Have to think of somethin to set up certain practical approach incognizant to the alarming surge of COVID cases. Although the second wave has already begun, lots of of the expected occurred like you wouldn’t believe that your secretary, employee, driver, kasambahay, worst your friends, and family members are infected by the virus. This sudden surge is brought by the accommodation of OFW’s, LSI’s (opening of ports and airports), denial of most people and becoming careless, disregard of health protocols, implementing guidelines by the LGU’s, balancing between economy and health issues, availability of mass testing ( most people are asymptomatic but carries the virus), poor contract tracing, and lack of facilities to quarantine positive patients. The only consolation is that recoveries are high and mortality is low.

Hence, I collaborated with my Pulmo and Infectious Disease colleagues  in formulating this regimen reachable by any person even in the absence of a Healthcare Professional.

I. Normal person, asymptomatic, no exposure regardless of Age:

a.) Good Sleep

b.) Sunlight exposure between 8-9 am for 30 minutes- 1 hour ( Vit. D3)

c.) Minimum 1.5 liters- 2 liters water (warm) a day

d.) Diet of more fruits, green leafy vegetables, no soda, coffee and fatty/ salty foods

e.) FBS less than 130 mg/dl and Random Blood Sugar (4HPP) less than 180 mg/dl, A1c less than 7%

f.) Control your Hypertension ( BP equal or less than 120 mm/Hg and other Co-morbid diseases and have your regular                 check up

g.) Limit your stress and over fatigability

h.) Strict compliance of health protocols ( frequent hand washing, social distancing 2-3 meters, use of alcohol, other devices         – UV ionizer, humidifier, exhaust fans, stay at home, buy online for essential items, cover your mouth with a tissue or                 handkerchief when coughing or sneezing, avoid crowded places such as Malls, Restaurants, Bars and public transport.

i.) Medicines to enhance your immune system

i1.) Conzace ( Vit. C, B Complex, D3, Zinc Sulfate) once daily

i2.) Melatonin 3mg tablet at bedtime

i3.) IgCo 1 sachet daily in warm water at night

i4.) Optional:

– For Asthmatics and with Chronic Allergic Bronchitis take ( Fluticasone+ Folmoterol- Flutiform 125mcg/ 5mcg) 2 puffs

2x daily

– For Allergic Rhinitis ( which is common), Levocetirizine or + Montelukast – Zykast 10mg/ 5mg 1 tablet daily.


II. Normal person, Asymptomatic, with Confirmed Exposure:

1.) Follow a) to i)

2.) Self Quarantine at home

3.) Report to authorities, set contact tracing in motion

4.) Isolation if possible

5.) Have a Swab Test right away!!!

6.) After your swab test confines yourself for self- quarantine away from your family, friends, officemates, business                        associates, etc. Do not expose yourself to others while waiting for your swab test results (golden rule).


III. A person with confirmed Exposure, Symtomatic:

1.) Immediate Swab Test (Rt-PCR)

2.) Follow II but Facility Quarantine. (COVID Center)

3.) Wait for Swab Test results and continue praying


IV. Positive but Asymptomatic Patient:

1.) Follow I, II, and III except for swab test

2.) Repeat swab test after 3-5 days

3.) Add to your Medication ( with doctors prescription)

– Azithromycin 500 mg 1 tablet daily for 7 days

– Hydroxychloroquine ( Plaquenil) 200 mg daily after meals 5- 7 days


V. Positive with Milder Symptoms:

1.) Follow IV

2.) Admit to a designated Hospital with COVID Isolation Wards

3.) Follow  IV-3 but add:

– Cefixime 400 mg PO daily for 7- 10 days or Ceftriaxone 1 gm IV Q 8 hours for 5- 7 days

– Acetylcysteine (Exflem/ Flumucil 600 mg sachet dissolve in 1/2 glass of water daily for 7 days

– Omeprazole/ Pantoprazole 40 mg tablet or IV daily for 5-7 days

4.) Linghua Qinwen as a supplement (OPTIONAL) for positive and milder symptoms 3 capsules 2x daily for 5 days

for moderate to severe symptoms 4 capsule 3x daily for 7 days

5.) Favipiravir (Avigan/ Fluvir) 200 mg 9 tablets loading dose p.o., then 4 tablets BID for 9 days.


VI. Positive with Moderate to Severe Symptoms:

1.) Follow V

2.) ICU when a ventilator is needed and X- ray showed Pneumonia + Disseminated Intravascular Coagulation (DIC) is                   indicated with mild to moderate respiratory distress (dyspnea)

3.) Additional Medications:

– Dexamethasone 500 mg Q8h or 500 mg IVT Q12h

4.) Antiplatelet Aspirin 100 mg daily or Clopidogrel 75 mg or Ticagrelor 90 mg 2x daily+ Heparin or Enoxaparin ( Clexane) or         Coumadin

5.) USN Inhalation with steroid and bronchodilators

6.) Remdesivir 2 ampules as  loading dose, then 1 ampule daily for 7 days

 

PRECAUTION**

1.) Inform your physician ahead of time if you have any heart issues like Enlargement or Cardiomyopathy, Ischemia, Coronary Syndrome, Post CABG or Stent, Valvular Heart Disease such as Rheumatic Heart, Congenital Heart Anomaly, taking the Hydrochloroquine ( Plaquenil) 1 tablet daily after a meal should be with precaution.