If I were in charge of the public health response to COVID-19, I would implement the following:
Pharmacy Boards should never get between a doctor and patient except in matters of life and death or illegal practice. Politicians, State Medical Boards and our House of Medicine professional organizations should defend our legal practice of medicine rather than threatening physicians and changing the rules during a pandemic.
2. Encourage shared information & fact-checking among physicians as part of our missions of education & transparency.
JAMA review of masks, August 2020
4. Where a high percentage of the local population tests positive, local authorities should consider – and have the ethical responsibility to – impose higher isolation measures like masks and public distancing. The threshold for mandates must be locally determined with public input, and explained – clearly, frequently.
This means you, anti-maskers!
5. Stress that surgical procedure masks are nearly as effective as N95 masks, blocking nearly as much aerosols and viral particles for both wearer and those around us. Medical providers and those with a high risk of prolonged close contact need fitted N95 masks, the rest of us don’t.
Single layer cut-up T-shirts and homemade masks, balaclavas or bandannas, aren’t very effective protection at all, either for the wearer or the people around us. N95 Masks with single valves are a money-maker, but not nearly as effective as surgical masks, even with an added filter layer.
8. Begin early prophylaxis with hydroxychloroquine/zinc and/or inhaled steroids for the willing & likely exposed.
Treatment dosing (always allowing treating physicians who prescribe determine need & frequency of alternate doses & monitoring)
This isn’t a prescription!
Hydroxychloroquine: 400 mg. twice on day one then 200 mg. twice a day for either 5 or 10 days;
Azithromycin: 250 mg. tablet, 2 on day one, 1 on day 2 to 5;
Budesonide: unit dose via hand held inhaler or nebulizer twice a day. (I’m looking for references for this one. )
Zinc 150 mg. to 250 mg. a day indefinitely. (Best evidence for lozenges or syrup multiple times a day. See references.)
Vitamin D, 1000 IU a day, up to 4000 IU is safe
Vitamin C, No set dose, but extra will be excreted in the urine or feces, can cause diarrhea.
Journal of the American Medical Association review. Published August 11, 2020. (Free, with Tables)
CDC recommendation on cloth masks:
John’s Hopkins recommendation:
Journal article on treatment for the common cold: https://www.acpjournals.org/doi/10.7326/0003-4819-125-2-199607150-00001
Unpublished, non-peer reviewed: https://www.researchgate.net/publication/47794995_Zn_Inhibits_Coronavirus_and_Arterivirus_RNA_Polymerase_Activity_In_Vitro_and_Zinc_Ionophores_Block_the_Replication_of_These_Viruses_in_Cell_Culture
International Journal of Infectious Diseases (Henry Ford or Ashad report):
On synergistic effect of hydroxychloroquine plus steroids:
Description of study in progress on treatment for loss of smell in patients without severe symptoms:
Vitamin C safety:
Note: comments are off. Please comment on my Facebook page, Beverly Nuckols.
Edited 31/08/20 12:30 for mis-spellchecked word. BBN