136 CMAAO CORONA FACTS and MYTH BUSTER Mortality Reduction in CMAAO countries Drug Protocol for Treating Doctors
Dr K Aggarwal
958: CMAAO GUIDELINES
1. Evidence of fever, hyper immune inflammatory response (High ESR, CRP or ferritin): Tab HCQS (hydroxychloroquine) 400mg 1 tab twice on first day, 400mg 1 tab once a day based on acute phase reactants response
2. Tab Doxycycline (DOXT) 200 mg first day and 100 mg from day 2 to 7 Or Azithromycin 500 mg daily for five days. (Antibiotic with anti-viral response)
3. Anti-parasitic Tab Ivermectin 12 mg I tablet once only (by all family)
4. If severe hypoxia or pneumonia with very high D Dimer and Ferritin give IL-6 pathway inhibitors (Actrmra 400 mg 50K) IV: 8 mg/kg as a single dose (NIH 2020b; NIH 2020e).
5. In high risk cases in first three days of onset: Favipiravir or Fabiflu 1600 mg twice daily on day 1, followed by 600 mg twice daily for a total duration of 7 to 14 days (Cai 2020; NIH 2020a).
6. Inj Clexane 0.6 Ml OD or BID in all above age 58, heart patients, hypertension, diabetes, heart failure, asthma, COPD, post cancer, on Oxygen, sudden drop of oxygen on rest or exertion
7. Prednisolone 1 mg per kg stat if sudden development of hypoxia on exertion or rest (3-7 days)
8. Ing Remdesivir (Cipla) 200 mg day 1 and 100 mg day 2-5 at the development of oxygen requirement
9. Sleep prone on your abdomen
10. Prone oxygen by oxygen concentrator, minimum rate to get 92-96% oxygen levels
11. Vitamin D Cap D-Rise 2000 IU once a day for three months
12. Elemental Zinc 75 mg daily
13. Vitamin C 500 mg twice daily for three days and then 500 mg daily
14. Tab Ranitidine 150 mg twice daily till the duration of illness
15. Tab Meftal 200 mg or Naprosyn 500 mg or Indomethacin 25 mg or Nice 100.
16. SpO2 and Pulse monitoring regularly, especially day 4-7 three times daily.
17. Inform your local authorities, if COVID positive.
18. Inform if Temp >1030F or lasts >14 days or Breathlessness, SpO2 falls by >4 after six minutes walking, persistent chest pain
19. Sudden loss of smell and taste is not a serious sign, may persist for some time, may come and go, may come before fever
20. Conjunctivitis may occur in one eye and is not a serious sign
21. Rash may occur on any part of body (more in women) and is not a serious sign
22. Pus cells may be present in urine, indicate cystitis and not secondary infection (TLC will remain low)
23. Monocytes presence indicates high viral response
24. High CRP > 100 means very high inflammatory response
25. Loose motions (70% women) means super spreader and often a mild sign. May come and go. Take ORS.
26. Whole family may get COVID or COVID like illness, all may have different symptoms, atleast one will get loose motions
27. All should do betadine povidone iodine gargles twice daily and povidone iodine nasal wash
28. Get CBC with ESR, CRP, LDH on day 1 and day 5 onwards every third day
29. If Lymphocyte count is low ( < 1000) LOPIMUNE one twice day for two weeks ( Ritinovir and Lopinovir)
30. Review with reports at email@example.com
31. 9th day onwards you have non replicative virus and cannot pass on the infection to others
32. RTPCR test may remain positive for up to 48 days
33. Those who are 65 plus or have underlying diabetes or heart disease should wear three layered fabric mass
34. Join daily zoom session at 8am (ID drkkaggarwal)
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