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___ Covid-19 ___

Coronavirus

1. INTRODUCTION
2. EFFECTIVENESS, SAFETY AND TOXICITY OF CHLORINE DIOXIDE

The Covid-19 pandemic shocked the world and has claimed many thousands of lives, and as one of the equally complicated consequences, the world economy was compromised. Undoubtedly, this is a problem that required an urgent solution and the commitment of everyone, especially health personnel, in the search for its prompt solution.

 

In order to identify a solution to this problem and also based on the scientific evidence already published and clinical experiences of use of chlorine dioxide (ClO₂) by physicians and researchers, we made an assessment of the main information to support our proposal for the use of chlorine dioxide solution (CDS), following the protocol standardized by Dr.h.c. Andreas Ludwig Kalcker as a safe and effective alternative to combat infection by SARS-COV2.

 

A review survey on the use of chlorine dioxide in the indexed international literature was carried out from January to July 2020 and as an example, if we analyzed only the PubMed website (National Library of Medicine 2020), we observe that only using the descriptor “chlorine dioxide”, we have available a total of 1,372 documents dating from 1933 to the research date, 2020 (Figure 1).

1.1 BACKGROUND
Figure 1 - Number of documents found with the descriptor "chlorine dioxide" in the PubMed scientific database. The first red arrow indicates the descriptor used for the search and the second the number of published documents. Source: https://pubmed.ncbi.nlm.nih.gov/?term=chlorine+dioxide&sort=pubdate. Access date: 07/24/2020.

Another important source was the PubChem database (Figure 2), in which it is also possible to identify biochemical and toxicological information, among others, and registered patents (which can also be found in Google Patents), among which the following stand out:


1) The patent on the disinfection of blood bags (Kross & Scheer, 1991);

2) The patent on HIV (Kuhne 1993);

3) The patent on the treatment of neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), Alzheimer’s disease and multiple sclerosis (McGrath MS 2011);

4) Taiko Pharmaceutical’s patent (2008) for human coronavirus;

5) the patent on um method and composition “for treating cancerous tumors” for treating cancerous tumors (Alliger 2018);

6) the patent on pharmaceutical composition for treating internal inflammation (Kalcker LA, 2017);

7) the patent on pharmaceutical composition for the treatment of acute intoxication (Kalcker LA, 2017) and;
8) the patent on a pharmaceutical compound for the treatment of infectious diseases (Kalcker LA, 2017);
9) the patent on the use of CDS for coronavirus type 2 (Kalcker LA, 2020 – still pending publication: /11136-CH_Antrag_auf_Patenterteilung.pdf).

Figure 2 - Number of documents found with the descriptor "chlorine dioxide" in the PubChem scientific database. The first red arrow indicates the descriptor used for the search and the second the number of documents published. Source: https://pubchem.ncbi.nlm.nih.gov/#query=chlorine%20dioxide Date of access: 24/07/2020.

Therefore, with these initial data alone, we note that research on ClO₂ is nothing new, that it is a chemical molecule already known for more than 200 years and marketed for 100 years with various uses: treatment of water for human consumption, treatment of contaminated water, for biofilm control in cooling towers and in the processing of food and vegetable disinfection.

In addition, since 40 years there are clinical and clinical studies conducted, as well as studies that allow us to understand its toxicological and safety characteristics especially for human use (Lubbers et al 1984, Ma et al 2017).

1.2. A BRIEF SUMMARY OF CHLORINE DIOXIDE

The chemical formula of chlorine dioxide is ClO₂ and according to the Chemical Abstracts Services (CAS) from Chemical American Society its CAS number is 10049-04-4. In this formula, it is clear that there is one chlorine atom (Cl) and two oxygen atoms (O₂) in a chlorine dioxide molecule. These 3 atoms are held together by electrons to form the ClO₂ molecule. It can be used as a saturated gas in distilled water and can therefore be drunk or applied directly to the skin and mucous membranes, with appropriate dilutions. Andreas Ludwig Kalcker, Biophysicist and Researcher, standardized a saturation of the gas in distilled water called chlorine dioxide solution or CDS (National Library of Medicine 2020).

The discovery of the ClO₂ molecule in 1814 is attributed to the scientist Sir Humphrey Davy. ClO₂ is different from the element chlorine (Cl), both in its chemical and molecular structure, as well as in its behavior. ClO₂, as has already been widely reported, can have toxic effects if the necessary care is not observed for its various uses and the appropriate recommendations for human consumption are not respected. It is more than well known that clo2gas is toxic to humans if inhaled pure and/or ingested in quantities higher than recommended (Lenntech 2020, IFA 2020).

ClO₂ is one of the most effective biocides against pathogens such as bacteria, fungi, viruses, biofilms and other species of microorganisms that can cause disease. It acts by disrupting the synthesis of the pathogen’s cell wall proteins. As it is a selective oxidant, its mode of action is very similar to phagocytosis, where a mild oxidation process is used to eliminate all types of pathogens (Noszticzius et al 2013, Lenntech 2020). It is worth saying that ClO₂, generated by sodium chlorite (NaClO₂), is approved by the Environmental Protection Agency in the United States (EPA 2002) and by the World Health Organization for use in water fit for human consumption, as it leaves no toxic residues (EPA 2000, WHO 2002).

When applied at appropriate concentrations, ClO₂ does not form any halogenated products and its residual ClO₂ by-products are normally within the limits recommended by EPA (2000, 2004) and WHO (2000, 2002). Unlike chlorine gas, it does not hydrolyze readily, remaining in the water as a dissolved gas. Also in contrast to chlorine, ClO₂ remains in molecular form in the ph ranges commonly found in natural waters (EPA 2000, WHO 2002). WHO and EPA include ClO₂ in Group D (substances not classifiable in terms of human carcinogenicity) (IARC 2001, EPA 2009). According to the U.S. Department of Health and Human Services 2004, the FDA recommends that ClO₂ be allowed for use as a permitted food additive and as an antimicrobial agent (disinfectant).

