Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

BRETHREN, I WANT YOU TO NOTICE HOW MANY TIMES DR. ZELENKO’S PROTOCOL IS MENTIONED IN THIS ARTICLE FROM AUSTRALIA.

From mail.google.com

Review began 11/03/2021
Review ended 11/22/2021
Published 11/25/2021
© Copyright 2021
Ried et al. This is an open access article
distributed under the terms of the Creative
Commons Attribution License CC-BY 4.0.,
which permits unrestricted use, distribution,
and reproduction in any medium, provided
the original author and source are credited.

NIIM Research, National Institute of Integrative Medicine, Melbourne, AUS 2. Health and Nutrition, Torrens University, Melbourne, AUS 3. Discipline of General Practice, The University of Adelaide, Adelaide, AUS 4. Gold Coast Clinic, National Institute of Integrative Medicine, Gold Coast, AUS 5. NIIM Clinic, National Institute of Integrative Medicine, Melbourne, AUS
Corresponding author: Karin Ried, karinried@niim.com.au

Abstract

Background
COVID-19 is a global pandemic. Treatment with hydroxychloroquine (HCQ), zinc, and azithromycin (AZM), also known as the Zelenko protocol, and treatment with intravenous (IV) vitamin C (IVC) have shown encouraging results in a large number of trials worldwide. In addition, vitamin D levels are an important
indicator of the severity of symptoms in patients with COVID-19.

Objectives

Our multicenter, randomized, open-label study aimed to assess the effectiveness of HCQ, AZM, and zinc
with or without IVC in hospitalized patients with COVID-19 in reducing symptom severity and duration and
preventing death.

Methods

Hospitalized patients with COVID-19 in seven participating hospitals in Turkey were screened for eligibility and randomly allocated to receive either HCQ, AZM, and zinc (group 1) or HCQ, AZM, zinc plus IV vitamin C treatment (group 2) for 14 days. The patients also received nontherapeutic levels of vitamin D3.
The trial is registered on the Australian and New Zealand Clinical Trial Registry ACTRN12620000557932 and has been approved by the Australian Therapeutic Goods Administration (TGA).

Results

A total of 237 hospitalized patients with COVID-19 aged 22-99 years (mean: 63.3 ± 15.7 years) were enrolled in the study. Almost all patients were vitamin D deficient (97%), 55% were severely vitamin D deficient (<25 nmol/L) and 42% were vitamin D deficient (<50 nmol/L); 3% had insufficient vitamin D levels (<75 nmol/L),
and none had optimal vitamin D levels.
Of the patients, 73% had comorbidities, including diabetes (35%), heart disease (36%), and lung disease (34%).

All but one patient (99.6%; n = 236/237) treated with HCQ, AZM, and zinc with or without high-dose IV vitamin C (IVC) fully recovered. Additional IVC therapy contributed significantly to a quicker recovery (15 days versus 45 days until discharge; p = 0.0069).
Side effects such as diarrhea, nausea, and vomiting, reported by 15%-27% of the patients, were mild to moderate and transient. No cardiac side effects were observed. Low vitamin D levels were significantly correlated with a higher probability of admission to the intensive
care unit (ICU) and longer hospital stay.

Sadly, one 70-year-old female patient with heart and lung disease died after 17 days in ICU and 22 days in the hospital. Her vitamin D level was 6 nmol/L on admission (i.e., severely deficient).

Conclusions

Our study suggests that the treatment protocol of HCQ, AZM, and zinc with or without vitamin C is safe and

effective in the treatment of COVID-19, with high dose IV vitamin C leading to a significantly quicker recovery. importantly, our study confirms vitamin D deficiency to be a high-risk factor of severe COVID-19 disease and hospitalization, with 97% of our study’s patient cohort being vitamin D deficient, 55% of these being severely vitamin D deficient, and none had optimal levels.
Future trials are warranted to evaluate the treatment with a combination of high-dose vitamin D3 in addition to HCQ, AZM, and zinc and high-dose intravenous vitamin C.

