A Candid Discussion On Early Outpatient Treatment For COVID-19

Thoughtful notes from an anonymous contributor.

1. We are all lifelong learners

COVID is complex and sometimes unpredictable.

When it comes to medical information, often the truth is in the middle and it should always be applied to a unique individual person. Avoid the temptation to focus on the extremes and overgeneralize.

Medically speaking, the 2 people best equipped to help you make medical decisions are you and your primary medical provider (clinician).

It comes down to informed consent and shared decision making.


My experience:

Phase 1: Fear (Fear of the unknown)

I initially had fear of getting COVID and giving it to my family and friends.

Then, I got COVID and although I became very sick, when I recovered it helped my fear. This was even before natural immunity was discussed.

I observed that the medical community seemed to be not treating patients early due to fear and there be in no accepted early outpatient treatment options.


Phase 2: Treat the patient

I tried to apply principles that I had seen work in other similar illnesses when treating patients. I actively searched for protocols that were being used and tried to use ones with which I was most familiar and comfortable.


The introduction of Monoclonal Antibody Therapy (MAT) – Game changer?

-Good results with preventing hospitalization.

-No observed serious lasting side effects.

-I focused on treating and educating the people most at risk and trying to help people not live in constant fear.


I also asked people how the pandemic was affecting them and tried to help them work through it.


Phase 3: Listen to your patient

Ivermectin? Game changer #2?

A patient shared an article with me and asked if I would be willing to prescribe it for prevention or treatment.

Initial excitement drove me to do my own research.

It appeared that the effectiveness was overblown by the article so I sought what the Infectious Disease Society of America (ISDA) had to say:

“Insufficient evidence” “Recommend against use unless in a clinical trial.”

I told my patient and several other patients that although I wanted to try Ivermectin, I did not think that I could in light of the ISDA statement.


Phase 4: Listen to your gut

Refusing to treat my patients with a potentially helpful medication out fear/lack of understanding did not sit right with me.

I found the FLCCC Alliance (FLCCC) and began to listen to their rational approach to understanding and treating patients with COVID in all phases.



Graphic:

Phases of COVID (Available on FLCCC site at the following link and has some different information now on the potential therapies section of the graphic)


I realized that the larger agencies that were dismissing Ivermectin appeared to not be putting the same effort into reviewing the worldwide data and implementing rational and data-based treatment protocols for all phases of COVID.

Sick patients (most likely with delta variant) came to me asking for Ivermectin to treat COVID. I showed them what I had learned and started them on the protocol.

I saw them back for follow-up and adjusted their treatment as needed based on their response.

I discovered that telemedicine visits, while a helpful tool do have their limitations.

I treated 4 different patients using Ivermectin with surprising results:

  • Well man 40 y/o– Ivermectin higher dose, then MAT

  • Well woman 38 y/o – Ivermectin lower dose, then MAT

  • Chronically ill man 62 y/o mild uncontrolled diabetes, obesity – MAT, Ivermectin higher dose over weekend

  • Well man 44 y/o – MAT, Ivermectin higher dose – “you saved my life”


All survived with no adverse reactions!


Phase 5: Gut punch

I encouraged my colleagues to consider self-education and treating patients early with Ivermectin instead of believing the statements against it from the media and the regulatory agencies.

I was chastised and realized that many of my colleagues did not agree with me. I found few allies.


Phase 6: The ongoing battles

Internal

-I decided to stop prescribing Ivermectin for prevention at this time.

-Fighting discouragement

External

-Feeling pressured to not prescribe Ivermectin for COVID at all.

-Barriers to patients getting Ivermectin – coverage, cost, and availability/limitations.


A word of caution:

DO NOT take veterinary forms of Ivermectin. There is no regulation of what is put in veterinary medicines.


2. Online resources for you:

www.FLCCC.net

Educational videos and sign up for watching/participating in weekly update live webinars:

Videos and Press 🡪 Webinars and Lectures and FLCCC Weekly Updates

https://odysee.com/@FrontlineCovid19CriticalCareAlliance:c


Prevention and Early Outpatient Treatment Protocol: I-MASK+ Prevention & Early Outpatient Treatment Protocol


3a. How to approach your clinician when you are seeking early treatment:

Humbly with respect.

Regardless of how you feel about the vaccine, discussing it can be a distraction and derail conversations about early treatment.

