There is an important principle in Judaism, a source of hope and also one of the structuring principles of the Torah. It is the principle that God creates the cure before the disease. Bad things may happen but God has already given us the remedy if we know where to look for it.
An Effective Treatment for Coronavirus (COVID-19)
Presented by: Thomas R. Broker, PhD (Stanford PhD, [email protected]), James M. Todaro, MD (Columbia MD, [email protected]) and Gregory J. Rigano, Esq. ([email protected]) In consultation with Stanford University School of Medicine, UAB School of Medicine and National Academy of Sciences researchers.
March 13, 2020
Recent guidelines from South Korea and China report that chloroquine is an effective antiviral therapeutic treatment against Coronavirus Disease 2019. Use of chloroquine (tablets) is showing favorable outcomes in humans infected with Coronavirus including faster time to recovery and shorter hospital stay. US CDC research shows that chloroquine also has strong potential as a prophylactic (preventative) measure against coronavirus in the lab, while we wait for a vaccine to be developed. Chloroquine is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune and various other conditions.
The U.S. CDC and World Health Organization have not published treatment measures against Coronavirus disease 2019 (“COVID-19”). Medical centers are starting to have issues with traditional protocols. Treatments, and ideally a preventative measure, are needed. South Korea and China have had significantly more exposure and time to analyze diagnostic, treatment and preventative options. The U.S., Europe and the rest of the world can learn from their experience. According to former FDA commissioner, board member of Pfizer and Illumina, Scott Gotlieb MD, the world can learn the most about COVID-19 by paying closest attention to the response of countries that have had significant exposure to COVID-19 before the U.S. and Europe.
As per the U.S. CDC, “Chloroquine (also known as chloroquine phosphate) is an antimalarial medicine… Chloroquine is available in the United States by prescription only… Chloroquine can be prescribed for either prevention or treatment of malaria. Chloroquine can be prescribed to adults and children of all ages. It can also be safely taken by pregnant women and nursing mothers.”
CDC research also shows that “chloroquine can affect virus infection in many ways, and the antiviral effect depends in part on the extent to which the virus utilizes endosomes for entry. Chloroquine has been widely used to treat human diseases, such as malaria, amoebiasis, HIV, and autoimmune diseases, without significant detrimental side effects. “The treatment guidelines of both South Korea and China against COVID-19 are generally consistent, outlining chloroquine as an effective treatment.
Specifically, according to the Korea Biomedical Review, in February 2020 in South Korea, the COVID-19 Central Clinical Task Force, composed of physicians and experts treating patients agreed upon treatment principles for patients with COVID-19. In China, the General Office of the National Health Commission, General Office of the State Administration of Traditional Chinese Medicine as well as a Multi-Center Collaborative Group of Guangdong Provincial Department of Science and Technology and Guangdong Provincial Health Comp and the China National Center for Biotechnology Development have established effective treatment measures based on human studies.
According to their research (reported in Clinical Trials Arena), “Data from the drug’s [chloroquine] studies showed ‘certain curative effect’ with ‘fairly good efficacy’ … patients treated with chloroquine demonstrated a better drop in fever, improvement of lung CT images, and required a shorter time to recover compared to parallel groups. The percentage of patients with negative viral nucleic acid tests was also higher with the anti-malarial drug… Chloroquine has so far shown no obvious serious adverse reactions in more than 100 participants in the trials… Chloroquine was selected after several screening rounds of thousands of existing drugs. Chloroquine is undergoing further trials in more than ten hospitals in Beijing, Guangdong province and Hunnan province.”
Treatment Guidelines from South Korea
According to the Korea Biomedical Review, the South Korean COVID-19 Central Clinical Task Force guidelines are as follows:
- If patients are young, healthy, and have mild symptoms without underlying conditions, doctors can observe them without antiviral treatment;
- If more than 10 days have passed since the onset of the illness and the symptoms are mild, physicians do not have to start an antiviral medication;
- However, if patients are old or have underlying conditions with serious symptoms, physicians should consider an antiviral treatment. If they decide to use the antiviral therapy, they should start the administration as soon as possible. Chloroquine 500mg orally per day.
- As chloroquine is not available in Korea, doctors could consider hydroxychloroquine 400mg orally per day (Hydroxychloroquine is an analog of chloroquine used against malaria, autoimmune disorders, etc. It is widely available as well).
- The treatment is suitable for 7 – 10 days, which can be shortened or extended depending on clinical progress.
COVID-19 and Chloroquine: How Does it Work? NITROGEN
Before I continue here is the KEY TAKEAWAY. Statistics show that the countries and locations with the most concentration of COVID-19 have the highest concentrations of AIR POLLUTION with China being number one and Italy being number 2 worldwide. The atmosphere is composed MAINLY of Nitrogen (78%) and Oxygen (22%).
