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77 views36 pagesTWC Contagion Emergency KitBook Beckwith FINAL 1
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johnandmarinaCopyright
© © All Rights Reserved
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/ 36
iG
THE WELLNESS
— COMPANY —
CONTAGION
EMERGENCY KIT
GUIDEBOOK Y
THE WELLNESS
— COMPANY
Copyright @ 2023 The Wellness Company
All rights reserved. No portion of this publication may be reproduced, distributed,
or transmitted in any form or by any means, including photocopying, recording, or
other electronic or mechanical means without proper prior written consent from
the publisher except in noncommercial uses permitted by copyright law.
Printed by The Wellness Company
in the United States of America
2 Edition, 2023
For the most up to date version, please vi
https://www.twe.health/pandemic-preparation-kit-guidebook INTRODUCTION
Welcome to The Wellness Company family. We are thrilled to
be part of your health and wellness journey!
Don't get caught unprepared -- in times of emergency, natural
disaster, geopolitical turmoil, bioterror attack, or resource
shortages, The Wellness Company Emergency Kit Series is the
solution to ensuring you possess vital medical supplies.
This reference guide is NOT intended to replace individualized
medical attention from your personal provider. Instead, this
reference guide is to be used for general educational purposes,
in combination with more complete literature.
Specific pharmaceutical agents listed, along with indications
for use, dosing regimens, in combination with other medical
supplies are simply common use practices, for reference use
only.
Always consult with a qualified healthcare professional for
diagnosis and treatment instructions before utilizing any of
the medications in your kit. CONTENTS
UNDERSTANDING RESPIRATORY ILLNESS PANDEMICS p4-8
CONTAGION EMERGENCY KIT po
READ BEFORE USE plo
STORAGE INFORMATION pil
LEGAL DISCLAIMER plz
AZITHROMYCIN (generic Z-Pak™) 250 mg pis-i6
BUDESONIDE (generic Pulmicort™) 0.5 mg/2 ml pl7-19
NEBULIZER p.20-21
HYDROXYCHLOROQUINE (generic Plaquenil™) 200 mg p.22-25
IVERMECTIN (generic Stromectol™)12 mg, 7 p.26-29
APPENDIX A (FDA PREGNANCY RISK CATEGORIES) p30
REFERENCES psr32 UNDERSTANDING RESPIRATORY
ILLNESS PANDEMICS
Whatis a Pandemic?
A pandemic is an outbreak of an infectious disease that occurs
on a global scale, affecting large numbers of people across
multiple continents,
Pandemics can be caused by viruses (e.g. COVID-19, HIN]
Influenza, HIV/AIDS, Spanish Flu), bacteria (e.g. Black
Death/Bubonic Plague, Cholera Pandemic), and other
pathogens.
Pandemic pathogens are
often associated with high
rates of transmission,
relatively high morbidity
and mortality rates, and
are significant strains on
fragile healthcare systems
with limited resources. The following table depicts some notable pandemics and
outbreaks over the years
Table 1. Worldwide Pandemics & Outbreaks
Years
en ial
foto
Peter)
Suey
Mortality
‘Smallpox or measles Up to10
165-180. AD. | Antonine Plague & oe
virus million
Bubonic Plague up to 200
1347-1352 ube! ue] | versinia pestis bacteria pto
The Black Death million
1870-1874 ener ‘Smallpox virus Tmillion
Pandemic
R Asiati
1918-1919 Spanish Flu HINT Influenza A virus 50 million
1957-1958 ‘Asian Flu H2N2 influenza A virus Imillion
1968-1969, Hong Kong Flu HGN2 Influenza A virus Imillion
1977-1978 Red / Russian Flu HINI Influenza A virus 700,000
Human
1981 - Hiv/aIDS 40 million
Immunodeficiency virus
2002-2004 SARS SARS-COV=1 virus 774
2008-2010 ‘Swine Flu HINI/09 influenza A virus_| 500,000
coed MERS MERS-CoV virus 858
2018
2019 - COVID-19 SARS-CoV-2 virus 2
Typical Seasonal 300,000+
Current Influenza A &B viruses
Flu annually In the last century, we have witnessed multiple viral outbreaks,
notably from Influenza A and Coronaviruses (CoV). Through
respiratory droplet transmission, these viruses result in
respiratory illnesses in humans
The most recent respiratory illness pandemic, COVID-19,
required novel treatment strategies due to a lack of
established therapies.
