Simple Nasal Wash Reduces Risk of COVID Hospitalization

By Dr Frank Yap, M.D. - October 23, 2022

A study, published in the Ear, Nose & Throat journal in August 2022, showed that rinsing your nasal passages with a saline solution within 24 hours of a COVID-19 diagnosis could reduce your chances of being hospitalized by 8.5-fold. Why hasn't your doctor told you about this? And why haven't public health agencies shared the good news with the public that they can significantly reduce their risk of severe COVID-19 with a simple nasal wash?

The practically free solution is just too inexpensive. Unlike Pfizer's Paxlovid, which was granted emergency use authorization to treat mild to moderate COVID-19 in December 20212 — and is slated to make the company $22 billion in profits in 20223 — there's little money to be made by promoting the ancient practice of nasal lavage.

Simple Way to Reduce Your Risk of COVID Hospitalization

Nasal irrigation, sometimes referred to as nasal lavage, is a relatively popular method for relieving cold symptoms, often via the use of a neti pot. The practice is an ancient technique with roots in the traditional Indian health care system, however.

Irrigating the nasal passages with saline is used in traditional yoga practice, where it's known as jala-neti.5 It involves the use of a saline solution in teapot-like device, used to flush out the nose and sinus cavities. After inserting the end of the pot in one side of your nose, the solution moves through your sinuses and out the other nostril. A bulb syringe or squeeze bottle can also be used.

In the U.S., nasal irrigation continues to be an adjunctive therapy for upper respiratory conditions and is currently prescribed after nasal and sinus surgeries.6 The featured study, which was published in the Ear, Nose & Throat journal in August 2022, involved 79 participants 55 and older who were diagnosed with COVID-19.7

They were randomly selected to use either one-half teaspoon of sodium bicarbonate (alkalinization) with an isotonic normal saline (0.9% saline) rinse twice a day for 14 days or to include 2.5 milliliters (roughly a half-teaspoon) of povidone-iodine (PVP-I) 10% solution (antimicrobial) for the same period. The researchers then followed up with each group 14 days after their final intervention.

Those who used nasal irrigation were more than 8.5 times less likely to be hospitalized compared to the national rate, the study found. A dose-response relationship was also found. Among those who irrigated twice daily, 80% had zero or one mild symptom, compared to 42% of those who irrigated less often.

Further, only 13% of those who used nasal irrigation still had symptoms at day 28, compared to nearly 50% of those in another study, who had continued symptoms for 21 days or more.8 According to the researchers:9

"Our results support that pressurized nasal irrigation reduces the likelihood of hospitalization in high-risk COVID-19 + outpatients, suggesting a safe and over the counter measure with potentially vital public health impact.

The reduction from 11 to 1.3% as of November 2021 would have corresponded in absolute terms to over 1,000,000 fewer older Americans requiring admission. If confirmed in other studies, the potential reduction in morbidity and mortality worldwide could be profound."

Senior study author Dr. Richard Schwartz noted, "We found an 8.5-fold reduction in hospitalizations and no fatalities compared to our controls. Both of those are pretty significant endpoints."10 In addition to the featured study, other research also supports the use of nasal irrigation as a "useful add-on to first-line interventions for COVID-19."11

Nasal Wash Findings Render COVID Response Useless

Dr. Amy Baxter, featured study author and emergency medicine physician at the Medical College of Georgia at Augusta University, said she got inspiration for the study from visits to Southeast Asia, where nasal irrigation is used daily as part of personal hygiene. She explained:12

"What we say in the emergency room and surgery is the solution to pollution is dilution … If you have a contaminant, the more you flush it out, the better you are able to get rid of dirt, viruses, and anything else … One of our thoughts was: If we can rinse out some of the virus within 24 hours of them testing positive, then maybe we can lower the severity of that whole trajectory."

That indeed turned out to be the case, a finding that should not come entirely as a surprise. In 2019, researchers with Khon Kaen University in Thailand similarly found that nasal irrigation was an effective treatment for nasal disease, helping to clear nasal secretion, improve nasal congestion and improve sinus pain, headache, taste and smell, and even sleep quality.13

Steve Kirsch, executive director of the Vaccine Safety Research Foundation, took it a step further, explaining that the impressive effectiveness of nasal irrigation for reducing COVID-19 hospitalizations renders the pandemic response "unnecessary and harmful":14

"All the pandemic mitigations were unnecessary. Simply telling newly infected people to rinse their nose with a saline rinse if they got sick would have reduced the hospitalization rates to levels comparable to the flu. The CDC is still not telling people to do this today even though there is no risk to anyone …

This would apply to any other virus or bacteria as well, based on the mechanism of action. It's also extremely safe … This treatment is still being ignored by every mainstream medical institution … Universities should mandate students do nasal washes after getting COVID instead of taking vaccines."

Mouth and Nose Spray Shields Against COVID-19

Nasal irrigation is just one tool to help protect against COVID-19. A simple mouth and nose spray containing povidone iodine (PVP-I), a microbicidal agent with a virucidal efficacy of 99.99%,15 could also act as an effective shield to protect against COVID-19.

A study in the Indian Journal of Otolaryngology and Head & Neck Surgery, recommended the PVP-I oro-nasal spray for health care workers and anyone else to help prevent COVID-19,16 echoing a number of other studies that have also found benefits to gargling, nasal irrigation and nebulization of PVP-I and other compounds, including Lugol's iodine, saline and hydrogen peroxide.17

In this case, the spray formulation was particularly effective because it allowed the active ingredient to diffuse further and reach deeper into the nose and nasopharynx, which is the upper part of the throat behind the nose. The oro-nasal spray acts as a protective layer, coating the nasal and oral mucosa.

Typically, if you're exposed to SARS-CoV-2, it will enter your body through your nose and mouth, remaining there for a time before binding with ACE2 receptors and entering cells. Once inside your cells, the virus has an opportunity to multiply.

By creating a protective shield, oro-nasal spray helps prevent SARS-CoV-2 from binding with ACE2 receptors and gaining entry into your cells. In a clinical trial that has not yet been published,18 researchers got positive results using 0.6% PVP-I oro-nasal spray in 189 patients with COVID-19. The 0.6% solution had an efficacy rate of about 81.5%, which was greater than that of other concentrations (0.4% and 0.5%) and produced "almost no mucosal irritation."19

Tips for Effective Nasal Irrigation

Traditionally, slightly warm saline water — a solution of 2.5 grams of salt in 500 milliliters of water — is recommended for nasal irrigation.21 For additional antimicrobial action, povidone iodine (0.5% to 1%) can be added to the saline solution.

A study published in the Indian Journal of Otolaryngology and Head and Neck Surgery advised that using saline and PVP-I "as irrigation solution can combine and enhance the protection against COVID-19 and this can be an important armor in the fight against COVID-19."22

If you want to try nasal irrigation with a neti pot or other device, and you're thinking of making your own saline solution, it's important to remember to use only distilled, sterile or cooled, boiled water. Tap water can contain bacteria and protozoa that can be harmful if they receive access to your nasal passages,23 so unboiled tap water should not be used for this purpose.

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