Courage to Face COVID-19 in Central America

Oct 3, 2022

Medicine is an art and a science and is one of the least standardized professional activities in each country. Given the novelty and complexity of illness SARS-CoV-2, the virus causing COVID-19 illness called doctors from all specialties with the courage to face the illness. With the worldwide nature of the SARS-CoV-2 pandemic, with >600M people affected and so many doctors engaged, it should come as no surprise that many different approaches developed over time and were found to be successful based upon empiric observations.

While the world had a hyper-focus on antivirals — hydroxychloroquine and ivermectin, innovative doctors learned how to treat COVID-19 with a greater focus on inflammation, cytokine storm, and thrombosis. In many regions, to make matters worse, governments, hospitals, and pharmacies essentially made hydroxychloroquine and ivermectin unavailable.

This week’s Report features Dr. Maria Eugenia Barrientos, MD, from El Salvador in Central America.1 She developed a practice of treating only the highest risk (~10%) patients (elderly, multiple medical problems) with a sequenced approach that featured non-steroidal anti-inflammatory agents (Ibuprofen and naproxen), aspirin, nebulized budesonide, and oral prednisone.

Dr. Barrientos relied on laboratory patterns revealed in the complete blood count, hs-CRP, and d-dimer to triage and risk-stratify patients. Because the syndrome was more likely to induce respiratory epithelial tract injury, she relied upon conventional antibiotics (amoxicillin/clavulanate, and Levaquin) to cover bacterial superinfection. She developed a network of doctors in Central America and Spain, and she estimates they treated thousands of patients.

Barrientos emphasizes that catching patients within the first three days of illness allowed a lighter multidrug regimen than was commonly used in the United States, which employed an NIH guideline that encouraged doctors to defer early treatment. El Salvador, which has a population of 6.5 M according to Worldometer, recorded 201,785 cases and 4,229 deaths.

These are far lower in cases, and deaths per million population than the United States, albeit the population is younger and in a more temperate climate spend more time out of doors where the viral transmission is low. It should be no surprise that Dr. Barrientos has not found the killed virus or genetic vaccines to be effective in stopping COVID-19.  In this extended interview, she gives us insights into the lab abnormalities seen in those who have taken the genetic COVID-19 vaccines.

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