What causes COVID-19?
COVID-19 is an illness caused by the virus SARS-CoV-2 (Severe
Acute Respiratory Syndrome Coronavirus 2). SARS-CoV-2 is
transmitted person-to-person through respiratory droplets
containing very small viral particles.
Is COVID-19 life-threatening?
The spectrum of COVID-19 in adults ranges from asymptomatic
to mild respiratory tract symptoms to severe clinical
complications including pneumonia, acute respiratory distress
syndrome (ARDS), and multiorgan dysfunction.
There are a number of factors that play into one’s risk of
experiencing a severe COVID-19 infection including, but not
limited to: age, general health, comorbid medical conditions,
and exposure to certain SARS-CoV-2 variants.
6 What symptoms are associated with COVID-19?
COVID-19 may present through a wide range of symptoms
which usually appear 2-14 days after exposure.
Mild to moderate symptoms may include fever, chills, cough,
shortness of breath, difficulty breathing, fatigue, muscle and
body aches, headache, sore throat, congestion, runny nose,
nausea, vomiting, and loss of taste and/or smell
Severe clinical symptoms of COVID-19 may include significant
trouble breathing, persistent pain or chest pressure, new-onset
confusion, profound sleepiness, and pale, gray, or blue-colored
skin.
NOTE: The presence of one or more severe clinical symptoms
may indicate that urgent medical support is needed. Call your
medical provider or local emergency medical services for
attention.
How to treat COVID-19?
The vast majority of COVID-19 infections can be managed at
home. Treatment regimens continue to evolve. While there are few FDA-approved treatments for COVID-19, expert clinicians on
the frontlines treating patients (to great success) have
proposed therapeutic guidelines. A sample of these protocols
can be found online at the following URLS:
petermcculloughmd.com (see MeCullough Protocol’)
vladimirzelenkomd.com/treatment-protocol/
Based on the presenting symptoms and clinical severity of
disease, your medical provider may utilize a treatment plan
combining supportive care, over-the-counter agents,
nutritional supplements, and/or prescription medications.
What is Long-COVID?
Following recovery from acute illness, including COVID-19, a
person may experience a wide range of symptoms (physical,
cognitive, psychological) that develop during or soon after
illness, continue for at least 2 months post-infection, have a
negative impact on a person’s daily life, and are not better
explained by another diagnosis
Treatment strategies for Long-COVID are different from
managing acute COVID-19 illness. CONTAGION EMERGENCY KIT Kit contains the following medications
* Azithromycin 250 mg tablets - #12
* Budesonide Inhalation 0.5 mg/2 mi** - #20
**May be substituted with budesonide 1mg/2 mil - #10
+ _Hydroxychloroquine 200 mg tablets - #20
+ Ivermectin 12 mg compounded capsules - #25
* Nebulizer - #1
READ BEFORE USE
Always consult with a healthcare provider before taking any of
the medications discussed herein.
Always consider individual allergies and hypersensitivities to
each medication before use. Inform your provider of any other
medications you take as many drug-to-drug interactions exist
that can impact the both efficacy and safety of certain
medications.
Note that all typical dosing practices are for adults only.
Contents of the kit are intended ONLY for the person to whom
they are prescribed. Do not take any medication without first
consulting with a qualified provider for diagnosis and
treatment.
“10+ STORAGE INFORMATION
Most solid oral drugs have a longer shelf life when stored at
room temperature (68-77°F / 20-25°C) and are shielded from
UV radiation in airtight containers. The governmental program
called the Shelf-Life Extension Program showed that many solid
forms of medications stayed potent well beyond their
expiration date.