Categories: Infectious Disease, Therapeutics, Integrative/Complementary Medicine
Keywords: vitamin d, intravenous vitamin c, zinc, hydroxychloroquine, covid-19 treatment, covid-19

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, has affected millions of people worldwide. COVID-19 was first reported by the World Health Organization in December 2019 and was declared a worldwide pandemic in March 2020. Exploring therapies potentially of benefit for COVID-19 has been a public health emergency.
SARS-CoV-2 enters cells by binding to the ACE2 receptor. Higher blood levels of ACE2 reflect shedding from the myocardium and pulmonary epithelium and identify patients who are vulnerable to the development of life-threatening complications.
Early in the pandemic, the combination of hydroxychloroquine (HCQ), azithromycin (AZM), and zinc, alsoknown as the Zelenko protocol, had shown great promise in the treatment of COVID-19 [1,2].
In vitro, chloroquine increases the endosomal pH required for the virus to fuse with cells and interferes with the glycosylation of SARS-CoV-2 cell receptors, thereby blocking viral infection [3,4]. Investigatorsperformed a time-of-addition assay, which showed that chloroquine is effective at both the entry and post-entry stages of the SARS-CoV-2 infection in cells. Hydroxychloroquine has greater in vitro potency thanchloroquine against SARS-CoV-2 and, because of its enhanced safety profile, can be given at higher doses
than chloroquine [5].
As of October 2021, a meta-analysis of more than 290 worldwide trials involving more than 412,000 patientsfound that HCQ significantly reduced morbidity and mortality in patients with COVID-19. Specifically, when HCQ is used in early treatment, a meta-analysis of 32 studies involving more than 54,600 patients suggested HCQ to improve symptoms and prevent death by 64%-75% (all early treatment studies (n = 32): RR, 0.36
(0.29-0.46), p < 0.0001; early treatment studies reporting mortality (n = 13): RR, 0.25 (0.16-0.40), p < 0.0001)
[6].
Azithromycin is a macrolide antibiotic that has been found to inhibit the viral tropism and replication of Zika and Ebola viruses [7,8]. An in vitro study has shown the activity of azithromycin (AZM) in combination with hydroxychloroquine (HCQ) against SARS-CoV-2 [9].
In addition, the effectiveness of this combination therapy of HCQ and AZM, when used early, as was demonstrated in a clinical study involving 83 patients in Turkey, reduced recovery time and shortened hospital length of stay [10].

In therapeutic doses, HCQ has a high safety profile and works as a zinc ionophore, enabling zinc to enter a virus-infected cell, increasing intracellular zinc concentrations [11].
Zinc itself has antiviral properties, boosting both innate and humoral immunity [12]. High intracellular concentrations of zinc are essential to inhibit viral replication and proliferation, including coronavirus RNA-dependent RNA polymerase activity [13].

The Zelenko COVID-19 treatment protocol consists of the following triple therapy for five consecutive days in addition to standard supportive care: zinc sulfate (220 mg capsule once daily, containing 50 mg elemental zinc), HCQ (200 mg twice daily), and AZM (500 mg once daily) [2].

In addition, intravenous vitamin C (IVC) has known immune-stimulating and antiviral properties [14] and had shown promise as a treatment for acute respiratory syndrome and pneumonia [15]. Recent studies reported on the benefits of IVC therapy for COVID-19 [16,17].

Furthermore, a large number of studies (n > 200) have demonstrated low vitamin D levels to be a risk factor for the severity of COVID-19 symptoms and hospitalization [18-20].

