Symmetry cannot provide medical advice, but in the circumstances I thought that I ought to share what I personally did and found helpful when I caught covid in March. This is not advice or a suggested treatment plan, and you ought to seek medical advice as appropriate.
- Make sure you have a pulse oximeter with spare batteries and that you know how to use it and read it. consider buying one for younger children if you have them (available for a low price on Amazon).
- Consider buying two pulse oximeters (or buying a second one the moment someone gets sick) if you live with other people, because otherwise you risk infecting people through shared use of the device.
- Consider purchasing an oxygen concentrator (GBP300 to 400), especially if you live in a remote region, or one where one cannot depend on having adequate healthcare. (In my opiinion this applied to the UK, certainly in March/April becase they were not treating people unless they had very severe symptoms). Make sure you buy some tubing for it (it usually comes with one or two). I would not suggest taking oxygen without medical advice - it could make things worse if you are not careful; but for people who are independent-minded, they may wish to have choices
- Consider purchasing UV wands and UV sterilizing boxes (make sure they have safety features) - they are available from Amazon at a modest price. If you get sick then it’s better to have some way of sterlising objects than to be dependent on using disinfectant
- Stock up on covid supplements and existing medication before you need either. You don’t want to be waiting a week for an Amazon order if you develop covid symptoms.
- Consider purchasing medication from trusted sources before you need it if you decide to take an independent-minded approach. Unregulated internet pharmacies may have product of uncertain quality, and that’s also a risk to bear in mind.
- Have a mini-plan about what you will do if you get sick or your partner or flatmate does. If you have children, who will look after them.
- Think about how you could isolate if somebody in your household catches covid. It’s very infectious, but I think the attack rate is only 10 - 20% within households: you do stand a chance of avoiding infecting others if you are careful. My wife and daughter didn’t seem to catch it this time.
- 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 at Symmetry 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.
0.I do not intend to cover basics like masks and hand washing here, except to say that it's worth getting N99 or N95 masks instead of cloth masks if you can although even T shirt plus tights material beats no mask. It's not just about your chance of catching it but also about viral load. Every little thing you do matters.
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 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).
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.
8.Midwit Twitter made fun of people in Asia who were gargling in an attempt to reduce covid disease severity. There’s a lot that Midwit Twtter doesn’t know, and I personally believe after reading research that gargling with iodine mouthwash (I bought Betadine on eBay) may help reduce chance of developing covid symptoms (mild prophylaxis) and reduce the chance of it spreading to the lungs. Alternatively using an iodine saltpipe may have similar benefits. Iodine solution
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.
10.Air conditioning hacks. I do not advise the following because it's easy to end up hurting yourself. __ice9 took the following steps to sterilise air conditioning. Don't copy him unless you are as talented as him.
personally, I simply placed a 36W quartz mercury vapor UV-C aquarium sanitizing bulb inside the main intake for my residential HVAC system. It runs continuously.
Sometimes I ran exposed 11W bulbs of the same nature in spaces I believed to have a higher risk of contamination at a given time. Oh I see what you were asking-- yes any open use of UV-C bulbs needs to be in unoccupied spaces to prevent UV burns to the skin or corneas. 254nm is not vacuum UV.
I also do not notice any ozone odor from ozone-free models, even in the immediate vicinity of one just after shutdown. Ozone can be perceived as low as 5 parts per billion. Hence I think 185nm leakage is likely negligible.
Also helps in cleaning up after discarding spoiled fruit etc.
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.
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Vitamin D. Take with fatty food in the morning. It’s unknown as to whether it’s too late to raise vitamin D levels if you wait till you get sick. 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; I take 10,000 IU daily; and my two year old daughter takes 600IU daily.
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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.
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N-Acetyl-Cysteine, glutathione precursor, may reduce cytokine storm and have antiviral activity. 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.
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Undenatured whey
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Sodium/Magnesium Ascorbate crystals, vitamin C - a flat teaspoon in water is c. X grammes. I was taking 2 grammes every few hours. 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.
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Magnesium, anti-inflammatory. Take before bed on empty stomach. I gave myself magnesium IV shots that I had prescribed for me for other reasons. There can be problems absorbing Magnesium through the gut, so I would consider this option in the event it’s open to you. Otherwise you might try taking several different forms of magnesium.
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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.
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*Melatonin. 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.
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Ubiquinol and Acetyl-L-Carnitine
I repeat again that neither I nor Symmetry can 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.
To Do
- add doses
- add more colour, references to research, doses, sources
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Ambroxol or Bromohexine. Bromohexine 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. 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.
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Ivermectin. An anti-worm medication that has remarkable anti-inflammatory effects; it might have an anti-viral effect too, although that is uncertain. I have found this helpful for treating the effects of long-covid, although I think mostly likely it would be effective early on.
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Hydroxychloroquine (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 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.
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Niclosamide. 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.
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Doxycycline. Antibiotic that is an immune modulator.
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Famotidine / Pepsid AC. Anti-viral effects. I did not take but would next time. Be careful of drug interactions.
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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.
(first draft, not yet finished and may not yet be quite correct). 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.
- CT scan lungs
- platelet count
- DDIT, D-Dimers (Fibrinogen Degradation Products)
- DL2,DL2 Biochemistry (24 Parameters) & Haematology Profile
- HCRP, C Reactive Protein (High Sensitivity)
- FIB, Fibrinogen
- IL6, Interleukin 6
- TNF, Tumour Necrosis Factor - Alpha
(might be overkill)
- CT scan lungs
- platelet count
- DDIT, D-Dimers (Fibrinogen Degradation Products)
- DL2,DL2 Biochemistry (24 Parameters) & Haematology Profile
- IGE, IgE (Total)
- TRAC, Trace Metal (Blood) Profile
- VIT2, Vitamin Profile 2
- ISAC,ISAC Panel (allergies)
- RMIN, Mineral screen (whole blood)
- NKP2, Natural Killer Profile 2 (CD3,CD4,CD8,CD16/CD56,CD19)
- RH2, Rheumatology Profile 2 (Connective Tissue)
- 1TH2, TH1/TH2 Cytokine Profile
- 6RF, TH1/TH2 Cytokine Ratio
- 1A, Allergy Profile 1 (Food & Inhalants)
- AUTO, Autoantibody Profile I
- HCRP, C Reactive Protein (High Sensitivity)
- FIB, Fibrinogen
- PTIM, Prothrombin Time
- APTT, APTT/KCCCT
- IL6, Interleukin 6
- TNF, Tumour Necrosis Factor - Alpha
- HOMO, Homocysteine (Quantitative)
- ESR, ESR
- EFAR, Essential Fatty Acid Profile (Red Cell)