Hello and good evening. My name is Dr. Cameron Jones and I'm an environmental microbiologist. Now, this is actually the second recording because the first one that I did a few minutes ago, there's something wrong with the audio. In any case, there's nothing worse than a Livestream with poor audio. So I am repeating the Livestream and what I'm going to be focusing on today really emerged because every week I have to go through the research literature, I'm looking for interesting facts in the research literature to bring to your attention. And obviously the focus of The Mould Show is on fungal biology and its impact on health. But increasingly with the COVID-19 pandemic, I'm certainly very aware of the importance of infection control and the various different publications that are out there that are focusing on practical infection control interventions. And so I want to bring to your attention something called: Could Iodine Nasal and Oral Antiseptics Help Protect You Against SARS-CoV-2?

And so what I'm going to be doing here is I'm going to be presenting a range of different summaries of some of the research literature that I collected on what I consider to be very practical methods that you yourself can use and you can go and exploit this in order to help you. And obviously the whole point here is to provide some guidance to the research literature from an infection control viewpoint that I think is important, and that you should discuss this with your healthcare provider, your medical doctor. But there's some really interesting information in the literature about some practical antiseptics that you can exploit today.

Now, why is this important? Well, the SARS-CoV-2 vaccine, we're all waiting for it, but vaccine development takes time. Now, when do we want it? Well, we want it now. And therefore the lock-in, the ISO restrictions would be behind us. But the scientists and academics and medicos themselves say that the vaccine development is not going to occur fast enough and certainly not within the first wave of the pandemic.

So what are we to do? Well, I can just review to put in context why I think a look at some of the other potential options to treat people and to treat ourselves because what are we going to do if we also are exposed to this particular virus? And the context for this is that vaccine development takes time. So other options and modalities of treatment, we need to be aware of them and that's the purpose of today's Livestream. I want to make you aware of some of these very simple infection control strategies using antiseptics that you can purchase from the pharmacy that the research academics and medicos are writing up in the contemporary research literature, that you can go out and emulate or replicate their work yourself.

So the context for this is that polio vaccine development, for example, took 60 years. Ebola vaccine development took 15 years. The first SARS-CoV-1 virus, there was no vaccine for 17 years. Similarly, for MERS, there was no vaccine for 6 years. And so the expectation for SARS-CoV-2 is that it will be 12 to 18 months before we see a useful, practical vaccine for this horrific illness. So what are the non-vaccine options that are being published and discussed by research academics? Well, these fall into antiseptics. I focus a lot of attention on disinfectants because disinfectants are used on surfaces, whereas antiseptics are used on the skin and because the SARS-CoV-2 virus overwhelmingly goes after the respiratory pathway. That's the dominant way that it's introduced with the T-zone through our mucus membranes. The potential opportunity for using antiseptics is quite profound, and this is what these academics are publishing. And I want to highlight these research papers today.

So let's look at some of the chronology of publications they have been written about for the last couple of months and I've pulled up the front pages of each of these publications. I'm going to put it in the show notes at the end of this Livestream and also of the podcast. But you can see that there are five key papers which have been published in the research literature, all with different titles, all of which you can download and read yourself. And they have been published on a range of different dates from early May right through to mid-June. And we're going to be going through some of the key research findings in these publications about antiseptics because I suggest that you be aware of this and talk about this because you may need to take advantage of this information.

So, of course, you're probably wondering, just tell me what you're saying. Well, I am going to be talking about something called iodine. Well, what is iodine? Well, it's a burnt orange colour. Any of you that have had a wound have possibly used or taken advantage of the antibacterial properties of iodine and the suggestion and recommendation in many of these publications is to now exploit iodine for its viricidal ability to deactivate the SARS-CoV-2 virus. And that's what I'm really focusing on today. That's the key take-home message. I hope you'll stick with me to the end of this Livestream because I've got some interesting recommendations for how to use this and what the doctors in ear, nose, and throat, ENT specialists are recommending for their patients, but also other healthcare workers. And if it's good for them, it could be good for you.

So what is this iodine? Well, it's a trace element it's present in seawater, in seafood, in legumes, like bananas, in fish, milk, cheeses, and it is important. Iodized salt contains iodine as well. It is important in that it regulates hormones and it is vital for your thyroid health. In the event of a nuclear emergency, the recommendation is to take iodine immediately to reduce the impact and the damage to the thyroid. Now it has a long history of use for wounds and cuts and abrasions, and it has been used to help treat infections. It's been talked about, even a disciple of Aristotle, one of his champions wrote about using seaweed, which contains iodine for its pain relief, for its analgesic ability. And it's been certainly written about for the last 170 years or so in terms of its antibacterial properties.