Open Access Original
Article DOI: 10.7759/cureus.19902

Adequate vitamin D levels are of great importance in the prevention of respiratory infections, as vitamin D
protects against pathogens including viruses via the innate and adaptive immune systems, involving white
blood cells and T-cells [21].
In our study, we aimed to assess the optimal treatment protocol for hospitals to consider in their treatment
for patients with COVID-19, in order to reduce the severity and duration of symptoms and save lives.
Patients presenting at hospitals with COVID-19 symptoms were randomly allocated to the Zelenko protocol
(HCQ + AZM + zinc) or the Zelenko protocol plus IV vitamin C.
All enrolled patients also received supplementation of 5000 IU/day of vitamin D3, an adequate dose if levels
of vitamin D are insufficient (51-75 nmol/L); however, this dose is considered inadequate for vitamin D
deficiency (<50 nmol/L). Materials And Methods Trial design and participants Our study is an international, multicenter, open-label, randomized controlled trial evaluating the efficacy and safety of therapies with hydroxychloroquine (HCQ), azithromycin (AZM), zinc, and vitamin D3 alone (group 1) or HCQ + AZM + zinc in combination with IV vitamin C (group 2) in hospitalized patients with COVID-19. For stage 1 of the trial, we aimed to recruit 200 patients. The trial was conducted in Australia and Turkey between January and June 2021. Stage 1 of the trial took place primarily in Turkey and involved seven participating hospitals in Eskisehir, Elazig, Istanbul, Erzincan, and Izmir. The trial was approved by the National Health and Medical Research Council (NHMRC)-endorsed National Institute of Integrative Medicine (NIIM) Human Research Ethics Committee in Australia, the Turkish Ethics Committees at the Ministry of Health in Turkey, and participating hospitals. The trial is registered on the Australian and New Zealand Clinical Trial Registry ACTRN12620000557932 and has been approved by the Australian Therapeutic Goods Administration (TGA). All eligible participants provided electronic written informed consent. Inclusion criteria The inclusion criteria were as follows: (1) age ≥ 18 years, (2) informed written consent, and (3) diagnosis of active symptomatic COVID-19 confirmed by polymerase chain reaction (PCR) testing via nasal and/or oral swab at the time of enrolment for quantitative PCR assessment. Exclusion criteria The exclusion criteria were as follows: (1) known G-6-PDH deficiency; (2) contraindication to hydroxychloroquine, azithromycin, or vitamin C, allergy to study interventions, epilepsy, serious hearing or visual problems, advanced liver disease, history of severe depression, calcium oxalate stones, and pregnant or lactating women; (3) already receiving hydroxychloroquine, azithromycin, vitamin C >3 g daily, or an experimental antiviral; (4) history of fever
(e.g., night sweats and chills) and/or acute respiratory infection (e.g., cough, shortness of breath, and sore
throat) of more than seven days’ duration; (5) calculated creatinine clearance of <30 mL/minute; (6) baseline
electrocardiogram (ECG) showing QTc ≥ 470 for males and QTc ≥ 480 for females; and (7) receipt of a drug
known to increase QTc, such as quetiapine, amiodarone, and sotalol.
Intervention
Group 1 received HCQ + zinc + AZM + vitamin D3, whereas group 2 received vitamin C + group 1
interventions. Hydroxychloroquine (HCQ) was given as 400 mg peroral (PO) once a day for one day, followed
by 200 mg once a day for six days. Azithromycin (AZM) was given as 500 mg PO on day 1, followed by 250 mg
PO once daily for four days. Zinc citrate was given as 30 mg elemental zinc PO daily for 14 days. Vitamin D3
was given as 5,000 IU PO daily for 14 days. IV vitamin C (sodium ascorbate) was given as 50 mg/kg every six
hours on day 1, followed by 100 mg/kg every six hours (four times daily, 400 mg/kg/day) for seven days
(average: 28 g/day; maximum dose: 50 g/24 hours for those weighing more than 125 kg).
Data collection
Project management and data collection were carried out by appointed teams at the participating sites.
The participants’ gender, age, disease severity, comorbidities (smoking, diabetes, heart disease, lung
disease, and immunosuppression), other medications, and trial outcomes were entered into an electronic
2021 Ried et al. Cureus 13(11): e19902. DOI 10.7759/cureus.19902 3 of 11

