By Michael J González, DSc, NMD, PhD, FANMA, FACN;  Miguel J Berdiel, MD; Luis Martínez, MD

Protocol for COVID-19 Prevention

In addition to the precautions given by the medical and government authorities to wash our hands, use masks, alcohol, and sanitizers…what else can we do? Prepare the immune system to work the fastest and most effectively!

Food:
1. Diet low in sugar and in simple and refined carbohydrates
2. Limit processed meals
3. Eat more vegetables, fruits and nuts
4. Hydrate well with water! (Your weight in lb, divided by 16, gives you the 8oz cups of daily intake)

Lifestyle:
1. Exercise at least three times a week
2. Sleep eight hours
3. Meditate, hear music, read a book

Recommended Supplementation:
1. Multivitamin and Mineral Formula one daily
2. Vitamin C, 1,000 mg three daily
3. Vitamin D3, 10,000 IU daily
4. Zinc Gluconate, 30 mg daily
5. Magnesium Citrate, 500 mg daily
6. Selenium Methionine, 200 mcg daily
7. Probiotics, >30 billion CFU daily
8. Melatonin, 10 mg daily

Other Suggested Supplements:
1. NAC, 500 mg
2. Lipoic Acid, 300 mg
3. Quercetin, 500 mg
4. Vitamin A, 10,000 IU
5. CoQ10, 100 mg
6. Vitamin E (mixed tocopherols with tocotrienols), 200 IU twice daily
7. Echinacea, 400 mg
8. Astragalus, 500 mg
9. Rhodiola, 250 mg
10. Maitake, 500 mg
11. Shitake, 500 mg
12. Ginger, 500 mg
13. Garlic, 600 mg
14. Elderberry, 450 mg
15. Astaxanthin, 10 mg twice daily

Protocol for Suspected Contagion (Pending COVID-19 Test Results)

Follow the precautions by the medical and government authorities as to washing hands, use of masks, alcohol and sanitizers. Boost the immune system to work the fastest and most effectively!

Food:
1. Diet without sugar or refined carbohydrates
2. Avoid processed meals
3. Eat more vegetables, fruits and nuts.
4. Lots of water (Your weight in lb divided by 16 equals 8oz cups daily intake)

Lifestyle:
1. Sleep eight hours
2. Meditate, hear music, read a book

Recommended Supplementation:
1. Multivitamin and Mineral Formula one daily
2. Vitamin C, 1,000 mg every hour while awake
3. Vitamin D3, 25,000 IU daily
4. Zinc Gluconate, 50 mg daily
5. Magnesium Citrate, 500 mg twice daily
6. Selenium Methionine, 200 mcg twice daily
7. Probiotics, >30 billion CFU daily
8. Melatonin, 10 mg daily
9.  Quercetin, 500 mg twice daily
10. Vitamin A, 10,000 IU daily
11. Vitamin E (mixed tocopherols with tocotrienols), 200 IU twice daily

It is highly recommended that physicians managing patients also prescribe the following:
1. IV Vitamin C, 25 g for at least 3 days
2. Thymosin Alpha-1, 1.6 mg (subcutaneous) twice weekly

Other Suggested Supplements:
1. NAC, 500 mg
2. Lipoic Acid, 300 mg
3. CoQ10, 100 mg
4. Echinacea, 400 mg
5. Astragalus, 500 mg
6. Rhodiola, 250 mg
7. Maitake, 500 mg
8. Shitake, 500 mg
9. Ginger, 500 mg
10. Garlic, 600 mg
11. Elderberry, 450 mg
12. Astaxanthin, 10 mg twice daily

Protocol for Patient, Positive to COVID-19, with Mild Symptoms at Home

Follow the precautions by the medical and government authorities to wash our hands, use masks, alcohol and sanitizers. Boost the immune system to work the fastest and most effectively!

