I cannot provide medical advice, but in the circumstances I thought that I ought to share the information I have to allow others to make up their own mind. This covers the preparations I made and continue to make, as well as what I did personally and found helpful when I caught covid in April 2020. This is not medical advice nor is it a treatment plan; you ought to seek your own medical advice as appropriate.
Time constraints prevent me keeping this as up to date as I would like.
We have spoken to many people who caught covid. No one was as prepared as they could have been - nor, indeed, as prepared as they themselves wanted to be. But every little thing you do matters because severity of disease is related to viral dose, so the sooner you know you have covid and can act, the less severe your experience of the disease is likely to be. Being prepared also means that you may be able to reduce the chance of passing on the virus to those close to you, and it seems likely that one can reduce one's chances of long covid which may be life-altering. Plus you are less likely to die.
In the world of yesterday we expected to be taken care of and not have to take matters into our own hands. But that is not the world of today. There are things you can do to help if you catch covid, and they aren't expensive or time consuming. So please do consider what actions are appropriate for you, and remember that inaction is unlikely to be appropriate for anyone.
Covid preparation list on Amazon UK \ This is not comprehensive but is a good starting point. Ambroxol is a no-brainer (do read the instructions if you are eg breast feeding) to have at home and is available over-the-counter in many countries. The list does not include the pharmaceuticals listed below which need to be sourced elsewhere, nor does it include all of Laeeth's items.
Amazon US may not ship to certain countries. You can use a reshipping service like Skypax US.
Have a mini-plan about what you will do if you get sick or your partner or flatmate does. It’s very infectious, but in the previous waves I think the attack rate is only 10 - 20% within households: you do stand a chance of avoiding infecting others if you are careful. (The attack rate is higher with the more contagious Type G strain, but it's still possible to avoid catching covid). My wife and daughter didn’t seem to catch it this time. Every little thing you do matters because even if you catch it then the outcome will be better if you have a lower viral dose than a higher viral dose.
It is an unpleasant subject, and may sound macabre, but if you haven’t written a will yet then now would be a very good time. Ideally it would be best to use a family solicitor, but in a pinch you can buy DIY packs online. Most people probably don’t expect to ever need to have written a will for years to come, and let’s hope that is right. But if you are looking into the abyss, as I was for a few days just a few months ago, then you will be very glad to have made some preparations when your mind is clear.
The NHS constrains treatment choices based on evidence from randomised controlled trials. Some people question the wisdom of this framework given that it will be years before we have very good evidence in how to treat a disease new to humanity. The Chief Medical Advisor in the UK refused to advise vitamin D on the grounds of now RCT, but he also refused to fund RCTs - in my opinion this is quite a strange dynamic. So it is not my personal belief that you will get the best possible care from an NHS doctor in the UK.
Private doctors in the UK who prescribe treatments not approved by the National Institute for Clinical Excellence face persecution from regulatory agencies. It’s possible to receive tele-medicine from doctors abroad, including North America. Please contact @dominic if you would like to receive what information we have been able to find at this point.
Ideally under supervision of a doctor and in any case paying due care to risks and cautions for the medications. For example may be advised against if breast-feeding.
0.I do not intend to cover basics like masks and hand washing here.
1.Consider that even if you are actually pretty sick, you may not feel that bad Covid seems to have an analgesic - or pain-killing - effect. My oxygen saturation (SpO2) was pretty bad, but until towards the worst point I didn’t feel too bad. So don’t tell yourself I am fine and end up pushing yourself too hard.
2, Overwork Don’t be like Boris - it’s a bad idea to overwork - if you do choose to work, work a bit less than you think you can. Stress makes things worse. Don’t try to return to working too hard too quickly either.
3.Avoid Exercise Don’t be like Boris - do not start exercising until at least a few weeks after you feel completely well and symptoms have resolved; I suggest having a full medical checkup first. Covid can impair metabolism and cause damage to the heart and circulation, so vigorous exercise without having the all-clear first could be quite bad.
4.Sleep Sleep is very important for covid, yet at the same time it can cause insomnia. Don’t feel bad about not being able to sleep. I found that GABA and melatonin helped with sleep. (See below).
