Upper respiratory tract infections

SARS, influenza, RSV, common cold, …

2020-11-24 — 2025-11-01

Wherein the modes of respiratory contagion are surveyed, topical remedies are described, and a nitric‑oxide nasal spray, Enovid/VirX, is noted as having passed clinical trials.

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Figure 1: Ah-choo!

1 Epidemiology of

See also epidemiology, contact tracing.

2 Topical sprays

Various nasal sprays are used for colds and other viruses; some might affect COVID-19 or other respiratory viruses (Fais et al. 2022; Friedland et al. 2022; Kozlov 2022; Little et al. 2024).

2.1 Iota-carrageenan

Seems legit (Figueroa et al. 2021; Hemilä and Chalker 2021). Available in Australia as Flo travel.

2.2 Nitric oxide nasal sprays

Topical nitric oxide (Salman 2021) passed clinical trials (Sanotize Research and Development corp. 2021; Winchester et al. 2021) and has been released as a product, Enovid/VirX, in a slow-release nasal spray formulation.

enovid and VirX are the identical product, branded under different names for marketing in various territories around the world. Nitric Oxide Nasal Spray (NONS) is the generic name of the product.

Does nitric oxide nasal spray (Enovid/VirX/FabiSpray) help prevent or treat COVID-19? — Those Nerdy Girls

2.3 Hypochlorous acid nasal sprays

Very recent. Seems credible and also happens to be approved in many jurisdictions (Winter, Boecker, and Posch 2025).

2.4 Povidone-iodine (PVP‑I)

Seems credible. No companies have bothered to apply for TGA approval in Australia yet, AFAICT.

2.5 Zinc

No longer supported (Hemilä and Chalker 2024; Hulisz 2004; Hunter et al. 2021; Ronald 2001) since it has weak effects at best and some risks of anosmia (losing your sense of smell) (Jafek2004Nasal?; Mavragani2021Loss?).

3 Airborne transmission

Figure 2

There are probably several reasons that we were slow to be careful about sharing the contents of our lungs with each other int he west. Here’s an interesting one: The 60-Year-Old Scientific Screwup That Helped Covid Kill documents the debate about which particle sizes can transmit viruses, and traces the lineage of cargo-cult science that helped those misunderstandings persist.

3.1 protective masks

See hygienic masks for details on mask types and fit.

4 COVID-19

All my COVID-19 content is archived here.

