Listen to this video ; death due to Covid is NOT because of the C-19 Virus attack that damages our lung ; but due to *allergic reactions* ; which will manifest on the *8th day*
听这部影片; Covid致死并不是因为C-19病毒袭击损害了我们的肺； 但由于 *过敏反应* ; 这将在 *第8天* 显示
Dengarlah video ini; kematian akibat Covid BUKAN kerana serangan Virus C-19 yang merosakkan paru-paru kita; tetapi disebabkan oleh *reaksi (Tindak balas) alahan* ; yang akan terjadi pada *hari ke-8* .
Scroll right down for the conversation transcripts.
He is a general practitioner with a natural science background in genetics, advanced biology, microbiology and biochemistry - has been critically reviewing information that has arisen from observations of the COVID pandemic from around the world. Dr. Shankara Chetty works in a poor rural part of South Africa. He has treated thousands successfully with only antihistamines and steroids. Defying all the "science" of Big Pharma. Watch and especially share with folks you know in our medical community.
‼️🙏🌹
Please forward this video link to all
*Medical Doctors Take Note*
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*GROUND SHATTERING* *NEWS* ‼️
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https://m.youtube.com/watch?v=EI7SaAhJ1LI&feature=youtu.be
Listen to this video ; death due to Covid is NOT because of the C19 Virus attack that damages our lung ; but due to allergic reactions ; which will manifest on the *8th day* in few percentage of the population) ; that causes INFLAMMATORY response in lung resulting DYSPNOEA (Breathlessness ) which rightfully is the Precursor of Cytokine Storm in Lung & finally the Flooding of lung.
This Doctor Shankara Chetty in South Africa has treated 4000 Covid positive patients ; some came to him in LATE stages; on OXYGEN supplementation & one ventilated ; he saved them ALL and ZERO died under his care.
His score card is a bewildering
*4000 saved : 0 died*
His line of therapy are common drugs ...
1.Anti Inflamatory
2.Anti Histamine
All our Doctors need to do is prescribe one extra medicine that is "Promethazine" to handle dyspnea caused by C19. My belief is , the intake of this antihistamine should be 100% Safe. That is what Dr. Sankhara precisely used to save his Hypoxic patients due to C19 invasion.
*DOCTORS*
🙏Please👨🔧
watch this MD Dr.Shankar Chetty (Port Edward), South Africa being interviewed (1 hour) over skype by another doctor from UK, Dr.Phillip McMillan (Physician) in a very recent interview (video posted on May 2021)
Our Malaysians pandemic fate lies in your hand. *Do listen to this video at least from 20 minutes onwards*.
I list here the exact timing ; for your easy reference ; where Dr. Shankara mentioned his Treatment method
*21min:40sec* Dr. Shankara begins to share
*24:55*
Breathlessness, Hypersensitivity, Steroid for Treatment
*28:50-34:08* ‼️
Hypersensitivity *Antihistamine*
*46.32* ‼️
The 7th Days/ 8th Day discussion
*49:40* Hypersensitivity Treatment
*51.12*
Those with Gastro Intestinal symptoms - he used H2 class of Histamine blockers
57:00
One Case / 8th day with severe Hypoxia 60% Saturation & his prescriptions
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Video Conversation TRANSCRIPTS:
ALTERNATIVE STRATEGIES FOR MANAGING COVID-19.
By Dr Shankara Chetty, South Africa.
Saturday 24th April, 2021 @ 18:00 UK Time.
Introducing Dr. Shankara Chetty:
• Natural Science Biologist
• Microbiology
• Family Practitioner
• Treated over 3500 COVID-19 outpatients
• COVID-19 researcher
He is stationed at Port Edward, South Africa.
Conversation hosted by Dr Philip McMillan, physician at United Kingdom.
Dr Philip McMillan
(PMM) : Hello, hi , good afternoon Shankara. It wasn't supposed to be you on the front. It was supposed to be me. But since you've started off, we may as well get straight into it. Now, welcome to everyone this evening. We've doctor Shankara Chetty from South Africa. Listen. Even if you guys weren't interested, I can tell you that this is probably going to be one of the most interesting conversations I'm likely to have with another physician. So, Shankara, just tell us a little bit about yourself and where you are in the world.
Dr Shankara Chetty (SC): Good evening Philip and good evening to your viewers. I'm a general practitioner in Port Edward, South Africa.
PMM: Shankara, when you say Port Edward, I've got an image here (computer screen) that I want people to see where you are in the world (map). So, that's South Africa, and we can see Cape Town here, um, we can see Durban here, and that's main South Africa. And you are (this is) just Google Map, there is Port Edward which is the major city closest to you. And then, as we get closer, you are right down, you are beyond Port John's, aren't you?
SC: No, bit above, me, I'm slightly north.
PMM: Yes, I see. there we go ( computer cursor zooming into a location) and there is Port Edward, right here. So, you are quite close to the rural part of South Africa, aren't you?
SC: Yes, yes I am.
PMM: Mm, so yes, so you have been working in South Africa for a number of years but you actually didn't study in South Africa. Why was that?
SC: Philip, I did my science training here. I did a major in genetics and advanced biology at the University of Vantis Frontier in South Africa. I went ahead and added microbiology and biochemistry to my degree. But this was at the time of apartheid where we had photo systems for entering into universities. So I, I, I wanted to study medicine but due to cultural systems I couldn't get in, get a place at, a placing a placement at the university. I had a friend that studied at college in India and he suggested I applied to them. And I was promptly accepted and so I spent another seven years in India studying medicine in a town called Mysore which is the south of India, at a college , JSS medical college. (Location here)
PMM: Wow, wonderful. And so, then you came back to South Africa and you have been practicing for what over 20 years now, wow.
SC: It's actually, I started my practice in 2001 and this year is my 20th anniversary.