FDA Shelf-Life Extension Program details here:
https://www.fda.gov/emergency-preparedness-and-response/mem-
legal-regulatory-and-policy-framework/expiration-dating- extension
LEGAL DISCLAIMER
This document may contain information about TWC products
and solutions. The information is not medical advice and
should not be treated as such. Information about off-label
use treatments, including COVID-19, is not reviewed,
approved, or recommended by the FDA. TWC assumes no
responsibility or liability for any errors or omissions in the
content of this document.
The information contained in this document is provided on an
“as is" basis with no guarantees of completeness, accuracy,
usefulness, or timeliness. TWC does not represent, warrant,
ae undertake, or guarantee that the use of guidance in the
document will lead to any particular outcome or result.
Do not use any medications included in this kit if you are
allergic to any of the ingredients in them.
If any provision of this disclaimer is invalid or unenforceable
under applicable law, that provision shall be enforced to the
maximum extent possible, and the remaining provisions shall
remain in full force and effect.
This document is protected by copyright law and by using it
you agree not to reproduce or copy it, in whole or in part, or
to furnish such information to others, or to make any other
use of it except for evaluation purposes without express
written consent from TWC 2022 Inc.
This disclaimer shall be governed by, construed, and enforced
under the substantive laws of the State of Florida, without
regard to the principles of conflicts of laws of the State of
Florida with any other state or jurisdiction
Any disputes related to this document will be subject to
the exclusive jurisdiction and venue of any state or federal
courts located in Miami-Dade County in the State of Florida
All claims and disputes arising under or relating to this
Emergency Kit and the services rendered by TWC are to be
settled by binding arbitration in that state of Florida.
a12- AZITHROMYCIN 250 mg
(generic Zithromax™; Z-Pak™)
Pharmacologic Category: Antibiotic, Macrolide
FDA-Approved Uses:
Community- acquired pneumonia, mild severity
Acute Pharyngitis, Group A streptococcus (strep
throat)
Acute bacterial sinusitis (sinus infection)
Acute otitis media (inner ear infection)
Acute bacterial exacerbations of chronic
obstructive pulmonary disease (COPD)
Uncomplicated skin infections
Urethritis and cervicitis (caused by Chlamydia
trachomatis)
Common Off-Label Uses:
Babesiosis (malaria-like parasitic disease)
Bartonella (cat scratch disease)
Infectious traveler's diarrhea
Pertussis (whooping cough)
Bronchiectasis
Covid-19 Respiratory Illness Applications: Azithromycin has been
shown to exhibit both antiviral and immunomodulatory
properties that could be of therapeutic benefit
throughout COVID-19 infection. Studies indicate
azithromycin may directly inhibit viral load as well as
viral replication, particularly in the early stages of
disease. Immunomodulatory properties include the
ability to downregulate cytokine production (associated
with hyperinflammation), maintain epithelial cell
integrity, and prevent lung tissue damage. Azithromycin
can also be used as an adjunctive COVID-19 therapy in
the presence of superimposed bacterial pneumonia.!?
Typical Adult Dosing:
Weeiaco sic aaictens
oro Pa Rin aol)
Pertussis infection
Bronchitis
Take Azithromycin 500 mg (2 tablets) by mouth
DAILY on day 1, then 250 mg (1 tablet) by mouth DAILY
on days 2-5
4 Pregnancy: Pregnancy Risk Category B (see Appendix A).
Breastfeeding: Present in breastmilk, use caution.
Consult with a medical provider.
Notes: While Azithromycin may be taken with food or on
an empty stomach, the risk of gastrointestinal side
effects is decreased when taken with meals.
Common Side Effects: Gastrointestinal including
diarrhea and nausea.
Contraindications: DO NOT TAKE if known allergy or
hypersensitivity to Azithromycin (Zithromax™, Z-Pak™),
Clarithromycin (Biaxin™), Erythromycin (Erythrocin™, Ery-
Tab™, or EE.S.™), or any other Macrolide; history of
cholestatic jaundice/nepatic dysfunction associated
with prior azithromycin use. Azithromycin is listed as a
contraindication in the manufacturer's labeling for
pimozide.
a Caution: Significant drug interactions exist, and may
require dose/frequency adjustment or avoidance.
