Amy Baxter, MD, holding a Buzzy, the physiologic pain blocker she invented
Amy Baxter, MD, is a pediatric emergency physician, pain management researcher, engineer, writer and mom as well as the founder and CEO of Pain Care Labs in Atlanta.
Baxter is probably best known as the inventor of the Medical Design Excellence Award winning Buzzy® physiologic pain blocker. She’s a doctor known for creative solutions to medical challenges.
And now she’s got an idea for lessening the impact of Coronavirus-19 and the severity of COVID-19.
PROBABLE IMPACT OF NASAL IRRIGATION ON CORONAVIRUS-19
While Wuhan, the sprawling capital of Central China’s Hubei province, and other parts of China have been hard hit by Coronavirus-19, nearby Thailand, Laos and Vietnam have had a remarkably low number of cases. Baxter’s take on this is that nasal irrigation (also called nasal wash), a personal hygiene habit widely practiced in Thailand but not in China, helps explain the difference.
Performing regular nasal irrigation with a solution of sea salt and warm water is an easy and effective way to clear nasal secretions; improve nasal congestion; decrease post-nasal drip; stop runny nose, sneezing and coughing; alleviate sinus pain and headaches; improve taste and smell and even improve sleep quality. It’s also an inexpensive natural remedy with a very low risk of side effects. (Piromchai, 2019)
Nasal irrigation has long been considered a good way to remove viruses and bacteria from sinus cavities. Baxter points out that recent clinical trials demonstrate that nasal irrigation reduces the duration and symptoms for other viral illnesses like flu and the common cold. Baxter has multiple reasons for believing that this approach can also be effective with Coronavirus-19. She notes that “SARS-CoV2’s viral load is heaviest in sinuses/nasal cavity.”
Also, the known sex and age discrimination of COVID-19 supports her conclusion. “Children don’t develop full sinuses until teens; males have larger cavities than women, and the cavities are largest [in those] over 70 years,” Baxter says. At least so far, children have been the least affected by COVID-19 while the elderly and men are dying at faster rates.
Regarding the very low COVID-19 death rates in Southeast Asian countries like Thailand, Laos, and Vietnam, Baxter says, “Yes, they wear masks, and yes, they bow and don’t shake hands, but the biggest difference between them and places like South Korea or Japan is that nasal irrigation is practiced by 80 percent of people.” Laos has had less than 20 reported cases, and Vietnam roughly 300. (Hall, 4/20/2020) & (Hall, 5/16/2020)
Last week, on May 15 2020, Thailand reported they had no new cases of COVID-19 and and no deaths from it. “Since the outbreak started, there have been 3,025 reported cases of the coronavirus in Thailand, leading to 56 deaths. These numbers are surprisingly low in a country with a population of 70 million inhabitants that is also a popular tourist destination. (Hall, 5/16/2020)
CORONAVIRUS-19: VIRAL LOAD vs INFECTIOUS DOSE
SARS-CoV-2 virus particles, isolated from a patient and imaged using a transmission electron micrograph. (Credit: NIAID)
Viral load is a measurement of the amount of a virus in an organism, typically in the bloodstream. It’s usually stated as virus particles per milliliter. A high viral load jump starts the virus’s effort to make its host sick.
Having a high viral load may increase the odds that the recipient will develop COVID-19 while also raising the risk of that person’s immune system’s becoming overloaded in its battle against the virus. An often cited example of this explanation is that someone who becomes infected indirectly by touching a door handle may develop a mild case of COVID-19 compared to a person who inhales a large load of the virus from an infected person’s sneeze or cough. (Boyd, 5/6/2020)
Some disagree but many in the medical community believe that the size of the initial viral load of Coronavirus-19 influences whether or not an individual develops COVID-19. Baxter points out that flushing the build up of viral particles from the sinuses once or twice a day “gives the immune system time to figure out what it needs while reducing the enemy.” (Hall, 5/16/2020)
Emerging research indicates that the relationship between viral load at exposure and being sickened by this coronavirus is probably more complex – and also different from that of other communicable viral respiratory illnesses like influenza, MERS and SARS.
Infectious dose refers to the number of viral particles needed to establish an infection. “We don’t know what this is for covid-19 yet, but given how rapidly the disease is spreading, it is likely to be relatively low – in the region of a few hundred or thousand particles, says Willem van Schaik at the University of Birmingham, UK.
“Viral load, on the other hand, relates to the number of viral particles being carried by an infected individual and shed into their environment. “The viral load is a measure of how bright the fire is burning in an individual, whereas the infectious dose is the spark that gets that fire going,” says Edward Parker at the London School of Hygiene and Tropical Medicine.
