Prevention protocols

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I-PREVENT

Covid, Flu and RSV Protection Protocol

A Guide to Preventing COVID-19, Influenza and Respiratory Syncytial Virus (RSV)

While flu and RSV infections were uncommon in 2020 and 2021, a dramatic increase in infections was documented in the fall and early winter of 2022. We have therefore adapted I-PREVENT to include prevention against flu and RSV. It should be noted that the medications in I-PREVENT are inexpensive, safe, and widely available.

This protocol includes a section on how to prevent infection before you’ve been exposed (pre-exposure/long term) as well as how to prevent infection if you have potentially been exposed (post-exposure/acute, short-term).

At the onset of flu-like symptoms please refer to the I-CARE: Early COVID Treatment or I-CARE: RSV and Flu Treatment Protocols.

About this Protocol

Learn about nutritional therapeutics and how they can help with COVID-19.

Read about the safety of vitamins and nutraceuticals in pregnancy.

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How to prevent infection before you’ve been exposed

  • Antiseptic antimicrobial mouthwash: gargle twice daily (do not swallow). Choose mouthwashes containing chlorhexidine, povidone-iodine, cetylpyridinium chloride, or the combination of eucalyptus, menthol, and thymol. If tooth staining occurs, discontinue use of mouthwash and try another product.

  • Vitamin D: dosing varies; optimal target is greater than 50 ng/ml (Table 1) presents a safe and practical treatment schedule for raising serum concentrations in non-urgent situations. The dosing schedule illustrated in Table 2 should be used when recent serum concentration levels are unavailable.

  • Vitamin C: 500 mg twice daily

  • Zinc: 20-50 mg/day
    Commercial zinc supplements are commonly formulated as zinc oxide or salts with acetate, gluconate, and sulfate.

  • Melatonin: 1-6 mg nightly (slow/extended)
    Begin with 1 mg and increase as tolerated to 6 mg at night. Causes drowsiness. Some patients are intolerant to melatonin, having very disturbing and vivid dreams; in these patients, it may be best to start with a 0.3 mg slow-release tablet and increase slowly, as tolerated.

  • Elderberry syrup, supplements or gummies: follow manufacturer’s dosing recommendations
    Take during periods of high transmission of COVID-19, influenza, and RSV. A triple combination containing elderberry, Vitamin C, and zinc may be a convenient approach. Patients with autoimmune disease should take for 2 weeks or less and monitor their symptoms closely.

  • Resveratrol or a Combination Flavonoid supplement: 400-500 mg daily
    The safety of resveratrol, quercetin, and pterostilbene has not been determined in pregnancy and they should therefore be avoided. Due to the possible drug interaction between quercetin and ivermectin, these drugs should not be taken simultaneously (i.e., should be staggered morning and night).

  • Coffee: One to two cups of caffeinated or decaffeinated coffee per day.

  • Ivermectin: In the current situation of abundant natural immunity along with the recent circulation of less severe and more highly transmissible variants, chronic weekly or Twice weekly ivermectin prophylaxis is no longer applicable to most people.

    The following prophylaxis approaches with ivermectin can be considered and applied based on patient preference, comorbid status, immune status, and in discussion with their provider:

    1. Twice weekly ivermectin at 0.2mg/kg; can be considered in those with significant comorbidity and lack of natural immunity or immunosuppressive states or those with long COVID or post-vaccine syndrome who are not already on ivermectin as treatment
    2. Daily ivermectin just prior to and during periods of high possible exposure such as travel, weddings, conferences, etc.
    3. Immediate initiation of daily ivermectin at treatment doses (0.4mg/kg) upon first symptoms of a viral syndrome