Coronavirus 2019, Covid19, the Wuhan or Chinese corona virus, SARS CoV2-19.
H. Robert Silverstein, MD, FACC
First principles. Simplicity.
This corona virus CoV2-19 is an RNA virus (as opposed to a DNA virus) with 30 proteins that is brand new. A human cell has 20,000 different proteins. Being an RNA virus, it is similar to hepatitis C; it is not a DNA virus like hepatitis B. There are 200 viruses that can cause the common cold and several of these are corona viruses. The specific Co V2-19 genetic RNA fact will affect anti-viral treatment design and decisions CoV2-19 was detected by it having a new genetic sequence as recognized by GenBank—it may have been around for a thousand years, but it is just now discovered. The Chinese symbol for it is pronounced “wayG” and means both “crisis” and “opportunity”: two sides of the same coin. The first known novel and important coronavirus was called SARS = Severe Acute Respiratory syndrome. There are only 2 known previous serious corona virus versions: SARS and Middle East respiratory syndrome = MERS.
This Covid19/CoV2-19 corona virus is named for its site of origin as was the Ebola (a river in Zaire), German measles, Rocky Mount spotted fever, Norovirus (Norwalk Connecticut), and Spanish flu, etc. It was first documented mid-November in China. China notified the World Health Organization of this infection 12/31/19 saying “the disease is preventable and controllable” incorrectly at that time. 7 million people had been in and then left Wuhan to go else(every)where as of 1/20/20. The first overseas case was 1/15/20. The first USA case was 1/21/20. Wuhan lockdown occurred 1/31/20. USA shutdown for non-Americans was 1/31/20.
Symptoms initially are fever (50%) and later 90%, dry cough, mild shortness of breath, malaise, headache, but usually not a runny nose, diarrhea, or vomiting. X-Ray/thin slice CT scan findings show “ground glass” bilaterally in both lungs, no pneumothorax, lymphadenopathy, or effusions 80% of non-severe cases have normal chest X-rays or CT scan. Incubation is 2 to 11 days, for an average of five days; that is, symptoms develop on average 5 days after exposure. Onset to recovery is 12-32 days. Patients at high risk are over age 65, have high blood pressure, a d-dimer blood test greater than 1, and have an adverse SOFA sepsis score. X-RAY/thin slice CT scan findings show “ground glass bilaterally in both lungs, no lymphadenopathy, effusions or pneumothorax. 80% of non-severe CoV2-19 cases have normal chest X-rays or CT scans. One is safe 3 days after having no fever + resolved respiratory symptoms + improved chest CT scan + 2 negative PCR tests for the virus separated by 1 day. Viral shedding can occur for up to 37 days after onset of symptoms. Viral RNA can persist in the blood for up to 29 days and does not correlate with symptoms.
Although the Chinese are currently stating that the virus originated in the United States, almost certainly it originated in either what is called a live market where wild animals are sold for food in the Wuhan, China, or the virus escaped the research Wuhan National Biosafety Laboratory close to Wuhan, China: the latter is less likely. Currently 80% of the USA’s pharmaceuticals are manufactured abroad, mainly in China and India. Industrial rare earth metals are predominantly imported from China.
Here is a link to what life is like in Wuhan as of today:
There is no prior experience with this current CoV2-19 virus and it spreads relatively easily. The spread has slowed significantly in China. 95+% of the Chinese population did not contract the virus. In China, infectivity has decreased from 2 to 3 other people per infected case to 1.5 per case now. Infection rate doubles every five days. China stated in January, 2020, that the virus could not be transmitted from person to person: that is wrong. A cough can send infected droplets 15 feet. A sneeze can send infected droplets 25 feet. The virus can live in the air for three hours, on wet surfaces for three days, 24 hours on cardboard, and 3 days on plastic: after 45 minutes the viral count is reduced by half on copper. The half-life of the virus in infected droplets is 5 hours on stainless steel. The virus count decreases by half every 7 hours on plastic so that by day 2 there is only 1/100th of the original viral count on plastic. In China, with their strong quarantine and isolation procedures, new cases have slowed to a trickle. South Korea has been the best and most effective country in dealing with this infection also by using strong quarantine and GPS tracking of contacts: “acceptance of surveillance.” South Korea has drive-through testing which is ramping up in the USA. Unfortunately, South Korea, Hong Kong and Taiwan are seeing a second wave of CoV2-19 infections as infected returnees come back to these areas from elsewhere.
