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I've spent, really, untold hours googling around preprint docs, research and medical reporting on HCQ. My best guess on any question about using HCQ for COVID-19 (prophylaxis or treatment) in short, I will give for free, and worth every penny.

And I am not a clinician, researcher or molecular biologist. And I am not prescribing, recommending, making claims, etc. You know the drill.

That said, here's what it looks like to me. COVID-19 usually has, by one schema, 8 stages, consisting of:

exposed/infected (but asymptomatic)-->
mild URVI (flu-like symptoms) -->
moderate URVI (quite sick, difficulty breathing, at some point in this stage is where people usually get hospitalized)-->
THEN...
ARDS -->
cytokine storm -->
sepsis -->
septic shock -->
multiple organ failure and death.

More or less.

HCQ/Zn has by far its greatest success in stages 1, 2, maybe 3, but by all means outpatient, and the earlier the better. It is to be used prevent hospitalization and clear symptoms and detectable virus usu. in 6 days.

This is complicated by the fact that virtually all the research is on patients already hospitalized, which means they are probably already past the stage where HCQ/Zn can make a big positive difference for them.

This is complicated also by the fact that most people under age 60 only get to stages 1 or 2 and then recover on their own. So did HCQ/Zn help them or not?

Here's what Zelenko successfully does on the basis of his own experience. He sees patients on an outpatient basis in the earliest stages and divides them in two groups: low-risk and high-risk.

He doesn't do anything for the early-stage-low-risks at all: if they're young and (previously) healthy, he assumes they're getting better on their own (unless they come back in a day or two and say, doc, it's getting worse.)

He treats the early-stage-high-risks aggressively and a.s.a.p with the HCQ/Zn/Azith, and this is where he's arguably having lots of success, preventing lots of hospitalizations and saving lots of lives.

Zelenko said the idea behind his approach is to treat the spread of the virus in the body before it damages the lungs beyond repair. Once the lungs of a Covid-19 patient exhibit ARDS (acute respiratory distress syndrome), according to WHO, the patient’s likelihood of death is about 50%, according to early estimates.

So he doesn't treat people who are already hospitalized. If they're there, they're already out of his hands as a Family Practitioner, and quite possibly past the stage where HCQ can help them.

PROPHYLAXIS

This is what was described to me as the prophylactic dosage for health workers and people in the same household with a COVID-19 positive family member:

loading dose of 400 mg Plaquenil total, in two doses, taken with food
- plus any standard, OTC, low-dose ZN supplement
over the next 5 days (Day 2, 3, 4, 5, 6): 200 mg Plaquenil total, in one dose, daily, taken with food.
- plus any standard, OTC, low-dose ZN supplement
over the next two months: 200 mg Plaquenil, taken in one dose, every week.
- plus keep taking the low-dose zinc daily. Preferably by pill or lozenge, not nasal spray.

HCQ has quite a long half-life, so after the loading dose it will subside slowly; the maintenance dose will keep it up to effective levels.

In contrast, Zn is water-soluble, is not stored by the body, and has to be regularly replenished. However, it is needed only in minuscule amounts. Don't bother taking large doses, it's just upset your stomach and then will be uselessly excreted. If you don't have any particular absorption problems, and you eat ordinary amounts of meat, fish and especially shellfish, it's not likely you'd need any supplementation at all. If you want, 25-50 mg/day should do you fine.

No guarantees. That's what I heard. That's it.