Board Certified Family Practitioner
501 Rt 208, Monroe, NY 10950
845-782-0000
April 28, 2020
To all medical
professionals around the world:
The current sensitivity and specificity of the
RT-PCR nasal swab test for Covid-19 is 99% and 66%, respectively. (1) In simple terms,
when the test is positive, it is very accurate to diagnose patients with Covid-19.
However, when the test is negative it is wrong 33% of the time.
In most
outpatient situations, the RT-PCR Covid-19 test takes two to three days to get the
results. This is unacceptable since it is imperative to initiate treatment for viral
infections as soon as possible. (2) This clinical principle is derived from the
recommendations of treatment for other viral infections (i.e. influenza,
herpes zoster, HIV, etc).
According to the CDC, symptoms of Covid-19 may appear
2-14 days after exposure to the virus. The clinical symptoms of Covid-19 are: (3)
Cough and/or shortness of breath
Fever or chills (with or without
rigors)
New loss of taste or smell
Myalgia
Headache and/or sore
throat
Diarrhea
Given the urgency of the situation, I recommend
initiating treatment based on clinical suspicion as soon as possible, even without
confirmatory testing.
I developed the following treatment protocol for the
prehospital setting and have seen very positive results:
1. Any patient with
shortness of breath is treated.
2. Any patient in a high-risk category with
mild symptoms is treated.
3. Young, healthy and low risk patients even with
symptoms are not treated (unless their circumstances change and they fall into
category 1 or 2); as is well known, these patients likely self resolve.
My
outpatient treatment regimen is as follows:
1. Hydroxychloroquine (11) 200
mg twice a day for 5 days
2. Azithromycin 500 mg once a day for 5 days
3. Zinc sulfate 220 mg once a day for 5 days
The rationale for my treatment
plan is as follows. I combined the data available from China and South Korea with the
recent study published from France (cites available on request). We know that
hydroxychloroquine (10) helps Zinc (7) enter the cell. We know that Zinc (8&9) slows
viral replication within the cell. (5) The use of azithromycin (4) prevents secondary
bacterial infections and has antiviral effects. These three drugs are well known and
usually well tolerated, hence the risk to the patient is low.
Since 3/15/20, my
team has seen approximately 1450 patients in Monroe, New York with either test proven
or clinically suspected coronavirus infection. The majority of the patients were
treated with only supportive care. The patients with shortness of breath or who are in
the high risk category were treated with the above regimen (approximately 405 patients
at this point).
Of this group and the information provided to me by affiliated
medical teams, we have had two deaths, six hospitalizations for pneumonia, and four
intubations (all extubated now). In addition, to my knowledge there have not been any
negative side effects other than approximately 10% of patients with temporary nausea
and diarrhea.
In sum, my urgent recommendation is to initiate treatment in
the outpatient setting as soon as possible in accordance with the above. Based on
my direct experience, it prevents acute respiratory distress syndrome (ARDS), prevents
the need for hospitalization and saves lives. (6)
With much respect,
Dr. Vladimir (Zev) Zelenko M.D.
1)
Estimating false-negative detection rate of SARS-CoV-2 by RT-PCR
2) Influenza Antiviral Medications
3) Symptoms of Coronavirus
4)
Clinical Pharmacology Perspectives on the Antiviral Activity of Azithromycin and Use in COVID-19
(5&6&7&8&9&10&11&12) is inserted by me - Hermes Atar Trismegistus for additional knowledge
5)
Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture
6)
Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win todays battle against COVID-19?
7) Can Colloidal Zinc be used as a treatment if inhaled?
8)
Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients
9)
How to Improve Zinc Uptake with Quercetin to Boost Immune Health
10)
Get the Most From Your Green Tea
11) KILLING Hydroxychloroquine
12)
Brazil: Early treatment with Covid Kit including HCQ is effective and safe
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