These two issues must be kept separate or you will lose your focus. If you are not interested in receiving the vaccine, simply state that, but only if you are asked about it.

Don’t talk about all the “noise” around COVID. It is real but it will be a distraction that might close the door to future conversations.

If possible, don’t wait until you are sick.

Provide some data to them either in print or via a link but don’t go through the data with them. Let them be self-enlightened if they are willing.

Remember your goal is to have an understanding with your clinician that they will work with you to help you get early outpatient care if you get COVID.

It’s not all about Ivermectin. The other parts of the protocol have rational data behind them too. Also the monoclonal antibody treatments can be VERY helpful especially when used early.

You are more likely to get agreement to treat COVID than to prevent COVID.

Although patient portals are great for communication and documentation, since they are a part of the permanent record, your clinician may prefer to talk candidly to you over the phone about these things.

Don’t assume that all of the office staff is on the same page as your clinician when it comes to early outpatient COVID treatment. That is likely not the case.

Focus on your relationship as a patient with your treating clinician.


3b. Resources for you to consider printing or sharing in a message with your clinician for them to review:


A scoping review of the pathophysiology of COVID-19

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477699/pdf/10.1177_20587384211048026.pdf

This is a very scientific but comprehensive overview but also does not discuss treatments so is less controversial in that manner.


Links on the NIH website:

Characteristics of Antiviral Agents That Are Approved or Under Evaluation for the Treatment of COVID-19

https://www.covid19treatmentguidelines.nih.gov/tables/table-2e/

This shows that the NIH does have data on Ivermectin. It’s right below Remdesivir in this table.


A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness

https://pubmed.ncbi.nlm.nih.gov/33278625/

This is an article in an infectious disease journal on the NIH website.


Therapeutic Management of Nonhospitalized Adults With COVID-19

This article is a good reminder that other than monoclonal antibody therapy, there are no endorsed early outpatient treatments for COVID and that you would like to have other options if you did not completely improve with monoclonal antibody therapy.


Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

This is a good article showing benefit of Ivermectin in several trials looked at as a group (Meta-analysis). The key statement is: “Meta-analysis of 15 trials found that ivermectin reduced risk of death by 49% compared with no ivermectin.”

Cutting the risk of death by almost 50% is significant.


I specifically would be careful in sharing the FLCCC website with your clinician unless you think they are open to the idea of using Ivermectin or they have responded positively to you approaching them with a request to consider early outpatient treatment options if you do not respond fully to monoclonal antibody therapy.

I personally think some of the most convincing data on Ivermectin is in the real world epidemiologic studies that are on the FLCCC.net site but unfortunately, due to some bad press, the mention of FLCCC may shut down the conversation.

If you do share it with them make sure they know it was started by 5 ICU doctors who have looked at worldwide data for treating patients with COVID-19.

It’s important that they know that this is not a fringe organization. These are real doctors who treat patients with COVID and all of their protocols are driven by data and experience.

At their site, to find the powerful graphs showing real world data for Ivermectin, go to: IVERMECTIN: EPIDEMIOLOGIC ANALYSES ON IVERMECTIN IN COVID-19


If your clinician is concerned about the safety of Ivermectin, on FLCCC site, go to:

https://covid19criticalcare.com/wp-content/uploads/2021/09/FLCCC-Information-Evidence-for-Safety-of-Ivermectin.pdf

There are links in this article that link outside of FLCCC if you want to present other sources of information.


4. Please get personally involved

If you feel strongly that you should have the right with informed consent and shared decision making with your clinician to use repurposed medication therapies to treat you if you get COVID, tell your Missouri elected officials. If you have a story about this, share your story with them:

https://www.house.mo.gov/legislatorlookup.aspx

https://www.senate.mo.gov/legislator-lookup/


If you feel strongly that you should be able to get Ivermectin that is prescribed by your treating clinician without pharmacy interference, consider taking some of the steps listed on this document.

https://covid19criticalcare.com/wp-content/uploads/2021/09/Overcoming-Pharmacy-Barriers.pdf


Here’s a list of some pharmacies who agree with you.

https://covid19criticalcare.com/pharmacies/


Remember: You are the patient. In the clinician-patient relationship, you are the focus. Don’t lose trust in the people you have trusted to care for you and your family over the years.

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