Many continue to confuse ClO₂ with sodium hypochlorite (NaClO – Bleach) and the latter with sodium chlorite (NaClO₂), as well as other chemical compounds, leading to frequent inappropriate comments both in the media and among professionals due to lack of knowledge of elementary chemistry. NaClO (bleach), for example, is a potent corrosive agent and the danger due to chronic and massive exposure to NaClO is well known. It is believed that asthma symptoms developed by professionals working in contact with that substance may be due to continuous exposure to lye and other irritants.

In contact with fats, sodium hydroxide (NaOH) degrades fatty acids into glycerol and soaps (fatty acid salts), which reduces the surface tension of the remaining fat-solution interface. NaClO is responsible for the dissolution of organic tissue. Thus, it is observed that the main toxicity of the substances generated from the chemical reactions of sodium hypochlorite is the appearance of a hydroxyl NAOH radical, in the various reactions with the secretions and chemical structure of human tissues (Daniel et al 1990, Racioppi et al 1994; Estrela et al 2002, Medina-Ramon et al 2005, Fukuzaki 2006, Mohammadi 2008, Peck B et al 2011).

Based on this brief review of what chlorine dioxide is and its biocidal capacity, the results obtained by the physicians of the Ecuadorian Association of Specialists in Integrative Medicine (AEMEMI) are not surprising: Who claim the administration of CDS in appropriate and safe dilutions is an effective and low-cost alternative that can rapidly contribute to the restoration of health of the individual infected by human coronavirus type 2, and it is assumed that it can promote the reduction of morbidity and mortality, hospitalizations by COVID-19 mostly, up to 4 days (AEMEMI 2020).

Through evidence from available scientific publications demonstrating the efficacy of ClO₂ in eliminating different pathogens (Kullai-Kály et al 2020), including SARS-CoV (Tables 1, 2, 3 and 4; Taiko Pharmaceutical patent 2008), as well as the work confirming the safety of the use of chlorine dioxide for water potabilization and, more recently, the aforementioned work of AEMEMI, we evaluate positively and with great biocidal potential the use of aqueous ClO₂ solution (CDS) to combat coronaviruses (AEMEMEMI 2020, EPA 2000, WHO 2005, WHO 2002).

In this context, we are surprised that official bodies such as the Ministries of Health, PAHO/WHO and regulatory agencies and/or health entities do not recommend the use of ClO₂ and all, instead of recommending it, draw attention to its toxicity and danger, but, in their speeches, do not clearly indicate in what form and by what route of administration ClO₂ is really toxic. However, everything leads us to understand that they are referring to the pure and concentrated form of this gas and not to the formula standardized by Kalcker: the aqueous solution of chlorine dioxide (CDS), at 3,000 ppm.

Thus, to help clarify the concepts, we invite all official bodies to learn about Kalcker’s work with the aqueous solution containing gaseous chlorine dioxide (CDS). Certainly, after having this knowledge, we believe that definitely, these Agencies, which appreciate health, will naturally understand the potential of this solution for human use and from then on, they should revise their documents which may be at odds with the published scientific reality and current medical experiences and maybe they can offer this information in a clearer and more assertive way in their articles published on official websites or even in their documents.

1.3. KEY POINTS FOR REFLECTION

In view of the serious scenario to which the whole world is exposed with the coronavirus pandemic, we address the authorities and institutions responsible for human health that lead the main institutions to ask them the following questions:

What could be the purpose/impact of disclosing a document with information that can be misinterpreted?

Is there a purpose to hide and/or translate scientific knowledge in a way that causes doubt or harm to the health of thousands of people, and prevent them from benefiting from something that can really save lives?

What is the purpose for not using so-called “unconventional” but potentially promising options with proven clinical evidence by physicians who are on the front line with COVID-19?

With the legally established purpose of saving lives, it is neither logical, nor healthy, nor even less a humanitarian and compassionate action, in the face of a global public emergency situation, that misunderstandings in the translation of scientific knowledge occur for any purpose other than the preservation of life. We consider that these concepts that generate misunderstandings may be caused due to lack of knowledge of the existing literature (even though it is open for public consultation). To recall: in the PubMed database alone, there are more than 1,300 documents published using only the descriptor “chlorine dioxide”.

Assuming that the team in charge of writing the official documents, the articles, the reports published on the websites of official bodies such as PAHO/WHO of the member countries, the Ministries of Health and the health regulatory bodies, were not aware of the articles and patents (which does not exempt them from legal responsibility) where they prove the non-toxicity at these doses and the possible benefits of chlorine dioxide for human health and that, therefore, these teams in charge still do not consider the potential of ClO₂ for the fight against coronavirus type 2, as the AEMEMI and the team of Doctors and Researchers who sign this dossier have done, we invite you to reflect on the following:

-There are many scientific bases for public access, with many articles freely available, containing the necessary information for the production of a document to support a decision in public management, why were these bases not consulted or poorly analyzed or simply not considered? For what reason? After all, it is an important decision to use or ban a substance for human health, in a context of global public emergency to overcome COVID-19.

-How is it possible that the official, legally responsible health agencies would make such an important decision without a thorough analysis of the effects of banning a substance that could simply end the pandemic quickly, safely and effectively?

-The fact is that any neophyte in the matter who reads the different official publications coming from some health agencies about ClO₂ will naturally be afraid of consuming this product because he thinks that it is toxic and harmful to health, and that it could endanger his life. Likewise, a health professional would also be afraid to use it in his therapeutic practice, since he might loose his medical license.

Based on the dissonant and inconsistent information when compared to what is actually known about CDS and its potentiality is that we, health professionals in the intention to respectfully give our contribution for the governing institutions of health to review their documentation and officially published guidelines to promote the clearest and most truthful information on the use, efficacy and safety of ClO₂ for oral human consumption (CDS), according to the standardized by Kalcker (2020 – On evaluation: /11136-CH_Antrag_auf_Patenterteilung. pdf), we share below a summary of the key scientific facts and evidence that CDS is effective against several pathogens, including human coronavirus type 2, the etiological agent of SARS-CoV2.

Unfortunately, the way in which information about ClO₂ is disseminated raises doubts and above all reveals to those who understand the scientific aspects of the subject that the misinformation generated is somewhat surprising.

