“MATH+” is the COVID-19 protocol by Dr. Paul Marik and the Front Line Covid-19 Critical Care Alliance (FLCCC), as previously reported by TrialSite. And while NIH is still recommending ivermectin be used only in clinical trials, the September 28 update to MATH+ includes this drug as described below. The protocol notes that it, “is our recommended approach to COVID-19 based on the best (and most recent) literature. This is a very dynamic situation; therefore, we will be updating the guideline as new information emerges.” Beginning with prophylaxis, or prevention, the protocol notes that a safe and effective “cocktail” of substances may prevent or mitigate COVID-19. For this purpose, Marik recommends melatonin, high-dose vitamin D3 (deficiency of which has been tied to increased risk of catching COVID-19 and worse outcomes), vitamin C, zinc, and famotidine. For post-exposure prophylaxis, home-treatment during the acute phase, and mildly symptomatic hospital patients, ivermectin is listed as an optional medication.
The Phase Dictates the Approach
The MATH+ protocol emphasizes that COVID-19 has different phases requiring different approaches. For example, antivirals likely only help during the initial viral replication phase, and anti-inflammatories are, “expected to be effective during the pulmonary phase and possibly the post-COVID-19 phase.” And as patients progress, “down the pulmonary cascade,” the disease is much more difficult to reverse. Early treatment in the pulmonary phase is, to quote, “ESSENTIAL” to a positive outcome. In this phase, MATH+ indicates anti-inflammatories for cytokine storms plus anticoagulants to limit vascular clotting. If the “storm” is not stopped, often patients do not recover. The scientific basis for the MATH+ protocol is reviewed in an article in the Expert Review of Anti-Infective Therapy. And an interesting talk from Dr. Marik on COVID-19 is found here.
Who Is Dr. Marik?
Paul E. Marik, MD, FCCP, FCCM, is Chief of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School in Norfolk, Virginia. Dr. Marik got his MD at the Witwatersrand, in Johannesburg, South Africa. He also has a Master of Medicine degree, a Bachelor of Science in Pharmacology, and diplomas in Anesthesia and Tropical Medicine and Hygiene. Dr. Marik is a Fellow to the Royal College of Physicians and Surgeon of Canada, and he is board certified in Internal Medicine, Critical Care Medicine, and Nutrition Science. Dr. Marik’s work includes over 400 peer-reviewed articles, 50 book chapters, and four books on critical care.