COVID-19 Critical Care

Analysis by Dr. Joseph Mercola Fact Checked

• May 29, 2020

Story at-a-glance

• Despite the fact that many critical care specialists are using treatment protocols that differ from standard of care, information about natural therapeutics in particular are still being suppressed by the media and is not received by critical care physicians
• Five critical care physicians have formed the Front Line COVID-19 Critical Care Working Group (FLCCC). The group has developed a highly effective treatment protocol known as MATH+
• Of the more than 100 hospitalized COVID-19 patients treated with the MATH+ protocol as of mid-April, only two died. Both were in their 80s and had advanced chronic medical conditions
• The protocols call for the use of intravenous methylprednisolone, vitamin C and subcutaneous heparin within six hours of admission into the hospital, along with high-flow nasal oxygen. Optional additions include thiamine, zinc and vitamin D
• COVID-19 kills by triggering hyperinflammation, hypercoagulation and hypoxia. The MATH+ protocol addresses these three core pathological processes

"Why is success in critical care being ignored?" the Alliance for Natural Health rightly asks.¹ The organization claims "much more could be done to save lives" if critical care protocols were to take into account what critical care doctors are finding in practice. A May 14, 2020, article reads, in part:²

"After around 8 weeks in lockdown and 3 months since the spectre of Covid-19 loomed large in our media headlines, why is it that a team of frontline critical (intensive) care doctors in the USA who have delivered close to 100% survival with their unique protocol being roundly ignored?

Wouldn't you think that hospitals and governments would be biting their hands off to get a hold of their protocol? Or clamoring for more information and training to understand why their own outcomes from standard care fall so far short, delivering around just 50% survival in most critical care settings? …

It's now very clear that the outcomes among the very seriously ill patients in critical care units (also referred to as ICU [intensive care units]/ITU [intensive therapy units] in the UK) are being used to inform lockdown (or lock up!) strategy and keep the fear levels sufficiently high to ensure citizen compliance …

Why is there such widespread censorship of anything but the party line by online platforms which lack sufficient expertise to adjudicate on matters of science and medicine?

The public-facing narrative continues to profess that there is nothing you can do to support your immune system, there is nothing in the natural arsenal for Covid-19 … social distancing must be maintained at all times and that the only cure for this terrifying infection will magically come from a vaccine created at warp speed.

When you add these untruths to the plans being rolled out for ramping up citizen surveillance through test, track and trace, the erosion of our rights and freedoms through the emergency coronavirus legislation, the destruction of economies and the forced reliance of so many on the state for survival handouts, you realize how much we might lose whilst much of the world cowers behind closed doors in fear."

Front-Line Critical Care Working Group

As noted by the Alliance for Natural Health, despite the fact that "the obstacle course posed by the peer review process to scientific publication has been removed," and despite many critical care specialists using treatment protocols that differ from standard of care, information about natural therapeutics in particular are still being suppressed by the media and is not received by those who need it most — critical care physicians.

"We all need to be asking why. After all, people are dying. How would it make relatives feel if it was found that their loved one had died needlessly just because the doctors who were having greatest success were not being listened to and their innovative protocols had been systematically ignored?" Alliance for Natural Health states.³

According to the article, efforts by Dr. Pierre Kory — medical director at the Trauma & Life Support Center and a faculty member in the Division of Allergy, Pulmonary and Critical Care Medicine in the Department of Medicine at the University of Wisconsin School of Medicine and Public Health — to share the Front Line COVID-19 Critical Care Working Group's⁴ (FLCCC) successes with other health care professionals have so far come to naught.
Kory was one of five doctors participating in a May 6, 2020, roundtable discussion⁵ on COVID-19 with ranking senate committee member Gary Peters, D-Mich. In his testimony, Kory states, in part:⁶

"I want to start by saying that I am part of a group of physicians which include several of the most highly published and well-known critical care experts in the country and world (Drs. Paul Marik, Umberto Meduri, Joseph Varon and José Iglesias). In response to the COVID crisis we formed the Front-Line Critical Care Working group …

Members of our group have now treated in excess of 100 hospitalized patients with our treatment protocol. Nearly all survived. The two that died were in their 80s and had advanced chronic medical conditions.

None of the patients have had long stays on the ventilator nor become ventilator dependent. The patients generally have a short hospital stay and are discharged in good health …

Our protocol has been out over four weeks. It is not unique, in fact, we are not alone in what we propose or have been trying … In fact, we are seeing an increasing number of similar protocols with nearly identical therapeutics come out from various institutions and countries, including the Italian guidelines, Chinese guidelines, Yale protocol, Montefiore protocol and others.

We are doctors, trained to diagnose and treat illness, we are experts in our field with decades of experience and hundreds of publications … We have clearly devised an effective treatment for use, prior to the publication of randomized controlled trials.

Those trials are critical for sure, as they will help us further refine and/or perfect our treatment doses, durations, and indications, but waiting for the perfect is and will be the enemy of the good, which we are already achieving … We just want to save lives, and we know how to do it."

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COVID-19 Early Intervention Protocol

According to Kory, the FLCCCs MATH+ protocol has been delivered to the White House on four occasions, yet no interest has been shown. Worse, he says they continue to be stonewalled by the U.S. Centers for Disease Control and the National Institute for Health. Why?
Isn't saving lives, right now, and by any means possible, more important than pushing for a vaccine? If the MATH+ protocol works with near-100% effectiveness, a vaccine may not even be necessary. The MATH+ protocol gets its name from:

Intravenous Methylprednisolone High-dose intravenous Ascorbic acid Plus optional treatments Thiamine, zinc and vitamin D Full dose low molecular weight Heparin

Kory's testimony transcript reviews and summarizes the MATH+ protocol, and explains why the timing of the treatment is so important. As explained by Kory, there are two distinct yet overlapping phases of COVID-19 infection.