online database using Microsoft Forms questionnaires.
Outcomes
Primary Outcome
The primary outcome was mortality or need for invasive mechanical ventilation at any time in the first 15
days from enrolment.
Secondary Efficacy Outcomes
The secondary efficacy outcomes (measured at both 15 and 45 days from enrolment) are mortality, invasive
mechanical ventilation, need for humidified high-flow oxygen, admission to the intensive care unit (ICU),
days in the hospital, days in the ICU, renal replacement therapy, and extracorporeal support.
The secondary efficacy outcomes also include the World Health Organization (WHO) Master Protocol ordinal
score at day 15 as follows: (1) not hospitalized, no limitations on activities; (2) not hospitalized, limitation
on activities; (3) hospitalized, not requiring supplemental oxygen; (4) hospitalized, requiring
supplemental oxygen; (5) hospitalized, on noninvasive ventilation or high-flow oxygen devices; (6)
hospitalized, on invasive mechanical ventilation or ECMO; and (7) death.
Secondary Safety Outcomes
The secondary safety outcomes are QTc prolongation (>500 ms) 24 hours following the initial dose of study
drugs, serious ventricular arrhythmia (including ventricular fibrillation) or sudden unexpected death in the
hospital, and any of the following adverse events in the first 10 days from enrolment: diarrhea, grade 2
or greater; nausea, grade 2 or greater; and vomiting, grade 2 or greater (Appendices).
Adaptive design features
The study was overseen by the Steering Committee consisting of chief investigators (TB, KR, and AS) and
investigators at recruited sites. Independent Data Safety Monitoring Committees (DSMC) at participating
hospitals monitored the progress and safety of the trial treatment and were to make recommendations on
whether to continue, modify, or stop the trial for safety or ethical reasons.
Sample size calculation
In stage 1, the sample size required is n = 100 in each intervention arm in order to have a statistical power of
80% to detect a relative risk reduction (RRR) of 30% in the proportion progressing to mechanical ventilation
or death, compared with standard care, and assuming a standard-of-care risk of progression of 30%. Since
the participants were hospitalized, we assumed minimal (<1%) loss to follow-up. The total sample size was n
= 200.
Analyses were performed using IBM SPSS version 26. Statistical significance was set at p < 0.05. The primary
analysis of efficacy was conducted under the intention-to-treat principle; all randomized participants were
included in the analyses. Descriptive analysis was conducted on all variables. Any variable differences
between groups were included in analyses as covariates. Differences between the groups and comparison of
continuous outcome variables were analyzed using Student’s t-test or analysis of covariance (ANCOVA) and
chi-square analysis for dichotomous variables or Mann-Whitney U-tests for ranking variables. Correlations
between variables were assessed using Pearson’s correlation coefficient.
Results
Seven hospital sites in Turkey participated in the multicenter trial (Figure 1).