1.4. WHAT IS CHLORINE DIOXIDE SOLUTION (CDS) AND WHAT ARE THE DIFFERENCES WITH MIRACLE MINERAL SOLUTION (MMS)?

More than 17 years ago, Andreas Ludwig Kalcker started scientific research to study the applicability of ClO₂ and its dilutions, so that it can be safely used for human consumption. On the basis of these studies, he has developed 4 patents, of which 3 are published and one is pending approval. These studies are based on the safe toxicity levels established by the German toxicology database Gestis (IFA 2020), and take into account other reference studies already developed, for example, by WHO (2000, 2005) and EPA (2000).

These studies confirm the non-toxicity of this gas in aqueous solution for human consumption and establish, for example, that the safe dose is 0.3 mg/L to be used for drinking water. Kalcker’s studies and the clinical experiences of Doctors, recommend using 10 mí of this concentrated solution, diluted in 1000 mí of water as one of the protocols to combat SARS-COV 2. In this specific recommendation, it is allowed at the end, the consumption of 30 mg/day, divided into 10 doses of 100mL, which is safe and non-toxic based on recognized scientific references (Lubbers & Bianchine 1984; Ma et al 2017).

The unnecessary controversy and its consequences

Contextualizing the origin of the misguided controversy that has arisen over the “chlorine dioxide” issue, it is important to clarify: Historically, a product called “miracle mineral solution” (MMS) has been the subject of much controversy in the media around the world because it is sold as a “medicine.”

We often see news stories on the Internet confusing “miracle mineral solution” (MMS = citric acid + sodium chlorite + water) with “chlorine dioxide solution” (CDS = hydrochloric acid + sodium chlorite + water) and the latter with sodium hypochlorite (bleach). The main differences between MMS and CDS can be conferred in Table 1:

Main characteristics

MMS

CDS

ClO₂ Concentration (parts per million – ppm)

unknown

3.000 ppm

Ph

Acid

Neutral (7)

Residue

Chlorates, chloride

No residue

The consequences and impact of these failures in the translation of scientific knowledge at a time of global public health emergency, when the lives of many people are at risk, are worrying.

Therefore, it is urgent that all institutions are alert through the prior qualification of the information that is published so that there are no failures in the translation of scientific knowledge, thus generating space for doubts and misinterpretations through the media, with serious consequences and negatively influencing the decision making of managers.

If we were to use sodium hypochlorite (NaClO) with hydrochloric acid in water, the solution would contain Cl₂ + NaCl + H₂O. Cl₂ is a toxic gas that reacts with organic substances, mainly in aqueous media where it can form toxic acids.

Although we are clear about the well-established biochemical differences, many still confuse some chemicals with ClO₂ (Table 2):

CHEMICAL COMPOUNDS
BIOCHEMICAL CHARACTERISTICS Sodium Perchlorate Sodium Chlorate Sodium Chlorite Sodium Hypochlorite Sodium Chloride Chlorine Chlorine Dioxide
Structure  
Chemical Formula NaClO4 NaClO3 NaClO2 NaClO NaCl Cl2 ClO2
Molecular Weight 122.44 g/mol 106.44 g/mol 90.44 g/mol 74.44 g/mol 58.44 g/mol 70.9 g/mol 67.45 g/mol

2. Effectiveness, safety and toxicity of Chlorine Dioxide

2.1. Action against viruses

Most viruses behave similarly because, once they infect the cell, the nucleic acid of the virus takes over the synthesis of the cell’s proteins.
Certain segments of the nucleic acid of the virus are responsible for the replication of the genetic material of the capsid, (spike) a structure whose function is to protect the viral genome during its transfer from one cell to another and assist in its transfer between host cells.

When ClO₂ encounters an infected cell, a irrevesable denaturation process occurs very similar to phagocytosis because it is a selective oxidant (Noszticzius et al 2013).

2.2. PRE-CLINICAL STUDIES

Pre-clinical studies exploring the toxicity of ClO₂ do not usually find adverse effects when animals are exposed to different concentrations of this biocide. Some of the most important ones are listed here. Ogata (2007) exposed 15 rats to 0.03 ppm of gaseous ClO₂ for 21 days.

Microscopic examination of histopathological samples from the lungs of these rats showed that their lungs were “completely normal”. In another preclinical study, Ogata et al. (2008) exposed rats to 1 ppm gaseous ClO₂ for 5 hours per day, 5 days per week for a period of 10 weeks. No adverse effects were observed. They concluded that the “no observed adverse effect level” (NOAEL) for gaseous chlorine dioxide is 1 ppm, a level considered to be nontoxic to humans and exceeding the reported concentration of 0.03 ppm to protect against influenza virus infection.

In studies on rats, Haller and Northgraves (1955) found that long-term exposure (2 years) to 10 ppm chlorine dioxide produced no adverse effects. However, rats exposed to 100 ppm seemed to show an increased mortality rate.

Musil et al (2004) reported that high doses (200-300 mg/kg) of sodium chlorite caused oxidation of hemoglobin to methemoglobin. However, when rats drank water for 40 days with varying levels of chlorine dioxide (ranging from 0.175 to 5 ppm), no changes in hematological parameters were observed. In another study, chickens and rats that drank daily chlorine dioxide in drinking water at concentrations as high as 1000 ppm for 2 months did not produce methemoglobin. 

Richardson (2004) reported that high doses of oral sodium chlorate (NaClO3) (which is not the same as sodium chlorite – NaClO₂) produced methemoglobinemia and nephritis (US DFridliand & Kagan (1971) reported that rats orally consuming 10 ppm ClO₂ solution for 6 months had no adverse health effects. When exposure was increased to 100 ppm, the only difference between the treatment and control groups was a slower weight gain in the treatment group. In an effort to simulate the conventional human lifestyle, Akamatsu et al (2012) exposed rats to chlorine dioxide gas at a concentration of 0.05 – 0.1 ppm, 24 hours a day, 7 days a week for a period of 6 months. They concluded that for rats whole body exposure to chlorine dioxide gas up to 0.1 ppm for a period of 6 months is not toxic.Department of health and human service, 2004).

