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Saturday, August 1, 2020

Nasal and Oral Decontamination procedure has capability to reduce nasal SARS-COV-2 viral load

Question: Do nasal application of Povidone Iodine helps in COVID 19 patients.

Answer: Yes, nasal application of Povidone Iodine provides good results, in COVID19 positive patients nasal viral load is drastically reduced.
But this is required to do in early stage, the efficacy of the procedure will be less in late stage when infection makes way to lungs.

This procedure help in halting or hindering prognosis of SARS-COV-2 virus propagating towards lungs.

Point 1 describes nasal and buccal cavity decontamination procedure for Positive Patents and point 2 describes how to do nasal and buccal cavity decontamination procedure for people living with COVID19 patients.
Corona Virus Lodges itself in initial infection stage in Nasal and Oral Cavity

Nasal and Buccal Cavity decontamination Procedure for SARS-COV-2 infection as follows.

Nasal Decontamination: Two times a day for first 2 days and once in a day then after till 7th day. With Povidone Iodine liquid or Cream. 

Apply Povidone Iodine Cream 5% w/w and lay down looking up for 15 minutes allow cream melt down and pass through nasal cavity and spread inside it and allow to go down to throat.
If you have got Povidone Iodine liquid solution, the one which is used topicaly with 5%w/w pvpi can be used after dilution with water to make 2.5%w/w means dilute the liquid with equal amout of water.

This procedure to do before 1 hour before going to sleep.
In afternoon after 2 hours after lunch.
(Available as Cipladine Cream, Betadine Cream, Wokadine Cream) 

Can we use Povidone Iodine Liquid for Nasal wash ( decontamination ) for Covid 19 positive patients?
Yes Povidone Iodine liquid available in market for topical solution can be used for nasal wash, in covid 19 positive patients, only topical solution of PVPI to be used, PVPI gargle should not be used since it contains menthol it will give very cooling effect in nostril. 
Take 5% W/W PVPI topical liquid and dilute it and make it 2.5% w/w and use it for nasal wash.

This is an alternative method for people who cant hold cream for longer time in nose, use 5% Povidone Iodine Liquid by diluting it to 50 % making it as 2.5% PVP iodine solution with water, this concentration is almost isotonic.
Take this diluted solution in a syringe without needle and spray liquid deep inside nose slowly allow the liquid to come out from other nostril if you are pushing liquid from one nostril, this is absolutely ok.
Wash nose with at least initially for two washes, and twice a day, and later on after 4 th day it can be stopped.

Buccal Cavity Decontamination, Gargles with Betadine Gargle (Contains Povidone iodine Liquid for gargle)
Gargle to do for four times a day, that include one which is required to be done 1 hour before going to sleep.

1) For Covid19 Patients.
Nasal decontamination procedure to follow for two times a day for 2 days initially, and to continue till first 5 to 7 days. If there is no fever it can be stopped after 4th day.

Gargles to do four times a day till 14t day, and after retest for covid19 is confirms negative results it can be stopped.

What to do when one comes in contact with COVID19 patient?

2) For people living with Covid19 positive patients preventive measure.

For People Living with Covid19 Positive patients to follow Above procedure of nasal decontamination till the subject living with tests negative for once a day for 7 days
And then after Nasal decontamination procedure to follow every alternate day till 14th day once in a day preferably 1 hour before going to sleep.

Gargle with Betadine Gargle to do every day two times a day and must be done before going to sleep.

Precaution:
1)Do not apply Povidone Iodine cream 24 hours prior to test of COVID19. One must not apply Povidone Iodine cream inside nose for 24 hours before nasal swab for covid19 test is to be taken.

2)Thyroid Patients, do not use Povidone Iodine cream.
Instead of povidone Iodine cream use Silver Sulfadiazine or Silver Nitrate Cream for nasal decontamination.
They can use Povidone Iodine Gargles.

The procedure is completely safe and hamless while this is only one method to ensure that in event of exposure to Corona Virus, viral load from nasal and buccal cavity is completely eliminated, before it makes way in the lungs.

References:
1) Ongoing Clinical Study : https://clinicaltrials.gov/ct2/show/NCT04364802

2) Utilizing topical applications of PVP-I to attenuate nosocomial transmission of COVID-19 surrounding head and neck and skull  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161480/

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