5.Monitor your SpO2 and heart rate Pulse oximeter can measure both. If you don’t have one or do not know how to use then email @dominic. (Some good instructions can be found on YouTube). I found my resting heart rate was 10bpm higher than normal and would shoot up to 120bpm after modest emotional stress. It seems to have completely normalised after following my own regime for some months. Normally < 94 % SpO2 is a medical emergency. Mine was as low as 58 - and when it was in the 60s I still didn’t feel that bad.
There’s a new phenomenon of ‘happy hypoxics’ - people with oxygen levels at a level that would normally mean they are unable even to walk or think. I didn’t have difficulty programming with SpO2 at 58. It would be a mistake to think you are fine just because you don’t feel that bad. Measure your SpO2 (oxygen saturation).
Lower-quality devices may give incorrect readings for people with darker skin.
6.Measure SpO2 (oxygen saturation) of other members of your household Given the difficulties of getting Covid tests, monitoring SpO2 may be a crude substitute. I believe that even asymptomatic Covid patients can still see changes to lung function. It’s highly advisable to use a different device lest you infect everyone from using a shared pulse oximeter.
7.Better late than never, but if you do not have an air filter then I highly recommend getting a HEPA and UV air filter (either separately or combined). BlueAir filters cost GBP 200 - 300 on Amazon, and UV air filters about 60 pounds. This may reduce the load on your lungs if you live in a polluted region like London, and may reduce the chances of spreading covid to other members of your household. You should have one per room, and size the filter unit according to the capacity of the room. Note that PM2.5 fine microparticles damage the ciliary cells in the lungs responsible for keeping them clean and this may both increase the susceptibility to covid and worsen its virulence.
9.Early treatment The NHS doesn’t have many early treatments available, but my reading of the research suggests that early treatment leads to much better outcomes.
it’s possible to have a negative reaction to anything (for a while a few years ago I seemed to have an allergy to vitamin C!) but my personal belief is that the supplements are mostly pretty safe for short-term use. That’s just my personal belief, and should not be misinterpreted as medical advice.
Most of these may be obtained from Amazon.
Nattokinase - enzyme that breaks apart peptide bonds in proteins. Fibrinolytic breaking down fibrin in clots. May be able to break down the spike protein and fibrin that causes blood clots. Might be able to improve blood flow, reduce viral load in infected cells, inhibit expression of inflammatory cytokines. Non-GMO source preferred.
Systemic proteolytic enzymes - break down proteins into smaller peptides and amino acids. Break down inflammatory proteins, support immune function and circulation. Protease + bromelain + papain + amylase + lipase + pancreatin.
Sulforaphane. Reduces expression of ACE2, anti-inflammatory and immunomodulator.
Nicotinamide Riboside.
Vitamin D with K2. Take with fatty food in the morning. It may be that it's a little too late to start supplementation once infected. In his most recent video on the subject, John Campbell states that it takes a week for the supplementary form to be metabolised to the active form. Google “Vitamin D hammer” and “vitamin D hammer covid”. I personally took an extremely high dose of vitamin D for five days - 25,000 IU a day along with the standard dose of K2 (which is advisable if taking high doses of vitamin D), and I think it was beneficial although it is hard to be sure. Not for treating covid: Fauci takes 6,000 IU daily; over autumn and winter I increased my dose from 10,000 IU daily to 20,000 IU daily; and my two year old daughter takes 1200IU daily. Oral D3 spray is more convenient and likely better absorbed than tablets or capsules.
Zinc. Take before bed on empty stomach. I took a very high dose of 240mg whilst I was feeling sick. This might be pretty important. I started out taking 120mg daily, but that didn’t seem to make a difference.
N-Acetyl-Cysteine, glutathione precursor, may reduce cytokine storm and has antiviral activity - perturbing the functionally active conformation of spike protein through reduction of its solvent accessible disulfide bond disintegrates its structural architecture and leads to 50%+ inhibition in viral replication in VeroE6 cells. It is also mucolytic -it thins mucus - and this has been found to help in respiratory diseases. Take on empty stomach. When I was sick I took 2 x 600mg capsules a few times a day and I still take 2x 600mg twice a day. Pre-covid I only took 600mg.
