Early Treatment Protocols for COVID-19: Early Treatment Can Reduce COVID-19 Hospitalizations and Deaths?

It is critical to recognize that infection with SARS-CoV-2, the virus that causes COVID-19, progresses through a number of stages and phases. Treatment is therefore highly stage-specific. COVID-19 is a clinical diagnosis; a confirmed antigen or PCR test is not required. Treatment should be initiated immediately after the onset of flu-like symptoms. The multiple therapies and drugs in this protocol have different mechanisms of action and work synergistically during various phases of the disease.

I-CARE COVID Treatment Protocol for Outpatients

The FLCCC I-CARE Early Treatment Protocol

The I-Care protocol has been updated several times and below is their latest version (version 1.3: June 29, 2022).

FIRST LINE THERAPIES (In order of priority; not all required)
  • Ivermectin: 0.3 to 0.6 mg/kg – one dose daily for at least 5 days or until symptoms resolve. If symptoms persist longer than 5 days, consult a healthcare provider. See Table 1 for help with calculating correct dose. Due to a possible interaction between quercetin and ivermectin, these drugs should be staggered throughout the day (see Table 2). For COVID treatment, ivermectin is best taken with a meal or just following a meal, for greater absorption. 
  • Hydroxychloroquine (HCQ): 200 mg twice a day for 5 to 10 days. Best taken with zinc. HCQ may be taken in place of, or together with, ivermectin. While ivermectin should be avoided in pregnancy, the FDA considers HCQ safe in pregnancy. Given the pathway used by the Omicron variant to gain cell entry, HCQ may be the preferred drug for this variant. 
  • Zinc: 75-100 mg daily. Take with HCQ. Zinc supplements come in various forms (e.g., zinc sulfate, zinc citrate and zinc gluconate). 
  • Mouthwash: three times a day. Gargle three times a day (do not swallow) with an antiseptic-antimicrobial mouthwash containing chlorhexidine, cetylpyridinium chloride (e.g., Scope™, Act™, Crest™) or povidone-iodine (e.g. Betadine® Antiseptic Sore Throat Gargle™).
  • Nasal spray with 1% povidone-iodine: 2-3 times a day. Do not use for more than 5 days in pregnancy. If 1% product is not available, dilute the more widely available 10% solution (see box) and apply 4-5 drops to each nostril every 4 hours. 
  • Aspirin: 325 mg daily (unless contraindicated). 
  • Melatonin: 5-10 mg before bedtime (causes drowsiness). Slow- or extended-release formulations preferred. 
  • Curcumin (turmeric): 500 mg twice a day. Curcumin has low solubility in water and is poorly absorbed by the body; consequently, it is traditionally taken with full fat milk and black pepper, which enhance its absorption. 
  • Kefir and/or Bifidobacterium Probiotics. 
  • Vitamin C: 500-1000 mg twice a day. 
  • Quercetin (or a mixed flavonoid supplement): 250 mg twice a day. Due to a possible interaction between quercetin and ivermectin, these drugs should not be taken simultaneously (i.e., should be staggered at different times of day – see Table 2). As supplemental quercetin has poor solubility and low oral absorption, lecithin-based and nanoparticle formulations are preferred.
  • Home pulse oximeter: Monitoring of oxygen saturation is recommended in symptomatic patients, due to asymptomatic hypoxia. Take multiple readings over the course of the day and regard any downward trend as ominous. Baseline or ambulatory desaturation under 94% should prompt consultation with primary or telehealth provider, or evaluation in an emergency room.

SECOND LINE THERAPIES (In order of priority/importance)

Add to first line therapies above if: 
1) more than 5 days of symptoms; 
2) poor response to first line agents; 
3) significant comorbidities.
  • Nigella sativa (black cumin): 80 mg/kg daily and Honey 1g/kg daily. 
  • Vitamin D3: 10,000 IU daily (two 5,000 IU capsules) for two weeks. 
  • B complex vitamins
  • Nitazoxanide (NTZ): 600 mg twice a day for 5 days. 
  • Fluvoxamine: 25-50 mg twice a day. Can substitute fluoxetine (Prozac; 20-40mg daily) if fluvoxamine not available. 
  • N-acetyl cysteine (NAC): 600-1200 mg orally twice a day. 
  • Omega-3 fatty acids: 4 g daily. Vascepa (Ethyl eicosapentaenoic acid); Lovaza (EPA/DHA); or alternative DHA/EPA. Vascepa and Lovaza tablets must be swallowed and cannot be crushed, dissolved, or chewed.
Table 1. How to calculate ivermectin dose


Ordinary Vitamin D3 Does not work in Acute Illness

According to this webinar (below) by Dr Pierre Kory and Dr. Keith Berkowitz:


Video time from 11:30 - 12:30: 

Vitamin D3 (ordinary form) does not work in acute illness. It doesn't become active for at least a week... Vitamin D3 is for prevention and you should continue to take it if your levels are below 50 ng/ml...

There is only one form of vitamin D that will have an acute impact and that is calcifediol (vitamin D3 analog). 


d.velop Vitamin D Supplements 2400 IU, 20 mcg – High Potency Vitamin D3

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Calcifediol, the form of vitamin D in d.velop, doesn’t need to be processed by the liver, it can be absorbed right into the bloodstream and throughout your body. That's why calcifediol is 3x more effective for raising vitamin D levels when compared to regular vitamin D on an equal microgram (mcg) basis.

The NIH COVID-19 Treatment Guidelines Panel’s Statement on Early Therapies for High-Risk, Nonhospitalized Patients With Mild to Moderate COVID-19 (Last Updated: April 8, 2022)

This statement contains the Panel’s recommendations for treating these non-hospitalized patients using the currently available therapies.

The Panel’s recommendations take into account the efficacies of these drugs and the high prevalence of the Omicron VOC. When resources are limited, therapy should be prioritized for patients who are at the highest risk of progressing to severe COVID-19.

The Panel’s current outpatient treatment recommendations are as follows (in order of preference):

Preferred Therapies
  • Paxlovid (nirmatrelvir 300 mg plus ritonavir 100 mg) orally twice daily for 5 days
  • Remdesivir 200 mg IV on Day 1 followed by remdesivir 100 mg IV on Days 2 and 3
Alternative Therapies
For use only when neither of the preferred therapies are available, feasible to use, or clinically appropriate. Listed in alphabetical order:
  • Bebtelovimab (monoclonal antibody from Eli Lilly)
  • Molnupiravir 800 mg orally twice daily for 5 days
Notes: 
  • Bebtelovimab is active in vitro against all circulating Omicron subvariants, but there are no clinical efficacy data from placebo-controlled trials that evaluated the use of bebtelovimab in patients who are at high risk of progressing to severe COVID-19. Therefore, bebtelovimab should be used only when the preferred treatment options are not available, feasible to use, or clinically appropriate.

For post-covid or long covid syndrome, check out Long Haulers Treatment Protocol

Disclaimers: Please do not consider these protocols as personal medical advice, but as a recommendation for use by professional providers. Consult with your doctor, share the information on this website and discuss with her/him. 

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