Evolving strains of COVID-19 being reported from India, South Africa, and others suggest that the virus may be a disruptive element for a while. This despite the fact that numerous effective vaccines are becoming available worldwide. What if new strains outpace the efficacy and/or availability of new vaccines? How can we protect ourselves beyond masks and social distancing? A body of scientific evidence points to nasal and oral hygiene to offer significant help.

1. Why this memo? Don’t we already know everything we need to know?
   True, there is an abundance of information on vaccines, boosters, and virus variants. Yet there is a case of willful ignorance on the topic of nasal and oral hygiene’s well documented benefits against COVID-19. This memo is intended to fill the gap.
2. What is the scientific basis for nasal and oral hygiene?
   COVID-19 virus enters the body mainly through the nose and throat. These entry points have long been recognized by allergy sufferers and scientists alike. Investigators at European and American Research Institutions identified two cell types in the nose that have surface receptor sites specific to this virus (Nature, May 2020).¹ These cells appear to be “the doorway” to the disease. They allow initial viral attachment, infection, replication, and the spread of the virus. A targeted attack at these key access and exit portals will add a powerful protection to our presently adopted protocols of hand washing, masks, and safe distancing.
3. Why is heat injurious to COVID-19?
   Did you know that as with MERS, SARS, and the influenza virus, COVID-19 has an Achilles heel – an oily/lipid outer shell that is susceptible to heat, soap, and commonly known, safe disinfectants including steam. Many lipids typically have melting points ranging from 20° to 40°C – hence the likely explanation why local hyperthermia (such as steam or hot water as tolerable) will be disruptive to the virus viability.^2,3,4 Lab experiments by Chan² clearly establish significant (3 log₁₀) degradation of SARS coronavirus viability with higher temperatures (at 38°C). An in silico study by Gowrishankar et al. in February 2021⁵ further supports efficacy of steam against COVID-19, enhanced by traditional phytochemicals such as eucalyptus (present in Vicks).
4. Is there clinical evidence in support of heat and steam treatment?
   Yes, there is. A recent study⁶ authored by seven medical researchers (five of which are MDs) at Seven Hills Covid Hospital in Mumbai, India reported exceptionally effective results among a group of 105 patients and healthcare workers exposed to COVID-19. All 80 patients that tested positive and were symptomatic recovered. Additionally, a 2020 study by a group of nine University of Florence researchers reported similarly successful results.⁷ Swain and Sahu report in a March 2021 study 100% recovery on 96 COVID-19 positive patients following a treatment of steam inhalation as an adjuvant treatment.⁸
   The question remains as to why there are not many other similar clinical studies given the strong science-based rationale as supported by Endnote References.^{1,2,3,4,5,6,7,8,9,10,11}
5. What are practical steps for nasal hygiene?
   
   • Hot showers as tolerated with nasal rinse and steam inhalation (twice a day).
   • 1% baby shampoo nasal rinse solution inactivated COVID-19 with a 99.9% efficacy using a 2-minute contact time.^9,10,11
   • Povidone iodine under medical supervision.¹⁰
6. What are practical steps for oral hygiene?
   Gargling with Listerine or other Listerine-like products with a 30-second contact time is effective to destroy 99.9% of the virus. ^9,10,11
7. Are these steps also effective against new strains of the virus?
   The measures described above are applicable to a general class of viruses such as MERS, SARS, and COVID-19 which all have an oily/lipid outer shell. Furthermore there is virtually no downside to the recommended measures. Hence the likelihood of their efficacy to new strains is very high.
8. Is Melatonin protective against COVID-19?
   A study published by Cleveland Clinic’s Lerner Research Institute (November 2020, PLOS Biology) revealed that melatonin usage was associated with a nearly 30% reduced likelihood of testing positive for SARS-CoV-2. While the results are preliminary, they appear highly promising.

Yours sincerely,

Dr. Nansen G. Saleri

References:

¹Sungnak, W., Huang, N., Bécavin, C. et al. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med 26, 681–687 (2020). https://doi.org/10.1038/s41591-020-0868-6
²Chan, K.H. et.al. The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus. Hindawi Publishing Corporation. Advances in Virology. Volume 2011, Article ID 734690. https://doi.org/10.1155/2011/734690
³Cohen M. Turning up the heat on COVID-19: heat as a therapeutic intervention [version 2; peer review: 2 approved]. F1000Research 2020, 9:292 https://doi.org/10.12688/f1000research.23299.2
⁴Lowen, Anice C. and Steel, John. Roles of Humidity and Temperature in Shaping Influenza Seasonality. Journal of Virology. DOI 10.1128 (2014). http://jvi.asm.org/content/88/14/7692.abstract
⁵Gowrishankar S., Muthumanickam S., et al. Promising phytochemicals of traditional Indian herbal steam inhalation therapy to combat COVID-19 – An in silico study, Food and Chemical Toxicology, Feb 2021, 148:111966, ISSN 0278-6915, https://doi.org/10.1016/j.fct.2020.111966.
⁶PawarD, AdsulB, BhallaR, et al. Use of steam as adjuvant-treatment in covid-19 patients : an observational study. Ind Med Gaz. 2020: 1–2. Indian Medical Gazette
⁷ la Marca, G., Barp J., Frenos S., et al. Thermal inactivation of SARS COVID-2 virus: Are steam inhalations a potential treatment?, Life Sciences, Volume 265 (2021).
⁸Meyers, C, Robison, R, Milici, J, et al. Lowering the Transmission and Spread of Human Coronavirus. J Med Virol. 2020; 1– 8. https://doi.org/10.1002/jmv.26514
⁹Swain SK, Sahu A. Steam Inhalation as an Adjuvant Treatment in Covid-19 Positive Health Care Professionals: Our Experiences at Tertiary Care Teaching Hospital. Int J Cur Res Rev, Vol. 2021 Mar;13(05):121.
¹⁰ Meyers, C, Robison, R, Milici, J, et al. Lowering the Transmission and Spread of Human Coronavirus.J Med Virol. 2020; 1– 8.
⁸Eggers, M., Koburger-Janssen, T., Eickmann, M. et al. In Vitro Bactericidal and Virucidal Efficacy of Povidone Iodine Gargle/Mouthwash Against Respiratory and Oral Tract Pathogens. Infect Dis Ther 7, 249–259 (2018). https://doi.org/10.1007/s40121-018-0200-7
¹¹Ramalingam, S., Graham, C., Dove, J. et al. A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Sci Rep 9, 1015 (2019). https://doi.org/10.1038/s41598-018-37703-3

NOTE: My main goal in distributing this information is to bring about more public awareness to the fact that we as Americans and global citizens are not helpless against COVID-19. If you like the contents, please feel free to disseminate liberally via all channels available to you.

Chairman and CEO, Quantum Reservoir Impact (QRI), Houston, www.qrigroup.com;
President and Cofounder, Kristin Saleri Art Foundation (KSAF), Houston, www.kristinsaleri.com