PMM: Wow, wonderful, wonderful. So, tell us a little bit about where you work because this is very relevant when we start talking about COVID-19. What is that area like? um Port Edward.
SC: Port Edward is a holiday destination. So, I see a lot of foreign travellers. It is also a place that a lot of South Africans choose to retire in. So, I have a wide demographic of geriatric patients. I'm also surrounded by many rural communities. And do I have quite a large contingent of poor patients that use my services. So I have a broad diversity in age, in race and social economic group that I serve. And I have kept my practice that way, I think the diversities allows me some passion in what I do.
PMM: Absolutely, and so, in reality how far away are you from the nearest major hospital ?
SC: The closest private hospital to my location is about 35 kilometres away. And the closest government facility is closer to 45 kilometres.
SC: I don't have. I don't have any other services between us.
PMM: Wow. So therefore, so this the interesting bit. Then, so therefore what that means is that you and your patients have no access to tertiary care facilities like ventilators or anything like that you or do you even have access to good amounts of oxygen.
SC: Okay, look uh, with the diversity of patients that I see, we have a medical aid system in South Africa where some patients pay into a medical aid and they can afford good healthcare. Now those patients I could transfer to hospitals, run blood testing on there, I can invest in their care. But a large proportion is rural community that have no access to such facilities. So even in my treatment, I have had to look at a diversity of ways to handle this, dependent on the patient's needs.
PMM: Absolutely, so okay, so let's get closer to the issue about COVID because you clearly had an interest in microbiology. What was it that peaked your interest when it came to covid-19, prior to it becoming a global pandemic. Were you looking at it from the point of even when it hit China?
SC: Yes, uh Philip, it is a passion of mine, uh, nature generally, is when I heard the news of this uh, virus starting in Wuhan, I started to watch closely as to how it spread. The information coming out. But the Chinese were very quiet about research and information at that point. So, I had to wait for this to spread out of China before I could rely on any data that was being published. When it got to Italy, I started to get more information about the nature of the illness, the symptoms that were presenting, how quickly it, the disease evolved and the virus spread. So, just from that I had an inclination that we were missing something. And it seemed like the virus could not be giving us all the kinds of pathology we will see. So, I think I had a healthy, uh, I would call it an intuition that something was amiss. And needed to be further investigated.
PMM: Mmm, and so you have been looking at that in detail and even before we come to what you do with your patients. What conclusion did you come to when you looked at the the way how the disease presented with patients.
SC: Uh, Philip, I've seen a lot of cases of the pneumonia. I've treated a lot of patients with respiratory illness. I have the large contingent of my patients that have severe COPD and lung conditions, a lot of cardiac patients , a lot of co-morbidities that I manage routinely in my practice. [NOTE: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. ]
I see a lot of, uh, HIV and TB and those kinds of things. So I'm well aware about the disease pathologies. And when I look at coronavirus, it didn't make sense. There were those people that progressed very slowly and resolved completely, and, there were those who suddenly fell ill and critically ill within a day or two. The age groups that were affected didn't make any sense. The co-morbidities didn't seem to play a part in the illness. So I looked at it and I thought there is definitely something that we are missing with this. And the only thing that could explain this diversity of presentation would have to be an allergic reaction to something, depending on the patient, not the virus. And so I suspected that there was something going on that needed to be further investigated. Looking at the research at that point that was going on around the world, there was a lot of studies done on hospitals patience and the rest. But there was, there weren't any studies done on the initial presentation and progression of this illness before the patient got to hospital. So, I thought that we examining this far, too far away from the onset of the illness to find understanding in it. And that's when I made the choice to start to see patients and examine them from day one and understand how this disease got you to hospital in the first place.
PMM: And let me, let me put it into context for people. There's a reason why Shankara is so important here. Because you have managed over about 4000 outpatients without any one of them dying or needing to go to hospital.
SC: Yes, Phillip. And to date is I don't have oxygen in my practice. I've never found a need for it as yet.
PMM: Wow, that's incredible. So this is where the understanding that you have is of tremendous value to the rest of the world. And again, let me put something in, into context. When we speak of the management of Covid-19 and we speak of using intravenous heparin or low-molecular-heparin and we are talking about people going on oxygen and they're going into intensive on ventilators and we're putting them in the prone position. The reality is that the rest of the world outside of the first world does not have good access to those kinds of facilities. They just don't have it. And what it almost seems as though even though the first world (countries) is in the front with regards to the management and the leadership of COVID-19. It doesn't seem to have or face some of the challenges that the rest of the world has to face, in terms of resources.
SC: Yes, that's, that's, that's very true. A lot of the medication that has been touted for the treatment of corona virus from the start is unavailable to the greater majority of the population in the world. And of course, if it requires hospital administration for any intravenous drugs, that precludes me using them. So, I had to choose from the toolbox I had available to me to make an impact on this.
PMM: Wow, okay, so when you, let's again remind ourselves that whatever you are doing is working because you said none of over 4000 patients that you have managed have died or needed oxygen. And primarily, your strategy is to catch them early, is it?
SC: Yes, it is. And , uh, and Philip, I've relooked at all the medication that I use , and the clinical benefit of every medication that I'm used is absolutely obvious. I was forced to use clinical improvement as a measure of the medication efficacy. And every single patient that I have had shown improvement with every medication that I've put them on, there's an expectation of a certain type of improvement. Every patient was educated about what I expect. And every patient within a day or two of starting treatment showed great improvement. So, I have no reason to question my treatment modalities.
PMM: Wow, and so how did you manage the issues in terms of cross infection and so on? Because you didn't have full scale PPE (Personal Protection Equipments), how, how were you coping with that kind of issue.
