This is another article about the same decision.

Secretariat recommends using Ivermectin to prevent and treat coronavirus 2020-06-19

19/06/2020, 07h49, Photo: reproduction-Campos 24 Horas.

The Natal Department of Health (SMS) published this week a new protocol to guide doctors and health professionals in general on the care of patients with Covid-19, an infection caused by the new coronavirus. The protocol ranges from instructions on the reception of suspected cases in health units to drug therapies for confirmed serious cases. (read more below)

The document, approved by the Secretary of Health, George Antunes, and by Mayor Álvaro Dias, recommends the use of drugs such as hydroxychloroquine even for patients with initial symptoms of the disease. In addition, it especially indicates ivermectin as a preventive measure. Studies that prove the effectiveness of any of the drugs to contain Covid-19 are not cited.

The protocol records that Covid-19 has three phases. The first, which can be asymptomatic, is called viral replication and has an average duration of 5 days. Symptoms such as fever, cough, malaise and diarrhea may appear. “In most patients, particularly young people without comorbidities (risk factors), the disease ends at this stage and progresses to a cure,” says the report.

The second phase is called inflammatory and includes the persistence of the initial symptoms with the possible appearance of shortness of breath and alteration of laboratory tests. At this stage of the disease, if there is no drug intervention or reaction from the organism itself, the case may progress to lung involvement and reduced blood oxygenation.

The protocol of the Health Department of Natal states that “the intervention in this phase can have an impact on the clinical course of the disease, reducing the possibility of worsening the clinical condition and, consequently, reducing ICU hospitalizations and the need for invasive ventilatory support”.

In the third phase, the patient progresses to heart failure and may have a worsening of the inflammatory condition, which usually requires hospitalization in intensive care units. The scenario may evolve to death.

According to the SMS recommendations, treatment in patients with symptoms suggestive of Covid-19 should be started early, preferably within 48 hours after the onset of symptoms (stage 1 of the disease), even if the blood oxygen level is low. greater than 95% the chest X-ray shows a normal result. Patients who are in the risk group, such as the elderly, diabetics, hypertensive and obese patients, should have priority in treatment.

THE TREATMENT

For patients in the early stage of Covid-19, the protocol indicates the use of hydroxychloroquine or chloroquine diphosphate associated with azithromycin and zinc chelate, in addition to antibiotics and Tamiflu if bacterial pneumonia and influenza are suspected together.

The Department of Health recommends that doctors, before prescribing hydroxychloroquine or chloroquine, tests be performed on patients to identify possible contraindications. The drug is not recommended for cardiac patients, due to the risk of arrhythmias.

For patients who cannot take chloroquine, the protocol recommends the associated use of ivermectin and azithromycin, in addition to antibiotics and Tamiflu if bacterial pneumonia and flu are suspected together.

The use of corticosteroids, such as prednisone, is not indicated for stage 1 of the disease because it can stimulate viral replication.

In the second phase of the disease, which commonly starts from the 6th day of infection, the Health Department protocol indicates the adoption of the same drugs as the first phase, with the addition of corticosteroids and antithrombotics (such as heparin).

There are also indications for phase 3 of Covid-19, but they are restricted to treatments inside hospitals, in case of hospitalization.

PREVENTION

In an unprecedented way, the protocol also included the recommendation of ivermectin as a preventive measure against Covid-19. According to the document, the drug, which is an antiparasitic, has decreased the replication of the new coronavirus in laboratory tests.

“Considering its pharmacological safety profile (few side effects), extensive experience of clinical use in other diseases, cost and dose comfort, this medication proves to be an option to be used not only for treatment, but also for prophylaxis, added other non-drug interventions, ”says the document.

According to the protocol, in these cases (prevention), ivermectin should be used by those who are highly exposed to the virus, such as health and safety professionals, and those who are at risk for the disease.

