Can nasal sprays help in the fight against Covid-19?

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Can nasal sprays help in the fight against Covid-19?

A study in Israel found that nasal sprays can help to prevent coronavirus infections. Here is everything you need to know...

 

A study in Israel suggested that they could stop infection 

 

Scientists are working round the clock to develop game-changing new treatments in the fight against Covid-19. One unlikely candidate to emerge is nasal sprays. This week, it was revealed that out of 83 worshippers who attended a Jewish festival in Bnei Brak and were given nasal sprays, only two contracted coronavirus. Indeed, the research - was the largest test of its kind: the Jewish New Year, and the festival, which was held in the densely populated city of Bnei Brak in Israel, were predicted to be super spreading events, and infections rose from 18 per cent of the population to 28 per cent.

 

This isn't an entirely new idea. The nasal sprays used in the Israeli study are available to buy now, but many others are still in trials. Scientists at the University of Birmingham have been developing a nasal spray that can stop a coronavirus infection for up to two days since April last year, and are currently in discussions with shops and pharmaceutical companies on the next steps to mass-produce it. In Holland, scientists have tested a "nasal inhibitor" on ferrets, that they believe could protect people for 24 hours. If these trials prove to be successful, regular nasal spraying could become part of everyday life. 

Here is everything we know so far about how they help in the fight against covid...

What are nasal sprays?

Nasal sprays aim to provide fast relief when you feel all stuffed up from having a cold or the flu, and are available to buy in pharmacies and from retailers such as Boots. Usually, they come in three types: decongestants, salt-water solutions and steroid nasal sprays. These types of nasal spray are different to the ones being used to treat coronavirus, but the application method is the same: the vapour is sprayed directly into the nostrils and inhaled. 

How do they prevent covid-19?

Broadly speaking, the sprays help to prevent coronavirus infection by capturing the virus in the nose and enclosing it in a coating that it cannot escape from. As a result, it would be safe for a person to breathe out - even if inhaled by another person - because the virus would be inactive and harmless.

 

Pankaj Sharma, a Professor of Neurology at Royal Holloway, University of London, is working on the first UK clinical trials of a nasal spray proven to kill 99.9% of the coronavirus that causes Covid-19. The people in the trial have all had a positive lateral flow, or PCR, test, but aren’t showing any symptoms. The scientists behind the trial are hoping that the nasal spray will reduce the viral load in the nasal passages so it doesn’t reach the lungs. As a result, symptoms and transmission will be reduced. He explains that the key to the nasal spray is the nanomolecule nitric oxide, which is created by mixing two liquids together. 

"We all have it in our body: it keeps the blood vessels dilated and it’s involved in immunity. When it comes into contact with viruses or bacteria, it kills it dead virtually on contact, by disrupting the structural integrity of the virus,” he says.  This is effective at killing covid-19 because infection happens through the nasal passages, and the nasopharynx - the back of the throat. “It incubates there for seven days: if it gets to a certain viral load, then it drifts down through the trachea into the lungs, which causes symptoms,” says Prof Sharma.

Are they effective?

A study undertaken in November last year found that a nasal spray protected ferrets from catching the virus. The spray contained a lipopeptide, a cholesterol particle linked to a chain of amino acids. This works by obstructing the proper functioning of the spike protein, which allows coronavirus to infect our airway or lung cells. Although it was undertaken on animals. it's a positive sign that nasal sprays could work on humans too: ferrets are often used in studies of respiratory diseases because the lungs of these animals and humans are similar. Ferrets are highly susceptible to infection with coronavirus, and the virus spreads easily from ferret to ferret.

 

Experts issued a similar approach to the Israel study. 83 willing participants agreed to squirt the spray up their nose before mass gatherings, and they topped it up every five hours. Out of 81 people who followed the regime, none contracted coronavirus. In the remainder of the group, 16 people did get infected with the virus. 

 

Although this sounds promising, the paper is yet to be peer-reviewed; and experts are in agreement that masks shouldn’t be used in place of measures such as social-distancing, face coverings, or isolation.

 

The NONS trials are still ongoing - but the treatment proved 99.9% effective in killing the coronavirus in independent test labs at Utah State University’s Antiviral Research Institute. Additional studies in rodents with a covid-19 infection showed over 95% reduction within the first day after infection.

Can I buy one now?

The nasal spray used in the study in Bnei Brak is Taffix, which is developed by the biopharmaceutical company Nasus Pharma. You can buy this nose spray in the UK from the company’s website and Amazon. The nasal spray in the NONS trial is not available to buy.  

 

However, Prof Sharma says that normal nose sprays won’t work on covid, because they don’t contain the virus killing Nitric Oxide. “It’s a difficult compound to make, and it’s an unstable product so it only lasts a short amount of time. Decongestants won’t disrupt the structural integrity of the virus,” he says. 

Will they be a game-changer? 

As Prof Sharma sees it, the “real game-changer” is the vaccination: but that’s not to say that nasal sprays can’t help as the rollout continues. Prof Sharma explains that because nitric oxide is a “naturally occurring compound” in our bodies, people may not have the same hesitations using the spray, as they do about receiving the vaccine.

“This could mean that it’s more widely available; I can’t think of anyone who wouldn’t be eligible for nasal spray,” he explains.  Some even think that, if the trials continue to be successful, nasal sprays could be the key to getting society moving again - partly, because of the speed at which they can be distributed. Dr. Richard Moakes, who is leading a study into developing a nasal spray at the University of Birmingham, previously told the Telegraph he is confident in the spray’s formula to help unlock society from social distancing restrictions and “get schools going again”.

He added: “As an over-the-shelf product, we have spoken to companies with a presence on the high street as we think they could distribute it effectively. Based on the product, it will be much quicker to get to the user than a novel drug.”

 

Dr. Sharma says the real benefit of nasal spray would be seen if it can be used “prophylactically” - so before someone gets an infection. “Then, I can imagine prior to someone going into the cinema, or a theatre, spraying up their nose and then coming out again, every four to six hours in the day,” he says. He adds that because nasal spray destroys the structure of the virus, it is still effective against new variants. 

“If we take the South African variant, once it touches nitric oxide it’s going to be structurally destroyed anyway; the fact that it has got a different RNA profile makes no difference to nitric oxide,” he says. 

Are they unpleasant to use?

Not really, says Prof Sharma. He explains that the spray being trialled is “completely odourless”, and no patients have expressed discomfort. This may be particularly promising when it comes to reopening schools; while covid testing is uncomfortable, nasal sprays are relatively quick and painless making it an easier process for children. 

 

 

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