SC: Look, I have a, I have a broad knowledge of how respiratory viruses work. So, I choose to fall back on my education rather than follow what was coming out of research. There seemed to be a lot of controversy. There seemed to be a lot of confusion around the virus. [ Mani Karimzadeh messaged : Beautiful points] Now when I look at a respiratory virus, the two main things that would prevent its spread is sunlight and ventilation. And of course, me keeping my hands away from my face and keeping patients' distant from each other. So, my home is above my practice. I am a solace practitioner, so I don't have a wide group of staff to assist me with this. I have two nurses and that's it. The three of us have to find a way to deal with this. So, I moved out of my home to protect my family. And of course, isolate from public because I would be the most at risk person in the, in the community. And I pitched a tent outside my home, a proper A-frame tent with a consulting room and a screening area. And I marked my floors, in my practice, with red stripings to keep people, uh, that it , it creates an understanding that your hands must be kept to yourself. So, you stay between the red lines. So , I did little things where I could triage patients at the front gate separate them out into COVID positives , those that were suspects and those that were in my practice for other reasons. And so, in so doing keep the population separated. As far as prevention goes, I double masked, I put a visor on , I use a white lab coat to keep myself from touching anything around me. And I went and saw my patients. I never donned full PPE in all this years that I've been seeing with patients. I just ensured that once I was done in my COVID tent, my coat came off carefully, I sanitize my hands, I took off my visor and I was ready to see those patients that were not exposed over there for other reasons. And so far, I have never had a single cross-infection in my practice. Not a single patient has come back within a few days reporting COVID like symptoms.
PMM: That, that is absolutely incredible. Absolutely incredible, okay, wow, okay. So let's now get down to the nitty-gritty. What do you think of using initially and why. What made you choose what you decided to use with the limited resources and why?
SC: Ur, before Corona came to South Africa and from observing all the data that was coming out from the rest of the world I had a suspicion that we're dealing with an allergic process. So, in doing such I mean I'm a dispensing doctor so I needed to get stock of medications to prepare for this and so I look at all the different modalities of treating different allergies I look I needed to have antihistamine available, I needed to have good stock of a, steroid available. I knew the concerns with using a steroid in a viral illness. I needed to figure where it would be of most benefit. At that time, hydroxychloroquine was the hot topic around the world. And I looked at the medication but more from an immunomodulatory perspective rather than it's antiviral properties. Because I had an inclination I'm going to be dealing with an allergic condition. And I also had an inclination that the benefits that we're seeing around the world were due to its immunomodulation rather than its vericidal effect. It is the reason I chose ivermectin as well. Those were the two medications that I chose that are out of my routine treatment. Everyone treat a bee sting or analogy. So, we all are clued up on how to do that. So, I chose those two medications solely to look at them from an immunomodulatory perspective and see whether there was some benefit to them.
PMM: And so with regards to HCQ then? So when you saw all the studies coming out across that were either equivocal or saying that there was no benefit, um, what was, what made you still think that was worthwhile to do?
SC: Hydroxychloroquine has a long history of being used in large groups of people that will face viable illness. Army use it, soldiers going to war use it, there's been a lot of use of use of this medication and I've used it in the treatment of malaria in South Africa, so I know the effects and side effects and all the rest of it. So, I wasn't concerned about it being something that would be risky to do. And so, I thought there's no reason for me not to try this and very quickly I would be able to evaluate its efficacy and make a choice as to whether I need to continue or whether I need to change to something more effective. And that's the reason behind me choosing hydroxychloroquine. But the thought process was always around its immunomodulation benefit. I have a lot of patients that use hydroxychloroquine for the treatment of rheumatoid arthritis. And I'm well aware of how we should be managing those patients and the dosages should be adjusted. And all that, all that kind of things. So, there was no concern about safety, with using that particular medication. So, I decided from the start to try it and see where we go with it.
PMM: So, that's, that's very interesting. And what I'm trying to understand is that from a practical point of view when patients start to feel unwell, the standard practice in most, most countries is to say 'stay at home' and then if you need, if you really get short of breath, then you come into hospital. What advice were you giving to your patients in the, in their district.
SC : Okay, look, when the world health organisation (WHO) brought out protocols that everyone must isolate patients wording allowed to seek the attention of the doctors personally of their doctors personally. I had a mob outside my practice, asking what what was going to happen. And so I ensured all my patients that I would make myself available to them. So they were well aware that they could seek medical care timelessly. Very soon into the pandemic I realized the importance of the eighth day and what was transpiring on that day. So, very quickly the community were informed that if they develop any flu-like symptoms, they need to report it immediately. And so I had floods of people coming in with flu-like symptoms that I needed to assess and decide how to treat this. So, I think my community was very well educated (by me) from the start. Not to be fearful after all we are in charge of taking care of people's health, be it emotional, be it their physical health and I found that the fear around the pandemic was going to to cause problems. So I had to provide my patients reassurance even if it was going to challenge my own existence. I am passionate about what I do. And I think that I needed to do what needed to be done. And so I make myself available today.
PMM : And so, therefore the primary strategy, I'm just thinking about what you are saying, your primary strategy was to get people as soon as they started to feel unwell, coming to you for thorough potential therapy. And how did you differentiate Covid symptoms from, say, a typical flu or something? What what what did you use to differentiate that?
SC : Okay, Philip, from the beginning I asked patients to come in early, not, not because I understood the benefit of early treatment. But the reason I had done what I did to set up a tent and things was more academic. To understand the pathology from day one. So, that was the reason I put the tent so that I could see how this evolved. And the symptoms of coronavirus and the flu are almost identical. They cannot be told apart clinically in those first 7 days. So initially in South Africa, there was a big push towards testing. So every patient that came in with symptoms got sent for a coronavirus test. So it made it a little simpler to find those that were positive and focus on them. But it quickly became clear that the test was not reliable. And I was seeing cases that are tested negative and was actually positive. So it became more a clinical endeavour. I asked, I knew that we were dealing with an illness that causes severe dyspnea. So, I explained to every single patient that the onset of dyspnea needs for them to report back to me immediately. So that I could understand where this dyspnea was coming from, and how it presented and all the other symptoms associated with it. So that it will give me an understanding of what I'm dealing with, with that breathlessness.
