Gustavo Aguirre Chang (Peru) group's recommendations for higher dose ivermectin for the newer variants - calls for typically double the dose of the FLCCC I-MASK+ protocol for pre and post-exposure prophylaxis

stereomatch | 18 points | Apr 16 2021 05:53:41

NOTE: Gustavo Aguirre Chang's group from Peru has been at the forefront with their innovative studies - with their high dose studies of ivermectin + aspirin for taste/smell reversal and for reversing body pain/myalgia etc. during covid19

NOTE: my commentary is in the NOTE paragraphs

https://www.researchgate.net/publication/350711187_COVID_BY_VARIANTS_POST-EXPOSURE_PROPHYLAXIS_FOR_CONTACTS_WITH_IVERMECTIN

COVID BY VARIANTS: POST-EXPOSURE PROPHYLAXIS FOR CONTACTS WITH IVERMECTIN.

March 2021

Authors:

Gustavo Aguirre Chang - National University of San Marcos

Aurora Natividad Trujillo Figueredo - SIGESA

COVID BY VARIANTS: POST-EXPOSURE PROPHYLAXIS FOR CONTACTS WITH IVERMECTIN.

The new standard dose of Ivermectin is 0.4 mg. per kilo of weight per day for COVID by Variant.

COVID by Variants of SARS CoV-2

Since December 2020 and the first months of the year 2021, a significant increase in the number of new cases of COVID has begun to be presented in several countries of the world, this situation being due in large part to the presence of the new Variants of the SARS virus CoV-2.

One of the characteristics initially identified in the Variants is a significantly higher contagiousness.

For our part, in medical practice we have observed greater resistance to treatment by the Variants, requiring higher doses and a greater number of drugs to be able to treat it.

(NOTE: actually this is my feeling as well from observation of some recent cases - typically patients respond to Famotidine 40mg per day for 5 days with immediate reduction in symptoms within 24 hours - however for a recent husband/wife case, it took them 1.5 days to have similar effect)

Dose of Post-Exposure Prophylaxis (PEP) with Ivermectin in Contacts

When a person becomes ill with COVID due to one of the SARS CoV-2 Variants, in general, it is indicated that Contacts should take 1 dose a day of 0.4 mg Ivermectin per kilo of weight for 3 days continued.

(NOTE: this is double the daily dose typically used by FLCCC's I-MASK+ protocol for pre and post-exposure prophylaxis)

In male contacts over 70 years of age, the indication is to take 1 dose of 0.4 mg. per day for 5 days continued.

In these cases, more days are indicated due to the greater risk that this age group presents of developing a disease of greater severity and a higher mortality rate.

And in the person (s) who assumes the role of “Caregiver” it is indicated to take 0.4 mg. per kilo of weight per day for 6 days continued, this because due to more frequent contact, the risk of infection is considerably increased.

(NOTE: this doctor makes a lot of sense - and Gustavo Aguirre Chang's group has been the most innovative and prolific - with their high dose studies of ivermectin + aspirin for taste/smell reversal and for reversing body pain/myalgia etc. during covid19)

Table 1 details the doses for Post-Exposure Prophylaxis (PEP) for COVID by Variants.

In practice, the greater contagiousness of the SARS CoV-2 variants has been evidenced. When a person gets sick, the other people with whom they live in their place of residence are quickly infected, and in those already ill, the required doses of Ivermectin are 2 to 4 times higher compared to the typical COVID-19 that was presented during the year 2020.

That is why it has been seen convenient to increase the standard daily dose of Ivermectin from 0.2 mg. to 0.4 mg. per kilo of weight per day.

Identification of the Contacts of a person with COVID

Post-Exposure Prophylaxis (PEP) is indicated in all Contacts, which must be identified especially in the place of residence of the person sick with COVID.

All people who live in the same place of residence of the person who fell ill are considered Contacts, this includes young children, in whom the dose of 0.4 mg. per kilo of weight per day can be divided into 2 doses a day of 0.2 mg. per kilo of weight each, this for a greater tolerance to the drug.

Although the side effects of Ivermectin are mild, temporary and reversible. To maintain the Contact Condition, they must be asymptomatic. If they present symptoms that suggest COVID-19, they are no longer Contacts and become a Suspected COVID Case, in which case they must start treatment with Ivermectin in a similar way to the COVID-19 Case already identified.

Follow-up and Control of Contacts

All Contacts (without symptoms) must be evaluated daily, this in order to identify in a timely manner if they begin to present symptoms associated with COVID.

