The paper is already available at the National Library of Medicine and is set to be published in the American Journal of Medicine. McCullough has been published over 1,000 times and is joined by 22 other doctors in the article.
“In my view, doctors can do a big part in turning the tide on this debacle,” McCullough told The Texan. He believes more experts need to step forward and recommend treatment based on what has already been learned.
His advice for early treatment of patients, who may even be awaiting for test results but are manifesting symptoms, revolves around four principles: (1) reduction of reinoculation, (2) combination antiviral therapy, (3) immunomodulation, and (4) antithrombotic therapy.
To reduce the chance of a coronavirus patient continuously breathing in more of their own infected air particles, which in turn may increase their viral load, McCullough advises that rooms be open to fresh air, fans be used to circulate air, and infected persons not wear a face covering.
To further reduce the viral load (or amount of virus in a person’s blood), McCullough recommends the use of zinc, antimalarials like hydroxychloroquine, antibiotics such as azithromycin or doxycycline which are known to have antiviral properties, and favipiravir, which has shown treatment promise in Russia and India.
As the disease progresses, a common occurrence is inflammation and cytokine activation, where the body starts to attack its own cells instead of the disease. In this situation, McCullough recommends that doctors consider using immunomodulators like dexamethasone, a corticosteroid.
In order to avoid pulmonary thrombosis, or blood clots, which McCullough theorizes is a cause of the chest heaviness described by some COVID-19 patients, aspirin is suggested. Heparin or other short-acting anticoagulants can also be considered.
The paper includes an algorithm for doctors to follow that demonstrates McCullough’s current advice and practice in treating COVID-19.
“Previously all experts have advised on wearing masks, washing hands, and quarantine but gave no expert advice on treatment at home. This has led to nearly 180,000 American deaths and a population that is held in fear when COVID develops. The average person over age 50 and or with medical problems waits in complete terror while being ill for two weeks before coming into [a] hospital where they may never see their loved ones again. In my view this is a national tragedy,” McCullough asserted.
McCullough believes that many of the measures discussed in his article could be extended to successfully treat seniors in nursing homes and other non-hospital settings.
His father, a nursing home resident, contracted coronavirus in April and recovered after 60 days. His treatment included hydroxychloroquine, azithromycin, and an anticoagulant used to prevent blood clots known as Lovenox.
The North Texas doctor also attributes his father’s recovery to fresh air and windows open constantly to reduce the viral reloading in the air and all surfaces and personal items sterilized in the room daily.
“If the information was known about steroids, I believe treating with prednisone on day five could have shortened his course of illness,” McCullough added.
While McCullough supports the use of randomized trials to test treatments, he acknowledges that they are not well-suited in the circumstances of an emergency pandemic.
“In the U.S., definitive randomized double blind placebo controlled trials are very expensive and take many years to complete. In the setting of an acute pandemic with potentially fatal outcomes, our clinical trials system is not equipped to deliver timely results to impact the population. To date, there are no definitive randomized trials for the treatment of COVID at home and I do not anticipate any for many months if not years to come,” McCullough explained.
McCullough is also leading a study at Baylor University Medical Center that is testing the use of hydroxychloroquine as a prophylaxis or preventative for frontline healthcare workers. While the results have not yet been released, McCullough said that they have reported to the FDA that hydroxychloroquine was found to be safe and well-tolerated.
Additionally, McCullough and fellow cardiologist Dr. Kevin R. Wheelan issued a letter supporting the emergency use authorization (EUA) of hydroxychloroquine for outpatient treatment and prophylaxis for COVID-19 to the FDA.
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Kim Roberts is a regional reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.