By now, you probably understand the importance of hand-washing to prevent the spread of infectious illness. But did you know flushing your sinuses might be an even better way to inhibit the progression of a viral illness such as COVID-19? In an April 20, 2020, article,1 MSN’s Best Life features the recommendations of Dr. Amy Baxter, a pediatric emergency medicine physician in Atlanta, Georgia. Nasal irrigation, she says, is a rarely discussed strategy that can help reduce the progression of illness in those who have tested positive for COVID-19 infection. In an April 2, 2020, response2 to a BMJ paper about the lack of personal protection equipment on COVID-19 frontlines, professor Robert Matthews also brought up the importance and potential usefulness of oropharyngeal washing to protect health care workers from infection. As reported by MSN Best Life:3
Why Nasal Irrigation?As noted by Baxter, researchers have found that the viral load of SARS-CoV-2 tends to be heaviest in the sinuses and nasal cavity. Regularly rinsing your sinuses therefore makes sense since it would help clear out the pathogen and prevent it from gaining a strong foothold and migrating into your lungs. The age and gender discrepancies observed in COVID-19 also supports nasal irrigation. Children are at virtually no risk from COVID-19, while death rates among the elderly are at their highest. More men than women also die from the infection.
Research has previously demonstrated that nasal irrigation reduces the symptoms and duration of other viral illnesses such as the seasonal flu and common cold. In one randomized controlled trial,4 nasal irrigation and gargling with hypertonic saline were found to reduce the duration of the common cold by 1.9 days and reduce transmission within the household by 35% by reducing viral shedding when done within 48 hours of symptom onset. While it has not yet been studied as a preventive method for COVID-19 specifically, there’s reason to suspect nasal irrigation might be helpful. Baxter points out that COVID-19 death rates in Southeast Asian countries such as Thailand, Vietnam and Laos have been surprisingly low, and nasal irrigation is common practice in those areas. According to Baxter, some 80% of the Southeast Asian population do it. How to Irrigate Your SinusesBaxter suggests irrigating your sinuses any time you’ve been exposed to an infected individual or test positive for COVID-19. She recommends flushing your sinuses in the morning using a mixture of boiled lukewarm water (8 ounces) and povidone-iodine (half a teaspoon). Povidone-iodine has been shown to effectively kill not only Klebsiella pneumoniae and Streptococcus pneumoniae bacteria, but to also rapidly inactivate SARS-CoV, MERS-CoV, H1N1 influenza virus A and rotavirus after 15 seconds of exposure.5 The mixture used in this study — 7% povidone-iodine diluted 1-to-30, which equates to a total concentration of 0.23% povidone-iodine — inactivated over 99% of the coronaviruses causing SARS and MERS. Either a neti pot or NeilMed sinus rinse bottle can be used. The water pressure you get from a sinus rinse bottle can provide a more effective flush. If higher pressure is uncomfortable, a neti pot, which relies on gravity, may be a more comfortable choice. In the evening, Baxter recommends flushing your sinuses again with a mixture of:
Gargling May Also Be HelpfulYou may also be able to reduce the risk of SARS-CoV-2 migrating into your lungs by gargling. As noted by Dr. Neal Naito in a March 29, 2020, New York Times article,6 while there’s “no firm proof” that gargling can prevent COVID-19, there are virtually no downsides to the advice. Like Baxter, Naito points out that many East Asian countries such as Japan see gargling as a commonsense hygiene practice.
An over-the-counter povidone-iodine8 oral gargle solution, used for decades by the Japanese for the treatment of sore throat, appears most useful. One small study9 from Japan, published in 2002, found patients diagnosed with chronic respiratory disease who gargled with a povidone-iodine solution at least four times a day reduced their incidence of acute respiratory infection by about 50%. Do Not Use Iodine-Based Skin Disinfectant for GarglingImportantly, Naito stresses that povidone-iodine solutions sold as skin disinfectants are NOT suitable for gargling as they contain potentially harmful ingredients that should not be ingested. “It’s critical that people not gargle with skin disinfectant solutions, including those that contain povidone-iodine,” he says. So, when using povidone-iodine for gargling, be sure to look for solutions such as Betadine formulated specifically as a sore throat gargle, not products intended for cuts and wound care. Nebulized Hydrogen Peroxide — Another Prevention StrategyWhile gargling and nasal irrigation may certainly be useful, I believe nebulizing hydrogen peroxide or colloidal silver may be even more effective. Dr. Thomas Levy10 has issued guidance11 on how to use nebulized hydrogen peroxide for the prevention and treatment of viral respiratory infections, including COVID-19. To inactivate viruses with hydrogen peroxide, all you need is a face mask that covers your mouth and nose and a nebulizer that emits a fine mist with properly diluted food grade hydrogen peroxide. Typically, food grade peroxide comes in concentrations of 12%, which must be diluted down to 1% or less before use, as described in the chart below and video above. If you are using 3% hydrogen peroxide, then you would multiply the number in the first column by 4, or divide the second column by 4. The microscopic mist, similar to smoke or vapor, can be comfortably inhaled deep into your nostrils, sinuses and lungs. Hydrogen peroxide (H2O2) consists of a water molecule (H2O) with an extra oxygen atom, and it is the additional oxygen atom that allows it to inactivate viral pathogens. Coronaviruses are held together by a lipid (fat) envelope. Soap, being amphipathic12 — meaning it can dissolve most molecules — dissolves this fat membrane, causing the virus to fall apart and become harmless. Hydrogen peroxide works in a similar way. You can find more details about the mechanism of action in my previous article, “Could Hydrogen Peroxide Treat Coronavirus?” Some of your immune cells actually produce hydrogen peroxide to destroy pathogens. By killing the infected cell, viral reproduction is stopped. So, hydrogen peroxide therapy is in essence only aiding your immune cells to perform their natural function more effectively. Hydrogen peroxide is also a key redox signaling agent that creates oxidative eustress.13 Contrary to oxidative stress or oxidative distress, oxidative eustress denotes an oxidative challenge that has positive or beneficial effects and is essential in redox signaling. Many studies have looked into the use of hydrogen peroxide against different pathogens. One of the most relevant is a review14 of 22 studies, published in March 2020 in the Journal of Hospital Infection. They found 0.5% hydrogen peroxide effectively inactivated a range of human coronaviruses, including those responsible for SARS and MERS, within one minute of exposure. If you’re already presenting with a runny nose or sore throat, Levy recommends using the nebulizer for 10 to 15 minutes four times a day until your symptoms are relieved. You can also use nebulized hydrogen peroxide for prevention and maintenance, which may be advisable during flu season, or while the COVID-19 pandemic is in full swing. According to Levy:15
from http://articles.mercola.com/sites/articles/archive/2020/07/01/nasal-irrigation-benefits.aspx
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