PMM: So, when, so, you would find because this is no, what you have observed is what I've been trying to find the answers for, so, this is, this is perfect. So, when did the patient started with the symptoms, how long after it is start to get short of breath ?
SC: Okay, this is the most important thing in this pandemic. Uh, the initial viral illness is something I treated typically. The way I would treat any other virus lineas, symptomatically. Patients got an antihistamine for a runny nose and something to control their temperature And and anti-inflammatory for the body aches and pains. And if they develop symptoms of bacterial infection, they got an antibiotic to go with it. But everyone got educated that symptoms must improve and any worsening or change of symptoms should be reported immediately, but this was more an academic endeavour for me to understand the illness. Then I noticed, in the first, I think 5 patients that got breathless that the breathlessness always occurred exactly a week after the onset of illness. And I found this strange. I went back to my records and looked at those 5 patients very clearly. Yes, I had patients who hadn't had any symptoms post 7 days. But these 5 patients presented on exactly a week after the start of their symptoms. So I knew that the allergic process was being initiated on that 8th day, a week later. And it almost occurred to the hour. I had patients who developed symptoms in the evening on a Monday, would phone me on a Monday morning, a week later, to say, " I'm feeling perfectly fine. I must be over this. And I say, "Please just wait a few days, just to make sure you are fine." And without fail, they called me that evening to say, ' I got body aches and pains again.' And then, they're in the hypersensitivity phase of this reaction. Look, hypersensitive, hypersensitivity was a consideration but never something that I considered from the start. I knew I was dealing with an allergic process. What drew my attention to hypersensitivity was I knew that steroids would need to be started on that 8th day because that's the trigger of this allergic process. But I did not understand the nature of that allergy and I knew that it was a new process because I've had patients having flu-like symptoms for a day and improve. They spend the next 6 days perfectly fine. I've had patients play sports and things in that time. But exactly a week later, presented back with sudden onset of dyspnea with (oxygen) saturations that dropped to 70% within that day. So, it triggered my understanding, it brought an understanding that we were dealing with something that was occurring on that eighth day. So, I started treating it with steroids. So ...
PMM: Hold on, I just want to clarify something here because people listening may not know this. So, when you said hypersensitivity, people may not quite understand that from a medical point of view, there are four (4) types of hypersensitivity. (Shankara Chetty nodding his head)
PMM : Yes , there is type 1 which is like the nut allergy or the, um, well, just a typical nut allergy is a good example where they have anaphylaxis. Type 2 is where they've got an allergy where the body is producing antibodies that attacks their cells. And type 3 is when the body forms complexes in the bloodstream thickness ( Shankara says 'serum'). And type 4 is where it's cell mediated where the T- cells are attacking the body, that's the TB reaction that that demand two tests that we use (Shankara nodding his head) So, just to put it in context for people that there are four types but you were focused on the type 1, the allergic type that we would see the asthma or with with the hayfever type of symptoms that people would get, yeah, on exposure to the allergen. Sorry , go ahead.
SC: Yes, yes. So, with seeing this sudden onset of change in the symptoms on that eighth day, I started treating patients with Prednisone. We, we have a positive facility to do blood tests and to clarify what you are actually seeing. So, I had to use clinical improvement as a measure of efficacy. So, I started patients on steroids and I found it took two or or three days for them to improve and all of them got better. And so, I noticed that steroids seemed to have the benefit, like it was reported around the world, uh, the reason for me looking at steroids as my first choice. And then one fateful patient came in with the (oxygen) saturation of 80 odd, very dyspnea, a very young patient, overweight, diabetic and I knew I had to give her the steroid. And I looked at her and I thought if this is a type 1 hypersensitivity because of its speed of onset, then maybe I need to add a strong antihistamine like I would (treat) a bee sting. So, I gave it a kiddies dose of promethazine just for a day, to see what would happen. And I got, well, I got my staff to follow up on almost every patient on a daily basis just to see how they improved. Because obviously, the clinical side of things was vitally important in me fine-tuning how I treat them. And this particular patient by the next day was perfectly fine. And so, my staff were, were very excited and came to me and said, "Hey , she's perfectly fine." And I said, just watch and see. I only give her a day of antihistamines and as that well wears off, she probably will get breathless again. And that's exactly what happened. But she timelessly came in as soon as that happened and we continued the dose of antihistamines and she promptly recovered. Uh, since then, I've seen many of those immediate recoveries. And so if you might get into a sudden onset allergy process.
PMM: So , you were finding that use of antihistamines, simple antihistamines were beneficial once they started to become short of breath.
SC: Yes , very beneficial.
PMM: Mm. ( Dr Philip McMillan brings his clasped hands to his lips).
