Prevention and Treatment Protocols for COVID-19
For our most comprehensive clinical guide to the management of COVID-19, please click the following text to read and download “An Overview of the MATH+, I-MASK+ and I-RECOVER Protocols, A Guide to the Management of COVID-19”, by Dr. Paul Marik.
By clicking the logos below. you can read about and download the FLCCC Alliance’s most recent individual protocols to prevent and treat COVID-19:
In October of 2020, ivermectin was adopted as a core medication in our protocols for the prevention and treatment of COVID-19. For more information on ivermectin please go to our new Ivermectin in COVID-19 page. You can also read our review paper, which was published in the May 1, 2021, edition of the American Journal of Therapeutics as the “Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19”.
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Opmerking:
Er zijn ook Nederlandstalige (en Franstalige enz... ) versies van onderstaande Protocollen ga naar https://covid19criticalcare.com/covid-19-protocols/translations/ ) Korte (Nederlanstalige samenvatting hieronder)
I-MASS – Prevention & At Home Treatment Mass Distribution Protocol for COVID-19
I-MASS – Prevention
& At Home Treatment Mass Distribution Protocol for COVID-19 (updated May 10, 2021)
The I-MASS Protocol was created for generalized
distribution during mass outbreaks and in low-resource countries. To achieve
maximal impact as well as ease of deployment with the lowest burden of required
elements, the I-MASS treatment approach is centered on the fewest, core, high
impact elements such as the drug Ivermectin, an anti-parasitic medicine that is
on the WHO’s list of essential medicines, has been given 3.7 billion times
around the globe, and has won the Nobel prize in 2015 for its global and historic
impacts in eradicating endemic parasitic infections in many parts of the world.
Ivermectin has proven to be highly potent against
COVID-19. It has shown antiviral and anti-inflammatory properties in
observational and randomized controlled studies conducted throughout the world.
Practitioners and Health Ministries who have adopted Ivermectin in treatment
protocols report significant reductions in time to recovery, hospitalizations,
and death. The use of Ivermectin as prophylaxis and prevention has also been
proven in studies to reduce the spread of infection and offer protection to
high-risk individuals.
Also included in the protocol are Vitamin D3,
Melatonin, Aspirin, a multivitamin, a thermometer, and an antiseptic mouthwash.
The evidence for supporting the other vitamins and medicine can be found
here: https://covid19criticalcare.com/covid-19-protocols/medical-evidence-and-optional-medicines/.
The FLCCC peer-reviewed paper summarizing this data
has been published in the American Journal of Therapeutics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/.
Further supportive information can also be found
here: https://covid19criticalcare.com/ivermectin-in-covid-19/.
Additional treatment protocols for COVID-19,
including for hospitalized patients, can be found at https://covid19criticalcare.com/covid-19-protocols/.
Support for Ivermectin in the use of prophylaxis
can be found here: https://scivisionpub.com/pdfs/ivermectin-as-prophylaxis-against-covid19-retrospective-cases-evaluati…
Disclaimer: The
safety of Ivermectin in pregnancy has not been established. Particularly the
use in the 1st trimester should be discussed with your doctor beforehand.
I-MASS Protocol
I-MASS – Prevention & At Home Treatment Mass Distribution Protocol
for COVID-19 (updated May 10, 2021)
The Long Haul COVID-19 Syndrome (LHCS) is an often
debilitating syndrome characterized by a multitude of symptoms such as
prolonged malaise, headaches, generalized fatigue, sleep difficulties, smell
disorder, decreased appetite, painful joints, dyspnea, chest pain and cognitive
dysfunction. The incidence of symptoms after COVID-19 varies from as low as 10%
to as high as 80%. LHCS is not only seen after the COVID-19 infection but it is
being observed in some people that have received vaccines (likely due to monocyte
activation by the spike protein from the vaccine). A puzzling feature of the
LHCS syndrome is that it is not predicted by initial disease severity;
post-COVID-19 frequently affects mild-to-moderate cases and younger adults that
did not require respiratory support or intensive care.
The symptom set of LHCS in the majority of cases is
very similar to the chronic inflammatory response syndrome (CIRS)/myalgic
encephalomyelitis/chronic fatigue syndrome, although in LHCS, symptoms tend to
improve slowly in the majority of the cases. Furthermore, the similarity
between the mast cell activation syndrome and LHCS has been observed, and many
consider post-COVID-19 to be a variant of the mast cell activation syndrome.