Isoquercetin or Quercetin - bioflavinoid, anti-viral, anti-inflammatory, MAST cell stabilizer, zinc ionophore. Take with fatty food. Some people have raised questions about possible kidney damage from long-term use of Quercetin at high doses, but I have not heard about risks from lower doses for shorter-term use. There’s also a risk in not treating covid to many organs (including kidneys). Quercetin was very important for me - it has anti-viral activity and reduces inflammation. After Quercetin and NAC my oxygen levels would rise from the 60s to the 80s and I would be able to work well for most of the day. Isoquercetin is superior to Quercetin but may be harder to obtain. (Can be ordered from Amazon US and reshipped to UK via Skypax US). Quercetin hydrate powder might be useful for smaller children.
Bromelain - enzyme to increase bioavailability of Quercetin.
Sodium/Magnesium Ascorbate crystals, vitamin C - 1 - 2 grammes, three times a day. Overdose of vitamin C is pretty harmless - symptom is diarrhea and the answer to that is just to reduce the dosage a bit. You will be able to tolerate more vitamin C if you are very sick. Some work found ascorbic acid better than the salt ascorbate, but that’s tough on the teeth if taken in water and hard to take enough as capsules. Magnesium ascorbate better than sodium ascorbate but it may be harder to get in some places.
Liposomal vitamin C - fat-soluble vitamin C
Magnesium anti-inflammatory and necessary for vitamin D to be mosr effective. It both is depleted by [stress] (https://www.ncbi.nlm.nih.gov/books/NBK507250/) and buffers the effects of stress. I gave myself magnesium intramuscular shots that I had prescribed for me for other reasons; if this option is open to you then it is worth considering as there can be problems absorbing Magnesium through the gut. Otherwise you might try taking several different forms of magnesium - Magnesium Bisglycinate is well-absorbed. Take before bed on empty stomach Maybe a high dose like 2 grammes.
Undenatured whey protein, or failing that just regular whey protein
Melatonin. See 1. I used to take 2 to 3 mg two hours before bedtime occasionally before when I needed to reset my body clock. Post-covid that did not seem to have much of an effect and I needed to go up to 20mg. It’s available over the counter in many developed countries, but requires a prescription in the UK (and might not be sold at all). However it is still possible legally to obtain it via Google shopping, for example. Melatonin gummies may be better absorbed (personal experience) than tablets or capsues.
Ubiquinol and Acetyl-L-Carnitine for mitochondrial support. 300mg Ubiquinol and 500mg *2 for Acetyl-l-carnitine
GABA 750mg 2x daily. (Amazon US). Helps with sleep. Protective and calming effect on brain and body. See also @__ice9.
Carbon 60 in olive oil. This is a relatively new supplement so we do not know all the risks, but it seems to be a powerful anti-inflammatory.
Vitamin E 10k IU daily.
Vitamin B2
Symprov probiotics (Amazon). Gut health is very important for covid and immune regulation - dysbiosis can hinder the immune system's initial response to the virus and contribute to its severity and persistence.
Omega 3 epa dha eg vegepa
I repeat again that I cannot give medical advice. In the UK the administrative state has taken a highly conservative approach, awaiting evidence from randomised controlled trials before recommending treatments. A better question is to consider as well as the likelihood of efficacy the risk:reward - if a treatment has a decent chance of working and probably won’t do much harm then some might suggest it is worth considering even if the evidence is not satisfactory from a narrowly scientific perspective.
@ice9 on Twitter [says](https://twitter.com/ice9/status/1343999679672033280?s=20):
Theoretical justification arises from the fact that endosomal entry is of only secondary importance for SARS-CoV-2 replication in the respiratory tract. Both TMPRSS (proteases at the cell membrane) and cathepsins (proteases in endosomes) must be blocked.
So you need one of TMPRSS entry inhibitors (Ambroxol/Bromhexine or Camostat/Nafamostat) and one of endosomal entry inhibitors (Nitazoxanide, Niclosamide, HCQ).
Ambroxol 15-50+mg 3x daily or Bromhexine 8-32mg 3X daily 1 and 2. Bromhexine metabolizes into Ambroxol, the active compound, in the bloodstream. Both are sold over the counter (without a prescription) in many European countries as a cough medicine. As best I can tell they seem to be reasonably safe and are available for children as well as adults. @ice9 [says](https://twitter.com/ice9/status/1289164553603788805?s=20) "Ambroxol triggers the release in the lungs of endogenous compounds known to be inhibitory to serine proteases. As a cell-membrane-localized serine protease, TMPRSS2 would be fully exposed to them. It likely gets inhibited likewise." Prevents Covid attaching to TMPRSS receptor which may mean they have some prophylactic value and there may be some synergy with hydroxychloroquine (which in part prevents covid attaching to ACE2 receptor, the other entry target). Ambroxol is also a lung surfactant. Bromhexine dosage 8mg 3x daily; Ambroxol 15mg 3x daily.