A rather remarkable interview with virologist David Ho, MD
Here is a very MODERATE, EVENHANDED, optimistic yet sober perspective on this corona CoV2-19 virus:
As reported by Anthony Fauci, MD, Chief of the National Institutes of Health (NIH) Infectious Disease section, the current influenza virus is 0.1% lethal and this CoV2-19 virus is 1% lethal, ONLY 5% will need the ICU. In 80% it will be a mild cold or flu.
As of 3/23/20, there are 330 million Americans, 42,000 known cases of CoV2-19, and 500 have died from this disease. Worldwide there are 367,000 reported cases, 101,000 have recovered, and there are 16,000 deaths: 5% are serious cases. 3/23/20 the USA death rate is 1.3 % vs 1.25% in South Korea and 4% in China. Early on, most of those cases in the USA were elderly nursing home residents in Washington state. Now New York state leads. In the USA there are 500,000 flu hospitalizations per YEAR, and 35,000 flu deaths per YEAR. Both the flu and Cov2-19 cause pneumonia, “the old man’s friend”, and that is the usual cause of death for CoV2-19. 7500 Americans die of all causes every DAY normally. 562 have died so far in France as of 3/21/20 with its much smaller population of 67 million, compared to the USA = 330.000,000. VERY IMPORTANTLY, Italy, which has the highest case load outside of China on 3/22/20 has had its first decline in ICU admission: this will likely buoy mood and markets 3/23-24/20. The virus is now in 144 countries.
Preventive Medicine Center general suggestions and thoughts are at the bottom of this note.
An excellent website to follow the virus world-wide is by 17-year-old self-taught prodigy Avi Schiffman: http://ncov2019.live/data . Johns Hopkins University website is also excellent. https://coronavirus.jhu.edu/map.html For optimism, check out the twitter of a garbage man whose handle I lost: it had 3 letters in caps at the end. A fine source of information & perspective on CoV2-19 is Harvard’s infectious disease specialist Dr. Lindsey R. Baden of Brigham and Women’s Hospital.
In 1348, the BLACK PLAGUE killed 1/3 to 1/2 of the WORLD’s population. That was due to the bacteria Pasteurella or Yersina pestis carried by the rat flea. The SWINE FLU H1N1 virus of 2009-2010 originated in Mexico when there was an open Southern USA border during the Obama administration era. Should the border have been closed immediately? That is uncertain since the 2 nations were already so connected. The Swine Flu virus was in the United States 7 months before a national emergency was called and several months later it was named a pandemic by the World Health Organization/WHO. The current national emergency was so named 2 months after the virus was first here 1/21/20 and several days after the WHO called it a pandemic. 61 million Americans contracted the 2009-2010 Swine Flu and 12,000 died-compared to the response now. 34 million Americans have been affected by the 2019-2020 INFLUENZA virus. 400,000 have been hospitalized and 35,000 have died.” As perspective, in 2015, Ian Goldin, an Oxford University professor, in his book “The Butterfly Defect”, warned of the risks of a “global pandemic in a modern, interdependent world”: no one in the USA, including the 2015 Obama government, listened or prepared for the future affecting our ability to respond appropriately now. That is an historical fact, not a political polemic.