Higher doses of ClO₂ solution (e.g., 50-1000 ppm) supposedly produce hematological changes in animals, including decreased red blood cell counts, methemoglobinemia, and hemolytic anemia. Reduced serum thyroxine levels were  observed in monkeys exposed to 100 ppm in drinking water and in rat pups exposed to concentrations up to 100 ppm through gavage or indirectly through their prey drinking water. The fact that the bad taste in high doses made the monkeys drink less water was not taken into account.

Moore & Calabrese (1982) studied the toxicological effects of ClO₂ in rats and observed that when rats were exposed to a maximum level of 100 ppm via drinking water and neither A/J nor C57L/J rats showed any hematological changes. It was also found that rats exposed to up to 100 ppm sodium chlorite (NaClO₂) in their drinking water for up to 120 days could not demonstrate any histopathological changes in kidney structure.

Shi and Xie (1999) indicated that an acute oral LD50 value (expected to result in the death of 50% of the dosed animals) for stable chlorine dioxide was> 10.000 mg / kg in mice. In rats, the acute oral LD50 values for sodium chlorite (NaClO₂ ) ranged from 105 to 177 mg / kg (equivalent to 79-133 mg chlorite / kg) (Musil et al 1964, Seta et al 1991. No exposure-related deaths were observed in rats that received chlorine dioxide in water drinking for 90 days at concentrations that resulted in doses up to approximately 11,5 mg / kg / day in men and 14,9 mg / kg / day in women (Daniel et al 1990).

2.3. Clinical studies

According to the United States Environmental Protection Agency (EPA), the short-term toxicity of ClO₂ it was evaluated in human studies by Lubbers et al (1981, 1982, 1984a and Lubbers & Bianchine 1984c). In the first study (Lubbers et al 1981, also published as Lubbers et al. 1982), a group of 10 healthy adult men drank 1.000 mL (divided into two 500 mL servings, 4 hours apart) of a solution of 0 or 24 mg / L chlorine dioxide (0,34 mg / kg, assuming a reference body weight of 70 kg). In the second study (Lubbers et al 1984a), groups of 10 adult men received 500 mL of distilled water containing 0 or 5 mg / L ClO₂ (0,04 mg / kg day assuming a reference body weight of 70 kg) for 12 weeks.

No study found physiologically relevant changes in general health (observations and physical examination), vital signs (blood pressure, pulse rate, respiratory rate, and body temperature), serum clinical chemical parameters (including glucose levels, urea nitrogen and phosphorus), alkaline phosphatase and aspartate and alanine aminotransferase), serum triiodothyronine (T3) and thyroxine (T4), nor hematological parameters (EPA, 2004).

Michael et al (1981), Tuthill et al (1982) and Kanitz et al (1996) examined the effects of drinking water disinfected with ClO₂. Michael et al (1987) found no significant abnormalities in hematological parameters or serum chemistry. Tuthill and colleagues (1982) retrospectively compared data on morbidity and mortality of newborns in two communities: one using chlorine and one using ClO₂ to purify the water. In reviewing this study, EPA found no differences between these communities (US Department of Health and Human Service, 2004).

Kanitz et al (1996) studied births in two Italian hospitals where the water was purified with chlorine or ClO₂. Although the authors concluded that babies born to mothers who consumed drinking water treated with ClO₂ during pregnancy they were at increased risk of neonatal jaundice, a reduction in head circumference and body length, the EPA wrote that confusing variables prevented the possibility of drawing conclusions from this study (US Department of Health and Human Service, 2004).

Survival was not significantly decreased in groups of rats exposed to chlorite (such as sodium chlorite) in drinking water for two years at concentrations that resulted in estimated chlorite doses of up to 81 mg / kg / day.

In another study, Kurokawa et al. (1986) found that survival was not adversely affected in rats receiving sodium chlorite in drinking water at concentrations that resulted in estimated chlorite doses of up to 32,1 mg / kg / day in males and 40,9 mg / kg / day in females ”.

Exposure of rats to sodium chlorite for up to 85 weeks at concentrations resulting in estimated doses of chlorite up to 90 mg / kg / day has not affected survival (Kurokawa et al. 1986).

According to Lubbers et al 1981, there were no signs of adverse liver effects (evaluated in serum chemistry tests) in adult men who consumed ClO₂ in aqueous solution, resulting in a dose of approximately 0,34 mg / kg or in other men adults consuming approximately 0,04 mg / kg / day for 12 weeks. The same researchers administered chlorite to healthy adult men and found no evidence of adverse liver effects after each individual consumed a total of 1.000 mL of a solution containing 2,4 mg / L of chlorite (approximately 0,068 mg / kg) in two doses (4 hours apart), or in other normal or G6PD-deficient men who consumed approximately 0,04 mg / kg / day for 12 weeks (Lubbers et al 1984a, 1984b).

No signs of ClO-induced impairment of liver function were observed.2 or chlorite among rural village dwellers who were exposed for 12 weeks through ClO₂ in drinking water at weekly concentrations measured from 0,25 to 1,11 mg / L (ClO₂) or 3,19 to 6,96 mg / L (chlorite) (Michael et al 1981). In this epidemiological study, the levels of ClO₂ in drinking water before and after the treatment period they were <0,05 mg / L. Chlorite level in drinking water was 0,32 mg / L before treatment with ClO₂. One week and two weeks after stopping treatment, chlorite levels fell to 1,4 and 0,5 mg / L, respectively.

In its official document entitled “Laboratory biosafety manual” (page 93), WHO (2005) talks about ClO₂:

“Chlorine dioxide (ClO₂) is a powerful, fast-acting germicide, disinfectant, and oxidant that tends to be active in concentrations lower than those required for chlorine bleach. The gaseous form is unstable and decomposes into chlorine gas (Cl₂) and oxygen gas (O₂), producing heat. However, the ClO₂ It is soluble in water and stable in aqueous solution.

Mainly it can be obtained in two ways:

1) By generation in situ, mixing two different components, hydrochloric acid (HCl) and sodium chlorite (NaClO₂), as a mixture. 
2) Ordering the stabilized form, which is clorite  activated electrolytic in the laboratory.

ClO₂ is the most selective of the oxidizing biocides. Ozone and chlorine are much more reactive than ClO₂ and they are consumed by most organic compounds.

