Front Line COVID-19 Critical Care Alliance

Mission Statement and Objectives

Formed by leading critical care specialists in March 2020, at the beginning of the Coronavirus pandemic, the ‘Front Line COVID-19 Critical Care Alliance’ is now a 501(c)(3) non-profit organization dedicated to developing highly effective treatment protocols to prevent the transmission of COVID-19 and to improve the outcomes for patients ill with the disease.

We are dedicated to

• Reviewing all emerging published medical literature on COVID-19 from in-vitro, animal, clinical, and epidemiologic studies.
• Developing effective treatment protocols for COVID-19 that evolve by incorporating newly identified, applicable therapeutic and pathophysiologic insights.
• Educating physicians on safe and effective treatment approaches to all phases of COVID-19, from disease prevention strategies to the use of our combination-based therapy protocols in both early-stage (I-MASK+) and hospitalized patients (MATH+).
• Improving outcomes for people impacted by COVID-19 disorders through preventive and treatment strate­gies designed to optimize health.
• Teaching the public ways to prevent transmission of the virus and to advocate for the best possible care.
• Coordinating and accelerating the formation of research studies that will support effective prevention and therapeutic treatments for all impacted by COVID-19.
• We accomplish these goals by sponsoring high quality medical education for both the public and health care providers, via the publication of scientific manuscripts, media interviews, and medical lectures for medical providers and the public.

Versions downloaded in August 2021 below. Please check for updates on the FLCCC Alliance’s webpage:

Below you can download the I-MASK+ Prevention & Early Outpatient Treatment Protocol for COVID-19 with guidance on the timing and doses of each component medication. Further below please find more information on the I-MASK+ Protocol.

The I-MASK+ Protocol complements our  MATH+ Hospital Treatment Protocol for Covid-19 from March 2020, which is intended for hospitalized patients. Both are physiologic-based combination treatment regimens developed by leaders in critical care medicine. All component medicines are FDA-approved, inexpensive, readily available and have been used for decades with well-established safety profiles. In October 2020, we added  ivermectin as a core medication in the prevention and treatment of COVID-19.

The protocol document is available in several languages (see below) – more translations are available  here. This is not a medical advice, but a recommendation – please consult your doctor, share the information on this website with her/him, and listen. Please review our  Disclaimers!

Please check this page regularly for updates – new medications may be added and/or dose changes to existing medications may be made as further scientific studies emerge.

I-MASS – Prevention & At Home Treatment Mass Distribution Protocol for COVID-19 (updated June 2, 2021)

The I-MASS Protocol was created for generalized distribution during mass outbreaks and in low-resource countries. To achieve maximal impact as well as ease of deployment with the lowest burden of required elements, the I-MASS treatment approach is centered on the fewest, core, high impact elements such as the drug Ivermectin, an anti-parasitic medicine that is on the WHO’s list of essential medicines, has been given 3.7 billion times around the globe, and has won the Nobel prize in 2015 for its global and historic impacts in eradicating endemic parasitic infections in many parts of the world.

Ivermectin has proven to be highly potent against COVID-19. It has shown antiviral and anti-inflammatory properties in observational and randomized controlled studies conducted throughout the world. Practitioners and Health Ministries who have adopted Ivermectin in treatment protocols report significant reductions in time to recovery, hospitalizations, and death. The use of Ivermectin as prophylaxis and prevention has also been proven in studies to reduce the spread of infection and offer protection to high-risk individuals.

Also included in the protocol are Vitamin D3, Melatonin, Aspirin, a multivitamin, a thermometer, and an antiseptic mouthwash. The evidence for supporting the other vitamins and medicine can be found here: https://covid19criticalcare.com/covid-19-protocols/medical-evidence-and-optional-medicines/.

The FLCCC peer-reviewed paper summarizing this data has been published in the American Journal of Therapeutics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/.

Further supportive information can also be found here: https://covid19criticalcare.com/ivermectin-in-covid-19/.