Travel bans have been set up by Saudi Arabia, Russia, Poland, Kenya, Morocco, Argentina, Brazil, Canada, Denmark, the Netherlands, Germany, the European Union, and others as well as the quite appropriately and early on, the USA beginning on 1/31/20. That early quarantine was supported by the NIH’s infectious disease chief Dr. A. Fauci. The virus is in 188 countries.
The Israeli company MIGAL says it has a vaccine that will be finalized in three weeks and ready for distribution in 90 days. J Craig Venter, the team leader who first sequenced the human genome and an originator of chromosome insertion has his own California institute that in all probability more quickly than anyone else in the USA will develop an efficient CoV2-19 testing and the relevant & an effective CoV2-19 vaccine. Distributed Bio/Dr Jacob Glanville is developing an antibody that neutralizes the virus in 20 minutes: see also below.
At the present time almost all of us feel off balance because of the inability to find out if we are (+) or (-) for the CoV2-19. There has been a general loss of joy across the United States. The stock market is responding to FUD: fear, uncertainty, doubt—all of which translates to me as
anxious uncertainty. The PRESS with its model of “if it bleeds, it leads” has been acting as if its moniker is “Project Fear” which is translated as a “loss of reason and a wave of fear.” The press and media as a whole have functioned as the voice of doom avoiding the evenhandedness demonstrated by the federal government. And although I believe allowing oneself to panic is largely a personal responsibility, in my mind, the press and media are responsible for predisposing the susceptible to panic on a nationwide basis. People will eventually adjust out of reason and/or necessity. It is important to be careful, but not to be paranoid.
Early on it was apparent that the hold up for reliable and adequate testing was caused by mistakes at the CDC (Centers for Disease Control) and specifically virologist and chief there Robert Redfield, MD—he and especially his predecessors in the preceding administration had not learned from the past and should have started preparing for this viral pandemic after the much more dangerous Ebola, SARS, and MERS crises as that preparedness was needed then and now! The President did not discontinue the Pandemic Office, he merged it with other governmental groups. Said bluntly, the previous Bush and Obama CDC people were responsible for the current lack of preparedness and for not having the necessary vision to understand the implications of what was happening then and then preparing the appropriate response that could have been used now.
Old and outdated CDC legislation has been swiftly and correctly discarded by the current administration. Those rules held back allowing cities, states, and the private market to independently create their own testing. Moreover, the tests that were available from the CDC had a technical flaw and proved unreliable. The USA did not refuse WHO test kits; those were to be made available to lower income countries without testing capability. Now that the President has joined hands with industry; the Roche pharmaceutical company in particular has developed a simplified and automated technology that will increase testing from 30 to 1,000 tests per day and Roche will be quickly able to upscale its production and distribution of this simpler and accurate CoV2-19 virus testing. Independent test development by D S Chugh, MD, of Washington state allowed the recognition of the first case of coronavirus19/CoV2-19 on 1/21/20 which, remarkably, was in a teenager–as it is now felt that they are relatively immune to the serious consequences of CoV2-19. Initially she was held back by the CDC and eventually decided on her own to correctly develop accurate testing by NOT adhering to CDC guidelines. The proper sample culture areas are nasopharyngeal, oropharyngeal, and sputum, but not urine, blood, or stool. Companies that are making test kits: Cepheid is probably the quickest test at 45 minutes for an answer. GeneMatrix, Chembiao Diagnostics, Hologic, GenMark, Integrated DNA, Pharma Mar, Thermo Fisher. 3M is scaling up N95 face masks.
From elsewhere: “A State Department official ignored a presidential order to hold returnees from China overseas in quarantine. Worse, due to a 1938 regulation, inattention and foot dragging in the CDC, the bureaucrats there and in prior administrations, the CDC was not prepared and actually, hindered a faster response. …officials at the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) stymied private and academic development of diagnostic tests that might have provided an early warning and a head start on controlling the epidemic that is now spreading across the country. …the CDC required that public health officials could only use the diagnostic test designed by the agency. That test released on February 5 turned out to be badly flawed. The CDC’s insistence on a top-down centralized testing regime greatly slowed down the process of disease detection as the infection rate was accelerating. … On February 29, the FDA finally agreed to unleash America’s vibrant biotech companies and academic labs by allowing them to develop and deploy new tests for the coronavirus that causes COVID-19.”