In contrast, ClO₂ It only reacts with reduced sulfur compounds, secondary and tertiary amines, and other highly reduced and reactive organic compounds.

Therefore, with the CDS a more stable solution with less residues  can be obtained at much lower doses than using chlorine or ozone. If generated correctly, the ClO₂ Due to its selectivity, it can be used more effectively than ozone or chlorine in cases of higher organic matter load ”.

 

Based on the WHO Strategy on Traditional Medicine 2014-2023 (WHO 2013), which recognizes practices related to traditional, complementary and integrative or “unconventional” medicine as an important part of health services, a In order to continuously integrate them with the various member countries that are signatories of this initiative, we put here the potential of the aqueous solution of ClO₂ (Kalcker 2017) as a potent biocide and therefore a safe supplement alternative to combat SARS-CoV2. The ClO₂ It can fight viruses through the selective oxidation process through denaturation of capsid proteins and subsequent oxidation of the virus’s genetic material, rendering it inactive. As there is no possible adaptation of the virus to the oxidation process, it is impossible for it to develop resistance to ClO₂, it becomes a promising treatment for any strain of virus.

There is scientific evidence that ClO₂. It is effective against the SARS-CoV-2 coronavirus and others:

Aparricio Et.al (2021) a trillogy with more than 3000 patients proving the efficiency in protection, treatment and long Covid with no adverse effects where the 99,3% of the infected and simptomatic patients recovered in 4 Days.

 

Wang et al. (2005) will study the persistence conditions of SARS-CoV-2 in different environments and its complete deactivation by the effect of oxidants such as ClO₂;

The Department of Microbiology and Medicine at the University of New England investigated the inactivation of human and simian rotavirus (SA-11) by ClO₂. The experiments were carried out at 4 ° C in a standard phosphate-carbonate buffer. Both viruses were rapidly inactivated in just 20 seconds under alkaline conditions, with concentrations of ClO₂ ranging from 0,05 to 0,2 mg / L (Chen & Vaughn 1990);

The Japanese University of Tottori evaluated the antiviral activity of ClO₂ in aqueous solution and sodium hypochlorite against human influenza virus, measles, canine dystemperosis virus, human herpesvirus, human adenovirus, canine adenovirus, feline calicivirus and canine parvovirus;

The ClO₂ At concentrations ranging from 1 to 100 ppm, it produced powerful antiviral activity, inactivating> or = 99,9% of the viruses in just 15 seconds of treatment. The antiviral activity of ClO₂  it was approximately 10 times that of NaClO (Sanekata et al 2010).

The Italian University of Parma has carried out studies on the deactivation of viruses resistant to oxidizing agents, such as Coxsackie virus, hepatitis A virus (HAV) and feline calicivirus: the data obtained from the studies shows the following: complete inactivation of HAV and Feline calicivirus, concentrations> or = 0.6 mg / L are required. Similar tests for Coxsackie B5 gave the same results. However, for feline calicivirus and HAV, at low concentrations of disinfectant, it takes approximately 20 minutes to obtain a 99,99% reduction in viral load (Zoni et al 2007);

The Institute of Public Health and Environmental Medicine in Tainjin, China, conducted a study to elucidate the mechanisms of inactivation of the hepatitis A virus (HAV) through the use of ClO₂, observing the complete destruction of antigenicity after 10 minutes of exposure with 7,5 mg of ClO₂ per liter (Li et al 2004);

The Department of Biology of the State University of New Mexico (USA) conducted a study on the inactivation of poliovirus with ClO₂ and iodine. It concluded that the ClO₂ inactivated poliovirus by reacting with viral RNA and affecting the ability of the viral genome to act as a model for RNA synthesis (Alvarez ME & O’Brien RT 1982)

Taiko Pharmaceutical Co., Ltd., Seikacho, Kyoto, Japan demonstrates in this study that ClO gas2 in extremely low concentrations, without any harmful effect on human health, it produces a strong deactivating effect on bacteria and viruses, significantly reducing the number of viable microbes in the air in a hospital surgical center (Taiko Pharmaceutical 2016).

2.4. Toxicity

The LD50 toxicity (acute toxicity index) established by the German GESTIS toxicology database for ClO₂ is 292 mg per kilogram for 14 days, when the equivalent in a 50 kg adult would be 15.000 mg for 14 days (IFA 2020). According to the U.S. Department of Health and Human Services, the ClO₂ it acts quickly when it enters the human body. The ClO₂ it rapidly converts to chloride ions, which in turn decompose to chloride ions. The body uses these ions for many normal purposes. These chloride ions leave the body within hours to days, primarily through urine (EPA 1999).

The short-term toxicity of ClO₂. It has been evaluated in human studies by the research groups of Lubbers et al:

In the first study (Lubbers et al 1981; also published as Lubbers et al 1982), a group of 10 healthy adult men drank 1.000 mL (divided into two 500 mL servings, 4 hours apart) of a solution of ClO₂ 24 mg / L (0,34 mg / kg, assuming a reference body weight of 70 kg). In the second study (Lubbers et al 1984a), groups of 10 adult men received 500 mL of distilled water containing 0 or 5 mg / kg-day of ClO2 (0,04 mg / kg-day assuming a reference body weight of 70 kg) for 12 weeks. No study found physiologically relevant changes in general health (observations and physical examination), vital signs (blood pressure, pulse rate, respiratory rate, and body temperature), serum clinical chemical parameters (including glucose levels, urea nitrogen and phosphorus), alkaline phosphatase and aspartate and alanine aminotransferase), serum triiodothyronine (T3) and thyroxine (T4), nor hematological parameters (EPA 2000).

Ma et al (2017) evaluated the efficacy and safety of an aqueous solution of ClO₂ containing 2.000 ppm. Antimicrobial activity was 98,2% at concentrations between 5 and 20 ppm for fungal bacteria and H1N1 viruses. In an inhalation toxicity test, 20 ppm ClO2 During 24h, he did not show any mortality or abnormality in clinical symptoms and / or in the functioning of the lungs and other organs. A concentration of CLO2 up to 40 ppm in drinking water did not show any subchronic oral toxicity.

