I like the Zagazig Univ Egypt study on post-exposure prophylaxis within households - because of it's simplicity and direct applicability to household.

There they had an 8x fold reduction in symptomatic cases.

Would have been great if they did a follow-up on whether there were any long haulers.

The incidence of long hauler is nearly 25-30 percent for those who did not get early treatment.

This is a large enough number that it will be apparent even with a small group study.

In my experience of 30-40 infected off of 15+ PCR positive index cases in households who were given early treatment, there were zero long haulers. Zero hospitalizations, zero oxygen need (except for first one who took oxygen one time at home when oximeter dipped to 93).

Dr Been said recently he had treated 600 patients and there were zero persisting long haulers (he had a few long haulers also who came to him, who after one or two cycles of 6 day short course of steroids were also recovered).

Dr Steven Phillips author of recent bestseller "Chronic" says out of covid19 patients he treated there should be 25-30 percent long haulers, but he had none.

So even if we don't discuss mortality, hospitalizations, need for oxygen - just impact of early treatment on long haulers may be significant.

By early treatment I don't mean just ivermectin but the whole cocktail of ivermectin, Famotidine, zinc, vitamin d, vitamin c, vitamin b1/b-complex, NAC (others have given colchicine or Fluvoxamine - but those are harder drugs for which should not encourage the public to be pill popping) and aspirin (or an anticoagulant under doctor's supervision).

And then on oximeter declines/post-day-8 timely steroids course (1 week, taper off next week). This gives the body enough time to eliminate the viral debris without huge hyperinflammatory syndrome setting in. The patient essentially skips the most dangerous part of covid19 that kills people, causes micro clots and damages organs. So steroids are essential as well.

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That depends on what study you want to use as your baseline. I believe the most impressive prophy studies were the IVERCAR study out of Peru and the Zagazig Egypt study. These showed well over 90% efficacy. The FLCCC's meta analysis showed PrEP efficacy of 69% reduction. https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf

Personally, I think it's key to take it at least weekly to optimize protection for PrEP. The studies on tissue concentrations and clearance showed up to 6 days. I think every other week or monthly leaves the person vulnerable for periods in between dosing. I might argue a 150mcg/kg dose every 4-5 days would be optimal. Although, a 200mcg/kg weekly dose is probably highly protective and much easier to follow. Even if an infection did occur the benefits of having IVM administered even before symptoms present would be highly protective, IMHO.

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