Azithromycin may affect the efficacy of blood thinners,
like warfarin, which could increase the risk of bleeding.
Medical supervision may be necessary to monitor
clotting times and, if necessary, adjust the dosage of
anticoagulants during Azithromycin treatment.
Prolonged use (>28 days) of antibiotics may result in
fungal or bacterial superinfection
Please review the full package insert and consult with a
medical provider for additional information.
“6- Budesonide 0.5 mg/2 mL**
(generic Pulmicort™)
**May be substituted with Img/2ml due to shortages
Pharmacologic Category: Corticosteroid, Inhalant (oral)
FDA-Approved Uses:
* — Asthma maintenance/controller
Common Off-Label Uses:
* Chronic obstructive pulmonary disease (COPD)
maintenance
* Bronchitis
* Eosinophilic esophagitis (oral)
Respiratory Illness Applications: Inhaled corticosteroids
have been identified as potential therapeutic against
COVID-19 infection due to their targeted anti-
inflammatory effects on the lungs. Inhaled budesonide
has been shown to impair viral replication of SARS-CoV-
2. and downregulate the expression of the receptors
used for cell entry by the virus.2 #5
“7 Typical Adult Dosing:
Respiratory Maintenance
Inhale Budesonide 1 vial (0.5 mg / 2 mL)
TWICE a day for up to 7 days
Pregnancy: Pregnancy Risk Category B (see Appendix A).
Breastfeeding: Present in breast milk with maximum
concentrations 45 min after dose administration
Considered compatible with breastfeeding.
Notes: Do not shake the vial before use. Rinsing the
mouth (without swallowing) after use reduces the risk of
fungal infections. Nebulizer use around non-infected
persons increases the risk of transmission due to
aerosolization spread
Common Side Effects: Otitis media, respiratory infection,
rhinitis.
Contraindications: DO NOT TAKE if known
hypersensitivity to Budesonide or any other component
of the formulation; severe hypersensitivity to milk
proteins. DO NOT TAKE as primary treatment of status
asthmaticus, or other acute episodes of asthma
requiring intensive measures.
-18- Caution: Prolonged use at high doses may increase the
risk of adrenal suppression, secondary infection (ie.
fungal), and/or mask acute infection. Use may cause
bronchospasm.
Not intended to treat an acute asthma attack as
monotherapy.
Additional considerations of use in persons with poor
bone mineral density, hepatic impairment, and ocular
disease,
Do not shake the vial before use.
Please review the full package insert and consult with a
medical provider for additional information:
-19- Nebulizer
Whatis it: A nebulizer is a piece of medical equipment
that rapidly converts liquid into a very fine mist that a person
can then inhale through a face mask or mouthpiece. This
method of inhalation allows the medicine to move directly into
the lungs for immediate and targeted therapeutic action
How to use:
0)
Connect the USB cable to the adaptor,
computer, or power bank.
Pull the buckle to open the medicine cup.
Place medicine into the
cup and close the buckle.
Install the included mask i.
or mouthpiece. i
Turn on the unit =o)
(blue light indicates it is ON).
Hold the nebulizer with one hand and take slow,
deep relaxing breathsuntil the medication has
been depleted.
Turn the power OFF and clean the unit.
Caution: Clean after every use. Do not touch
medicine cup or mesh with hands or objects.
Do not shake the machine. Do not submerge the
unit in water. Do not operate the device or plug it
into a power source with wet hands.
-20- Caution: Clean after every use. Do not touch medicine
cup or mesh with hands or objects. Do not shake the
machine. Do not submerge the unit in water. Do not
operate the device or plug it into a power source with
wet hands
Cleaning:
(1) Open the cup and pour out any residual liquid,
(2) Removed the mask or mouthpiece.
(3
(4) Press the start button for 3 seconds (green light
will be ON and the device will clean
Put warm water into the medicine cup.
automatically).
(5) Remove the medicine cup by pushing the eject
button on the unit.