Taylor and Pfohl, 1985; Toth et al. 1990), Orme et al. 1985; Taylor and Pfohl, 1985; Mobley et al., 1990) studied the toxicity of chlorine dioxide, in various organs of the body, at different stages of development of the animal specimens studied, and reported a Minimum Observed Adverse Effect Level (LOAEL) for these effects of 14 mg kg -1 day-1 of chlorine dioxide.

While Orme, et al. (1985) identified a No Observed Adverse Effect Level (NOAEL) of 3 mg kg-1 day-1. The clinical experience of Latin American physicians, during the last six months, suggests that the ingestion of 30 mg day-1 of chlorine dioxide dissolved in one liter of water and drunk during ten events throughout the day as a successful treatment for COVID-19, which is 14 times below the LOAEL dose.

Therefore, the literature review confirms that the use of chlorine dioxide ingested at a dose of 50 mg  per day in an Adult definitivly does not represent a risk of toxicity to human health by ingestion and does represent a very effective treatment for COVID-19.

3. Recommendations, precautions and contraindications following medical experiences

  • Following medical experiences, we have made the following recommendations:
    It is recommended to generate chlorine dioxide the mixture between sodium chlorite (NaClO₂) and an activator (hydrochloric acid) or in its electrolytic form (the ideal one). What is used to make CDS is saturated chlorine dioxide gas in water with neutral pH;
  • We do not recommend that anyone ingest sodium hypochlorite (NaClO) or any other chemical substance;
    Do not inhale chlorine dioxide gas massively, for a long time, as it can cause throat irritation and breathing difficulties. In small amounts for a short time it is safe, as shown by the studies of Dr. Norio Ogata;
  • Preferably, do not mix CDS with: Vitamin C, bicarbonate, ascorbic acid, orange juice, preservatives or acid supplements (antioxidants). Although they do not usually interact, they can neutralize the effectiveness of chlorine dioxide;
    We recommend taking care of food in content and quantity;
  • The first recommendation should be: Chlorine Dioxide (ClO₂) should be administered under observation and medical follow-up, 
  • We do not promote self-treatment, we publish scientific information that might change the world for better.

4. International legal facts and human rights

Scientific advances and discoveries are constant, and in the field of health, prompt access to them by healthcare personnel and patients becomes essential and urgent, being logical and obligatory, out of a pure humanitarian sense and in accordance with scientific rigor, testing with substances such as Chlorine Dioxide (ClO₂) for which there is proven evidence of its efficacy and usefulness. In the history of medicine, the supremacy of the criterion of the “right to try ” has been constant over the criterion of the “perfectly contrasted appeal.”

The articles 32 and 37 of the Declaration of Helsinki of 1964 thus allow it in the case of “Unproven Intervention»(INC),”When proven interventions do not exist in the care of a patient or other known interventions have been ineffective, the physician, after seeking expert advice, with the informed consent of the patient or an authorized legal representative, may be allowed to use unproven interventions , if, in his opinion, this gives some hope of saving life, restoring health or alleviating suffering “.

Doctors, in accordance with the 1948 Geneva Declaration, before patients whose health and life are in danger, have the obligation to use all the means and products at their disposal, which offer indications of effectiveness and, to a greater extent, in a medical emergency, Since in accordance with the duty of fraternity and humanitarian aid, the use of Chlorine Dioxide (ClO₂) cannot be limited or denied, whose non-toxicity has been documented and whose efficacy and safety has been demonstrated in studies and practices carried out in different countries. 

To the same extent, States, Institutions and Organizations cannot restrict or prevent its use in the face of existing clinical evidence, otherwise they would fail to comply with the obligations assumed in international and national texts, incurring in the violation of fundamental rights such as the right to life and health as well as the patient’s right to self-determination and professional autonomy and clinical independence.

In accordance with the above, the exercise of the medical profession implies a vocation of service to humanity, with the health and life of the patient being its greatest concern, having to ensure the benefit of the interests of citizens, making medical knowledge available to them. Within the framework of professional autonomy and clinical independence. In the currently existing, fully applicable and enforceable legal framework, the medical profession must have professional freedom without interference in the care and treatment of patients, by having the privilege of using their professional judgment and discretion to make the necessary clinical and ethical decisions .

Physicians are legally conferred a high degree of professional autonomy and clinical independence, so they can make recommendations based on their knowledge and experience, clinical evidence, and holistic understanding of patients, including what is best for them without undue or inappropriate external influence , and take appropriate measures to ensure that effective systems are in place.

Every patient has the right to be cared for by a doctor who he knows is free to give a clinical and ethical opinion, without any outside interference. The patient has the right to self-determination and to make decisions freely in relation to his person. Patients in the free exercise of their right to autonomy have the right to dispose of their body, their decisions must be respected, being fully protected to prevent third parties from intervening in their body without their consent, and must be adequately informed about the purpose of the intervention, nature, its risks and consequences.

The right to health requires that governments comply with the obligations they have assumed in the aforementioned agreements, so that health goods and services are available in sufficient quantity, with public access, and of good quality, in accordance with the provisions of the General Comment 14 of the Committee of the Covenant on Economic, Social and Cultural Rights.

All this covered in the provisions that are related and whose essential contents are extracted below;
Universal Declaration of Human Rights, of December 10, 1948.
American Declaration of the Rights and Duties of Man, Bogotá, 1948.
American Convention on Human Rights, San José (Costa Rica), from November 7 to 22, 1969.
International Covenant on Economic, Social and Cultural Rights of December 16, 1966.
The Convention for the Protection of Human Rights and Fundamental Freedoms Rome of November 4, 1950.
International Covenant on Civil and Political Rights of December 16, 1966.
Convention for the protection of human rights and the dignity of the human being with respect to the applications of Biology and Medicine of April 4, 1997, Oviedo Convention.
Nuremberg Code of Ethics of August 19, 1947.
Geneva Declaration of 1948.
International Code of Medical Ethics of October 1949.
Declaration of Helsinki adopted by the 18th World Medical Assembly, 1964.
Belmont Report of April 18, 1979.
1981 WMA Declaration of Lisbon on the Rights of the Patient.
Declaration of the WMA on the Independence and Professional Freedom of the Physician of 1986.
Madrid Declaration of the AMM on Professional Autonomy and Self-Regulation of 1987.
WMA Seoul Declaration on Professional Autonomy and Clinical Independence 2008.
Madrid Declaration of the AMM on Professional Regulation of 2009.
WMA Declaration on the Relationship between Law and Ethics 2003.
UNESCO Universal Declaration on Bioethics and Human Rights of 2005.
International Health Regulations 2005