SC: I see if I have a case in point, Philip. I've treated lot of patients over the phone. I live in, uh, I'm from South Africa, so, I have lots of friends and family around. I had the gentleman, a 54 years old gentleman who's diabetic and hypertensive and had a double stents (in his heart) put in 2 months prior. Uh, he's not my patient (directly), he lives in my hometown and he's friends with family. And his daughter phone me to say, "Dad's got COVID." And I explained to her about the onset and I said, "Look, next week Wednesday is his day to have this kind of reaction, please keep me posted. I need to respond immediately." She contacted me on Friday, three or two days after this had started. Very frantically asking me to please give her a script for oxygen. So when I inquired why, it transpired that her dad started experiencing breathlessness on Wednesday, like I had predicted. By Thursday, it had developed to the point where he had become oxygen dependent , he had spent Thursday night on the oxygen, could not take his mask off because his sets (stats) kept dropping. They were prepared with the pulse oximeter and the rest. On Friday morning the oxygen was running out and so she frantically phoned me. I subsequently sent her a script to say, "Look, I don't see the need for oxygen." I sent him a script for a step close of 12 Prednisone and 25 milligrams Promethazine to continue with. She got to him at lunchtime. His cardiologist had already made arrangements for a hospital bed for him. He was sitting there with his bag pack contemplating his fate. Because obviously when patients go to hospital they never get to see their families again unless they come out recovered. And his daughter had picked up with this handful of pills. He took it , I phoned the next morning, being Saturday morning, to find out how he was doing. He had not needed the oxygen through the evening. Within an hour or two of taking the medication, he has shown improvement. He managed through the evening without oxygen. So, I got his telephone number from his daughter. I phoned again on Sunday morning to find out how, whether the improvement is continuing. And his wife told me that he's outside washing the car.
PMM: Wow ( with a smile)
SC: I can't, I could not ignore that. And the reason I'm here today is not because I did any research or anything down in this field. The the progress I saw with my patients was remarkable. We could not ignore it. My staff and a few pastors in the area that I had treated 'forced' me to make this information available. So, I wrote an article and give it to Modern Medicine. I was very well aware of the overreach in control of governing bodies and pharmaceuticals and the the whole, the whole governance around it. So, the last person I wanted (anyone) to hear about my findings was the World Health Organisation (WHO) because they were creating more controversy than they were solving at the time. And so, I sent it to all the doctors that I could think of. I send it to my principal in my college in India that I had studied. I put it on chat groups of doctors that I'm part of. And I had immediate great response from all of them. It was just in South Africa that I received complete silence.
PMM : Mm .
SC: And looked at the pathogenesis with doctors around the world. And I had to keep doing what I was doing. At that point it was 200 patients in the first wave. And so we had the second wave and so the numbers have increased drastically.
PMM: So, there's a question that keeps on coming up (from listeners) and I think we probably just need to deal with it. [ From Paulo Pires: Do you recommend Ivermectin?] And here it is Paulo says "Do you recommend Ivermectin?" And as soon as I said that, somebody else says "no Ivermectin" [From Christopher Cirino DO MPN: No Ivermectin.. people are taking veterinarian meds. No benefit]; um, no benefit. Any thoughts from your experience?
SC: Okay. Uh, Ivermectin has a very unique way that it acts in this pandemic. A lot of people are looking into its vericidal properties. But if you look at in vitro studies the dosage of Ivermectin required to inhibit this virus is toxic to human beings. Now, when I looked at Ivermectin at the start of this pandemic I was looking at it from an immunomodulatory perspective. So I found no need to use it early in the disease evolution. I managed to get just 20 tablets from a friend of mine overseas. So, I know that I needed to use it and make sure that I understood its benefits. So, I started to use it in patients who presented with dyspnea. Now there's a reason I did that. Ivermectin is an anti-parasitic agent which unlike people think it's a veterinary medication. It's used in the treatment of filarial illness in human beings. [ Note: plural fi·lar·i·ae; Any of various slender, threadlike nematode worms of the superfamily Filarioidea that are parasitic in vertebrates and are often transmitted as larvae by mosquitoes and other biting insects]. And it is one of the mainstays in treating filarial illness. Now the reason for that is when we treat filarial ..
PMM: infestation isn't it, sorry.
SC: Yeah.
SC: And that's been the controversy about us using a word medication to treat a virus. Now, when you treat filarial, the debris of the dead worms or parasites that are left in your lungs trigger a severe hypersensitivity reaction in the lungs. This presents as a sudden onset of dyspnea which progressively gets worse. Now, there's been years of investigation into the treatment of filarial. And what's been found is that medications like Ivermectin tend to clear eosinophils from these lungs very effeciently. And so, they have become the mainstay of treating filarial illness. So, I used Ivermectin for its potential to clear eosinophils from an allergic lungs. Because I was of the opinion that this virus was triggering an allergic reaction in the lung. It may not have been present in the lung. The site of entry might have been far away but it was triggering an allergic process in the lung. Whether a bee sting you or stings you on your behind or your chest, your lips swell up. So, we don't look at your lips for the bee sting. So, I knew what I'm dealing with pathology in the lung and it's an allergic process. Subsequently, I've been looking at medications like Diethylcarbamazine citrate. [Diethylc carbamazine citrate is a crystalline solid, scored white tablets. Used against filariasis in man and animals. (EPA, 1998)] Now Carbamazepine is a medication that is a first-line treatment. For the treatment of filarial and it has greater potential in clearing eosinophils from the lungs. It's just that in the country I'm in, it's unavailable. So, I've not been able to look into whether I have greater benefit from that kind of medication. But it has been shown in trials for the treatment of filaria, to clear eosinophilia within pulmonary eosinophilia within 24-hours . So, it was my next step to try and convince the world that we are dealing with the pulmonary hypersensitivity pneumonitis, not a viral pneumonia. Viral pneumonia cannot be treated within one day. Or else Carbomizine Citrate tablets would have been my saviour.
[ From Kelly Wagstaff : Have all your patients fully recovered? Any cases of long COVID? ]
PMM: And so here's a question, somebody said 'have all your patients fully recovered? And and any cases of long COVID?'
SC: Okay. I need to divide my clientele up to answer that question. Every patient that presented in those first 7 days and was educated about the hypersensitivity reaction on 8th day and presented promptly for treatment which which is the majority of the patients that are treated, recovered timelessly and had no long-term consequences. I've never had a case of long COVID, neither have I had a case of Covid sequela coming back after a few months. I have not (patients) had diabetes, yes, I had patients who have had severe illness which took a while to settle. And they had some long injury due to that illness which presented and needed to be controlled there in after. But I have never had a patient fully recovered and come back with new symptoms.