Camostat 200mg 3x daily or Nafamostat. Bromhexine/Ambroxol work only in lungs. These may be useful for systemic infection (eg gut). Camostat may be obtained from Bio Japan.
Nitazoxanide. 900 - 1200mg 3x daily. Prescription medication. Probably more effective than Niclosamide, but harder to obtain
Niclosamide. 1000mg 2x daily. Anti-worm medication used even in children that may reduce inflammation. I found it not as powerful as Ivermectin, but some months ago there were days that I couldn’t get much work done without it. It’s OTC (no prescription required) in some developed countries like Belgium under the brand name of Yomesan. There will be some benefit to chewing it, but there will be better absorption if you grind it up in a steel mortar and pestle to make nanoparticles first.
Hydroxychloroquine 200mg 2x daily. (chloroquine may work but is more toxic). It’s a heavily politicised drug. The first mention I could find in it was on an internal email forwarded from a consultant in China (although I had seen people talking about it on Reddit and Twitter). That was in January. So Trump got the idea from the same sources we did, and we didn’t learn about it through him. HCQ is no wonder drug, but there just aren’t many established treatments. I took 200mg HCQ in the evening and the next morning I felt much better, with my oxygen rising to the high 80s later that day from being 58 before; and I continued to improve in the subsequent days and weeks. I don’t think that was a coincidence. HCQ is probably best taken early on; it’s not going to be very helpful if someone waits till they are very sick. Many of the debunking studies have mistakes verging on what looks almost like fraud - it’s hard to know why that is, but it’s interesting that HCQ is very cheap.
Pyronaridine 720mg / day.
Ivermectin. 0.2mg per kg a day (15mg a day if you weigh 75kg) although some research suggests as high as 0.5mg /kg / day for acute treatment (37.5mg if you weigh 75kg). An anti-worm medication that has remarkable anti-inflammatory effects; and most likely indirectly an anti-viral effect too (it has a direct antiviral effect but not at the doses prescribe). Some benefit for prophylaxis, post-treatment exposure, early, late and post covid. I have found this helpful for treating the effects of long-covid. It's used as part of India's treatment pack. Requires a prescription - you might be able to purchase on the internet or via telemedicine from a doctor abroad. Risk:reward is very good. Some people have purchased Duramect horse paste or Animect injectable for cattle taken orally - I can obviously not recommend this, and there are risks but I report this merely as information.
Doxycycline Fake news - treating a viral infection with an antibiotic? Well, doxycycline is not only effective against bacteria; it is also effective against other microbial infections. But there is a dual effect; doxycycline is also an immune modulator and is used in Indian treatment pack for covid.
Famotidine / Pepsid AC. Anti-viral effects. Covid may be a serotinin excess syndrome, and there are benefits from the serotonin-blocking effects of famotidine. Be careful of drug interactions. This suppresses stomach acid, and it's advisable to consider taking with Betaine HCL (Amazon) and probiotics.
Thymosin Alpha One. Stimulates immune system. I took later on. Hard to tell the benefit but may be especially valuable for older people. Injectable subcutaneously. Recommended by Dr Hertoghe
Colchicine. Can be used to treat gout and as an anti-inflammatory to treat Bechet's disease. Well tolerated at lower doses. Higher doses can trigger gastrointestinal symptoms. Contra-indicated for certain kidney conditions, and there have been deaths with overdoses. Three recent randomised control trials found benefits including faster recovery time and a reduction in mortaility and ICU admission.
Fluvoxamine 100mg 3x daily.
Ciclesonide or Budesonide if already significant pulmonary symptoms.
Dipyridamole-aspirin if already significant pulmonary symptoms.
Spironolactone
Evidence as to why long haulers are still ill
I saw draltermimi at samedaydoctor.co.uk near Wimpole Street in London. Call to arrange an appointment, see the doctor, get a prescription for blood tests, take it to TDL around the corner, get blood drawn. Simple process.
Cytokines