Quoting the New York Post:
“Overregulation of diagnostic testing has played a major role in this delay… Test protocols using the polymerase chain reaction (PCR) were publicly available shortly after Chinese researchers published (or described) the sequence of the virus in mid-January. The World Health Organization (WHO) used a freely available German procedure to create a test kit, shipping 250,000 tests to 159 laboratories worldwide. … CDC testing criteria have precluded recognizing community spread because of requirements stipulating recent travel to China or exposure to an infected person. Adherence to these guidelines delayed testing in the first probable case of community transmission… The FDA has not allowed the experienced and highly skilled professionals at public-health, academic and commercial laboratories to set up their own laboratory developed tests (LDTs), and no manufactured test kits have been authorized for sale in the US. In Europe, several companies, at least one US-based, have regulatory approval to sell test kits there.”
In the American population there are 950,000 hospital beds, 45,000 ICU beds and 150,000 available in ventilators. Entrance is gained to the human body via a protrusion on the virus’s outside cover that attaches to an enzyme called ACE2 in the human body. Interestingly that is an enzyme that is blocked in the treatment of high blood pressure; it has been reported that patients who are on a related blocker called an “ARB” such as losartan are resistant to the CoV2-19 virus infection.
“Pipeline: Investigations therapies fo COVID-19/CoV2-19
Diana Ernst, RPh MPR March 11, 2020
Currently, there are no antivirals licensed by the FDA to treat patients with COVID-19. While no specific treatment for corona 2019 (COVID-19/CoV2-19) is currently available, several therapies are being investigated globally.
A five day treatment with chloroquine or hydroxychloroquine combined with azithromycin seems quite effective for CoV2-19 treatment. “An open-label study investigated hydroxychloroquine in hospitalized patients with confirmed COVID-19 at The Méditerranée Infection University Hospital Institute in Marseille, France. Patients received oral hydroxychloroquine 200 mg 3 times daily for 10 days (n=20) vs control group (n=16). Patients were age 12 years and older, and had PCR documented SARS-CoV-2 in nasopharyngeal samples at admission. Treatment with the antibiotic azithromycin was also provided. The end point was virological clearance at day 6.
Results showed that by day 6 post-inclusion, 70% of hydroxychloroquine-only treated patients were virologically cured vs 12.5% in the control group (p =.001). At day 6, 100% of patients treated with hydroxychloroquine + azithromycin were virologically cured compared with 57.1% of patients treated with hydroxychloroquine only, and 12.5% of the control group (p <.001). A significant difference between the hydroxychloroquine and control groups was reported as early as day 3.” (Similar results were found at the University of Minnesota.)
Colchicine may reduce the lung inflammation
AIM ImmunoTech: developing Ampligen, a broad-spectrum antiviral that will be tested as a potential treatment for COVID-19 in Japan. A significant survival effect was observed in a trial evaluating mice infected with the earlier Severe Acute Respiratory Syndrome (SARS) coronavirus.
Gilead: developing remdesivir, a broad-spectrum intravenous antiviral agent that is being investigated in a double-blinded, placebo-controlled study sponsored by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health (NIH). In addition, Gilead is initiating two phase 3 trials to evaluate the safety and efficacy of remdesivir in adults diagnosed with COVID-19, following a rapid review and acceptance by the Food and Drug Administration (FDA) of the investigational new drug filing for the novel antiviral.
Immunotherapies and Other Investigational Therapies
Distributed Bio/Dr Jacob Glanville: using computational-guided immune-engineering to create an antibody that neutralizes the virus in 20 minutes
Algernon Pharmaceuticals: developing ifenprodil, an N-methyl-d-aspartate (NDMA) receptor glutamate receptor antagonist, which is being prepared for US clinical trials for COVID-19 based on results of an animal study that showed the investigational therapy significantly reduced acute lung injury and improved survivability in H5N1 infected mice.