Adequate vitamin D levels are of great importance in the prevention of respiratory infections, as vitamin D
protects against pathogens including viruses via the innate and adaptive immune systems, involving white
blood cells and T-cells [21].
In our study, we aimed to assess the optimal treatment protocol for hospitals to consider in their treatment
for patients with COVID-19, in order to reduce the severity and duration of symptoms and save lives.
Patients presenting at hospitals with COVID-19 symptoms were randomly allocated to the Zelenko protocol
(HCQ + AZM + zinc) or the Zelenko protocol plus IV vitamin C.
All enrolled patients also received supplementation of 5000 IU/day of vitamin D3, an adequate dose if levels
of vitamin D are insufficient (51-75 nmol/L); however, this dose is considered inadequate for vitamin D
deficiency (<50 nmol/L). Materials And Methods Trial design and participants Our study is an international, multicenter, open-label, randomized controlled trial evaluating the efficacy and safety of therapies with hydroxychloroquine (HCQ), azithromycin (AZM), zinc, and vitamin D3 alone (group 1) or HCQ + AZM + zinc in combination with IV vitamin C (group 2) in hospitalized patients with COVID-19. For stage 1 of the trial, we aimed to recruit 200 patients. The trial was conducted in Australia and Turkey between January and June 2021. Stage 1 of the trial took place primarily in Turkey and involved seven participating hospitals in Eskisehir, Elazig, Istanbul, Erzincan, and Izmir. The trial was approved by the National Health and Medical Research Council (NHMRC)-endorsed National Institute of Integrative Medicine (NIIM) Human Research Ethics Committee in Australia, the Turkish Ethics Committees at the Ministry of Health in Turkey, and participating hospitals. The trial is registered on the Australian and New Zealand Clinical Trial Registry ACTRN12620000557932 and has been approved by the Australian Therapeutic Goods Administration (TGA). All eligible participants provided electronic written informed consent. Inclusion criteria The inclusion criteria were as follows: (1) age ≥ 18 years, (2) informed written consent, and (3) diagnosis of active symptomatic COVID-19 confirmed by polymerase chain reaction (PCR) testing via nasal and/or oral swab at the time of enrolment for quantitative PCR assessment. Exclusion criteria The exclusion criteria were as follows: (1) known G-6-PDH deficiency; (2) contraindication to hydroxychloroquine, azithromycin, or vitamin C, allergy to study interventions, epilepsy, serious hearing or visual problems, advanced liver disease, history of severe depression, calcium oxalate stones, and pregnant or lactating women; (3) already receiving hydroxychloroquine, azithromycin, vitamin C >3 g daily, or an experimental antiviral; (4) history of fever
(e.g., night sweats and chills) and/or acute respiratory infection (e.g., cough, shortness of breath, and sore
throat) of more than seven days’ duration; (5) calculated creatinine clearance of <30 mL/minute; (6) baseline
electrocardiogram (ECG) showing QTc ≥ 470 for males and QTc ≥ 480 for females; and (7) receipt of a drug
known to increase QTc, such as quetiapine, amiodarone, and sotalol.
Intervention
Group 1 received HCQ + zinc + AZM + vitamin D3, whereas group 2 received vitamin C + group 1
interventions. Hydroxychloroquine (HCQ) was given as 400 mg peroral (PO) once a day for one day, followed
by 200 mg once a day for six days. Azithromycin (AZM) was given as 500 mg PO on day 1, followed by 250 mg
PO once daily for four days. Zinc citrate was given as 30 mg elemental zinc PO daily for 14 days. Vitamin D3
was given as 5,000 IU PO daily for 14 days. IV vitamin C (sodium ascorbate) was given as 50 mg/kg every six
hours on day 1, followed by 100 mg/kg every six hours (four times daily, 400 mg/kg/day) for seven days
(average: 28 g/day; maximum dose: 50 g/24 hours for those weighing more than 125 kg).
Data collection
Project management and data collection were carried out by appointed teams at the participating sites.
The participants’ gender, age, disease severity, comorbidities (smoking, diabetes, heart disease, lung
disease, and immunosuppression), other medications, and trial outcomes were entered into an electronic
2021 Ried et al. Cureus 13(11): e19902. DOI 10.7759/cureus.19902 3 of 11

online database using Microsoft Forms questionnaires.
Outcomes
Primary Outcome
The primary outcome was mortality or need for invasive mechanical ventilation at any time in the first 15
days from enrolment.
Secondary Efficacy Outcomes
The secondary efficacy outcomes (measured at both 15 and 45 days from enrolment) are mortality, invasive
mechanical ventilation, need for humidified high-flow oxygen, admission to the intensive care unit (ICU),
days in the hospital, days in the ICU, renal replacement therapy, and extracorporeal support.
The secondary efficacy outcomes also include the World Health Organization (WHO) Master Protocol ordinal
score at day 15 as follows: (1) not hospitalized, no limitations on activities; (2) not hospitalized, limitation
on activities; (3) hospitalized, not requiring supplemental oxygen; (4) hospitalized, requiring
supplemental oxygen; (5) hospitalized, on noninvasive ventilation or high-flow oxygen devices; (6)
hospitalized, on invasive mechanical ventilation or ECMO; and (7) death.
Secondary Safety Outcomes
The secondary safety outcomes are QTc prolongation (>500 ms) 24 hours following the initial dose of study
drugs, serious ventricular arrhythmia (including ventricular fibrillation) or sudden unexpected death in the
hospital, and any of the following adverse events in the first 10 days from enrolment: diarrhea, grade 2
or greater; nausea, grade 2 or greater; and vomiting, grade 2 or greater (Appendices).
Adaptive design features
The study was overseen by the Steering Committee consisting of chief investigators (TB, KR, and AS) and
investigators at recruited sites. Independent Data Safety Monitoring Committees (DSMC) at participating
hospitals monitored the progress and safety of the trial treatment and were to make recommendations on
whether to continue, modify, or stop the trial for safety or ethical reasons.
Sample size calculation
In stage 1, the sample size required is n = 100 in each intervention arm in order to have a statistical power of
80% to detect a relative risk reduction (RRR) of 30% in the proportion progressing to mechanical ventilation
or death, compared with standard care, and assuming a standard-of-care risk of progression of 30%. Since
the participants were hospitalized, we assumed minimal (<1%) loss to follow-up. The total sample size was n
= 200.
Analyses were performed using IBM SPSS version 26. Statistical significance was set at p < 0.05. The primary
analysis of efficacy was conducted under the intention-to-treat principle; all randomized participants were
included in the analyses. Descriptive analysis was conducted on all variables. Any variable differences
between groups were included in analyses as covariates. Differences between the groups and comparison of
continuous outcome variables were analyzed using Student’s t-test or analysis of covariance (ANCOVA) and
chi-square analysis for dichotomous variables or Mann-Whitney U-tests for ranking variables. Correlations
between variables were assessed using Pearson’s correlation coefficient.
Results
Seven hospital sites in Turkey participated in the multicenter trial (Figure 1).