5 Incoming

6 References

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Adam. 2020. Special Report: The Simulations Driving the World’s Response to COVID-19.” Nature.
Bazant, and Bush. 2021. A Guideline to Limit Indoor Airborne Transmission of COVID-19.” Proceedings of the National Academy of Sciences.
Briggs, Goldstein, Kirwin, et al. 2021. Estimating (quality-adjusted) life-year losses associated with deaths: With application to COVID-19.” Health Economics.
Burridge, Fan, Jones, et al. 2021. Predictive and Retrospective Modelling of Airborne Infection Risk Using Monitored Carbon Dioxide.” Indoor and Built Environment.
Chavda, Baviskar, Vaghela, et al. 2023. Nasal Sprays for Treating COVID-19: A Scientific Note.” Pharmacological Reports.
Cirillo, and Taleb. 2020. Tail Risk of Contagious Diseases.” Nature Physics.
Cuschieri, Calleja, Devleesschauwer, et al. 2021. Estimating the Direct Covid-19 Disability-Adjusted Life Years Impact on the Malta Population for the First Full Year.” BMC Public Health.
Dolan, and Kahneman. 2008. Interpretations Of Utility And Their Implications For The Valuation Of Health*.” The Economic Journal.
Fais, Juskeviciene, Francardo, et al. 2022. Drug-Free Nasal Spray as a Barrier Against SARS-CoV-2 and Its Delta Variant: In Vitro Study of Safety and Efficacy in Human Nasal Airway Epithelia.” International Journal of Molecular Sciences.
Figueroa, Lombardo, Dogliotti, et al. 2021. Efficacy of a Nasal Spray Containing Iota-Carrageenan in the Postexposure Prophylaxis of COVID-19 in Hospital Personnel Dedicated to Patients Care with COVID-19 Disease.” International Journal of General Medicine.
Friedland, Tucker, Goodall, et al. 2022. In Vivo (Human) and in Vitro Inactivation of SARS-CoV-2 with 0.5% Povidone-Iodine Nasal Spray.” Australian Journal of Otolaryngology.
Hemilä, and Chalker. 2021. Carrageenan Nasal Spray May Double the Rate of Recovery from Coronavirus and Influenza Virus Infections: Re‐analysis of Randomized Trial Data.” Pharmacology Research & Perspectives.
———. 2024. Shortcomings in the Cochrane review on zinc for the common cold (2024).” Frontiers in Medicine.
Hulisz. 2004. Efficacy of Zinc Against Common Cold Viruses: An Overview.” Journal of the American Pharmacists Association.
Hunter, Arentz, Goldenberg, et al. 2021. Zinc for the Prevention or Treatment of Acute Viral Respiratory Tract Infections in Adults: A Rapid Systematic Review and Meta-Analysis of Randomised Controlled Trials.” BMJ Open.
Kimmitt, and Redway. 2016. Evaluation of the Potential for Virus Dispersal During Hand Drying: A Comparison of Three Methods.” Journal of Applied Microbiology.
Kozlov. 2022. Could a Nose Spray a Day Keep COVID Away? Nature.
Little, Vennik, Rumsby, et al. 2024. Nasal sprays and behavioural interventions compared with usual care for acute respiratory illness in primary care: a randomised, controlled, open-label, parallel-group trial.” The Lancet Respiratory Medicine.
Noakes, and Sleigh. 2009. Mathematical Models for Assessing the Role of Airflow on the Risk of Airborne Infection in Hospital Wards.” Journal of the Royal Society Interface.
Piroth, Cottenet, Mariet, et al. 2021. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study.” The Lancet Respiratory Medicine.
Ronald. 2001. Ineffectiveness of Intranasal Zinc Gluconate for Prevention of Experimental Rhinovirus Colds.” Clinical Infectious Diseases.
Salman. 2021. A Double-Blinded, Placebo-Controlled Parallel, Phase 3 Clinical Efficacy Study Evaluating Nitric Oxide Nasal Spray (NONS) To Treat and Prevent the Exacerbation of Infection in Individuals With Documented Asymptomatic or Mild COVID-19.” Clinical trial registration NCT05012319.
Sanotize Research and Development corp. 2021. Multi-Center, Randomized, Controlled, Phase II Clinical Efficacy Study Evaluating Nitric Oxide Releasing Solution Treatment for the Prevention and Treatment of COVID-19 in Healthcare Workers and Individuals at Risk of Infection.” Clinical trial registration NCT04337918.
Sze To, and Chao. 2010. Review and Comparison Between the Wells–Riley and Dose‐response Approaches to Risk Assessment of Infectious Respiratory Diseases.” Indoor Air.
Wang, Prather, Sznitman, et al. 2021. Airborne Transmission of Respiratory Viruses.” Science.
Winchester, John, Jabbar, et al. 2021. Clinical Efficacy of Nitric Oxide Nasal Spray (NONS) for the Treatment of Mild COVID-19 Infection.” The Journal of Infection.
Winter, Boecker, and Posch. 2025. Hypochlorous Acid (HOCl) as a Promising Respiratory Antiseptic.” Viruses.
Wong, Kelly, Ip, et al. 2013. Case Fatality Risk of Influenza A(H1N1pdm09): A Systematic Review.” Epidemiology (Cambridge, Mass.).
Wouterse, Ram, and van Baal. 2022. Quality-Adjusted Life-Years Lost Due to COVID-19 Mortality: Methods and Application for The Netherlands.” Value in Health.
Wright, McGrowder, and Bryan. 2025. Nitric Oxide in the Treatment of COVID-19: Nasal Sprays, Inhalants and Nanoparticles.” Biochemistry Research International.
Zhao, Li, Zhang, et al. 2023. Inhaled nitric oxide: can it serve as a savior for COVID-19 and related respiratory and cardiovascular diseases? Frontiers in Microbiology.