[ From Vivian R.F. Linssen: Outstanding pédagogue.]
PMM: Wow, so that is, that's tremendous, you know. And so this is, this is why I'm saying what you have been speaking here is so critical for the world to be able to hear because what you're doing is working whether or not people agree how you do it, at the end of the day as a clinician, I say, listen, if you make patients better, I don't care what you do as long as you make them better. And this is what you are doing. So, it then raises a question about what would your view be, after treating 4000 patients of which none have died, none have needed oxygen, would you vaccinate them?
SC: I'm in a unique position. None of my patients have died. None of them have had any long-term side effects from Covid, so I think a vaccine salesman will have some lofty goals to beat. Even one death or one side effect is one too many by my clientele. So, I would say that vaccination has its place, it might, if it, if instituted correctly, prevent us getting coronavirus, but as long as we have any deaths or side effects from the vaccine, I think my treatment has stood up to the test of time far better than the vaccine would.
PMM: And so, well, why is it that you are not getting more attention with regards to this work. What, what is, I mean, I'm thinking to myself, I, I was not, you were highlighted to me, you know, by someone else. Why is this work not getting the attention that it should?
SC: Uh, look, there but I think I, I would put it down, not my opinion. But I will put it down to the way medicine is taught around the world. There are countries where medicine is very regulated and people are taught to follow protocols and not to step outside the box. And so they got to wait patiently for governing bodies to set up protocols before they treat anyone. In India, we are taught to think outside the box and to try anything, uh, the paucity of testing and all the ancillary services that would give us direction to diagnosis are not available. So, we were taught to diagnose the patient on our clinical skills and only use further diagnostics tests to confirm our diagnosis or clarify it. Never testing to come to a diagnosis. I treat patients, not test results. So, uh, I've got, I, I've got to use my clinical skill to treat all these patients. And I think that plays a very big part in how we respond to our clientele. I think a lot of it as well comes down to arrogance and snobberry. Uh, it's difficult to convince someone of something when they are closed in the way that they are managed with people. A lot of patients made a comment to me, to say, you seem to have curtailed the mortality and the mobility that goes with coronavirus. But unfortunately, I might have impacted on the profitability as well. And I think that plays a part in people listening to what I have to say.
PMM : Oh, absolutely right.
SC : One my scope of opinion.
PMM: Yeah, so here is, [From Christopher Cirimo DO MPH : Are these patients also receiving Prednisone as well? Would these patients have improved without the therapy?( Is there any RCT) Yes, I understand the challenges of this format, but since it is an experimental agent, it could be further researched.] a point that was made about your patients receiving Prednisone. And I think they're differentiating between Dexamethasone which was demonstrated at Oxford, you have chosen ,um, Prednisolone. And do you think that these patients would have improved without your therapy? And RCTs that's in effect the viewpoint of most of the medical world if you haven't done a randomised controlled trial, um, it doesn't mean anything.
SC: Uh, look. Like I said, this was never intended to be a randomised control type and as far as I'm concerned, randomised controlled trials are unethical in a pandemic. Uh, Philip, I have, I have a broad understanding of what good clinical practice actually is. Uh, a few years back, I was approached to join a centre for research excellence to do phase two clinical trials on medications that are under development through pharmaceutical companies. So, I've been through all the the the means to to understand what good clinical practice is in doing a clinical trial. I'm also well aware of what was discussed in ( now Dr Shankara Chetty raises his right hand and pointed in the air) Nuremberg and Helsinki. And why those are very important things. Unfortunately, I never signed the contract because I can't see, I can't watch the placébo group disintegrate and I have to document it without instituting any treatment for them. So, I didn't get into that. But I am very well aware of what's required for running a clinical trial. Now when it comes to whether I'm sure of whether the medication worked or not, there were two means of me judging this. One was good clinical improvement. I had a patient in front of me that was steadily deteriorating over the past few days. And so, I instituted treatment and checked up on every single patient the very next day, to find up if they had improved. This was more from a perspective of having to adjust the dosage of steroid, so that I can get good clinical recovery very quickly. So that I'm not to prolong the agony of that patient and to allow this to spiral into a cytokine storm. So, the child is not a randomized controlled child (trial). I'm treating patients. [From Gretchen Magner: Thank you so much for speaking out! I wish more doctors and officials here in the US were more open to other treatments. It's like they have shut their eyes and ears to anything but the vaccine.] And I've got to make sure that there is a constant improvement in their symptoms. It is how I came to the understanding of a change in the symptomatology of this disease on the 8th day.
PMM: Yes .
SC: No testing or randomised controlled trial would have picked up.
PMM: Absolutely.That, that's just good clinical medicine. So, let me, let me, let me just, so I think this is what people want to know, understand, here's to reality. So, there will be medics listening to this conversation. So, I'm going to give you some examples. Okay. So, um, the first patient comes along, um, say for instance, uh, 25 years old, they have had flu-like symptoms for a week. When they come to you the first time and they have had a little bit of flu-like illness, you think it's coronavirus, do you give them anything?
SC: The initials 7 days, uh, I treat like a viral illness. Now all the patients that come after that seven days, they have to be interrogated about their symptom progression. Now, almost every single patient that was symptomatic in the first 7 days, reported clinical improvement on day 6 and 7. Now, I think we don't need to delve into all the semantics about recovery. We are all aware of when we start to feel unwell. And we tend to lose our appetite, and get body aches and pains and that kind of thing and we all are very well aware of when we feel better and get our appetite back and feel like we've passed the worst. And that was reported at the latest for every patient on the 6th or 7th day. Some patients recovered within a day but a majority I say 99 of patients reported that on the 6th or 7th day, they started feeling better but took a turn on the 8th day and presented to me on the 10th day.
PMM: Absolutely.
