Lecture abstract: In my lecture, I will explore evolving approaches to treatment based on my own clinical knowledge, patient survey data, and the emerging scientific literature. I will review the insights, successes, and failures gleaned from seven months of treating patients for COVID spike protein-induced disease in my private practice.  My team and I have largely been guided by an evolving understanding of pathophysiologic mechanisms amidst an ever-increasing knowledge of therapeutic options with favorable mechanisms of action. I will present our current treatment approach, which relies on successive trials of therapy in situations where diagnostic tests often provide limited guidance.  The lecture will conclude with a presentation of the data on the most effective treatments as reported to REACT-19 in their survey of a large sample of long-haul and vaccine-injured patients.