Dr. Vladimir (Zev) Zelenko M.D.
Board Certified Family Practitioner
501 Rt 208, Monroe, NY 10950 845-782-0000
April 12, 2020
To all medical professionals around the world:
For the last 16 years, I have cared for approximately 75% of the adult population of Kiryas Joel, which is a very close knit community of approximately 35,000 people in which the Covid-19 infection spread rapidly and unchecked prior to the imposition of social distancing. As of today my team has tested hundreds of people from this community for Covid-19, and approximately 61% of the results have been positive. If extrapolated to the entire community, that means more than 20,000 people are infected at the present time. Of this group, I estimate that there are 1,500 patients who are in a generally accepted high-risk category (e.g. above 60, immunocompromised, comorbidities, underlying respiratory issues).
Given the urgency of the situation, I developed the following treatment protocol in thepre-hospital setting and have seen only positive results:
- Any patient with shortness of breath is treated.
- Any patient in a high-risk category with mild symptoms is treated.
- Young, healthy and low risk patients even with symptoms are not treated (unless their circumstances change and they fall into category 1 or 2) (as is well known, these
patients likely self resolve).
My outpatient treatment regimen is as follows:
1. Hydroxychloroquine 200mg twice a day for 5 days
2. Azithromycin 500mg once a day for 5 days
3. Zinc sulfate 220mg once a day for 5 days
The rationale for my treatment plan is as follows. I combined the data available from China and South Korea with the recent study published from France (sites available on request).
We know that hydroxychloroquine helps Zinc enter the cell. We know that Zinc slows viral replication within the cell. Regarding the use of azithromycin, I postulate it prevents secondary bacterial infections. These three drugs are well known and usually well tolerated, hence the risk to the patient is low.
Since 3/15/20, my team has seen approximately 1354 patients in Monroe, New York with either test proven or clinically suspected coronavirus infection. The majority of the patients were treated with only supportive care. The patients with shortness of breath or who are in the high risk category were treated with the above regimen (approximately 405 patients at this point)..
Of this group and the information provided to me by affiliated medical teams, we have had two deaths, six hospitalizations for pneumonia, and four intubations (all extubated now). In addition, I have not heard of any negative side effects other than approximately 10% of patients with temporary nausea and diarrhea.
In sum, my urgent recommendation is to initiate treatment in the outpatient setting as soon as possible in accordance with the above. Based on my direct experience, it prevents acute respiratory distress syndrome (ARDS), prevents the need for hospitalization and saves lives.
With much respect,
Dr. Vladimir (Zev) Zelenko
Ivan Tkachenko
