late stage. Tracking inflammation biomarkers such as CRP is a good way to verify that the drug is, in fact, working. One hospitalized patient treated by Alex Natividad MD took over 9 weeks on a dosage of 50mg BID to recover to normal. So be patient if you are taking it late stage.
2. Cyproheptadine: This is an anti-serotonin drug. There's a big difference between COVID ARDS and non-COVID etiologies of ARDS, the degree of serotonin liberation which is basically highly toxic to multiple organs including lungs. One physician reports “we have 24-year olds with respiratory rates of 55 per minutes and impending doom completely resolve their tachypnea to normal respiratory rate within one day and get discharged within 48 hours with simple blockage of liberated serotonin.” Dosing is 8mg TID. Physicians having been using this for 6 months because it works. It is going to be added to I-SPY in March. We are not sure whether it is for all ICU patients, or just for those showing signs that are suspicious for serotonin syndrome. Typically you don’t stop the SSRI: typically serotonin syndrome is due to platelets releasing serotonin, so it may be better to keep the SSRI in order to inhibit further release of serotonin from platelets. Cyproheptadine is a centrally acting antihistamine and anticholinergic: older adults will get delirious. Watch:

1. Ivermectin: Same story as before. It still works at this stage, just not as well. Lots of data showing a beneficial effect at this stage in the disease.
2. Cyclosporine: Use this at the late stage to combat inflammation. It will kill any immune response which is why you only want to use it late stage.
3. Fluoxetine: There is convincing observational data that this drug works to increase your chances if you get hospitalized. I heard of an intubated patient who was given everything with no effect and the doctors were sure the person would die and gave the patient fluoxetine orally. Within 48 hours, the patients inflammatory biomarkers had dropped by an order of magnitude. SSRIs tend to be more useful at earlier stages and Cyproheptadine is going to be more effective at the late stage.
4. Leronlimab: Now in Phase 3 trials. A promising drug for mitigating the cytokine storm for very sick patients.
5. Zinc: Zinc has been shown in a clinical trial to reduce mortality by ~24%.
6. RLF-100: This experimental drug can improve your chances of getting out of the ICU by a factor of 2.66 over the current standard of care.

See also The best COVID treatments for hospitalized patients for some more options.

Case 5: Long haul COVID (PACS)

Your first stop should be Covid Long Haulers website. I’ve been most impressed with their approach. They give you a blood test and from that they can assess where you are and tell you exactly which drugs you should take. The good news is Dr. Patterson has found that the success rate to permanently rid yourself of long-haul is very high.

The four key drugs that Patterson has found work the best for long haul COVID are:

1. Maraviroc
2. Fluvoxamine
3. Simvastatin (or atorvastatin can be used as well)
4. Ivermectin

Maraviroc can cause serious, life-threatening side effects. This is why it is important to have your blood tested an analyzed before starting any treatment to minimize risk.

Fluvoxamine (50mg BID) has worked for many people with PACS. Sometimes it may take 2 weeks to see an effect, so it is very important to not “give up” early. If you under-dose the drug, you won’t get the benefit. Benefits start showing up at 50mg once a day, but most people see significant benefit at 50mg twice a day.

If you cannot tolerate fluvoxamine, then 30mg per day of prozac is the alternative. It works the same way as fluvoxamine.

Ivermectin is effective against long-haul COVID. 18mg every 3 days. It is synergistic with fluvoxamine and you’ll see an incremental improvement, but most of the effect will be from the fluvoxamine.

In general, any drug used to treat the virus is, in general, fair game to try to alleviate long haul symptoms, so vaccination (when a safe vaccine is available), fluvoxamine, prozac, ivermectin, leronlimab, etc. So look at the list above.

Steroids are counterproductive and make things worse.

If you have long haul, you’ll find that exercise will make your symptoms worse. This is known and Dr Patterson understands exactly why this happens.

Age range

Fluvoxamine and ivermectin are safe even for children. Dosages are typically reduced.

Summary

Don’t underestimate the virus. I would treat it as soon as I knew I was infected, no matter what my age or risk factors were in order to minimize the risk of long-term/permanent organ damage.

If everyone in the world took just ivermectin and fluvoxamine after learning they were infected, I believe that our hospitals and ICUs would be nearly empty today.

I have collected the evidence supporting the use of fluvoxamine to make it easier for doctors to learn about the drug. Here is the data for ivermectin.

The available evidence today is so compelling that on December 22, 2020, Vikas Sukhatme, MD, ScD, Dean of Emory University School of Medicine, speaking on his own behalf, called for physicians to consider the off-label use of fluvoxamine in treating COVID. At a minimum, all physicians should be recommending their COVID patients enroll in the fluvoxamine clinical trial.

Why aren’t more physicians following the lead of Dr. Sukhatme? Dr. Joseph Ladapo answered that question very eloquently in his superb Wall St. Journal op-ed, “Too much caution is killing patients.” I wish every physician would read that op-ed. Most don’t have time to do the research, so they just follow the CDC guidance which basically says do nothing (unless you qualify for a monoclonal).

On Jan 31, 2021, I wrote a (very long) op-ed on why the FDA should issue an EUA for fluvoxamine immediately but the core argument is it would save far more lives than it would possibly risk. A Stanford infectious disease professor told me he thought it was criminal that docs are saying “we will wait for the phase 3 study on fluvoxamine” when the evidence on the table is so compelling.

Doctors who prescribe ivermectin for COVID can be jailed, fined, or have their license revoked. The are also subject to having their social media posts censored and/or their accounts deleted.

Finally, If you’d like to make a donation to fund scientific research, please check out the CETF donation page.

If you’d like to learn more about fluvoxamine (papers, press articles, opinion pieces), see my personal website at Steve Kirsch Home page or the fluvoxamine page on the CETF website.

There are three ways to get fluvoxamine and other drugs:

1. Tell your doctor if you have COVID and get a prescription. Some docs will give you a prescription in advance, to be used ONLY if you have COVID, so you have the drugs on hand if you get sick.
2. If you are depressed (which many people are in this pandemic) or developed OCD, ask your doctor for fluvoxamine (or fluoxetine).
3. See How I would treat COVID for a list of telemedicine providers.

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