For the first group (health professionals), the secretary’s recommendation is to take one 6 mg ivermectin tablet for every 30 kg of body weight, for two days, and every 15 days. As an example, those who weigh 90 kg should take three pills in one day and three pills in the next – and repeat the dose two weeks later.

The second group of people (who have risk factors) should take a 6 mg pill for every 30 kg of body weight for just one day, and every 15 days.

The protocol says that it is recommended, after taking two doses of the drug, to assess liver function (liver). If there are no relevant changes, use can be continued. Nor can you take more than eight pills a day.

The use by young and healthy patients is not recommended, as well as by children under 5 years old, pregnant and lactating women.

Although the protocol includes all forms of use, including dosages, the document says that the use must be guided by a doctor.

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Natal adopts antiparasitic medication ‘as a prevention to Covid-19’ for healthcare professionals

New SMS protocol also adheres to the use of chloroquine, Hydroxychloroquine and Azithromycin in patients with symptoms of the disease. The Municipal Health Department of Natal will provide the medicine Ivermectin, an antiparasitic, for healthcare professionals, as a “prevention” measure to Covid-19. The action is part of a new protocol, who will also adopt, for the treatment of disease symptoms, the administration of the drugs Hydroxychloroquine, Chloroquine and Azithromycin. The new measures start to be applied from next week.

Secretary George Antunes, folder holder, account that SMS will distribute free Ivermectin to health professionals in the Municipality, that they can adopt, whether or not I use it.

According to Antunes, the medication will serve to prevent new coronavirus contagion, for these professionals who are at the forefront of fighting the disease. "Regardless of symptoms, because it will have a much more prophylactic action, a much more preventive action, regardless of presenting symptoms ”, claims the secretary.

Asked if the drug works as a vaccine, as it will be used to prevent infection, he said no. “It wouldn't be a vaccine, because he will take this medication more than once. These are drugs that you will have to take regularly. It is being recommended for body weight ”, Explain.

The action will start with the servers of the Mobile Emergency Service (Samu) and Emergency Care Units (UPA). Then it will also be available to those who work in the basic units.

Treatment of patients According to George Antunes, the new protocol related to patients will start in the basic units. “We are implementing in the basic units of extended hours, initially, because there in these units we have a service prioritization room, where we extend like an arm of the UPA, with primary care, doing prevention work ”, advance.

Still according to Antunes, within the new procedures, the work begins with community workers, to identify possible infected patients. Agents will visit homes that they know have sick people who may have Covid-19.

This screening will take place through family health strategies. Then, these patients, still suspicious, will be directed to basic health units in the region where they live.

“In these units, we will do the outpatient exams, like electrocardiogram, and medical consultation. With all this done in advance, on the same day, the doctor decides if this patient needs to be medicated. In case he needs, we implemented this protocol, which is done by the Scientific Committee (Municipal), approved by the Federal Council of Medicine and the Regional Council of Medicine ”, details.

In the basic units a quick test will also be done to identify the virus in the body. Secretary George Antunes says that the city of the capital of Rio Grande do Sul acquired 20 thousand tests, to be applied.

According to George Antunes, these patients will be given hydroxychloroquine, or chloroquine plus azithromycin. "Depending on the clinical case, we can make the association (of medicines) or not", adds.

The secretary says that this association of medicines depends on the signs and symptoms presented by the person possibly infected. "For example: fever plus dry cough more lack of smell. So we start the protocol. It's just fever with body pain? It's just diarrhea? So there is a score that we do to apply the medication, or not. This score is determined at the doctor's table ”, exemplifies the holder of the Health Department of Natal.

George Antunes reinforces that the choice to administer medications is up to the doctor, but that the patient can also refuse to adhere to treatment. “We have a consent form ready, that the patient has to be guided and accept, or not the treatment ”.

source: https://g1.globo.com/rn/rio-grande-do-norte/noticia/2020/06/05/natal-adota-medicamento-antiparasitario-como-prevencao-a-covid-19-para-profissionais-de-saude.ghtml12

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