CEL-SCI: developing an immunotherapy using LEAPS, a patented T cell modulation peptide epitope delivery technology, to stimulate protective cell-mediated T cell responses and reduce viral load.
Innovation Pharmaceuticals: developing brilacidin, a defensin-mimetic, that mimics the human innate immune system and causes disruption of the membrane of pathogens, leading to cell death. It has already been tested in humans in phase 2 trials for other indications.
Mesoblast Limited: investigating remestemcel-L, an allogeneic mesenchymal stem cell (MSC) product candidate, as a treatment for patients with acute respiratory distress syndrome caused by COVID-19. Remestemcel-L, which is comprised of culture-expanded MSCs derived from the bone marrow of an unrelated donor, is administered in a series of intravenous infusions and is believed to have immunomodulatory properties to counteract inflammatory processes.
Q BioMed: partnering with Mannin Research to develop a potential treatment that addresses vascular leakage and endothelial dysfunction, which may potentially help patients with severe cases of COVID-19.
Takeda: developing an anti-SARS-CoV-2 polyclonal hyperimmune globulin (H-IG) to treat high-risk individuals with COVID-19 (TAK-888). Pathogen-specific antibodies from plasma will be collected from recovered patients (or vaccinated donors in the future) and will be transferred to sick patients to improve the immune response to the infection and increase the chance of recovery.
Tiziana: developing TZLS-501, which has been shown to rapidly deplete circulating levels of interleukin-6 (IL-6) in the blood, a key driver of chronic inflammation. Excessive production of IL-6 is believed to be associated with severe lung damage observed with COVID-19 infections.
Altimmune Inc: developing a single-dose, intranasal vaccine against COVID-19 using its proprietary NasoVAX technology. The vaccine is moving toward animal testing.
Applied DNA Sciences: collaborating with Takis Biotech to develop a DNA vaccine candidate using PCR-based DNA (“LinearDNA”) manufacturing systems; preclinical testing in animals are expected to begin in the second quarter of 2020.
Codagenix Inc: co-developing a live-attenuated vaccine with the Serum Institute of India using viral deoptimization.
GlaxoSmithKline: collaborating with Clover Biopharmaceuticals to develop a protein-based coronavirus vaccine candidate (COVID-19 S-Trimer) using Clover’s proprietary technology (Timer-Tag©) and combining it with GSK’s pandemic adjuvant system.
Inovio Pharmaceuticals: developing a DNA vaccine (INO-4800) to address COVID-19; human trials to begin in the US in April.
Johnson & Johnson: partnering with the Biomedical Advanced Research and Development Authority (BARDA) to develop a vaccine using Janssen’s AdVac® and PER.C6® technology, which provide the ability to rapidly upscale production of an optimal vaccine candidate.
Moderna Inc: vials of the Company’s mRNA vaccine (mRNA-1273) have been shipped to the National Institute of Allergy and Infectious Diseases to be used in a phase 1 study in the US.
Novavax: currently evaluating multiple recombinant nanoparticle vaccine candidates in animal models; initiation of phase 1 testing is expected in late spring of 2020. The COVID-19 vaccine candidates will likely include the saponin-based Matrix-M™ adjuvant to enhance immune responses.
Sanofi: collaborating with BARDA to develop a vaccine using Sanofi’s recombinant DNA platform. The DNA sequence encoding the antigen will be combined into the DNA of the baculovirus expression platform and used to produce large quantities of the coronavirus antigen which will be formulated to stimulate the immune system to protect against the virus.
*This list is not all inclusive.”