Now, the reason that iodine works is that it has a complicated killing regime. And in a sense, it is thought to poison the electron transport chain, which the cells use to produce energy. So interfering with this means that they can no longer reproduce and therefore they can no longer cause infection and inflammation and all of the cascade of problems that occur with wounds. And it is a similar approach that iodine works on when it activates its virucidal properties. And I'm going to pull up a table here just to focus attention on certain different types of antiseptics that are available.

And obviously we're all familiar with 70% ethanol containing hand washes. Obviously we know that hand washing is very important to kill viruses on our hands and also reduce the microflora on our skin. But there are other antiseptics apart from 70% ethanol and one of them is povidone-iodine. And you can see in the top row of this particular table, you can see that povidone-iodine is very effective against a range of Gram-positive and Gram-negative bacteria, also against fungi and importantly shows a Medium level of activity against viruses. And that's what we want. And you can see that that is the function of an antiseptic.

Now, if we drill into some of the publications that have recently been published using this particular antiseptic for deactivating, this particular virus, it's been recommended that it can be used in the nose, in the throat and of course in the mouth, and this is readily available at the pharmacy. But the tables, which the research academics published based upon their research in using these antiseptics at a range of different concentrations, they wanted to see what the dwell time or how long it took and where the different concentrations from low, medium to higher concentrations, whether they all deactivated the virus or whether one was more or less capable of carrying out this particular function. And what they discovered and it's summarized in this table, that when the iodine was introduced into the nose at various different concentrations but left there for 60 seconds, all of the concentrations were capable of deactivating the SARS-CoV-2 virus, and they report the deactivation level in terms of something called a log reduction value. And you can drill into the paper yourself and find out what the 4.63 means.

Basically this is the limit of their ability to detect a reduction in the viability of the particular virus. And similarly, when the povidone-iodine antiseptic is used at a range of different concentrations from 1 to 3%, with an active concentration from 0.5 to 1.5%, all of them were able to deactivate the virus within 60 seconds. And that's really important. So the summary in the paper stated that all the concentrations of the nasal antiseptics and of the oral rinses that were evaluated were completely capable of inactivating the virus. And that is the takeaway message I want you to concentrate on and understand and remember.

So now let's move on to a different type of publication. What happens if you're an ear, nose, and throat surgeon? Obviously you'd be concerned about the potential of some of your patients or clients coming to see you who may be pre-symptomatic or asymptomatic, or potentially even have the COVID-19 virus when they come and see you. So if you are an ENT specialist, it's very interesting to read the types of publications that they're putting into the academic literature. And when we look at what they're saying, they're saying that 0.5% povidone-iodine gargles or nasal drops should be used as a prerequisite for office attendance for nose and throat examinations during the COVID-19 pandemic. So if it's good enough for them, I think from an infection control perspective, you need to be made aware of this as well, because why don't you emulate what the ENT specialists are doing! And so what are they actually saying in their paper?

Well, they have two steps. Step 1 is to use 4 to 5 drops of povidone-iodine in each nostril, ten minutes prior to examination. So that's what the ENT specialists are suggesting they should adopt.

And then Step 2, use 10 mL of a 0.5% povidone-iodine solution and use it as a mouthwash by gargling it for 30 seconds before spitting it out.

So they go on to say for hospitalized patients and those confirmed or suspected of having COVID-19, Steps 1 and 2 should be undertaken every six hours and four times per day for the health care workers. Now the health care workers, they could be people just like you and I or other family members exposed to individuals with this particular virus. So for healthcare workers, the ENT doctors are suggesting that Steps 1 and 2 should be performed before contact with patients. And if repeated, the contact should occur four times per day and be repeated every two to three hours.

Now another publication also came out in a journal called Medical Hypothesis. And what they were suggesting was that "The use of alcoholic povidone-iodine gargles in preclinical, subjective, oropharyngeal symptoms could act as a protection against the progression to tracheal-bronchial involvement." So essentially they're saying, get on top of any irritation or sore throat immediately in an effort to minimize the progression of the viral replication in the ear, nose, and throat.

The article goes on in Medical Hypothesis to suggest and state that, "Oral gargles and providing iodine eyedrops would attack the virus directly through the receptors, to which it binds, significantly reducing viral replication, a risk of evolution to phenotypes IV and V, and reducing hospitalization and therefore death." So if that is the conclusion that these research academics and research medical practitioners are making, you should be aware of it from an infection control perspective.

Now, this is definitely also supported by the Australian Commission on Safety and Quality in Health Care who released on the 15th of May, 2020, a document entitled Potential Medicines to Treat COVID-19. And on page 19, we have a whole page dedicated to the suitability of povidone-iodine, sore throat gargle, and antiseptic liquid, and some further references that suggest and support the contention that this is a very practical antiseptic to exploit for application to various oral and nasal cavities, which could potentially be exposed to the virus.