As these countries shut down manufacturing facilities and close down business, (reducing air pollution allowing the natural atmospheric ratio of Nitrogen to Oxygen to normalize and allowing sunshine by removing the smog, the infection rate shows a significant decline and the recovery rate shows a significant increase.
US Military hospitals have used FRESH AIR as their first line of defense and cure for servicemen for over 50 years. Statistics show that sunshine and fresh air (78% NITROGEN) have been effective in speeding up the process of healing in servicemen returning home. Typically the Department of Defense uses three methods.
- Cross ventilation indoors: Opening windows on both sides of the patient’s rooms.
- Placing the patients outdoors in tents, even in their beds.
- Moving them out of the tents into the fresh air and sunshine (which also has antibiotic and anti-viral qualities), weather permitting.
Because of its nitrogen structure, chloroquine has the unique ability to get into cells and cross endosomal membranes. Once inside, nitrogens in chloroquine (and quinines in general) prevent acidification by absorbing a high amount of hydrogens that simply then interact with nitrogen and then chloroquine becomes positively charged – an ionic interaction which makes it harder for the endosome to become acidified. The result is a buffer that holds it at the higher pH and prevents it from becoming acidic enough to be functional. To summarize, because chloroquine has a multitude of extra nitrogens, once it crosses the membrane and enters an organelle, the organelle is prevented from reaching a lower pH. The organelle’s enzymes cannot work because the donor group will be a hydrogen ion, disabling the hydrolysis required for coronavirus replication. This means that all kinds of events in the cell are incapable of performing optimally, including viral replication.
Chloroquine’s entrance into the organelle likely constipates the whole system. An analogy is that the virus is like a garbage facility which has to break down and burn up the garbage and if it cannot, the garbage piles up and the city becomes paralyzed. This is likely the case for any virus, cancer cells or any other condition that is dependent on turning over the worn out or incorrectly synthesized proteins.
Treating COVID-19 with chloroquine, as is being done in South Korea and China does have the potential to lead to a mutation. The mutation can either be beneficial or harmful to humans. In this particular case, chloroquine is likely being used to destabilize the replication quality of COVID-19, providing significant potential for COVID-19 to self-destruct, which would likely bide more time for health systems worldwide to increase capacity and equipment as well as allow time for the public release of a vaccine. All precaution must be taken into account for the risk of escape where COVID-19 comes out stronger.
Chloroquine and its analogs has been manufactured and distributed at global scale since approximately 1945. While there has recently been a shortage of N95 protective masks, medical systems can adjust and dramatically increase the supply of chloroquine in the world. Chloroquine tablets and intravenous formulations are generic and easy to produce.
Chloroquine is a prescription drug. It can have side effects and has contraindications. One often cited side effect is chloroquine retinopathy, which can result in permanent vision loss after high cumulative doses of chloroquine. However, retinal damage is extremely rare in patients with a total dosage under 400g (dosage level only reached after years of treatment). Medical professionals must be consulted before use of chloroquine. Chloroquine tablets are readily available in the U.S. and have never been removed from the market. Intravenous chloroquine was taken off the market in the USA pre-2000 because of the absence of acute malarial infections in the USA – there was no use for the intravenous form. It can easily be brought back to the market. Currently chloroquine is most widely administered in tablet form (chloroquine phosphate. While readily available, the issue is that when the tablet is ingested, it must be processed through the stomach and be taken up by the small intestine, for which then it enters the blood and subsequently the respiratory system. Because of the metabolism, this takes time and there is a loss of chloroquine delivery to the respiratory system (where COVID-19 replicates).
The nitrogens in chloroquine and quinines in general prevent acidification by absorbing a high amount of hydrogens that then interact with nitrogen, and,in turn, transfer a positive charge to chloroquine. This ionic interaction makes it harder and harder for the endosome to become acidified, therefore disrupting viral replication. If more nitrogens are added, either by making extra branches of ionizable nitrogens or lengthening one of the chains by putting extra carbons and other nitrogens around it, this may have even greater effect. The key issue will be whether there is a heavy change in bioavailability – will the new molecule be able to enter the cell and reach the right place with similar efficiency.
Medical doctors may be reluctant to prescribe chloroquine to treat COVID-19 since it is not FDA approved for this use. The United States of America and other countries should immediately authorize and indemnify medical doctors for prescribing chloroquine to treat COVID-19. We must explore whether chloroquine can safely serve as a preventative measure prior to infection of COVID-19 to stop further spread of this highly contagious virus.
God willing we should all stay safe, healthy and have a truly celebratory exodus from this pandemic by Pesach.
God creates the cure before the disease. Bad things may happen but God has already given us the remedy if we know where to look for it.