LHCS is highly heterogenous and likely results from a variety of pathogenetic
mechanisms. Furthermore, it is likely that delayed treatment (with ivermectin)
in the early symptomatic phase will result in a high viral load, which
increases the risk and severity of LHCS.
Although numerous reports describe the epidemiology
and clinical features of LHCS, studies evaluating treatment options are
glaringly sparse. Indeed, the NICE guideline for managing the long-term effects
of COVID-19 provide no specific pharmacologic treatment recommendations.
Given the lack of available treatment recommendations in the setting of
large numbers of patients suffering with this disorder globally, the FLCCC
developed the I-RECOVER protocol in collaboration with a number of expert
clinicians including Dr. Mobeen Syed, Dr. Ram Yogendra, Dr. Bruce Patterson,
and Dr. Tina Peers. Although our varied yet often overlapping treatment
approaches were initially empiric, while based on both preliminary
investigations into and prevailing theoretical pathophysiologic mechanisms of
LHCS, the consistently positive clinical responses observed, often profound and
sustained, led the collaboration to form the consensus protocol below. As with
all FLCCC protocols, we must emphasize that multiple aspects of the protocol
may change as scientific data and clinical experience in this condition evolve,
thus it is important to check back frequently or join the FLCCC Alliance to
receive notification of any protocol changes.
I-RECOVER Protocol
I-RECOVER Protocol: Version 1, Updated June 16, 2021
https://covid19criticalcare.com/covid-19-protocols/i-recover-protocol/
I-MASK+ Prevention & Early Outpatient Treatment
Protocol for COVID-19
Below
you can download the I-MASK+ Prevention & Early
Outpatient Treatment Protocol for COVID-19 with guidance
on the timing and doses of each component medication. Further below please find
more information on the I-MASK+ Protocol.
The I-MASK+ Protocol complements our MATH+ Hospital Treatment Protocol for Covid-19 from March 2020, which is intended for
hospitalized patients. Both are physiologic-based combination treatment
regimens developed by leaders in critical care medicine. All component
medicines are FDA-approved, inexpensive, readily available and have been used
for decades with well-established safety profiles. In
October 2020, we added ivermectin as a core medication in the prevention and treatment of COVID-19.
The protocol document is available in several
languages (see below) – more translations are available here.
This is not a medical advice, but a recommendation – please consult your
doctor, share the information on this website with her/him, and listen. Please
review our Disclaimers!
Please check this page regularly for updates – new
medications may be added and/or dose changes to existing medications may be
made as further scientific studies emerge.
Current I-MASK+ protocol: version 12, updated on
August 11, 2021 (English version, translations follow).
About the I-MASK+ Protocol
for COVID-19
In October 2020, the FLCCC Alliance developed a
preventive and early outpatient combination treatment protocol for COVID-19
called I-MASK+. It’s centered around ivermectin,
a well-known, FDA-approved anti-parasite drug that has been used successfully
for more than four decades to treat onchocerciasis “river blindness” and other
parasitic diseases. It is one of the safest drugs known. It is on the WHO’s
list of essential medicines, has been given 3.7 billion times around the globe,
and has won the Nobel prize for its global and historic impacts in eradicating
endemic parasitic infections in many parts of the world. Our medical discovery
of a rapidly growing published medical evidence base, demonstrating
ivermectin’s unique and highly potent ability to inhibit SARS-CoV-2 replication
and to suppress inflammation, prompted our team to use ivermectin for
prevention and treatment in all stages of COVID-19. Ivermectin is not yet
FDA-approved for the treatment of COVID-19, but on Jan 14, 2021, the NIH
changed their recommendation for the use of ivermectin in COVID-19 from
“against” to “neutral”. (see our press release).
Our life-saving MATH+ Hospital Treatment Protocol for COVID-19 (available in several languages), created in
March 2020, is intended for hospitalized patients. The recently developed I-MASK+
Prevention & Early Outpatient Treatment Protocol for COVID-19 (this
page) is designed for use as a prevention and in early outpatient treatment,
for those who test positive for COVID-19. The protocols complement each other,
and both are physiologic-based combination treatment regimens developed by
leaders in critical care medicine. All the component medicines are FDA-approved
(except ivermectin), inexpensive, readily available and have been used for
decades with well-established safety profiles.
Please download and share our I-MASK+ Prevention & Early Outpatient Treatment Protocol for COVID-19. (It is currently being translated into several
languages).
