The Frontline COVID-19 Critical Care Working Group recommends a prevention and treatment protocol called MATH+. This group is led by 10 physicians (listed here) who are professors of medicine, critical care chiefs, and other experts in caring for Covid-19 patients. The protocol they recommend includes supplements taken for prophylaxis (what to take while you are well) as well as a list of what to take if you are diagnosed with Covid-19 but are sent home. And for every patient, from those who are well, to those not hospitalized, to the most ill among the hospitalized, the protocol recommends Vitamin D (as well as other supplements).

The MATH+ Covid-19 Management Protocol — website here and PDF of the protocol here — is a set of recommendations for treatment of Covid-19, issued by the EVMS Medical Group, and developed by Paul Marik, M.D. He’s the Chief of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School, Norfolk, Virginia.

Here is exactly what the MATH+ protocol says for prophylaxis (supplements to take while you are well) — The Protocol itself was UPDATED on June 17th to this

Prophylaxis
While there is extremely limited data, the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease. This cocktail is cheap, safe, and widely available.
• Vitamin C 500 mg BID and Quercetin 250-500 mg BID
• Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1 month, reduce the dose to 30-50 mg/day.
• Melatonin (slow release): Begin with 0.3 mg and increase as tolerated to 2 mg at night
• Vitamin D3 1000-4000 IU/day
• Optional: Famotidine 20-40 mg/day
[Full Protocol Here]

The prophylaxis protocol is vitamin C, 500 milligrams, “BID” (twice a day); quercetin, a flavonoid found in onions, figs, buckwheat, and other foods, 250 to 500 mg twice a day; zinc, melatonin, and vitamin D, as stated above. For a faster correction of possible vitamin D deficiency, Grant et al. recommended 10,000 IU/day for a few weeks, followed by 5,000 IU/day [2]. Note that the “+” Plus in MATH+ is additional medications and treatments that might be added as time passes.

“Famotidine, sold under the brand name Pepcid among others, is a medication that decreases stomach acid production.” [Wikipedia]

A recent study in the New England of Medicine, published after the Protocol was released, found that hydroxychloroquine does not work as a prophylaxis. But that is listed as “optional/uncertain” in the protocol.

Vitamin D has the most research supporting its use as a prophylactic against Covid-19. For a review of the 11 studies on vitamin D and Covid, start here.

There’s also a study showing that vitamin D, magnesium, and vitamin B12 helped to reduce the severity of Covid-19. I review that study here.

What to take while you are well: at least take the vitamin D. “To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d.” [1]

Your 25(OH)D concentration is the level of vitamin D, specifically the type of vitamin D found in the blood. Vitamin D deficiency is common in Western society and common among the elderly. It is also common in women living in cultures where they are “veiled”, such that their skin is not exposed to the sun. In addition, darker skinned persons tend to have lower vitamin D levels, as it takes more exposure to the sun to make vitamin D in the skin. With the threat of this pandemic hanging over us, we should all be taking vitamin D supplements.

RLCJ

1. Grant, William B., et al. “Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths.” Nutrients 12.4 (2020): 988.

2. Grant, William B., et al. “Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths.” Nutrients 12.4 (2020): 988.