Coronavirus FAQ

Frequently Asked Questions

I am maintaining this Frequently Asked Questions page where I will be answering as many questions from the public as time allows. That means I won’t be able to respond to specific questions that would apply only to individual cases. Instead I will focus on those questions that are relatively short and that I also judge to be of broader interest. If you have a question you’d like to submit, you can do so using the form at the bottom of this page. Please don’t call my office with questions, as my staff doesn’t have the expertise to answer them. (People I am treating can email me, with my usual time charges.)

Disclaimer

Please be aware that medicine is complex and without actually being your attending physician we cannot give medical advice. Any information given is to be used as a teaching tool for you and your physician to work with, and therefore we cannot take any legal responsibility for its use. In the article and FAQ, I am simply discussing the recommendations I give for those that I am treating directly. Please check with your personal physician before applying any recommendations.

Is my risk for coronavirus increased because of the immune problems in CFS and fibromyalgia?

Because this is a new virus, nobody can say for sure. But having successfully treated thousands of people with CFS and fibromyalgia over the last 30 years, I have never seen a single death from influenza. Current research is also not seeing an increased problem even in those people taking immune suppressants for severe health conditions. But to be on the safe side, I recommend following the advice I discuss for both prevention and at the onset of symptoms.

Should I wait for a test confirming COVID-19 before beginning your suggestions?

No. Once they develop a test that gives the result within an hour, it will be reasonable to wait. But currently it takes several days to get the results back, and this can allow the virus to progress to its dangerous form. It is much better to nip the virus in the bud with early treatment, and the risks of treatment if one doesn’t have the virus are low. So in those I treat, I begin if the person has new symptoms of fever, cough, shortness of breath, and/or diarrhea.

I recommend to those I treat that if they can get the test by going to a drive through center within 72 hours of starting treatment (preferably 24-48 hours), it is good to get. So you will know if you actually had the virus and are likely immune after. But the studies suggest that most people no longer show viral activity after three days on the treatment.

With less than 20% of people testing positive, I think the risks of going to a non-drive through center where you might catch the virus from somebody else outweigh the benefits of the test.

How dangerous is coronavirus?

For most people, it’s no more dangerous than a bad case of run-of-the-mill flu. In some, it is so mild they don’t even know they have it. The problem is that in a small percent of people, especially those over 65 years of age with high blood pressure, diabetes, and/or heart disease, it can progress to being life-threatening. It does so by triggering a pneumonia and shock lung (Acute Respiratory Distress Syndrome, or “ARDS”), which requires treatment in an intensive care unit and possibly a ventilator. Having this occur in even a very small percent can quickly overwhelm our healthcare system.

What about social distancing?

Social distancing is meant to spread the disease over more months, thereby reducing the number of sick hitting hospitals all at once (“flattening the curve” as they say). This prevents our healthcare system from becoming overwhelmed. There is also a hope that the infection pandemic may burn itself out if less people catch it. So follow CDC and state recommendations to maintain six feet of distancing and even if you’re told to stay home. This doesn’t mean you can’t go out for a walk-in areas where there aren’t many people. Just keep your six foot distance, don’t touch surfaces that many other people touch like railings and door handles when you’re out, and wash your hands well when you get home for 20 seconds minimum (before touching anything in your house).

Should I use a face mask?

At first I didn’t wear a mask, because I viewed these supplies as best saved for our healthcare workers and others on the front lines. But the recent change in CDC guidelines is that we all should wear them when out, so that’s what I now do. This is less to protect yourself, as the masks available to the general public don’t provide much personal protection, but more to protect others from catching it from you (if you have it). So by wearing masks we are all protecting each other. Think of it as your way of saying “I love and care about you” to those who see you walking by.You may not feel like you have it, but most people are contagious before they develop any symptoms. In fact, the 48 hours before the onset of symptoms are when an asymptomatic carrier sheds the virus in greatest concentration.

Isn't zinc dangerous at high doses?