“If you have a high viral load, you are more likely to infect other people, because you may be shedding more virus particles. However, in the case of covid-19, it doesn’t necessarily follow that a higher viral load will lead to more severe symptoms.” (Geddes, 3/27/2020)
“Depending on the virus, people need to be exposed to as little as 10 virus particles — for example, for influenza viruses — or as many as thousands for other human viruses to get infected.
“Scientists do not know how many virus particles of SARS-CoV-2 are needed to trigger infection. COVID-19 is clearly very contagious, but this may be because few particles are needed for infection (the infectious dose is low), or because infected people release a lot of virus in their environment.
“In the case of the original SARS or influenza, whether a person develops mild symptoms or pneumonia depends not only on how much virus is in their lungs, but also on their immune response and their overall health.” (Lakdawala & Gaglia, 4/18/2020)
Whether viral load or infectious dose turns out to be a deciding factor for becoming ill with COVID-19 and/or having a severe case of it, it’s clear that the state of your immune system and your overall health is of the utmost importance. When our sinuses are blocked with gunk, we can’t breathe well through our noses. And we all know from personal experience that being able to breathe freely is vital to our physical and mental health. Nasal irrigation washes out nasty viruses, bacteria and fungi from our sinuses and nose – and helps us breathe fully and easily.
NASAL IRRIGATION FOR COVID-19
Clinical trials have shown that practicing nasal irrigation reduces the symptoms and duration of viral illnesses like the common cold (a simpler coronavirus is one of 100 viruses causing a ‘cold’) and the flu. Its impact on Coronavirus-19 hasn’t been fully studied yet but Dr Baxter “believe[s] strongly that nasal irrigation is the key to reducing COVID-19 progression of symptoms and infectivity.” She points out that the viral load of SARS-CoV2’s is heaviest in the sinuses and the nasal cavity. (Hall, 5/16/2020).
Many in the medical community believe that the viral load of Coronavirus-19 influences whether or not an individual develops COVID-19. Baxter points out that flushing the build up of viral particles from the sinuses once or twice a day “gives the immune system time to figure out what it needs while reducing the enemy.” (Hall, 5/16/2020)
Nine new registered trials investigating the effects of nasal irrigation on Coronavirus-19 are currently underway: at Stanford University, the University of Kentucky, NYU Langone Hospital, University of Pittsburgh, Vanderbilt University and elsewhere. (Hall, 5/16/2020)
Dr Baxter recommends that anyone who has been exposed to or is positive for COVID-19 do nasal irrigation with the following solution:
1/2 teaspoon of povidone-iodine
1/2 teaspoon of baking soda
1 teaspoon of salt (see note below)
Mixed with 8 ounces of lukewarm boiled tap water
Povidone-iodine is a broad spectrum antiseptic solution commonly used for skin disinfection before and after surgery. It kills a broad range of pathogenic microbes – bacteria (Gram-positive and -negative), viruses, fungi and protozoa. Povidone-Iodine is also known as iodopovidone. Some brand names are Betadine, Wokadine and Pyodine, available at stores like CVS and on Amazon.com.
My note: Use sea salt, not processed table salt in your nasal irrigator. Table salt is very harsh and will sting.
PRECAUTIONS WITH POVIDONE-IODINE
So I did a little research into povidone-iodine to see if I was willing to run it through my sinuses and found an article called Povidone-iodine: Safe Use of a Common Antiseptic posted by the National Capital Poison Center. Reading through the information there on how to use this antiseptic safely and the warnings about who should avoid using it, I decided it wouldn’t be safe for me. I have a thyroid condition and am generally hypersensitive to many substances (including a large number of pharmaceuticals) so will forego povidone-iodine and continue using sea salt and filtered water in my neti pot.
I recommend reading the National Capital Poison Center’s short and informative article to see if providone-iodine would be safe for you.
NETI POTS FOR NASAL IRRIGATION
Using a neti pot is an inexpensive and easy way to irrigate your sinuses and nose. They often look like little tea pots or genie lamps and come in a large variety of shapes and materials.
Neti pots are gravity-based containers designed for pouring a saline solution into one nostril and having it flow out of the other nostril. They were developed in ancient India as part of a set of purifying and cleansing ayurvedic yogic practices. References to neti pots appear in Indian writings from 3,000 BC – though they were likely invented centuries before that.
HOW TO USE A NETI POT
Here’s a video of how to use a neti pot to irrigate your sinuses to remove any nasty allergens, bacteria, viruses and molds that have taken up residence in there. Though the process may look scary or disgusting, you’ll find it easy and highly beneficial once you get the hang of it. I recommend doing it in the shower.
