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A Voice for Private Physicians Since 1943

Time to End Hygiene Theater: Patients Need Evidence-Based Infection Control for COVID

After more than a year of public health exhortations, and 168 million doses of COVID-19 vaccines, pandemic fears are still running high, states the Association of American Physicians and Surgeons (AAPS).

Public health officials and vaccine makers acknowledge that the products have not been shown to prevent disease transmission. Measures such as masking and social distancing are not supported by randomized controlled trials. In any event, they have not ended the pandemic.

The Centers for Disease Control and Prevention (CDC) has updated its guidance on disinfecting surfaces. It states that while it is “possible” for a person to become infected with COVID-19 through contact with contaminated surfaces or objects (fomites), “the risk is generally considered to be low,” less than 1 in 10,000. Thus, there is “little scientific support for routine use of disinfectants in community settings, whether indoor or outdoor, to prevent SARS-CoV-2 transmission from fomites.”

“So why are we still deep cleaning?” asked the prestigious scientific journal Nature in January. By the end of 2020, global sales of surface disinfectant totaled $4.5 billion, a jump of more than 30% over the previous year.

CDC now says, “It’s time to end ‘hygiene theater.’”

“Instead of disinfecting the backs of chairs in restaurants, why not disinfect the portal of entry where the virus attaches and from which it is spread—the nasal mucosa?” asks AAPS. There is convincing evidence that this is safe and effective, though not promoted by the CDC because of the lack of enough randomized controlled trials.

Disinfecting the nose is an “overlooked strategy,” states a review in the Ear, Nose & Throat Journal, though some of the formulations have been used for more than 20 years.

In a Bangladeshi randomized controlled trial with 606 subjects, the use of 1% povidone iodine in eye/nose drops and mouth gargle reduced COVID-19 hospitalizations by 84 percent and mortality by 88 percent, notes AAPS.

Antiviral activity is also demonstrated in nasal sprays containing xylitol or carrageenan. Both Israel and New Zealand have approved the use of a nitric oxide nasal spray that helps prevent COVID infection and transmission. It will be sold over the counter. A randomized controlled trial in confirmed COVID cases in the UK showed that the nasal spray reduced the viral load by 95 percent in the first 24 hours and 99 percent within 72 hours.

“There is no warp-speed process to approve inexpensive preventive measures, although vaccinated patients are still getting infected,” states AAPS executive director Jane Orient, M.D. “But over-the-counter products are available, with plenty of evidence of safety and effectiveness, and doctors need to tell their patients about them.”

The Association of American Physicians and Surgeons has represented physicians in all specialties since 1943. Its motto is omnia pro aegroto, everything for the patient.

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