The sophisticated American consumer has grown accustomed to the gold standard for drug and health products—the prospective randomized, double-blind, placebo-controlled trial (RCT). Operation Warp Speed (OWS) was supposed to be a churning mill of large RCTs to help the nation understand what conclusively is effective in the prevention and treatment of COVID-19.
Unfortunately, after three years, OWS has delivered failed products (remdesivir, baricitinib, molnupiravir, COVID-19 vaccines) and small inconclusive trials of products that doctors have found effective in practice, including off-target generic antivirals and anticoagulants. Operation Warp Speed didn’t test simple, affordable, available prevention strategies. Fortunately, such RCTs were done outside of the United States and have brought us important findings.
Balmforth, et al., conducted a prospective double-blind, placebo-controlled trial of a xylitol-based nasal spray in the prevention of SARS-CoV-2 infection in exposed healthcare workers in two hospitals in Uttar Pradesh, India. Xylitol is known to have anti-infective and anti-inflammatory properties and is used in XLEAR nasal spray and anti-infective chewing gum to prevent dental caries.
No harmful effects were associated with xylitol. A smaller study of xylitol nasal spray in mild COVID-19 cases demonstrated that persistent loss of smell may be eliminated with xylitol nasal spray during the acute congestion phase.
I’ve been impressed with the RCTs of topical nasal sprays and gargles in COVID-19 far more than those with oral or intravenous drugs. Xylitol available as XLEAR in U.S. pharmacies is one of several choices for local nasopharyngeal protection and treatment of COVID-19.
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