Additional treatment protocols for COVID-19, including for hospitalized patients, can be found at https://covid19criticalcare.com/covid-19-protocols/.

Support for Ivermectin in the use of prophylaxis can be found here: https://scivisionpub.com/pdfs/ivermectin-as-prophylaxis-against-covid19-retrospective-cases-evaluati…

Disclaimer: The safety of Ivermectin in pregnancy has not been established. Particularly the use in the 1st trimester should be discussed with your doctor beforehand.

The Long Haul COVID-19 Syndrome (LHCS) is an often debilitating syndrome characterized by a multitude of symptoms such as prolonged malaise, headaches, generalized fatigue, sleep difficulties, smell disorder, decreased appetite, painful joints, dyspnea, chest pain and cognitive dysfunction. The incidence of symptoms after COVID-19 varies from as low as 10% to as high as 80%. LHCS is not only seen after the COVID-19 infection but it is being observed in some people that have received vaccines (likely due to monocyte activation by the spike protein from the vaccine). A puzzling feature of the LHCS syndrome is that it is not predicted by initial disease severity; post-COVID-19 frequently affects mild-to-moderate cases and younger adults that did not require respiratory support or intensive care.

The symptom set of LHCS in the majority of cases is very similar to the chronic inflammatory response syndrome (CIRS)/myalgic encephalomyelitis/chronic fatigue syndrome, although in LHCS, symptoms tend to improve slowly in the majority of the cases. Furthermore, the similarity between the mast cell activation syndrome and LHCS has been observed, and many consider post-COVID-19 to be a variant of the mast cell activation syndrome. LHCS is highly heterogenous and likely results from a variety of pathogenetic mechanisms. Furthermore, it is likely that delayed treatment (with ivermectin) in the early symptomatic phase will result in a high viral load, which increases the risk and severity of LHCS.

Although numerous reports describe the epidemiology and clinical features of LHCS, studies evaluating treatment options are glaringly sparse. Indeed, the NICE guideline for managing the long-term effects of COVID-19 provide no specific pharmacologic treatment recommendations.

Given the lack of available treatment recommendations in the setting of large numbers of patients suffering with this disorder globally, the FLCCC developed the I-RECOVER protocol in collaboration with a number of expert clinicians including Dr. Mobeen Syed, Dr. Ram Yogendra, Dr. Bruce Patterson, and Dr. Tina Peers. Although our varied yet often overlapping treatment approaches were initially empiric, while based on both preliminary investigations into and prevailing theoretical pathophysiologic mechanisms of LHCS, the consistently positive clinical responses observed, often profound and sustained, led the collaboration to form the consensus protocol below. As with all FLCCC protocols, we must emphasize that multiple aspects of the protocol may change as scientific data and clinical experience in this condition evolve, thus it is important to check back frequently or join the FLCCC Alliance to receive notification of any protocol changes.

I-RECOVER Protocol: Version 1, Updated June 16, 2021

MATH+ Hospital Treatment Protocol for COVID-19

Below you can download the MATH+ Hospital Treatment Protocol for COVID-19, for use by professionals, with detailed guidance on the timing of initiation along with the suggested initial doses and durations of each component medication. The protocol document is available for download in multiple languages (see below) – more translations are available  here.

Please also review our  I-MASK+ Prevention & Early Outpatient Treatment Protocol for COVID-19, which was developed for the prevention and early outpatient treatment of COVID-19. Both are physiologic-based combination treatment regimens developed by leaders in critical care medicine. All component medicines are FDA-approved, inexpensive, readily available and have been used for decades with well-established safety profiles. In October 2020, we added  ivermectin as a core medication in the prevention and treatment of COVID-19.

Please do not consider these protocols as personal medical advice, but as a recommendation for use by professional providers. Consult with your doctor, share the information on this website and discuss with her/him. Please review our  Disclaimers!