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HOW CAN I BE SAVED?

MARANATHA!!

2 Thessalonians 2:3 – The Man of Lawlessness

Gary W. Ritter

(Jeremiah 1-2; 2 Thessalonians 2)

It’s incomprehensible to me how certain Christians can read Paul’s Thessalonian letters and come away with anything except a pre-Tribulation Rapture interpretation.  In the second chapter of the second letter, Paul tells the church that the things of which he will speak next will not happen until the advent of one very important event.  He says in 2 Thessalonians 2:1:

Now concerning the coming of our Lord Jesus Christ and our being gathered together to him …

False teachers had been infiltrating the church and distressing the believers into thinking that the Tribulation had already begun.  Paul reassures them that there is a critical first event before this occurs.  Yes, Jesus Christ is coming.  At that time those in Christ will be gathered to him.  This refers to an assembling of those who believe.  Paul says: “You haven’t missed that seminal event.  The false teachers saying the Day of the Lord has come are incorrect.”

What is the Day of the Lord?  This is often misconstrued.  Post-Trib Rapture adherents relegate the term strictly to the 2nd coming of Jesus on the single day that He returns to earth at the Armageddon conflict.  But, a survey of Old Testament usage indicates that it refers to the entire period of time associated with the seven years of the Tribulation.

Well-regarded Bible prophecy expert Dr. Arnold Fruchtenbaum, in his comprehensive book The Footsteps of the Messiah (https://www.amazon.com/dp/195105959X/), discusses this with the following comment:

The term the Day of Jehovah is the most common term in the Old Testament for the Tribulation.  It is a period of time that begins with the signing of the Seven-Year Covenant and ends with the Second Coming of Messiah exactly seven years later… a study of the term in every passage will show that it is never used in any context except that of the Tribulation.

What has to happen before the Tribulation, i.e. the Day of the Lord, begins?  Paul lays this out in 2 Thessalonians 2:3:

Let no one deceive you in any way. For that day will not come, unless the rebellion comes first, and the man of lawlessness is revealed, the son of destruction… 

The rebellion in this verse has been the topic of much discussion.  Various translations also use falling away or apostasy.  It is argued that earlier Bibles prior to King James, such as the 1599 Geneva Bible, show the translation of this Greek word differently and correctly.  This version states:

Let no man deceive you by any means: for that day shall not come, except there come a departing first, and that that man of sin be disclosed, even the son of perdition.

As you can see, it speaks of a departing.  That’s quite different than apostasy. Interpreted as a rebellion or falling away implies that there will be a massive turning from the truth of the Gospel, i.e. away from belief in God.  If seen as a departure, it is considered as a description of the Rapture.