1. Phase 1 is the viral replication phase. Typically, patients will only experience mild symptoms, if any, during this phase. At this time, it's important to focus on antiviral therapies.
2. In Phase 2, the hyperinflammatory immune response sets in, which can result in organ failures (lungs, brain, heart and kidneys). The MATH+ protocol is designed to treat this active phase, but it needs to be administered early enough.

The MATH+ Protocol

The MATH+ protocol⁷ calls for the use of three medicines, all of which need to be started within six hours of hospital admission:

• Intravenous methylprednisolone, to suppress the immune system and prevent organ damage from cytokine storms — For mild hypoxia, 40 milligrams (mg) daily until off oxygen; moderate to severe illness, 80 mg bolus followed by 20 mg per day for seven days. On Day 8, switch to oral prednisone and taper down over the next six days.
• Intravenous ascorbic acid (vitamin C), to control inflammation and prevent the development of leaky blood vessels in the lungs — 3 grams/100 ml every six hours for up to seven days.
• Subcutaneous heparin (enoxaparin), to thin the blood and prevent blood clots — For mild to moderate illness, 40 mg to 60 mg daily until discharged.

Optional additions include thiamine, zinc and vitamin D. In addition to these medications, the protocol calls for high-flow nasal oxygen to avoid mechanical ventilation, "which itself damages the lungs and is associated with a mortality rate approaching nearly 90% in some centers," Kory notes.⁸
Together, this approach addresses the three core pathological processes seen in COVID-19, namely hyperinflammation, hypercoagulability of the blood, and hypoxia (shortness of breath due to low oxygenation).

COVID-19 Should Not Be Treated as ARDS

In the video, Dr. Paul Marik points out that it's crucial for doctors to treat each patient as an individual case, as COVID-19 is not conventional acute respiratory distress syndrome (ARDS).
If the patient is assumed to have ARDS and placed on a ventilator, you're likely going to damage their lungs. Indeed, research has now shown that patients placed on mechanical ventilation have far higher mortality rates than patients who are not ventilated. While not discussed here, some doctors are also incorporating hyperbaric oxygen treatment in lieu of ventilation, with great success.
The reason for this is because the primary problem is inflammation, not fluid in the lungs. So, Marik says, they need anti-inflammatory drugs. "It's not the virus that is hurting the host, it's the acute inflammatory dysregulated response," he says. "That's why you need to use vitamin C and steroids." He points out that steroids play a crucial role, as it creates synergy with vitamin C.
COVID-19 patients also have a hypercoagulation problem, so they need anticoagulants. In addition to using the proper medication, they must also be treated early. "You have to intervene early and aggressively to prevent them from deteriorating," Marik says.

Methylprednisolone May Be a Crucial Component

Kory expresses concerns over the fact that health organizations around the world are warning doctors against the use of corticosteroids, calling this a "tragic error"⁹ as "COVID-19 is a steroid-responsive disease."¹⁰ In his testimony, he points out:¹¹

"Sorin Draghici, CEO of Advaita Bioinformatics, just reported¹² that their incredibly sophisticated Artificial Intelligence platform called iPathwayGuide, using cultured human cell lines infected with COVID-19, is able to map all the human genes which are activated by this virus …

Note almost all the activated genes are those that express triggers of inflammation. With this knowledge of the specific COVID inflammatory gene activation combined with knowledge of the gene suppression activity of all known medicines they were able to match the most effective drug for COVID-19 human gene suppression, and that drug is methylprednisolone.

This must be recognized, as the ability of other corticosteroids to control inflammation in COVID-19 was much less impactful. This is, we believe, an absolutely critical and historic finding. Many centers are using similar but less effective agents such as dexamethasone or prednisone."

As noted by Kory in his senate testimony, Marik, chief of pulmonary and critical care medicine at the Eastern Virginia Medical School in Norfolk, Virginia, is a member of the FLCCC.¹³ You may recall that Marik was the one who in 2017 announced he had developed an extraordinarily effective treatment against sepsis.
Marik's sepsis protocol also calls for intravenous vitamin C and a steroid, in this case hydrocortisone, along with thiamine. I for one am not surprised that the two protocols are so similar, seeing how sepsis is also a major cause of death in severe COVID-19 cases.

Safe and Effective Treatments Must Not Be Ignored

As noted by Marik in the video, COVID-19 is not regular ARDS and should not be treated as such. What kills people with COVID-19 is the inflammation, and steroids in combination with vitamin C work synergistically together to control and regulate that inflammation. The heparin, meanwhile, addresses the hypercoagulation that causes blood clots, which is a unique feature of COVID-19. As for the "lack of studies" supporting their protocol, FLCCC notes:¹⁴

"A number of official guidelines, such as those of the WHO and several other U.S. agencies, recommend limiting treatment for … critically ill patients to 'supportive care only' — and to allow the therapies described here to be studied in randomized controlled trials where half of the patients would receive placebo and where the results would come in months or years.

Our physicians agree that while a randomized controlled trial (RCT), under normal circumstances, might be considered, the early provisions of MATH+, which must be given within hours of critical illness, would inevitably be delayed by such a study design, rendering the validity of the RCT questionable.

Furthermore, while the results of an RCT would not be available for months or more, well-designed observational studies of the protocol could yield timely feedback during this pandemic, to improve the treatment process much more quickly."

I believe this information needs to be shared far and wide, if we are to prevent more people from dying unnecessarily. More and more, as doctors are starting to speak openly about their clinical findings, we're seeing that there are quite a few different ways to tackle this illness without novel antivirals or vaccines, using older, inexpensive and readily available medications that are already known to be safe.

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