MATH+ Hospital Treatment Protocol for COVID-19
Below you can download the MATH+ Hospital Treatment Protocol for COVID-19, for use by professionals, with detailed guidance on the timing of initiation along with the suggested initial doses and durations of each component medication. The protocol document is available for download in multiple languages (see below) – more translations are available here.
Please also review our I-MASK+ Prevention & Early Outpatient Treatment Protocol for COVID-19, which was developed for the prevention and early outpatient treatment of COVID-19. Both are physiologic-based combination treatment regimens developed by leaders in critical care medicine. All component medicines are FDA-approved, inexpensive, readily available and have been used for decades with well-established safety profiles. In October 2020, we added ivermectin as a core medication in the prevention and treatment of COVID-19.
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. Please review our Disclaimers!
Please check this page regularly for updates – new medications may be added and/or dose changes to existing medications may be made as further scientific studies emerge.
Current MATH+ protocol: version 9, updated on Feb 25, 2021.
About the MATH+ Protocol
Update: On December 14, 2020, the FLCCC Alliance peer-reviewed paper Clinical and Scientific Rationale for the “MATH+” Hospital Treatment Protocol for COVID-19 has been published in the Journal of Intensive Care Medicine. The MATH+ protocol potentially offers a life-saving approach to the management of hospitalized COVID-19 patients. It offers an inexpensive combination of medicines with well-known safety profiles based on strong physiologic rationale and an increasing clinical evidence base.
The MATH+ Hospital Treatment Protocol for COVID-19 is designed for hospitalized patients, to be initiated as soon as possible after they develop respiratory difficulty and require oxygen supplementation. The three core pathophysiologic processes that have been identified are severe hypoxemia, hyperinflammation, and hypercoagulability. This combination medication protocol is designed to counteract these processes either through the use of single agents or in synergistic actions. A unique insight into this disease made by members of our group is that the majority of patients initially present with an inflammatory reaction in the lungs called “organizing pneumonia,” which is the body’s reaction to injury and is profoundly responsive to corticosteroid therapy. If the organizing pneumonia response is left untreated or presents as a rapidly progressive sub-type, a condition called Acute Respiratory Distress Syndrome (ARDS) follows.
The two main therapies that can reverse and/or mitigate the extreme inflammation causing ARDS are the combination of the corticosteroid Methylprednisolone and the antioxidant Ascorbic acid, which is given intravenously and in high doses. Both of these medicines have multiple synergistic physiologic effects and have been shown in multiple randomized controlled trials to improve survival in ARDS, particularly when given early in the disease. Thiamine is given to optimize cellular oxygen utilization and energy consumption, protecting the heart, brain, and immune system. Given the numerous clinical and scientific investigations that have demonstrated consistent, reproducible, and excessive levels of hyper-coagulation, particularly in the severely ill, the anticoagulant Heparin is used to both prevent and help in dissolving blood clots that appear with a very high frequency. The “+” sign indicates several important co-interventions that have a combination of strong physiologic rationale with existing or emerging pre-clinical and clinical data to support their use in similar conditions or in COVID-19 itself, and all with a well-established safety profile. Such adjunctive therapies are continuously being evaluated and amended as the published medical evidence evolves.
Timing is a critical factor in the efficacy of MATH+ and to achieving successful outcomes in patients ill with COVID-19. Patients must go to the hospital as soon as they experience difficulty breathing or have a low oxygen level. The MATH+ protocol should be administered soon after a patient meets criteria for oxygen supplementation (within the first hours after arrival in the hospital), in order to achieve maximal efficacy. Delayed therapy can lead to complications such as the need for mechanical ventilation. If administered early, the MATH+ formula of FDA-approved, safe, inexpensive, and readily available drugs may eliminate the need for ICU beds and mechanical ventilators and return patients to health.