In the event that the Contact develops the disease, the Therapeutic Plan Scheme for the COVID disease must be established, and the corresponding treatment must be indicated according to the severity of the case.

Special attention must be paid to elderly people who are prostrate or with reduced mobility, in whom health checks must be more exhaustive and frequent.

They require a more thorough and detailed observation, since due to age they usually do not generate fever, or this is not high and can go unnoticed, and due to reduced mobility, dyspnea is not evident and can be detected only when there is an advanced commitment of the lungs.

In them it is recommended to monitor temperature (infrared thermometers are not recommended), heart rate and oxygen saturation (with pulse oximeter), appetite, presence of semi-liquid stools, night sweats and any symptoms that indicate acuteness of the illness.

On the other hand, it should be taken into account that during the incubation time people do not make symptoms, so it is possible that a "Contact" has already been infected, but is still in the incubation period.

Table 1 details the doses for Post-Exposure Prophylaxis (PEP) for Contacts in COVID by Variants.

Inclusion of ASA in the Prophylaxis Scheme

In addition to Ivermectin, in male Contacts who are over 45 years old and in those who belong to the group of "People at Increased Risk", it is indicated to include the use of Acetyl Salicylic Acid (ASA) at a dose of 1 tablet of 100 mg. a day, after lunch, for 6 to 10 days.

The use of AAS should be avoided in the following cases:

1) Diagnosis of duodenal or gastric ulcer, or history of Digestive Hemorrhage;

2) Clotting disorder or use of anticoagulants already established;

3) Hypermenorrhea or other gynecological pathology associated with increased uterine bleeding;

4) History of stroke caused by cerebral hemorrhage;

5) Arterial hypertension not controlled or difficult to control (presenting episodes of high pressure, which can lead to a hemorrhagic stroke);

6) Gum bleeding or presence of any hemorrhagic disease;

7) Asthma that worsens or is generated by the use of Aspirin or NSAIDs;

8) Allergy to Aspirin or NSAIDs;

9) Aspirin Resistance;

10) In children under 15 years of age, an evaluation of the risk and benefits of its use should be carried out. If you develop Moderate or Severe COVID-19 disease, your indication is supported. It should be taken into account that Kawasaki disease associated with SARS CoV-2 infection has been present in young children, and the protocol established for this disease, for more than 2 decades, includes high daily doses of Aspirin, the which range from 30 to 80 mg. x kilo of body weight.

In the case of diagnoses 1 to 6 mentioned, it is better not to use ASA, or anticoagulants or antiplatelets, due to the risk of bleeding that their use entails, and in diagnoses 7 to 9 the use of a drug should be evaluated alternative to AAS.

The risk of bleeding from the use of ASA is mainly at the gastro-duodenal level, and is manifested by very dark and shiny black stools, since the blood as it passes through the long intestinal tract turns black.

(NOTE: this is a known indicator of blood in the stool - the stool comes out dark/black)

Gastric Protection Measures to be taken together with the ASA

In cases in which the person who is going to take ASA has or has a history of symptoms associated with an increase in gastric acid (gastritis, heartburn) or gastroesophageal reflux (burning sensation in the middle between the chest and abdomen, of regurgitation of acidic fluid), the indication to take ASA, 100 mg. a day, it will necessarily be accompanied by one of the following gastric protection measures to be taken for the 6 or more days you take the ASA:

SODIUM BICARBONATE: 1 sachet of Andrews Salt or a similar commercial product that contains Sodium Bicarbonate, or 1/2 teaspoon (3 gr.) Of powdered Sodium Bicarbonate, in 1 glass with water; take it at 11 am and 10 pm for 5 days, then only at 10 pm for the other days you take the AAS and up to 10 days.
FAMOTIDINE: 120 mg. at 10 pm. or 60 mg. every 12 hours, or RANITIDINE: 300mg at 10 pm., in both cases during the days you take the ASA.

Sodium Bicarbonate and Famotidine or Ranitidine can also be used at the same time. In people who, in the days after starting to take ASA, present symptoms or signs of stomach acid, they must necessarily take one of the gastric protection alternatives mentioned above.

(NOTE: from my observation, Famotidine 40mg for 5 to 10 days - reliably reduces symptoms for patients within 24 hours so they become very comfortable - although with newer variants it may be 1.5 days to show the same effect - at least from a recent husband/wife case I have observed from latest wave (which matches what he has said above) - Famotidine also helps a sub-set of long haulers as evidenced by anecdotal reports on r/covidlonghaulers - meanwhile a subset of long haulers are also helped by ivermecting by similar anecdotal reporting on r/ivermectin and r/covidlonghaulers comments)