Below are a list of links to our one-page summary of
the latest evidence for the protocol, plus videos of FLCCC Alliance doctors
discussing the emerging evidence for the use of ivermectin in the prevention
and treatment of COVID-19, and a short list of up-to-date studies and clinical
trials on this topic.
I-MASK+ Prevention &
Early Outpatient Treatment Protocol for COVID-19
https://covid19criticalcare.com/covid-19-protocols/i-mask-plus-protocol/
MATH+ Hospital Treatment Protocol for COVID-19
Below you can download the MATH+ Hospital Treatment Protocol for COVID-19, for use by professionals, with detailed guidance on the timing of initiation along with the suggested initial doses and durations of each component medication. The protocol document is available for download in multiple languages (see below) – more translations are available here.
Please also review our I-MASK+ Prevention & Early Outpatient Treatment Protocol for COVID-19, which was developed for the prevention and early outpatient treatment of COVID-19. Both are physiologic-based combination treatment regimens developed by leaders in critical care medicine. All component medicines are FDA-approved, inexpensive, readily available and have been used for decades with well-established safety profiles. In October 2020, we added ivermectin as a core medication in the prevention and treatment of COVID-19.
Please do not consider these protocols as personal medical advice, but as a recommendation for use by professional providers. Consult with your doctor, share the information on this website and discuss with her/him. Please review our Disclaimers!
Please check this page regularly for updates – new medications may be added and/or doses changed to existing medications as further scientific studies emerge.
Current MATH+ protocol: version 13, updated on June 30, 2021.
About the MATH+ Protocol
Update:
On December 14, 2020, the FLCCC Alliance peer-reviewed paper Clinical and Scientific Rationale for the “MATH+” Hospital
Treatment Protocol for COVID-19 has been
published in the Journal of Intensive Care Medicine. The MATH+
protocol potentially offers a life-saving approach to the management of
hospitalized COVID-19 patients. It offers an inexpensive combination of
medicines with well-known safety profiles based on strong physiologic rationale
and an increasing clinical evidence base.
The MATH+ Hospital Treatment Protocol for COVID-19 is
designed for hospitalized patients, to be initiated as soon as possible after
they develop respiratory difficulty and require oxygen supplementation. The
three core pathophysiologic processes that have been identified are severe
hypoxemia, hyperinflammation, and hypercoagulability. This combination
medication protocol is designed to counteract these processes either through
the use of single agents or in synergistic actions. A unique insight into this
disease made by members of our group is that the majority of patients initially
present with an inflammatory reaction in the lungs called “organizing
pneumonia,” which is the body’s reaction to injury and is profoundly responsive
to corticosteroid therapy. If the organizing pneumonia response is left
untreated or presents as a rapidly progressive sub-type, a condition called
Acute Respiratory Distress Syndrome (ARDS) follows.
The two main
therapies that can reverse and/or mitigate the extreme inflammation causing
ARDS are the combination of the corticosteroid Methylprednisolone
and the antioxidant Ascorbic
acid, which is given intravenously and in high doses. Both of these medicines
have multiple synergistic physiologic effects and have been shown in multiple
randomized controlled trials to improve survival in ARDS, particularly when
given early in the disease. Thiamine
is given to optimize cellular oxygen utilization and energy consumption,
protecting the heart, brain, and immune system. Given the numerous clinical and
scientific investigations that have demonstrated consistent, reproducible, and
excessive levels of hyper-coagulation, particularly in the severely ill, the
anticoagulant Heparin is
used to both prevent and help in dissolving blood clots that appear with a very
high frequency. The “+” sign
indicates several important co-interventions that have a combination of strong
physiologic rationale with existing or emerging pre-clinical and clinical data
to support their use in similar conditions or in COVID-19 itself, and all with
a well-established safety profile. Such adjunctive therapies are continuously
being evaluated and amended as the published medical evidence evolves.
Timing
is a critical factor in the efficacy of MATH+ and to achieving successful
outcomes in patients ill with COVID-19. Patients must go to the hospital as
soon as they experience difficulty breathing or have a low oxygen level. The MATH+ protocol should be
administered soon after a patient meets criteria for oxygen supplementation
(within the first hours after arrival in the hospital), in order to achieve
maximal efficacy. Delayed therapy can lead to complications such as the need
for mechanical ventilation. If administered early, the MATH+ formula of
FDA-approved, safe, inexpensive, and readily available drugs may eliminate the
need for ICU beds and mechanical ventilators and return patients to health.
MATH+
Hospital Treatment Protocol for COVID-19
