A Protocol for the Prevention and Early Treatment of COVID-19 in Nursing Homes

This protocol is presented by Dr George Fareed, an Harvard Trained medical doctor with a distinguished career of 50 years in medicine, who has treated hundreds of COVID-19 patients, including in a nursing home in California.

Find the version in French at this link.

UPDATE: Dr Fareed’s detailed protocols are constantly evolving. If you intend to make use of such protocol in a nursing home environment, kindly contact him beforehand to receive the latest information. You can contact Dr George Fareed at gfareed @ gmail.com.

UPDATE 2: Watch this video featuring a medical doctor who treated according to a similar approach in a nursing home. He explains how he did it, and also how he considerably reduced mortality in comparison to other doctors in the same facility who did not use the treatment.

The protocol complements existing non-therapeutic measures in place to reduce new infections of COVID-19.

The present document does not constitute medical advice. In practice, any treatment protocol needs to be prescribed by a medical doctor, who may make some adaptations, depending on the particulars of the patients and availability of drugs.

This protocol is what Dr George Fareed recommends as of today, December 9, 2020, and may evolve with time.

PREVENTION AND EARLY TREATMENT PROTOCOL

Three phases need to be distinguished:

  • pre-exposure prophylaxis is before any resident or staff is known to have contracted C19, and is therefore purely preventative. This prophylaxis is recommended for both residents and staff.
  • post-exposure prophylaxis is when at least one resident or staff of the nursing home is a suspected or confirmed case of C19. This prophylaxis should ideally be provided to all residents and staff, as a preventative measure.
  • early outpatient treatment is for those who have a confirmed or suspected case of C19, be them residents or staff.
  1. Pre-Exposure Prophylaxis
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This is before any resident or staff has been suspected or confirmed to have C19 in the nursing home. This is the regimen that should be recommended, as a preventative measure, for all residents and staff.

  • Vitamin D – 4000 iu Daily
  • Zinc elemental- 25 mg Daily 
  • Ivermectin – Dose 1 of 0.2 mg / kg (bodyweight) on Day 1 – and then a weekly maintenance dose of 0.05 mg / kg or monthly maintenance dose of 0.2 mg/kg.
  • Vitamin C and/or a quality multivitamin supplement and possibly Quercetin also recommended.

2. Post-Exposure Prophylaxis.

This is once there is one confirmed case in the nursing home. This means the virus is present and may infect several residents, maybe many residents, maybe all of them.

Post-exposure prophylaxis should be provided immediately for all residents and all the staff.

The recommended regimen is:

  • Vitamin D – 4000 iu Daily
  • Zinc elemental – 25 mg Daily 
  • Ivermectin:  Dose 1 of 0.2 mg / kg (bodyweight) on Day 1; Dose 2 of 0.2 mg / kg (bodyweight) on Day 3; Weekly maintenance dose of 0.05 mg / kg or Monthly maintenance dose of 0.2 mg/kg.
  • Vitamin C and/or a quality multivitamin supplement and possibly quercetin also recommended.

3. Early Outpatient Treatment

For the residents having tested positive, or with suspected COVID-19, even before the confirmatory test result is known, an early outpatient treatment protocol needs to be immediately provided, within 2 days of first symptoms:

– Ivermectin – Dose 1 of 0.2 mg / kg on Day 1 – Dose 2 of  0.2 mg / kg on Day 3 and Dose 3 of 0.2 mg / kg on Day 5
– Doxycycline monohydrate 100 mg twice a day for Days 1 through 5
– continuation of Vitamin D, Zinc and possibly other supplements.

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Note that the combination of Ivermectin, Doxycycline and Zinc is the protocol that is recommended for C19, including in nursing homes, by the esteemed and internationally recognized Professor Thomas Borody from Australia.

NOTES

About Safety

Ivermectin is an extremely safe drug that has been taken billions of times, for anti-parasitic purposes. It has been for example recommended for mass administration by the World Health Organization for fighting onchocerciasis (river blindness).

Doxycycline is one of the most common antibiotics. Like Ivermectin, it is on the list of the Essential Medicines of the World Health Organization.

Both drugs are extremely safe, including when taken jointly. 

Both drugs are approved in Canada, the US and most other countries and can be prescribed off-label.

Vitamin D and Zinc are common and safe over the counter supplements.

About Effectiveness

The most up to date review of the literature about the effectiveness of Ivermectin for COVID-19 is by Professor Pierre Kory, MD, from St. Luke’s Aurora Medical Center, Milwaukee, WI and several collaborators, including Professor Joseph Varon, MD, from the University of Texas Health Science Center, Houston, TX, and Professor Paul Marik, MD, from the Eastern Virginia Medical School.

The review concludes:

“In summary, based on the existing and cumulative body of evidence, we recommend the use of ivermectin in both prophylaxis and treatment for COVID-19. In the presence of a global COVID-19 surge, the widespread use of this safe, inexpensive, and effective intervention could lead to a drastic reduction in transmission rates as well as the morbidity and mortality in mild, moderate, and even severe disease phases.”

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You can find the review at: https://osf.io/wx3zn/

About Additional Interventions

Also recommended are additional therapeutic interventions in case the disease would progress for some residents or staff members. If the level of oxygen goes below 94%, this may include supplementary oxygen, inhaled budesonide 0.5 mg/ 2 ml via nebulization twice a day, aspirin 325 mg daily, prednisone 60 mg daily and colchicine 0.6 mg twice a day for 5 or more days.

Transfer to hospital needs to be considered if oxygen levels further falls. An indicative threshold to trigger transfer to hospital is 92%

About Other Treatment Options

There are other valuable early treatment options being implemented all over the world, including in the USA. We consider this particular treatment option, relying on Ivermectin, Doxycycline and supplements, as especially safe, practical and simple, and, unlike other treatment options, not requiring more complex to implement monitoring tools such as ECGs.

About Vaccination

With the arrival of vaccines, early outpatient treatment for those with confirmed or suspected case of C19 will remain necessary, as no vaccine is expected to provide a 100% protection against C19. 

For maximum safety, post-exposure prophylaxis should also be provided in a nursing home where vaccination has taken place, when there is at least one suspected or confirmed case of C19.



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