Eastern Virginia Medical School COVID-19 protocol:
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

The EVMS guidelines take an expansive, proactive approach to case management.

They try to bet on favorable risk-benefit trade-offs, even if some suggested items (e.g. zinc) turn out not to matter.

The 'essential treatment' items look great:
- hydroxychloroquine
- ascorbate
- early anticoagulants
- low-dose short-course corticosteroids

I don't believe zinc is very relevant, but fairly harmless.

Melatonin is a nice suggestion. Helps in influenza, reasonable mechanism.

Medicine is not medical research.

It is crucial to exercise informed judgment in identifying and acting on favorable risk-reward trade-offs in treatment decisions.

The curse of dimensionality dictates that you will never have an RCT for all possible combinations of parameters.

Heuristics:

- treatments with different mechanisms that do well in similar RCTs are usually effective combined if no interactions

- low-risk treatments need less evidence

- high-risk treatments need more evidence

- inaction is a treatment, has risks

- listen to practitioners

With that in mind, some potential improvements:
- earlier prone positioning
- ACE-2 commentary dated: COVID-19 depletes ACE-2, Giapreza likely further worsens RAAS symptoms, use other pressors
- more tocilizumab in severe cases
- consider minocycline instead of azithromycin (QT)