Israel moving quickly to get out a COVID19 VACCINE
by Howard Richman 3/15/20
“Israeli scientists at the MIGAL Galilee Research Institute had worked for four years and had successfully developed a Coronavirus vaccine for chickens which passed clinical trials. When they saw the genetic sequencing of the COVID-19 virus, they realized that they could quickly adapt their chicken vaccine to the human virus. Ella Dagan, a spokesman for MIGAL told Europorter:
When the genetic sequence of the new coronavirus COVID-19 was published, the researchers realized that the two viruses have the same infection mechanism similarities so they can use it, with small amount of adaptation, to achieve an effective human vaccine in a very short period of time.
Dr. Shahar, one of the scientists told nocamels.com:
It’s a little bit like fate that we were working on this coronavirus vaccine at the same time that the world was suddenly hit by this epidemic of coronavirus for humans.
MIGAL created its vaccine by synthesizing two proteins. Unlike vaccines that are created by injecting a dead or weakened disease-causing virus, there is little danger that synthetic virus protein segments) will give patients a disease.
Its vaccine creates antibodies in the mucosal immune system of the body which consists of thin permeable barriers to infection in the lungs, gut, eyes, nose, throat, uterus, and vagina. Dr. Chen Katz, MIGAL’s biotechnology group leader, gave Europorter a detailed cellular-level description of how MIGAL’s vaccine works:
The scientific framework for the vaccine is based on a new protein expression vector, which forms and secretes a chimeric soluble protein that delivers the viral antigen into mucosal tissues by self-activated endocytosis (a cellular process in which substances are brought into a cell by surrounding the material with cell membrane, forming a vesicle containing the ingested material), causing the body to form antibodies against the virus.
Israel’s Minister of Science and Technology, Ofir Akunis, is expediting the human vaccine through Israel’s approval process. According to Europorter:
The minister has instructed the Director General of the Ministry of Science and Technology to fast-track all approval processes with the goal of bringing the human vaccine to market as quickly as possible.
Dr. Katz of MIGAL told Times of Israel that Israel’s approval process only involves about two months of actual testing:
The clinical testing experiments themselves are not so long, and we can complete them in 30 days, plus another 30 days for human trials. Most of the time is bureaucracy — regulation and paperwork.
CEO David Zigdon of MIGAL told Europorter that MIGDAL’s goal is to get their vaccine approved in just three months:
Given the urgent global need for a human Coronavirus vaccine, we are doing everything we can to accelerate development. Our goal is to produce the vaccine during the next 8-10 weeks, and to achieve safety approval in 90 days.
There are at least two American COVID-19 vaccines in the works:
1. Moderna Therapeutics has developed a synthetic virus vaccine made from mRNA and has gotten it approved by NIAID (National Institute of Allergy and Infectious Diseases) for testing with human subjects. Those tests won’t begin until April.
2. Regeneron Pharmaceuticals will soon have a treatment that will serve as a vaccine for those who don’t have coronavirus and a treatment for those who do. They will inject corona virus antibodies directly into the bloodstream instead of relying upon a vaccine to create those antibodies. They used a similar treatment to prevent and cure Ebola.
The Israeli government could approve the Israeli vaccine in as little as three months. President Trump may have to intervene in order to get NIAID moving just as fast with an American vaccine.”
Here are some of the Preventive Medicine Center positions: these are based on fact, judgment, reasoning, and experience.
Avoid MILK-DAIRY products 100 (100!!!) %. My belief is that ANY MILK-DAIRY thickens the mucus reducing clearance of the invading virus, allowing it to “settle in and invade.” A single drop begins this allergic type adverse pathway. It is 100% milk-dairy avoidance or as you choose. SWEETS, including dried fruits, and juices except for Pom Wonderful pomegranate juice, function as sweets = sugar = reduce/immobilize immune functioning at multiple levels. Basically, consume an organic unprocessed whole foods diet, ideally “macrobiotic” grains-vegetables-beans-fruit-nuts-seeds = GVBfns. See the www.thepmc.org website for general wellness information + this paper + how to prevent and or reverse possible high blood pressure, diabetes, open heart surgery, angioplasty, high triglycerides, overweight at the 95+% level.
