Do a Few Sprays a Day Keep COVID Away?
Reading Time: 4 minutesAn Innovative Development in COVID Protection Is Stuck in Limbo, An innovative prevention tool is available online—but I’m waiting on something specific before I try it., Do special nasal sprays work to protect you from COVID?
We’re in the fourth holiday season in which COVID is a reality that we have to deal with—and while most protective measures have disappeared from public view, some people are trying new approaches to avoid getting sick. As someone who works in public health, I follow these things closely. One of these tools I’m seeing more and more on social media is nasal sprays of all types, with some influencers suggesting the nasal sprays are part of a smart COVID prevention tool kit, along with tests, masks, and vaccines.
While these sprays are interesting, innovative, and have some data suggesting they do something, they aren’t approved by the Food and Drug Administration. Though there are ways of getting them—usually by ordering them online—you can’t buy these sprays from the shelves at a CVS in the U.S.
Before we can get into talking about the sprays themselves, we must understand the role the nose plays in getting infected. SARS-CoV-2, the virus that causes COVID, infects us by binding to receptors in our cells known as ACE2 receptors. The nose and mouth both contain a whole bunch of these receptors. Wearing a mask is one way to make these receptors less accessible to the virus. But what if you could interrupt the binding process more subtly? That’s where nasal sprays come in—at least, in theory. (Any protection offered by the sprays would be enhanced by also wearing a mask, since you do not spray your mouth.)
There are two main types of nasal sprays out there right now, both of which call for a few sprays a day. One type of nasal spray uses something called iota-carrageenan, which is derived from seaweed (I recognized it as being used in the vegan marshmallows I get at Trader Joe’s). The idea is that this gel-like substance acts like a protective barrier, which may physically prevent the virus from binding to the cells, at least to an extent. Lab studies have shown that there are potential antiviral properties to iota-carrageenan, and studies on children have shown that the ingredient is effective at reducing viral load when it comes to children who already have the common cold. One study among health care workers in Argentina found that workers who received four daily doses of the nasal spray containing the substance for 21 days had a lower rate of COVID diagnosis compared with those who received the placebo. Out of 196 and 198 health care workers in each group, two who received the nasal spray got COVID, and 10 got COVID in the latter group. One spray containing iota-carrageenan is marketed as ‘ePothex’ and is sold online for $20 a bottle, although there are many others that contain this ingredient.
The other type of spray contains nitric oxide, which acts as an antimicrobial and may inhibit the replication of viruses, among other properties. It is the primary ingredient in the spray known as Enovid, which retails for about $90 for one spray bottle. Unlike with iota-carrageenan, there aren’t studies that show nitric oxide has been effective at preventing COVID, but there have been studies that show it is effective at reducing the viral load when used by people who have a mild case of COVID.
But as to whether these sprays really work to meaningfully reduce your risk of catching or spreading COVID, the plain and simple answer is that there isn’t enough data. There are different types of data when it comes to evaluating the impacts of these sprays: in vitro studies (which are done in lab dishes or culture), in vivo studies (which are done in living creatures, typically animals), and finally clinical trials (which measure the therapeutic impacts of a drug on a group of people). Clinical trials are all about determining whether the benefits of any measured therapeutic results outweigh the harms of any potential side effects. We have good data on the antiviral and microbial properties of some of these ingredients from in vivo studies, but less so from the other two categories. What you’d really hope to see before purchasing a spray is a clinical trial done with that particular spray, not a relatively small study on people who used something with a similar active ingredient. The lack of clinical trial data makes some doctors skeptical about using these sprays as a preventive measure. The FDA and the Federal Trade Commission have even warned and taken action against some companies that they allege have misled consumers by making unproven claims about their particular nasal sprays and mists. Just because ingredients show promise in a lab and in small studies doesn’t mean that they will be effective in the real world.
Don’t take this all as a sign that nasal sprays don’t work, point blank. Some sprays have been approved in other countries but not the U.S. During the pandemic, the FDA was critiqued for moving too slowly or being too cautious in an emergency situation. A lack of political will or funding to pursue clinical trials (an expensive endeavor) at an accelerated pace (even more expensive) could be keeping us from getting more data on preventive measures for COVID, such as these sprays. The world has moved on from COVID, even though COVID continues to sicken and kill.
There is some promising research around new developments in preventive nasal treatments. At Johns Hopkins University, researchers have developed a spray that they tested on mice, which contains a filament that is similar to an ACE2 receptor—theoretically allowing any COVID virus to bind to the particles in the spray, rather than in your nose. At Cornell, researchers discovered a new molecule that can help prevent enzymatic activity that allows the virus to bind to host cells, which they also tested on mice and was found to be effective at preventing infection.
So, where does this leave us? The key ingredients in the nasal sprays that are currently available for purchase show promise. They can’t be completely dismissed out of hand. Perhaps one day one of these sprays will be recognized as effective by the FDA and sold in pharmacies everywhere. More generally, we can hope for, and work toward, a future where innovations in combatting viruses are studied and approved swiftly, even when we’re not at the very height of a pandemic. Until then, I’ll skip the spray and keep wearing my mask.
Reference: https://slate.com/technology/2023/12/covid-nasal-spray-fda-do-they-work.html
Ref: slate
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