(6) Once the cup is removed, you can disinfect it
and the mask or mouthpiece with 75% alcohol.
Storage: Store in a cool, dry place away from direct
sunlight. Do not store in the bathroom due to humidity.
Do not leave the medicine cup filled with any liquids.
Please review full instruction manual and consult with a
medical provider for additional information.
-2- Hydroxychloroquine 200 mg
(generic Plaqueni!™)
Pharmacologic Category: Aminoquinoline, Antimalarial
agent, Antirheumatic
FDA-Approved Uses:
Suppressive and acute treatment of acute
malaria due to Plasmodium vivax, P, malariae, P.
ovale, and susceptible strains of P. falejparum
Discoid and systemic lupus erythematosus
Rheumatoid arthritis
Common Off-Label Uses:
Q-fever (caused by Coxiella burnetil)
Whipple's disease
Brucella
COVID-19
Dermatomyositis, cutaneous
Primary Sjégren disease
-29- Respiratory Illness Applications: In vitro studies have
demonstrated that Hydroxychloroquine (HCQ) is
effective on several types of coronaviruses including
Middle Eastern respiratory syndrome coronavirus (MERS-
CoV), SARS-CoV and SARS-CoV-2. It has been
demonstrated that HCQ can prevent coronavirus
particles from recognizing host cell entry receptors,
interfere with membrane fusion, and suppress
immunomodulatory processes. Moreover, HCQ promotes
the production of immunosuppressive factors IL-6 and
TNFa and activates p38 MAPK, together exerting
therapeutic effects against COVID-19.°7%?
Typical Adult Dosing:
COVID-19 infection
Take Hydroxychloroquine 200 mg (1 tablet) by mouth
TWICE A DAY for days
Pregnancy: Pregnancy Risk Category C (see Appendix
A). Consult with a medical provider.
Breastfeeding: Present in breast milk in very small
amounts. Generally considered acceptable at typical
lower doses.
23+ Notes: Hydroxychloroquine is recommended to be taken
with food or milk so that the risk of gastrointestinal side
effects is decreased.
Common Side Effects: The frequency of adverse
reactions is undefined in the literature, though most
commonly include nausea, vomiting, diarrhea,
abdominal pain, and headache.
Contraindications: DO NOT TAKE if known
hypersensitivity to Hydroxychloroquine (Plaquenil™), 4-
Aminoquinolone derivatives, or any component of the
formulation.
Caution: Significant drug interactions exist and may
require dose/frequency adjustment or avoidance.
Significant drug-to-drug interactions include
antimalarials Dapsone and Mefloquine, Cimetidine, and
Remdesivir.
246 Additional considerations of use in persons with hepatic
(liver) impairment, myasthenia gravis, porphyria,
psoriasis, renal (kidney) impairment, retinopathy, and
glucose-6-phosphate dehydrogenase deficiency.
Prolonged use of Hydroxychloroquine has been
associated with QT prolongation (abnormal electrical
conduction in the heart).
Please review the full package insert and consult with a
medical provider for additional information.
25+ IVERMECTIN 12 mg
(generic Stromectol)
Pharmacologic Category: Anthelmintic
FDA-Approved Uses:
Onchocerciasis (River blindess caused by
parasite Onchocerca volvulus)
Strongyloidiasis (parasitic worm Strongyloides
stercoralis)
lice
Acne rosacea
Common Off-Label Uses:
Scabies (skin infection caused by Sarcoptes
scabiel)
Ascariasis (parasitic roundworm Ascaris
lumbricoides)
Lymphatic filaria (filiarial roundworms)
Strongyloides stercoralis
Loa loa (African eye worm)
Hookworm-related cutaneous larva migrans
Trichuriasis (whipworm infection caused by
Trichuris trichiura)
COVID-19
26+ Respiratory Illness Applications: Ivermectin is a Nobel
Prize-winning anti-parasitic agent considered to be one
of the safest known drugs and on the World Health
Organization’s list of essential medicines. Studies have
demonstrated that Ivermectin acts on SARS-CoV-2 by
inhibiting replication by preventing viral proteins from
entering the host cell nucleus. In addition, lvermectin has
been noted to have antiviral and anti-inflammatory
properties. 0218
Typical Adult Dosing:
COVID-19 infection
Take Ivermectin 0.6 mg/kg body weight
(0.27 mg/Ib body weight) by mouth DAILY for 5-7 days
(see table below)
27 Table 2. Approximate Ivermectin Dose by Body Weight
I eifeal-re1 ANP ox1-3
Body Weight (Based on 0.6 mg/kg
using 12 mg capsules)
ena 24 mg daily (2 capsules)
"ewe 36 mg daily (3 capsules)
188 ees 48 mg daily (4 capsules)
700 meas 60 mg daily (5 capsules)
2M ea 72mg daily (6 capsules)
Pregnancy: Pregnancy Risk Category C (see Appendix
A). Consult with a medical provider.