A few suggestions:
You can buy those more expensive packages of neti pot salt or get a big container of pure sea salt and use some of it. I like to use Pink Himalyan Sea Salt (fine) or La Baleine Sea Salt (fine). Do not use processed table salt. It’s harsh & will sting.
I recommend getting a ceramic rather than a plastic neti pot – much easier to keep it clean. The ceramic ones can be sterilized in the dishwasher. I’ve used the same white ceramic model for a few decades.
Using warm, filtered water in lieu of distilled water should be fine too.
If you use your neti pot in the shower, you don’t have to worry about dribbling the salt solution down your shirt and can also lean against the shower wall to get your head at the right angle so the solution doesn’t run down the back of your throat.
That’s the basic way to use a neti pot to get the gunk out of your sinuses and nose – clean hands, warm water and sea salt.
See NATURAL TREATMENT FOR SEASONAL POLLEN & MOLD ALLERGIES for more information on using a neti pot to clear seasonal pollens, mold and fungal biofilms out of your nasal sinuses. (Hardin, 5/26/2019)
Many thanks to Christian Lillis, Executive Director of the Peggy Lillis Foundation, for sending me the 5/16/2020 article on nasal irrigation for Coronavirus-19.The mission of the Peggy Lillis Foundation is to build a nationwide Clostridium difficile awareness movement by educating the public, empowering advocates, and shaping policy.
Boyd, C. (5/6/2020). The AMOUNT of coronavirus you get infected with decides how severe the illness is, SAGE scientist warns. DailyMail.co.uk. See: https://www.dailymail.co.uk/news/article-8291955/AMOUNT-coronavirus-infected-decides-severe-illness-SAGE-scientist-warns.html
Geddes, L. (3/27/2020). Does a high viral load or infectious dose make covid-19 worse? See: https://www.newscientist.com/article/2238819-does-a-high-viral-load-or-infectious-dose-make-covid-19-worse/#ixzz6N6fwfHOf
Hall, C. (4/20/2020). Nasal Irrigation Is the Key to Reducing COVID-19 Progression, Doctor Says: Amy Baxter, MD, Say6s Nasal Irrigation May Be the Best Way to Treat Positive Coronavirus Patients. See: https://bestlifeonline.com/nasal-irrigation-covid-19/
Hall, C. (5/16/2020). This One Habit May Be Why Thailand Has So Few COVID Cases, Doctor Says: This Personal Hygiene Habit May Help You Avoid the Coronavirus. See: https://bestlifeonline.com/thailand-coronavirus-hygiene/
Hardin, J.R. (5/26/2019). NATURAL TREATMENT FOR SEASONAL POLLEN & MOLD ALLERGIES. See: https://www.allergiesandyourgut.com/post/natural-treatment-for-seasonal-pollen-mold-allergies
Lakdawala, S. & Gaglia, M. (4/18/2020). What We Do and Do Not Know About COVID-19’s Infectious Dose and Viral Load: Two virologists share their thoughts about these often-used terms. DiscoverMagazine.com. See: https://www.discovermagazine.com/health/what-we-do-and-do-not-know-about-covid-19s-infectious-dose-and-viral-load
National Capitol Poison Center. (2019). Povidone-iodine: Safe Use of a Common Antiseptic. See: https://www.poison.org/articles/povidone-iodine-safe-use-of-a-common-antiseptic-193
Piromchai, P. et al. (2019). Effectiveness of nasal irrigation devices: a Thai multicentre survey. See: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542345/
© Copyright 2020. Joan Rothchild Hardin. All Rights Reserved.
DISCLAIMER: Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.
Comments submitted prior to 8/25/2021
Thank you so much for sharing this great article. It is very “a propos” since I read recently that one should clean the sinus cavities and throat as a preventive measure against Covid-19. A doctor was stating that this is where the virus comes into the body and remains there for a few days before making its way to the lungs. Since I read that medical article, I have been gargling with Hymalaen pink salt every morning and before I go to bed and using my nettipot with a salt solution as well once a day. I noticed that sometimes it stings a little and other times it doesn’t. They say that when it stings it means that your nose is either dry or that you are cleaning out bacteria…so it means it’s working. So, reading your article above solidified that this was a protocol I should continue. I love everything you share, it’s always such insightful, spot on information. Thank you for doing so. Super appreciated.
In reply to klaude
Thanks so much for your comment, Klaude. Always good to know the information I’m sending is useful.