Essential Educational Travel for Messrs Legault and Trudeau – Part 1: Prophylaxis & Nursing Homes

The first part of this article is about prophylaxis for high risk people and about the early treatment of COVID-19 in nursing homes. It relies on concrete examples in Argentina and Colombia. It highly recommends that our political leaders educate themselves about these crucial elements that can considerably reduce infections, severe disease and mortality, yet are denied to the population in Québec and more generally Canada, as well as in many other jurisdictions.

The third stage of the recommended essential education trip, about excellence in early outpatient treatment (versus therapeutic nihilism, as implemented in Canada), is now available: Excellence in Early Outpatient Treatment versus Therapeutic Nihilism

Voir la version française.

Barely two weeks after the request for negative tests prior to boarding any plane to fly to Canada, the new call by Québec’s Premier is for the federal government to ban all non-essential air travel. With the ongoing atmosphere in the province, with travellers blamed and serving as scapegoats for the COVID-19 situation, it’s likely he will be heard by the Canadian Prime Minister.

This article, instead of endorsing restrictions to non-essential travel, recommends instead an essential travel to Messrs Legault and Trudeau. Yes, it may sound polemical, some may say cynical, but it could actually be the fastest way to get out of the crisis in Québec and Canada.

How? By educating Messrs Legault and Trudeau about how to get out of this pandemic, with prophylaxis, early treatment and protection of those at high risk, including health care workers and the elderly in nursing homes, and with the right public policies to make this happen.

The itinerary of this essential travel is as follows: 1) Argentina; 2) Colombia; 3) California; 4) Dominican Republic. The whole trip could be wrapped up in less than 2 weeks, and if the two politicians open up to different perspectives from what they have heard over the past year, if they actually learn as best as they can during their trip, and if they take the right decisions on the basis of what they learned, it could make a huge difference, save numerous lives and reduce the social and economic crisis in the country.

Indeed, by immediately implementing in Canada the lessons learned from the trip, they could most likely put an end to the crisis in nursing homes, an end of the crisis in hospitals, an end to the substantial C19 risks for health care and other high risk workers. This would in turn lead to a considerable reduction in severe disease and mortality, which in turn would enable a safe and sustainable reopening of the economy and of society.

Now, you will think all of this crazy. The author wished it would be. But the reality is that what is presented in this article is real, based on facts, and provides an actual roadmap to end the COVID crisis in a reasonable timeframe, contrary to what is being implemented by the authorities. These solutions have been known for a while, but now they have become abundantly clear, even if those advising our politicians seem unaware of them.

Any delay in implementing the right policies can only prolong the unnecessary suffering, disease and death in Quebec, in Canada and elsewhere.

Stage 1: Argentina – Focus on Prophylaxis

First stop in Argentina is to learn about the prevention, the prophylaxis of COVID-19, with persons who are at high risk. There are many such people in our society, but those probably at the highest risk, with some having paid with their life, are the health care workers. How can we protect health care workers from COVID-19? Well we all heard about vaccination of course, but there is a more immediate, cheaper and easy to implement solution. It’s to provide an innocuous drug, on a weekly or bi-weekly basis, as a prophylaxis for COVID-19.

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It’s in Argentina that one of the most convincing prophylaxis clinical trial took place, in the Tucuman province. This is a randomized controlled trial with 234 health care workers participants, half of which received the treatment of Ivermectin orally 2 drops of 6 mg = 12 mg every 7 days, and Iota-Carrageenan 6 sprays per day for 4 weeks. In the treatment group, only 4 out of of 117 workers (3.4%) tested positive during the study period, while in the non-treatment / control group, 25 out of 117 workers, or 21.4%, tested positive. This was found to be statistically significant with a remarkable p-value of 0.0001.

Importantly, the 4 participants in the treatment group who got C19 only developed a mild form of the disease, while in the placebo group, out of the 25 participants who were found infected, 6 developed moderate symptoms and 3 developed severe symptoms. In other words, with prophylaxis, no-one developed a potentially dangerous form of the disease. This study is recent, with results posted on January 11. It confirms previous studies undertaken about Ivermectin-based prophylaxis, in Argentina and elsewhere.

The prophylaxis regimen used for this study is extremely safe and cheap. It’s kind of a turn-key solution for all health care and other workers who are at high risk of contracting COVID-19. This is extremely important, as both in hospitals and in nursing homes, the pandemic has created havoc for health care workers. Some got very sick and have long covid symptoms. Some even died from the disease. Many left their position and decided to change career to avoid having to expose themselves to a potential infection. Also, among health care workers, there is substantial reluctance to take vaccination, probably because of the many unknowns in terms of effectiveness and safety.

Prophylaxis is therefore an extremely important tool that should be offered, on a voluntary basis, and of course with the right dosages and medical supervision, to health care and other high risk workers. So, instead of reproducing such clinical trial in Canada, which would take several months, it would be much better for our leaders to learn first hand from those having participated in this clinical trial in Argentina, to talk to the medical doctors, academics, trial investigators, hospital administrators, and of course the health care workers who participated. There is lots to learn and this clearly justifies this first stage of the trip in Argentina for Messrs. Trudeau and Legault.

