Gerry Gajadharsingh writes:
“I remember in the anxiety driven early days of the COVID-19 pandemic (not including me though despite being a 60 year old BAME (Black Asian Minority Ethnic) with asthma having worked through the entire pandemic in healthcare face to face with patients), wondering what sort of advice I could share with my patients to try and see if we could minimise the risk of either developing COVID-19 infection or certainly minimising the risk of it turning into a very serious infection for them.
The “blob” (with thanks to Michael Gove for sharing this particular phrase), was all over the place, primarily trying to limit any information about COVID-19 that was contrary to so called “scientific opinion”. One of the problems with modern medicine is, it is almost a religion, paying homage to so-called evidence-based medicine. The research below, in relation to soft water gargling and nasal rinsing, significantly lowers COVID-19 hospitalisation rates, appears to back up, what I would consider to be simple common sense at the time. However, because there was limited research at the time, this would never have been recommended to patients from the medical establishment nor social media (the ones who were conforming to the advice from the blob), never mind, some of the suggestions I was giving my patients!!
Related, is that I see patients with colorectal cancer from time to time who ask me for advice and support, in addition to their normal medical interventions. One of the challenges is in regard to support for the gut Microbiome. There is now a lot of research regarding how important a healthy gut Microbiome is for overall health. However, there is currently limited “research” in particular in relation to colorectal cancer. As a consequence, guess what, conventional medicine says there is no evidence that trying to improve the gut microbiome will have any impact on either the development of colorectal council or as part of the treatment process. I know of at least one significant medical trial on the way, but the research will not be published for at least another couple of years. I confidently predict that over the next few years, it will be “proven” that supporting the gut microbiome will be critical for the prevention or treatment of colorectal cancer, or indeed in numerous other health conditions, however, until that time conventional medicine will not recommend it. What a shame.
The challenge with medical research is that generally with many interventions, using a more natural approach to healthcare, such as saltwater gargling or nasal irrigation, there is simply no commercial benefit (i.e. big pharma is not going to make billions of ££ from getting patients to simply gargle with saltwater). By the way, when I was doing my MPhil/PhD, I costed my research project and it was going to cost me £100,000 personally. I didn’t have that sort of money, and no one would fund it as there were no commercial benefits to any commercial company and guess what I stopped doing my PhD. My hypothesis was that stress, adversely affects human fertility.
Society seems to be so risk adverse these days. The unintended consequences is that very few people are willing to “take a view” and make a decision (and this permeates through most of society and various industries, not just in healthcare).
Whenever the government spends millions of pounds on the whatever the latest enquiry into the latest catastrophe is, I tend to raise my eyebrows when somebody says we need to learn the lessons so this will never happen again! It always happens again! I don’t see this as a problem of government. I see this as a problem of society of which government is simply trying to respond to. Humanity involves risk and human development depends on risk.”
ANAHEIM, California — Gargling and nasal rinsing with saltwater several times a day appeared to be associated with significantly lower COVID-19 hospitalization rates in a small, randomized, double-blind, controlled study.
“The hypothesis was that interventions that target the upper respiratory tract may reduce the frequency and duration of upper respiratory symptoms associated with COVID 19,” said Sebastian Espinoza, first author of the study; he is with Trinity University in San Antonio, Texas.
Adults aged 18-65 years who tested positive for SARS-CoV-2 on polymerase chain reaction (PCR) testing between 2020 and 2022 were randomly selected to use low- or high-dose saltwater regimens for 14 days at the Harris Health System in Houston, Texas. For patients to be included in the study, 14 days had to have elapsed since the onset of any symptoms associated with COVID.
The low dose was 2.13 grams of salt dissolved in 8 ounces of warm water, and the high dose was 6 grams. Participants gargled the saltwater and used it as a nasal rinse for 5 minutes four times a day.
Primary outcomes included frequency and duration of symptoms associated with SARS-CoV-2 infection; secondary outcomes included admission to the hospital or the intensive care unit, mechanical ventilatory support, or death.
The findings were presented in a poster at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Meeting.
Fifty-eight people were randomly assigned to either the low-saline (n = 27) or the high-saline (n = 28) group; three patients were lost to follow-up in both these groups. The reference control population consisted of 9398 people with confirmed SARS-CoV-2 infection. Rates of vaccination were similar for all participants.
Hospitalization rates in the low- (18.5%) and high- (21.4%) saline groups were significantly lower than in the reference control population (58.8%; P < .001). No significant differences were noted in other outcomes among these groups.
The average age of patients in the control population (n = 9398) was 45 years. The average age was similar in the low- and high-saline groups. In the low-saline group (n = 27), the average age was 39, and in the high-saline group, the average age was 41.
In all three groups, body mass index was between 29.6 and 31.7.
Exclusion criteria included chronic hypertension or participation in another interventional study.
“Low Risk, Small Potential Benefit”
Allergist Zach Rubin, MD, a spokesperson for the ACAAI, told Medscape Medical News that the findings are in line with other small studies that previously reported some benefit in using nasal saline irrigation and gargling to treat a SARS-CoV-2 infection.
“This is a type of intervention that is low risk with some small potential benefit,” he said.
The researchers did not evaluate the potential reason for the saline regimen’s association with fewer hospitalizations, but Rubin said, “It may be possible that nasal saline irrigation and gargling help improve viral clearance and reduce the risk of microaspiration into the lungs, so it may be possible that this intervention could reduce the risk of pneumonia, which is a major cause of hospitalization.”
Rubin, who is an allergist at Oak Brook Allergists in Illinois, said, “I generally recommend nasal saline irrigation to my patients for allergic rhinitis and viral upper respiratory infections already. It can help reduce symptoms such as nasal congestion, rhinorrhoea, postnasal drip, and sinus pain and pressure.”
The intervention may be reasonable beyond an adult population, he said.
“This could be used for paediatric patients as well if they are developmentally ready to try this intervention,” he said.
Espinoza said further study is warranted, but he said that if confirmed in later trials, the simple intervention may be particularly helpful in low-resource settings.