The missing link of COVID-19


Practical measures to address the virus outside of hospitals

As we approach 300,000 deaths from the COVID-19 virus in the U.S. and we brace ourselves through the second round of lockdown, we must reconsider strategy and do a few things differently.

The population is growing increasingly scared, and they are receiving no medical treatment from the medical establishment when they are positive for COVID-19 at the time of diagnosis if symptoms are not severe. Those same patient are returning to the hospital in respiratory distress, cerebral vascular event (strokes), and myocardial infarctions (heart attacks), and are then being hospitalized.

Much of the treatment of this disease is occurring in the hospital, as is done in heart disease, cerebral vascular disease, renal disease, and etc. This is costly in dollars and lives lost, as well as ineffective when compared to prehospital management. Perhaps time will come to re-evaluate the management of disease in health care, but it is certainly time to treat COVID-19 patients before they are near death. 

As a practicing physician treating COVID-19 infections, I see hope in early prehospital management. I hope to share insights that are not making headline news but are practical ways to minimize disease and save lives.

COVID-19 disease needs to be addressed outside of the hospital to curb the pandemic and save lives. Here are four ways that can be done:


It is well known that COVID infections are worse in the elderly and persons with chronic disease. What is much less discussed is that healthier people fare better with diseases in general, and COVID is no exception. 

Take away: Eat heathy, exercise at least 4-5 times per week, sleep at least seven hours per day, and do not abuse alcohol and drugs.


There is some evidence in the medical literature about the value of vitamins and minerals in COVID infection. Supplements may be used by asymptomatic patients as well as patients with COVID infection. Supplements worth taking during this pandemic include multivitamins, selenium, zinc and l-lysine. 

Take away: The supplements above are safe and may be helpful in helping to prevent COVID infections.


Hydroxychloroquine (HCQ) has shown promise to prevent COVID-19 infections in studies. In practice, none of the patients who I have placed on HCQ prophylactic therapy have contracted COVID-19.

Take away: Elderly and those with chronic conditions should discuss with a physician the risks and benefits of HCQ prophylactic therapy. HCQ prophylactic therapy may reduce their risk of contracting COVID-19 infection. As the vaccine is made available, these individuals need to be at the front of the line to receive vaccine.

Pre-hospital COVID-19 therapy

There are treatment regimens for COVID-19 infections that are keeping people alive and out of the hospital. In practice, most patients that start our treatment regimen within the first week of COVID symptoms are improving by day two of therapy and are relatively well after a week of beginning the therapy. 

Take away: If you have been exposed to a known COVID-infected person, are experiencing symptoms (nasal congestion, decrease in smell/taste, sore throat, cough, body ache, headache, decreased appetite, and fatigue), or have been diagnosed with COVID-19 infection, seek a physician who is treating COVID-19 and start therapy ASAP.

Mark Holder, MD is a Board Certified Family Medicine Doctor (and owner of Mperial Health in Edina, MN). He is a graduate of University of MN-Physiology; Morehouse School of Medicine; and University of Miami Family Medicine Residency. He is naturally optimistic, creative, determined, and caring. Dr. Holder provides patient-centered care through customized medical services and health services memberships.

Dr. Holder has practiced Medicine at Grady Health System in Atlanta, GA; Phebe Hospital in Gbanga, Liberia; JFK Hospital in Monrovia, Liberia; Jackson Memorial Health System in Miami, FL; AM/PM Emergency House calls in Miami, FL; The Port of Miami Clinic; MD Now in West Palm Beach, Florida; Whittier Clinic (HCMC) in Minneapolis, MN; and Mperial Health in Edina, MN.