SC : Okay, yes, at home, this became a very sad affair. Because as this information got out to my community, patients realized the importance of presenting early. And it seemed those with less education understood better. Because they didn't give the pharmacy a chance and their limited clinical understanding of the illness a chance with over-the-counter medication and present to me on the sixth day being very unwell.. And in anticipation of what might transpire. So, I had a lot of patients coming to me on the first or second day, understanding that this was very necessary. Now, when I educate them about what would transpire on the 8th day. So, I plotted for them, exactly which day they would experience certain symptoms if they were allergic. I school(ed) them about those symptoms and not to take them likely, even if it was a solitary symptom and very mild. Now, when explaining that to them, they had already had family members that had demised with this illness and it rang so true that I had patients crying that, that was exactly what happened to the family member that passed away. They thought he was improving, only to have taken a turn a week later. And ended up being critical condition in hospital and demise.
PMM: Okay, so the
SC : Patient understands it .
PMM: So the patient now, okay, so the patient has had the initial symptoms you've seen them , you've given them some general advice, you tell them you, you warn them that "listen, if you start getting short of breath, you come back immediately, okay?"
SC : Yes .
PMM: When you see them, this is Day 8, they're short of breath, what do you give them ?
SC: On day 8 , I start them on, look, we are dealing with a hypersensitivity reaction. So, my treatment followed that basis. I treat them with Prednisone and appropriate dose of Prednisone to stop that, yeah.
PMM: Not Dexamethasone ?
SC: No. I've never used Dexamethasone. It is an intravenous drug, I don't have the facilities to have that administered to patients. So, I used methylprednisolone, the dosage has changed from the first variant that we've seen. And that's the reason I considered the South African variant, the second variant a little more allergenic. It took me a week or two to realise that the dosage of steroid needs to be up drastically for the second wave. But the the start of treatment is a combination between methylprednisolone, the dosage I found with the South African variant from treating a lot of people averaged at about 80 milligrams a day, which is 65 milligrams of prednisone tablets to start with. I added to that an antihistamine for those (with) severe reactions, promethazine was the the drug of choice because it is a very strong inhibitor of h1 , uh, type 1 anti, a type 1 histamine, uh, but level citizens showed benefit. I gave it to peer patients at a 5 milligrams VD for those that came in breathless, uh, a lot of patients in this second wave presented with gastrointestinal symptoms, uh, I'm of the opinion that the change in spike protein with the South African variant made the virus more, had a greater affinity for ACE receptors in the guts. So, I had a lot a lot of patients presenting earlier on with gastrointestinal symptoms which only subsided with the use of H2 histamine blockers. Submetadine and famotidine and those kind of medications. PPIs and antibiotics and anti diarrheas showed no benefit at all. The only thing that suppressed those kind of symptoms post 7 days was the Prednisone and the antihistamines.
PMM: And what about, so, where would you have and used your HCQ or your Ivermectin in this group?
SC: Now I found, I tested Ivermectin in the first wave. I gave it to patients early on in the illness the first 5 days. Ivermectin is known to be anti-inflammatory and that kind of things, so patients did show an improvement in their symptoms. In the first wave very few patients on hydroxychloroquine progressed to the second part of the illness. [ From Tatiana Bilokha : Thank you very much for your clear position and success in your future struggle.] So, I was under the impression that this needed to be started early because those who presented to me on day four or five progressed into the hypersensitivity phase even though Ivermectin was started. It was only those that were started on day 1 or 2 that seemed not to go into that (hypersensitivity phase). I had none of my patients on on hydroxychloroquine have that reaction. But I didn't use hydroxychloroquine on a broad base. I had certain patients that I tried it on, I had certain patients that I didn't. And so that I could get a good understanding of efficacy. We'd call it our control group, even though they were treated with other medication. Uh, that's where I saw the benefit. But hydroxy chloroquine is not the silver bullet that we expect it to be, neither is Ivermectin on their own it will not save lives. You need to have a broad-based understanding of what you are trying to achieve, so that you can institute the right treatment at the appropriate doses at the appropriate point. This is not a bacterial infection where we can slide a script cross the table for 5-days of antibiotics and allow the patient to get better. The viral illness like a majority of violent viral illnesses have a finite time of infection. And they evolve through the process. Like chicken pox, you get a flu-like symptoms and headache and fever but you don't have pox as yet. And then after a few days, you develop a few spots on your body and then it becomes crops and eventually the last set of crops blister and dry (up) and you are over with the illness. So, the treatment on the first day (is) very different from the treatment on the last day. And so, understanding where you (are) in the evolution of the disease is paramount in formulating the type of treatment you need to use.
PMM : Absolute, what a tremendous, tremendous. Listen, I'll ask you one more question, we're going to start wrapping up shortly. Where is your position with regards to vitamin D?
SC: I've used, look, initially I advised a lot of people to get onto the supplements that were being touted as prevention for coronavirus. Very quickly it became evident that there were far more effective medications to treat this. And the supplementary medications became second-hand. They did not show the remarkable benefit I was seeing with conventional treatment. So, from a perspective of affordability I could not ask a rural patient to go and invest in vitamin C and vitamin D and zinc and not have the finance available to treat them when they got the illness. And it was the same issue with the PCR testing as well. I couldn't have patients waste money on a PCR test and be left without finance to treat the illness when it turned out positive. [ From Craig Mūller: And is the the PCR test the way to test? ] So, a lot of the, the diagnosis of the illness was based on clinical evidence on the 8th day. Those were the set of patients that I started testing, not before.
PMM: Mm .
SC: You have corona for 7-days and you improved with no consequences. On the the 10th (day) of illness, you would be fit to be let out into society, irrespective of whether it was coronovirus or not. That information means nothing to me in treating. The only reason I did the test on the 8th day where there were clear worsening of symptoms was to satisfy the research community that I was dealing with coronavirus.
