Thread by @FurnessColin

Maybe you'll like this; maybe it will get up your nose.

A promising thread on a promising anti-viral nasal spray that uses nitric oxide [NO].

The activity of [NO] in the respiratory tract is astonishingly complicated, I have discovered.

But I like what I have found.

1/13

Respiratory tract cells make and use a lot of [NO] for a lot of purposes. As a reactive free-radical molecule (a bit like having velcro all over it), [NO] is only around for milliseconds before attaching to something.

2/13

For the science geeks in the crowd, I found this review particularly helpful.

TLDR: in LARGE doses [NO] is a bad idea because it can damage tissue. But in small doses it appears to be an effective antiviral for respiratory viruses.

3/13

onlinelibrary.wiley.com/doi/full/10.10…

There are caveats. If illness progresses to pneunomnia, [NO] may make that worse. It also worsens herpes and a few other NON-respiratory viruses.

These mechanisms seem to be a bit of a head-scratcher.

But the antiviral effect on coronavirus and influenza is clear.

4/13

I started looking into it when my absolutely awesome dentist gave me an Israeli [NO] nasal spray called Enovid to try.

(An early birth control pill from the 1970s had the same name, so the literature search was a bit confusing at first.)

5/13

There is evidence that after exposure, using this spray significantly reduces risk of developing illness. If mild illness has developed, using the spray significantly reduces time to recovery.

Basically, by killing virions at the start, the effective viral dose is reduced.

6/13

You can buy Enovid online from Israel right now. I just bought a bunch more. It's really f-ing expensive, however: about $60 CAD for one spray that expires in 30 days after opening.

Because [NO] is so reactive, in this case I take the expiry date seriously.

7/13

However, the same spray is being marketed in Canada as "SaNOtize" and elsewhere as "virX". (sanotize.com/clinical-trial…).

Clearly they need marketing help.

But more importantly, a Health Canada approval trial is under way now. I hope that leads to domestic manufacture.

8/13

A domestic product might be much cheaper. Regardless, governments, health plans, and employers should subsidize this to make it equitably available.

I should mention that it's currently only approved for ages 12+, I hope more studies will push that approval age lower.

9/13

I'll conclude by telling you why I'm excited about it. I currently don't share indoor air without a mask.

Not surprisingly I haven't contracted COVID.

But my kids do some maskless sports (eg hockey), after which a blast of [NO] would make us all safer.

10/13

Moreover, I miss some social activities, like indoor dining. Having studied this product, it may be that outside of respiratory virus season (winter), I'd be willing to go unmasked in uncrowded, well ventilated venues, using Enovid as prophylaxis.

11/13

This doesn't feel to me like a license to be reckless. But having studied and used it for a month, I'll tell you it honestly makes me feel safer.

One last thing, fwiw: I don't know the company or anyone who works for it, and I'd never take money to promote a drug.

12/13

One other last thing.

I'm in no way surprised to have heard of this through my dentist, and not an infectious disease physician.

On the whole, dentists take COVID and prevention far more seriously, IMO.

13/13