Read Bill Spear’s Primer on Macrobiotics: www.williamspear.com. For cooking, rely on “The Changing Seasons Cookbook” making 1 recipe EXACTLY according to directions-avoid as many processed foods , and wheat products as possible therein. Miso, tamari, rice noodles are acceptable/even desired. Take the recipe with you to the natural food store to be sure to get the exact ingredients in that one recipe. Miso soup with kombu, millet + cauliflower, scallions and daikon; brown rice with pickled shiso specifically recommended for now. Live refrigerated sauerkraut. “Cough Sync” is a newly developed tool for aspirating thick lung secretions more effectively. CLEANING solutions: 4 teaspoons of bleach in a quart of water, 0.125% peroxide, 80% ethanol, and 75% isopropyl alcohol.
Medicine and supplement considerations to be specifically decided between you and your physician: when you take supplements take them daily for the first 2 weeks and then 5 DAYS A WEEK thereafter. Chew gum to keep your throat lubricated in order to “wash out” the virus. For colds or CoV2-19: the PMC position is to take vitamin C 500 mg 3 times a day, vitamin D3 5.000 units a day 5 days a week, Immune Renew 2 twice a day (Host Defense & OM manufacturers) also have beta glucan immune stimulating products), as is Brewer’s yeast. AHCC 2 twice a day (as just said, 5 days a week) is the top selling supplement in Japan. Manuka honey has anti-bacterial and possibly anti-viral properties. Pau d’arco is an herbal anti-inflammatory as is nanao-curcumin. Berberine, spirulina, glucosamine. Singulair (montelukast) is a lung leukotriene inhibitor that reduces lung inflammation and is worth considering in the armamentarium. If you are taking high blood pressure medication, try to have that be an ARB (angiotensin receptor blocker such as losartan). If on cholesterol lowering medicine, Livalo/pitavastatin seems more beneficial than Crestor/rosuvastatin or Lipitor/atorvastatin. Personally, my guess is that the gout treatment medication allopurinol would be helpful for serious CoV2-19 infection. If infection does occur and hydroxychloroquine is not available, I would take doxycycline with the azithromycin.
An excellent air purifier company: https://www.airpurifiersandcleaners.com/sun-pure-sp-20-portable-air-purifier. Dulera inhaler for bronchial cough issues. Zantac (or Pepcid as famotidine once daily) + Zyrtec (for complete histamine blockade) twice a day for nasal congestion. Fish oil is a generally anti-inflammatory: Carlson’s Cod Liver Oil (2 teaspoons = “a swig”) once or twice a day. Elderberry capsules for further immune enhancement. For a bothersome cough for my patients I recommend elderberry syrup 2 tsp 3 times a day. Generic Robitussin DM 2 teaspoons 3 times a day as necessary only for bothersome cough. For chest issues, the glutathione supporting antioxidant NAC 600 mg 2 or 3 a day. If there is a deep cough, in order to prevent scarring due to fibrosis/scarring consider taking serrapeptase 2 capsules three times a day. As above, if there is bacterial invasion in the lungs = pneumonia development, antibiotics should be chosen based on sensitivity: if treatment is begun without a culture, doxycycline + azithromycin would be my antibiotics of choice as they have an anti-inflammatory effect.
Read the 2020 Progress in Cardiovascular Diseases article by Mark McCarty & J DiNicolantonio regarding nutraceuticals inhibiting NOX2, thereby stimulating type 1 interferon response via Toll Receptor 7 (TLR7). HO-1 (heme oxygenase-1) enhancement to treat RNA viruses. Discussed/“recommended” in that article are alpha lipoic acid, sulforaphane, ferulic acid, resveratrol, spirulina (phycocyanobilin). EGCG as capsules or as green tea, with white tea for its high antioxidant content.