.
The International Covenant on Economic, Social and Cultural Rights of December 16, 1966, signed by Ecuador on June 24, 9 and ratified on June 1968, 11, recognizes the right of everyone to the enjoyment of the highest possible level of health. physical and mental; artº2010 “1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest possible standard of physical and mental health. “and the duty to protect this right by the state through a global health care system, which is available to all, without discrimination and economically accessible, article 2:

1.”Each of the States Parties to the present Covenant undertakes to adopt measures, both separately and through international assistance and cooperation, especially economic and technical, to the maximum of the resources available to it, to progressively achieve, by all the appropriate means, including in particular the adoption of legislative measures, the full realization of the rights recognized herein. “
The International Code of Medical Ethics of October 1949, so that articles 36 and 59 of the aforementioned text, among others, become effective;

Article 36 of Chapter VII regarding medical care at the end of life.

1. The doctor has the duty to try to cure or improve the patient, whenever possible. When it is no longer so, the obligation to apply the appropriate measures to achieve their well-being remains, even when this may lead to a shortening of life.

2. The doctor must not undertake or continue diagnostic or therapeutic actions harmful to the patient, without hope of benefits, useless or obstinate. Should withdraw, adjust or not initiate treatment when the limited prognosis so advises. The diagnostic tests and the therapeutic and support measures must be adapted to the clinical situation of the patient. You must avoid futility, both quantitative and qualitative.

3. The doctor, after adequate information to the patient, must take into account his willingness to reject any procedure, including treatments aimed at prolonging life.

4. When the patient’s condition does not allow him to make decisions, the doctor must take into consideration, in order of preference, the indications previously made by the patient, the previous instructions and the opinion of the patient in the voice of their representatives. It is the doctor’s duty to collaborate with the people who have the mission of guaranteeing compliance with the patient’s wishes 

– Article 59 of Chapter XIV relative to medical research;

“1.Medical research is necessary for the advancement of medicine, being a social good that must be fostered and encouraged. Research with human beings must be carried out when scientific progress is not possible by alternative means of comparable efficacy or in those phases 

2.-The investigating physician must adopt all possible precautions to preserve the physical and mental integrity of the research subjects. You must take special care in protecting individuals belonging to vulnerable groups. The good of the human being who participates in biomedical research must prevail over the interests of society and science.

3.- Respect for the research subject is the guiding principle of the same. Your explicit consent must always be obtained. The information must contain, at least: the nature and purpose of the research, the objectives, the methods, the expected benefits, as well as the potential risks and discomforts that its participation may cause. You must also be informed of your right not to participate or to withdraw freely at any time during the investigation, without being harmed by it.

4.- The medical researcher has the duty to publish the results of his research through the normal channels of scientific dissemination, whether they are favorable or not. It is unethical to manipulate or conceal data, whether for personal or group gain, or for ideological reasons. “
of research in which it is essential.

2.-The investigating physician must adopt all possible precautions to preserve the physical and mental integrity of the research subjects. You must take special care in protecting individuals belonging to vulnerable groups. The good of the human being who participates in biomedical research must prevail over the interests of society and science.

3.- Respect for the research subject is the guiding principle of the same. Your explicit consent must always be obtained. The information must contain, at least: the nature and purpose of the research, the objectives, the methods, the expected benefits, as well as the potential risks and discomforts that its participation may cause. You must also be informed of your right not to participate or to withdraw freely at any time during the investigation, without being harmed by it.

4.- The medical researcher has the duty to publish the results of his research through the normal channels of scientific dissemination, whether they are favorable or not. It is unethical to manipulate or conceal data, whether for personal or group gain, or for ideological reasons. “

The WMA Declaration of Lisbon on the Rights of the Patient of 1981, “Every patient has the right to be treated by a doctor who he knows is free to give a clinical and ethical opinion, without any outside interference.

The patient has the right to self-determination and to make decisions freely in relation to his person. The doctor will inform the patient of the consequences of his decision.

The mentally competent adult patient has the right to give or deny consent for any examination, diagnosis, or therapy. The patient has the right to the information necessary to make his decisions. The patient must clearly understand what the purpose of any examination or treatment is and what are the consequences of not giving consent “

The Declaration of the AMM on the Independence and Professional Freedom of the Physician of 1986, according to which; “Doctors must enjoy a professional freedom that allows them to care for their patients without interference.

The privilege of the physician to use his professional judgment and discretion to make the clinical and ethical decisions necessary for the care and treatment of his patients must be maintained and defended. By ensuring the independence and professional freedom for the physician to practice medicine, the community ensures the best medical care for its citizens, which in turn contributes to a strong and safe society. 

The 2009 WMA Madrid Declaration on Professional Regulation reaffirms the Seoul Declaration on the professional autonomy and clinical independence of physicians by providing”Physicians are given a high degree of professional autonomy and clinical independence, so they can make recommendations based on their knowledge and experience, clinical evidence and holistic understanding of patients, including what is best for them without undue or inappropriate external influence . 

“The universal principles that permeate all regulations must comply with respect for humanitarian laws innate in the collective unconscious, as stated in the maxim of the Hippocratic Oath “MAINTAIN the greatest respect for human life from the beginning, even under threats, and do not use medical knowledge against the laws of humanity.”

 

Ethical values have primacy over limiting legal provisions, as is well recognized in the WMA Declaration on the relationship between law and ethics of 2003, which provides “When legislation and medical ethics are in conflict, physicians should try to change the legislation. If this conflict occurs, ethical responsibilities prevail over legal obligations.”