Food:
1. Diet without sugar and without simple or refined carbohydrates
2. Avoid processed meals
3. Eat more vegetables, fruits and nuts
4. Hydrate well with water! (Your weight in lb divided by 16 equals 8onz cups daily intake)

Lifestyle:
1. Sleep eight hours
2. Meditate, hear music, read a book

Recommended Supplementation:
1. Multivitamin and Mineral Formula, one daily
2. Vitamin C at Bowel Tolerance dose. Take 3-5 gm every hour until you develop loose stool, then decrease the last dose 5 gm, and continue for 3 days
3. Vitamin D3, 25,000 IU daily
4. Zinc Gluconate, 50 -100 mg daily
5. Magnesium Citrate, 500 mg three daily
6. Selenium Methionine, 200 mcg three daily
7. Probiotics, >30 billion CFU twice daily
8. Melatonin, 10 mg daily
9. Quercetin, 500 mg twice daily
10. Vitamin A, 10,000 IU daily
11. Vitamin E (mixed tocopherols with tocotrienols), 200 IU twice daily
12. NAC, 1,000 mg three daily
13. Lipoic acid, 300 mg twice daily
14. CoQ10, 100 mg twice daily
15. Potassium Chloride, 99 mg twice daily

It is highly recommended that physicians managing Prevention Protocol also prescribe the following:
1. IV Vitamin C, intravenous 25 g daily for a week
2. Thymosin Alpha-1, 1.6 mg subcutaneous daily

Other Suggested Supplements:
1. Rhodiola, 250 mg
2. Glutathione (liposomal, >250 mg)
3. Ginger, 500 mg
4. Echinacea, 400 mg
5. Astragalus, 500 mg
6. Maitake, 500 mg
7. Shitake, 500 mg
8. Garlic, 600 mg
9. Elderberry, 450 mg
10. Astaxanthin, 10 mg twice daily

Protocol for Hospitalized Patient, Positive to COVID-19

Food:

1. Diet without sugar, and without simple or refined carbohydrates
2. Hydrate well with water! (Your weight in lb divided by 16 gives you the 8 oz cups of daily intake)

Medical Treatment:
1. Vitamin C intravenous, 15 gm every 6 hours for 7 days or until improvement
2. Hydroxychloroquine, 200 mg every 6 hours first day, after 200 mg tid for 10 days
3. Thymosin Alpha-1, during active infection, 1.6 mg subcutaneous daily. Continue during recovery twice weekly
4. Potassium Chloride, (150 mg-ml) 2 ml every 12 hours for 10 days
5. Zinc Chloride, (1 mg-ml) 15 ml every 12 hours for 10 days
6. Azithromycin 500 mg day 1 then 250 mg for 4 days
7. Kenalog 40 mg IM daily, for two days
8. Heparin (Lovenox, Low Molecular Weight) 30 mg sc bid
9. Solumedrone 40 mg IV daily
10. **Consider Acetazolamide, 250 mg every 12 hours

Respiratory Support:
See recommendations by Dr. Paul Marik, MD, Chief of Pulmonary and Critical Care Medicine , Eastern Virginia Medical School, Norfolk, VA:

Try to Avoid Intubation, if Possible.
Low-Flow Nasal Cannula
■ Typically set at 1-6 Liters/Min

High-Flow Nasal Cannula
■ Accept permissive hypoxemia (O2 Saturation > 86%)
■ Titrate FiO2 based on patient’s saturation
■ Accept flow rates of 60 to 80 L/min
■ Trial of inhaled Flolan (epoprostenol)
■ Attempt proning (cooperative proning)

Invasive Mechanical Ventilation
■ Target tidal volumes of ~6 cc/kg
■ Lowest driving pressure and PEEP
■ Sedation to avoid self-extubation
■ Trial of inhaled Flolan

Prone Positioning
■ Consider in patients with PaO2/FiO2 ratio < 150

VV-ECMO
■ Indications remain unclear
■ Early discussion with ECMO center or team may be advisable

(rev. 05/13/2020)

By Michael J González, DSc, NMD, PhD, FANMA, FACN (michael.gonzalez5@upr.edu);  
Miguel J Berdiel, MD (drberdiel@gmail.com);
Luis Martínez, MD (martinez911@gmail.com)