PMM: Absolutely. So where where do you think we are in the world, when we take into consideration what is happening in India? Is what is happening in India just another variant or does this look like another direction that this virus is taking?
SC: Uh, Philip, I've been in consultation with friends in India now for a few days looking at the second wave of illness and what we expect to see and how we should be managing it. Uh, the 8th day is still vitally important. From all that I've been hearing, patients get sick and show deterioration on that 8th day. Now from my practice, the most vital thing in saving patients' lives was educating them about the 8th day and the severity of what might transpire thereafter and the preparedness for that particular day. I went as far as giving patients, pre, I post dated script, I'm closed on the weekend. So when I predicted a patient to have this worsening on a Sunday morning , I was not available to treat them. And I found they pitched up at my practice on Monday morning with (oxygen) saturations of 60 percent and ready for hospital. So, I had to find a way to get to them a lot more quickly, so that I could buy time for them to get to medical care. So I printed out a script of Prednisone 80 milligrams a day for a week because I was an unaware of how quickly they could get to me, Promethazine 25 milligrams, three times a day, and for those who could afford it, I would add monte Lucas or/ and or a Ventris a salbutamol syrup for helping those that were asthmatic or the kind of predisposition. And this script had a label on it to say, ' Do Not Take This Medication Before ..' and in red I would write ,'their date' that they would expect the (hypersensitivity) allergic reaction. And below it, it said 'And Only If Your Symptoms Worsen '. And so, they would on my medication in the first 7 days, but be very vigilant about the onset of symptoms on the 8th day. Now dyspnea are presented sometimes a little later from the 8th day. So, body aches and pains onset of fatigue to the point where you want to sleep constantly or dyspnea. Where 3 symptoms and I found heralded the onset of the allergic phase on the 8th day. So, I instructed patients that if there was a distinct difference from the previous day and they noticed these symptoms, even a solitary symptom that was mild but unusual, they needed to combine that medication on that script (pre-scription) with whatever they were taking and get to me timelessly.
PMM: Wonderful. What a wonderful ..
SC : I have no patient got into problem. Now in India, that kind of information to a rural population is difficult. But I think not impossible. In my community, it became very evident very quickly about the importance of the 8th day. A few pastors there, uh, in the area around me got coronavirus and I treated them for it. And they started spreading the word in their congregations about watching for that eight day (allergic reaction manifestation). And I would hear even when the most illiterate Goku sitting and waiting for me, talking to patients outside about the importance of 8th day. So , it's not an impossible task. (Dr Philip McMillan is smiling ] It's not something that we need education to understand. We have a healthy dose of fear for people to widen their scope of understanding to protect their lives. So, I think it is the most important thing to educate people about what's going to transpire. The treatment is pretty simple.
PMM: Absolutely
SC : I have not the patients require oxygen. Every patient improved within a day or two. None of my patients, ever came close to being considered for hospitalization. And the two or three deaths (cases) that I've had where patients whose families, out of concern, asked for them to be put into hospital care hoping that they would get better understanding and treatment in that environment. But unfortunately, I'm not allowed to supersede anyone ( Dr Philip McMillan chuckles and smile). And once, my care, they steadily deteriorated. And that caused a lot of, a lot of psychiatric issues with patients that survived. Issues of guilt. I've had patients end up far more critically ill than their parents did but survived it, out(side) of hospital, with my treatment and advice. When they felt guilty that they put their patients in the hospital, their parents in hospital, while they (themselves) were under my treatment and had them (parents) demise.
PMM: Yes, yes,
SC: I think we need to relook at where we starting from this and you see, if the doctor in hospital doesn't know that you were stung with the bee, we got a problem.
PMM: Yes
SC: After the bee sting, and you are going to have multi-system disorders . [From LinkedIn User: I look forward to the day Dr Chetty replaces Dr Tedros at WHO !?]
PMM: Listen, I think that this is probably perfectly says it which we look to the day when you are in charge of the WHO. (Dr Shankara breaks into a smile and small laugh.) I mean some of the stuff you have said here has just been incredible. Really, really interesting. Thank you Vivian, [From Vivian R. F. Linssern: A very interesting discussion that must be extended worldwide.We must go global. My compliments, Viv] um, you know [From Sanja Jovanovich MD MSc: Exemplary clinical reasoning!] thank you as well Sanja. I couldn't necessarily get all of the points in, you can't see them but, um, [ From Raphael Kliju : This man is an artist in his profession. Very insightful.], I can see a lot of them. This is incredible, um, discussion. I have thoroughly enjoyed what you said. And I think that this really, really needs to be highlighted because especially in countries that don't have access to high quality and clinical care. [ From Marja van Doorn : Outstanding work Dr Chetty !] And actually based on what you are saying, they will almost be better off without the high-quality care and they will be better off with very simple work. If there's a takeaway from this Shankara is remember the 8th Day. (Dr Shankara Chetty nodding and smiling) God bless you. That's incredible piece of advice.
SC: I teach my patients, Phillip , that the day you get a sore throat is not important, but make a cross on your calendar eight days later and make sure there's no new symptom on that day. So, we don't have to send everyone for a coronavirus test. [From LinkeIn User : Superb clarity ].You can isolate yourself and be a responsible citizen. And if on the 8th day nothing transpires, you can go back out into the world in a day or two. [From Laiqha Khadro : Very relevant, Dr Shankara Chetty ]
PMM: Wonderful, wonderful. Just stay on the line for me, Shankara, we just going to close out now. Thank you everyone for listening. This has truly been a fascinating conversation and I look forward to bringing you more conversations like this in the future. Have a great day.
SC: Thank you, Philip.
( End of transcripts)
* Outpatient alternative management of COVID-19 : Perspectives from South Africa with Dr Shankara Chetty *
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https://covexit.com/the-8th-day-therapy-for-covid-19/
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