Stage 2: Colombia – Focus on Nursing Homes

Health care workers are clearly at high risk of COVID-19, in Canada and elsewhere, but those who are at the highest risk from COVID-19 are without doubt the residents of nursing homes and other aged care facilities. It’s now well proven that the risks associated with COVID-19 grow exponentially with age and are aggravated with chronic diseases, comborbidities. The risks are minimal for children and young adults. They are real for older people, in their 70s, 80s and beyond. In Quebec and in Canada, thousands have lost their lives in nursing homes. During the first wave, it’s about 80% of the Canadian deaths from the disease that occurred in such settings, where the virus typically circulate easily and infects many. Despite measures taken in anticipation of the second wave, there are continuing outbreaks and deaths in nursing homes, and there seems to be no end in sight to this. This brings not only death, but also misery in the lives of those people, who are deprived from family visits, and sometimes even, in Quebec, from potentially life-saving supplements like vitamin D, which have been declared non-essential by the authorities.

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Of course, there are vaccination efforts taking place, but their effectiveness and safety are not well known, especially when administered to the very old, as they were not part of the clinical trials leading to approvals. It’s also known vaccination tends to be much less effective with very old people. Regarding safety, it is an issue too, to the point that Norway has put a pause on its vaccination efforts for the very old and sick, as several deaths occurred following vaccination in that particular group. And of course, vaccination takes time to provide protection from the disease, with two shots needed, delayed second shots because of the limited supplies, and only limited protection after the first shot. All of these points at serious issues, serious shortcomings, with the current strategy of the provincial and federal authorities regarding nursing homes in Canada, where the elderly continue to die, on a substantial scale, from COVID-19. For a detailed discussion about vaccination v. early treatment, see the recent master contribution by Professor Robert Clancy.

Canada is not alone to have a huge part of its COVID-19 victims in nursing homes. Let’s take the example of Colombia. There, it’s some 77% of the COVID-19 victims who are elderly people. But something highly interesting happened in a nursing home in Cali, where there was a major outbreak, but where nobody died. Yes, nobody died, thanks to a simple therapeutic intervention aimed a saving the residents from COVID-19. Such therapeutic intervention, to this day, remains inexistent in Canada, from coast to coast. In the San Miguel nursing home, 59 out of 254 residents were found to be infected with COVID-19 this past August. Like in Canada, this would mean normally many, at least 25%, i.e. 15 deaths to be expected. But nobody needed a transfer to the ICU and no-one died.

The story is explained in a January 17 article in the El Pais newspaper. Despite many non-therapeutic control measures, similar as those in Canada, an infection was detected on August 6. Nothing new: non therapeutic barriers are now known to be ineffective to prevent the virus to get into aged care facilities. The director of the nursing home brought immediately in a multidisciplinary team from the University Del Valle, led by internist and pharmacologist Dr Oscar Guttierez Montes. It was decided to isolate the 46 non symptomatic patients for 28 days, and to hospitalize the 13 symptomatic ones, even if, from what is described in the article, hospitalization seemed not necessary. But medical care was given to this elderly people having serious COVID-19 symptoms.

According to the article – the following therapy was provided: the anti-parasitic drug Ivermectin, with a dose of 600 micrograms per kg of bodyweight, in two separate intakes separated by 7 days; the antibiotic Nitazoxanide with a dose of 500 mg every 12 hours for 6 days, and Aspirin, well known for its blood-thinning properties, every 48 hours, with a 100 mg dosage, every 48 hours for 7 days. Thanks to this therapeutic intervention, progression towards a severe form of the disease was avoided, and there was no mortality. This is something that our political leaders need to understand. With a simple, cheap and safe early treatment for COVID-19, even with very old people, you can curb the disease and, probably in most instances, avoid mortality. All of this indicates that there simply should not be any outbreaks with numerous deaths in nursing homes.

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A similar outcome as in Colombia was achieved, this time by chance, in a French nursing home, where Ivermectin had been given to all the residents and personnel for a scabies outbreak, and this resulted in preventing a COVID-19 outbreak, also with zero death, while there were numerous deaths in the nursing homes nearby, in one of the regions of France the most badly hit by the pandemic.

Today, the effectiveness of Ivermectin-based therapies both for the prevention and early treatment of the elderly is clearly established. These examples show it also works for the very old. Lots can be learned from this Colombian experience, and it’s why it appears critical that, for this essential trip, our two politicians learn as much as possible from this experience in Cali, through conversations with the medical team, the personnel of the nursing home, and the residents.

Other Ivermectin-based protocols exist for preventing or treating COVID-19 in nursing homes, including the Protocol developed by Dr George Fareed, and which you can find at this link. Today, even if it’s not at all implemented in a country like Canada, the tools exist to effectively prevent outbreaks and deaths in nursing homes. They can readily be implemented, are immediately effective, contrary to vaccination, which take time to provide protection and, as we already mentioned, may not necessarily effective and not necessarily safe with the very old.

The second part of this article will cover Stage 3 and 4 of the recommended essential trip for our political leaders, to California and to the Dominican Republic, with focus respectively on ambulatory early treatment and on public policy.

It’s also important to note that our political leaders should take all precautions when travelling, even if at least one of them already got COVID-19 and is therefore most likely immune (and accordingly does not need a vaccine even if intends to get one)

Here is an article explaining how to travel as safely as possible by plane during COVID-19 times, and that involves also prophylaxis, as flying, like any public transportation in a closed environment, with no social distancing possible, constitutes a risky activity.

In short, two simple measures – Ivermectin-based prophylaxis + wearing all the time on board a N95 mask -, in addition to the usual measures, as Professor Marik actually did for a recent trip, will considerably protect you from the disease.