When a patient in the face of a disease seeks relief or to save his life and requests to try a therapeutic option of which there are indications of usefulness, such as Chlorine Dioxide (ClO₂ ), it is the doctor’s duty to support the patient, acquire knowledge, do studies , and disseminate it in accordance with article 27 of the Universal Declaration of Human Rights of 1948, so that everyone benefits from scientific progress, information must be freely shared so that it is disseminated in all countries without restrictions, “Everyone has the right to freely take part in the cultural life of the community, to enjoy the arts and to participate in scientific progress and the benefits that result from it. “

5. Final Considerations

In view of the historical moment that all humanity faces with the Coronavirus pandemic and the urgent need to save lives, the recent events related to the treatment of COVID-19 in both the medical and academic fields, and especially the object of this document, which is to provide authorities with correct information on chlorine dioxide for correct and safe human use, some fundamental questions related to human rights and medical practice are worth considering for reflection:

Adherence to any treatment depends on the agreement and tacit collaboration between the parties: the doctor and the patient (or their guardian when they are in special conditions that do not allow a conscious choice of medical intervention, for example, memory loss situations , induced or trauma unconsciousness, in boys / girls). This agreement is freely and spontaneously agreed upon.

Based on his clinical experience, the doctor is free to prescribe what he considers appropriate for the patient, always communicating the correct way to use a medicine, the possible benefits and risks of a therapeutic intervention. On the other hand, the patient, based on the explanations given, personal beliefs and complementary information, also has the freedom to accept or not any form of indicated treatment.

Medical practice should always be based, whenever possible, on scientific data that support the diagnostic and therapeutic behaviors used. However, in situations where scientific evidence is not available, or is not reliable, it is up to the Doctor to use his knowledge, previous experience, and common sense to conduct the clinical situation in the way that seems most appropriate. In this case, it is important that the doctor ask the patient to sign a Term of Free and Informed Consent (TCLI). For this conduct, the Doctor relies on the Declaration of Helsinki (Article 37) which tells us: “In the treatment of an individual patient, when it is established that there have been no interventions or other interventions known to have been ineffective, the physician, after seeking expert advice, with the informed consent of the patient or an authorized representative, may use an unproven intervention if, in the judgment of the clinician, it offers hope of saving lives, restoring health, or alleviating suffering. This intervention should be investigated to assess its safety and efficacy. In all cases, new information should register and, where appropriate, be made available to the public.

Respecting the aforementioned aspects, we cannot underestimate the fact that there is not enough evidence in the scientific literature that indicates the use of SCDs for the prophylaxis or etiological treatment of COVID-19 cases of any severity, when we observe, for example , the technical report of AEMEMI doctors on the 97% efficacy of the treatment of patients with COVID-19 in 4 days in Guayaquil / Ecuador (AEMEMI 2020). It is worth mentioning that so far the only research group in the world that intends to carry out an international multicenter epidemiological study is registered with the number NCT043742 in the United States National Library of Medicine / National Institute of Health, in Dr. Eduardo Insignares Carrione (Fundación Génesis) and entitled “Determination of the Efficacy of Oral Chlorine Dioxide in the Treatment of COVID-19” (https://clinicaltrials.gov/ct2/show/study/NCT04343742) and so far it cannot begin its work because the regulatory institutions are making this confusion in the translation of knowledge, thinking that chlorine dioxide is toxic.

In the specific case of ClO₂ , currently available information and clinical tests point to the efficacy of this substance against coronavirus (AEMEMI 2020).

In summary:
In view of the above, on the basis of the evidence presented here with evident experience on the part of Scientists and Health Professionals, as well as already well demonstrated in scientific articles already published, we recommend the use of chlorine dioxide solution (CDS ), according to the standardized by Andreas Ludwig Kalcker (2017), duly diluted and therefore, respecting the safe doses from what is already known from toxicity studies, which according to reports from doctors from several countries has proven to be safe for human consumption and also effective against COVID-19 when consumed correctly in internationally standardized protocols.

As an example of the conscious and compassionate use of chlorine dioxide (ClO₂ ), we can cite the Plurinational State of Bolivia, after a prolonged process of debate and resolution within the framework of the exercise of Human Rights and within the framework of the Law of Participation and Social Control, the population has sued through its assembly representatives departmental and national law that allows the authorization of the production, distribution with quality control and compassionate use of Chlorine Dioxide.

To date (Sep. 13, 2020), 4 departmental laws and 1 national laws are in process; In La Paz, the government headquarters, the Law was promulgated on September 9, 2020.

6. References

  • AEMEMI – Ecuadorian Association of Expert Physicians in Integrative Medicine.Dioxide chlorine, una therapia effective for him treatment SARS-COV2 (COVID-19). May, 2020
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  • Kalcker AL.Report of Series of experiments: applications of Chlorine Dioxide as an Active Pharmaceutical Ingredient. Staff documents, 2018.
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  • Noszticzius Z et al.Demonstrating that chlorine dioxide is a size-selective antimicrobial agent and high purity ClO2 can be used as a local antiseptic. This work was supported by OTKA Grant 77908.
  • Ogata N & Shibata T.Protective effect of low-concentration chlorine dioxide gas against influenza A virus infection. Journal of General Virology: 89, 60–67, 2008.
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  • Ratcliff PA.Patent on a method of treating the epithelium of body orifices with chlorine dioxide and a phosphate compound. Available in:https://mega.nz/fm>. Accessed on 01.07.2020.
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  • United Department of Health and Human services. Public Health Service. Agency for toxic substances and disease registry.Toxicological Profile for chlorine dioxide and chlorite 2004.
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Conclusions

The responsibility and powers assumed by each of the actors in the country have led to acting in the most effective way in the face of the pandemic, health personnel within the framework of Ethics and Medical Deontology, assume the responsibility of joining the care of the needs and demands of the population, in this particular case the population has demanded the use of Chlorine Dioxide as a preventive and curative treatment.

 
Faced with a lack of control of the pandemic, the representatives of the population (Neighborhood Councils, Civics, grassroots organizations, associations, Central Obrera Boliviana, Federation of Miners of Bolivia, Departmental and National Assemblies) the latter have directed to elaborate, treat and enact the Law of Production, Use and Distribution of Chlorine Dioxide.


Finally, we appeal to scientific societies, bioethics, academic training institutions to join this advance in the exercise of human rights before the decision of the population to choose autonomously and in justice.

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