Will your doctor treat you for COVID?

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Figure Reprinted from The American Journal of Medicine DOI: 10.1016/j.amjmed.2020.07.003, McCullough P, et al Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection 2020, with permission from Elsevier.

View original article/figure at https://www.sciencedirect.com/science/article/pii/S0002934320306732

If you get COVID-19, you don’t want to be admitted to hospital. The death rate for patients sick enough to be admitted is quite high. And you will probably be a prisoner with no visits from family, clergy, or the doctor of your choice.

Unfortunately, many doctors will provide nothing besides an order to get a test, and advice on when to go to the emergency room. They are told by their employer or their medical society or public health officials that there is nothing they can do.

But actually home therapy could prevent thousands of hospitalizations and deaths, according to a just-published article from the respected American Journal of Medicine. Lead author Peter McCullough, M.D., a cardiologist at Baylor, is one of the most widely published physicians in America.

Young healthy patients will probably do fine with watchful waiting and self-quarantine. But according to these physicians, patients over age 50 or who have other risk factors or worsening symptoms should get immediate treatment with zinc and antivirals.

The protocol by Dr. McCullough and colleagues lists hydroxychloroquine (HCQ) with azithromycin or doxycycline, or favipiravir, which is available in Japan, as antiviral drugs. For respiratory symptoms it suggests prednisone and/or colchicine, and for suspected clotting, aspirin and/or blood thinners.

It suggests prevention of self re-inoculation with viruses in the breath by providing fresh air: open windows, fans, or spending time outdoors without face coverings, away from others.

Other physicians report success with ivermectin, an antiparasitic agent used for scabies or head lice, or inhaled budesonide (Pulmicort™) together with zinc and clarithromycin.

Definitive randomized controlled trials are not yet available, but Dr. McCullough and colleagues “emphasize the immediate need for management guidance.”

To counter the official word from the American Medical Association and others—no home treatment, just wait for the promised vaccine—patients need to call their doctors. Ask whether they are willing to read the McCullough paper or other studies about out-patient treatment with HCQ, and willing to prescribe for you if you get sick.

 It is important for patients to have a trusted physician who shares their views.

For further information, see AAPS compendium of articles on coronavirus.