I consider doses of up to 50 mg a day (but not higher) for one month to be quite safe. A small percent of people will have nausea or benign side effects, and they can lower the dose or stop it if they need to. The dose used in the Zalenko series was also 50 mg a day (220 mg of zinc sulfate). After a month, I suggest lowering to 15 mg a day in a multivitamin that also has 500 mg of vitamin C, 1/2 to 3 mg of copper, and 1,000 units of vitamin D. The main risk from higher doses of zinc for longer periods is that it can cause copper deficiency. But this is unlikely using the dosing above, especially if one is taking the multivitamin.

Can Plaquenil (hydroxychloroquine) prevent coronavirus?

There is a possibility that it can, and a high probability that it would lower the severity of the illness if one does catch it. Early research is suggesting that people taking Plaquenil every day (often for decades) for autoimmune illnesses have a much lower rate of hospitalization with coronavirus. But because we don’t have enough for everybody to do this, I recommend beginning when one becomes symptomatic of viral infection. Experience with millions of people on very low dosing has shown this medication to be very safe. But I think it is reasonable to offer to our healthcare workers on the front line, if they would like to take it for prevention.

Why doesn't Dr. Fauci recommend hydroxychloroquine for coronavirus?

Dr. Fauci is excellent, but his strict academic research background gives him a mindset that large randomized double-blind studies MUST be done before recommending a medication for an illness. I understand this and normally agree with it. But in this situation, my belief from extensively looking at the research is that the risks of waiting for these studies is too high relative to the alternative. Especially given the amount of information we already have about these medications’ benefits. The FDA has now granted approval for use of these medications for coronavirus in hospitalized people. The French and Chinese governments are also now recommending it for treating coronavirus.

What about the stories of people overdosing on Plaquenil (hydroxychloroquine), and the severe side effects of these medications?

The story most have heard is about one person in the US who died from ingesting something that they thought was chloroquine, but he did not take the medication. He and his wife ate some fishbowl cleaner that had a poisonous form of chloroquine listed on its ingredients label, which was simply insane. The overdoses reported in Africa were because people didn’t have information on proper dosing and likely took handfuls of the pills. Doing that with Tylenol could also kill you.

Who should not use the Zithromax?

If you’ve been diagnosed with an EKG abnormality referred to as a "long QT interval" (a condition that affects about one in 2,000 people), or you’re having a heart attack or have other acute heart problems, then you should not take Zithromax without first getting a risk assessment from your physician, and that you can then consider the monitoring guidelines when resources are available. (See the arrhythmia risk scoring shown at Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19.) But most people having acute heart problems are already in the hospital, or should be on their way there.

Will Plaquenil hurt my eyes/retinas?

There hasn’t been a single case of this being reported by millions of people who’ve been treated with Plaquenil short-term for malaria. This only occurs with long-term use, usually more than five years of taking the medication continuously.

Why do you recommend a six-day Plaquenil protocol instead of the ten-day protocol?

Initial research suggests that this shorter treatment is as effective for coronavirus as the longer one. Plus, if the research concludes that this is a treatment for coronavirus, then we’re going to have a lot of people who will need it and supplies are limited. If 14 pills are as effective as 30, then more people will be helped.

If I take the Plaquenil and Zithromax, and it turns out I didn't have the virus, can it still offer protection?

The Zithromax stays in the blood for five days after the last pill, and the Plaquenil for months. So it may well offer a fair bit continuing protection even after one finishes the pills.

How can I get the Plaquenil and Zithromax?

Pharmacies sold out of these very quickly, and the drug makers are appropriately prioritizing restocking hospitals and saving it for people who’ve tested positive for COVID-19. But production is being quickly ramped up, so my hope is that by mid-to-late April, these medications will be available by prescription at many pharmacies.

If I get COVID-19, would it be helpful (and safe) to take 25-50 mg of iodine for four days (I know of a physician who recommends this)?

Four days on that dose is fine. But if taken long term it would suppress thyroid function. If you’re a woman of childbearing age, you should limit your intake of vitamin A to 8,000 units a day, as higher doses can cause birth defects. The vitamin A should be the retinol form and not beta carotene. Taking zinc 50 mg a day at the onset of symptoms is most critical. For overall immune support, I recommend the Energy Revitalization System, which optimizes immune function and contains these vitamins along with 46 other key nutrients in one drink.

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