There are good arguments on both sides of this issue.  I’m agnostic about it.  If it means that a wholesale turning away from the Lord happens prior to the Rapture, I’m good with that, because we’re certainly seeing that in these latter days.  If instead it means that the man of lawlessness can only be revealed once the Rapture occurs, that’s even better in my book.

Regardless of these two interpretations, something dramatic happens, and only then can the Antichrist come forth onto the world stage.  There is a restraining force in play that keeps him hidden.  It is God Himself who holds back lawlessness until the right time (2 Thessalonians 2:6).

The Restrainer, of course, is the Holy Spirit.  The mystery of His restraint is that He indwells every believer.  In addition, He is integral to and indwelling the true church of Jesus Christ in its ability for the saints to assemble.  Paul states in 2 Thessalonians 2:7-8:

For the mystery of lawlessness is already at work. Only he who now restrains it will do so until he is out of the way. And then the lawless one will be revealed, whom the Lord Jesus will kill with the breath of his mouth and bring to nothing by the appearance of his coming.

The restraint of the Holy Spirit remains until He is removed.  Then, and only then, can Antichrist be made known.  Is it the apostasy or the departure that enables this to occur?  Yes.  The apostasy inevitably leads to the Rapture.  However one wants to define the term, the snatching away of believers by Christ in the clouds, and by extension, the removal of the church as a dwelling place for the Spirit on earth, must happen as the first move of God to allow all other events in the end times scenario.

This opens the door for Antichrist to demonstrate his charisma and power, and to draw the secular world to him.  But, he is a deceiver and eventually indwelt by the father of lies.  As such, mankind is deceived.  Only by the grace of God do many have their eyes opened and refuse Antichrist’s charms and sorceries., thus turning to faith in Christ in the midst of this incredible darkness.

The bottom line for Paul in writing to this church was that the seminal event enabling the son of perdition to come to prominence, and thus initiate the 7-year Tribulation, was the Rapture of the true church.  Nothing regarding the Day of the Lord could take place until the chaos of lawlessness could be unleashed.  That only happens when the Holy Spirit ceases to restrain evil in the world.

For those who think we have to go through some or all of the Tribulation, the error is that these terrible seven years simply cannot even begin until the Rapture.  That mysterious event is what triggers everything.

Just as Jesus declared and Paul echoed Him: “Don’t be deceived.”


As I’ve mentioned in the Author Note of previous articles, the Lord put it on my heart this year to write a daily essay relating to my practice of Reading Through the Bible in a Year.  Last year, that resulted in my producing the Awaken Bible Study Notes, a 4-volume set correlating with each quarter’s readings.  This year in my writings, truly through the grace of God, I’m producing the 4-volume Awaken Bible Commentary and Reflections series.  Volume 1, which covers January – March (Genesis 1 – Judges 5; Matthew 1 – Luke 7), is now available on Amazon in both paper and Kindle e-book formats at this link:

Awaken Bible Commentary and Reflections series Volume 1

If these daily writings have been a blessing to you, I hope that you’ll acquire this first book and the subsequent ones as I finish editing them.  My intent in all I write is to bring God the glory and to make His people think.  As in the Study Notes from last year, the Commentary and Reflections delve into the prophetic and supernatural nature of God’s Word, a combination you simply won’t find elsewhere.  They attempt to show the parallels to our times and the peril from the past when God’s people turn away from Him and His commands.  Scripture is very much a blueprint for today.

Gary W. Ritter is a lay pastor, Bible teacher, and prolific author.  His Whirlwind Series comprises three books: Sow the Wind, Reap the Whirlwind, and There Is a Time.  These books are contained in the collected volume of the Whirlwind Omnibus.  Gary has written many other Christian thrillers that will challenge you, and which you can learn about at his website: www.GaryRitter.com.  Recently, Gary wrote a novella for the new Kindle Vella platform called Tribulation Rising: Seal Judgments – The Coming Apocalypse.  This seven-part short work can be found at https://www.amazon.com/dp/B099Z462WD.  You can also watch Gary’s video Bible teachings on Rumble at his Awaken Bible Prophecy channel: https://rumble.com/c/c-783217.