Breastfeeding: Present in breast milk, use caution.
Consult with a medical provider,
Notes: ivermectin is typically dosed based on a person's
body weight. While the manufacturer recommends
taking on an empty stomach, studies have shown
bioavailability increases when taken with a high-fat
meal.
~28- Common Side Effects: itchiness, fever, swelling, rash,
hives, joint pain, and diarrhea. Some patients report
temporary visual aura.
Contraindications: DO NOT TAKE if known
hypersensitivity to Ivermectin (Stromecto!™), or any
component of the formulation
Caution: Significant drug interactions exist and may
require dose/frequency adjustment or avoidance.
Additional considerations of use in persons with
immunocompromised status (e.g. HIV)
Please review the full package insert and consult with a
medical provider for additional information.
29+ Appendix A
FDA Pregnancy Risk Categories
4
Description
Category
Adequate and well-controlled studies in pregnant
women have failed to demonstrate a risk to the fetus in
the first trimester of pregnancy (and there is no
evidence of risk in later trimesters).
Animal reproduction studies have failed to
8 demonstrate a risk to the fetus, but there are no
adequate, well-controlled studies in pregnant women.
‘Animal reproduction studies have shown an adverse
effect on the fetus and there are no adequate, well-
controlled studies in pregnant women, but potential
© benefits may warrant use in pregnant women despite
potential risks.
Positive evidence of human fetal risk is based on
adverse reaction data from investigational or
D marketing experience or studies in humans, but
potential benefits may warrant use in pregnant women
despite potential risks.
Positive evidence of animal or human fetal
x abnormalities and/or positive evidence of human fetal
risks, and risks clearly outweigh any possible benefit.
-30- References
Echeverria-Esnal D, Martin-Ontiyuelo C, Navarrete-Rouco ME, De-Antonio
Cuscé M, Ferréindez 0, Horcajada JP, Grau 8, Azithromycin in the treatment
of COVID-I9: a review. Expert Rev Anti Infect Ther. 2021 Feb;19(2)147-163. doi
101080/14787210 20201818024, [pub 2020 Oct 6. PMID: 32853038
2 khezri MR, Zolbanin NM, Ghasernnejact-Berenji M, Jafar R. Azithromycin:
immunomodulatory and antiviral properties for SARS-CoV-2 infection, Eur J
Pharmacol. 2021 Aug 18;905174191, doi 10.1016/j.ejphar2021174191, Epub 2021
May 17, PMID: 34015317, PMCID: PMC8I27529
+ Finney Li, Glanville N, Farne H, Aniscenko J, Fenwick P, Kemp SV, Trujllo~
Torralbo MB, Loo Sl, Calderazzo MA, Wedzichai JA, Mallia P, Bartlett NW,
Johnston Sl, Singanayagam A Inhaled corticosteroids downregulate the
SARS-CoV-2 receptor ACE2 in COPD through suppression of type linterferon
J Allergy Clin Immunol, 2021 Feb»147(2):$10-819.¢8. dot
101016/jjaci2020.09.034, Epub 2020 Oct 16. PMID: 38068660; PMCID
PMC7558236
* Ramakrishnan , Nicolau BY Jr, Langford B, Mahdi M, Jeffers H, Mwasuku C,
