Many Americans — and those of us right here in Maryland — have started new and heightened hygiene routines since the outbreak of COVID-19. Before we learned of the novel SARS-CoV-2 virus in 2020, it was less likely that people would sanitize their hands every time they entered a building, let alone wear face masks around friends and family. There is still one important infection prevention practice that is not being practiced widely enough: sanitizing the nose.

To date, 428,799 COVID-19 cases have been reported in our state, and sadly, almost 8,300 Marylanders have passed away due to the virus. This pandemic is even more acutely felt by communities of color who are more likely to serve as essential workers or live in densely populated neighborhoods.

As an infectious disease doctor based in Frederick, it’s encouraging to see people taking infection prevention seriously, although it has taken a nasty viral enemy to bring these issues to light. It’s my hope — and the hope of so many others in my field — that we continue some of these practices even after the current pandemic threat subsides. Many of the safety measures that have been effective this year will continue to be vital in preventing annual outbreaks from harmful germs that stress our medical system. In fact, we are most likely seeing historically low rates of flu across the country this season due in large part to these increased safety measures.

While infectious diseases are at the forefront of every American’s mind right now, infection prevention experts are responsible for providing accurate information to our community. I often have patients or friends approach me saying, “I wear masks, I social distance, and I sanitize my hands… what else should I be doing that I don’t know about?” My response usually includes sanitizing the nose. This year has brought much-needed attention to how often we touch our face, eyes and mouth, but have you ever thought about how frequently we touch our noses? (Answer: 100 times a day on average!)

Germs live and grow in the nose, which acts like a revolving door for harmful germs to enter and exit the body. Think about how often your hands touch your nose and how germs can be easily passed from your hands to your nose and vice versa. To combat this, specialized nasal antiseptic products can be applied to the skin inside the nostrils, which kills the germs and helps keep us protected before heading into crowded areas, such as grocery stores or airports. There are over-the-counter products available that are clinically proven to kill germs in the nose. Sanitizing the nose, also known as nasal decolonization, is practiced widely by hospitals and supported by peer-reviewed clinical research.

Well before the COVID-19 pandemic, I saw significant positive results from implementing universal nasal decolonization at Frederick Health Hospital, where I work as an infectious disease specialist. In April 2017, our 250-plus bed community hospital began using an alcohol-based nasal antiseptic for all adult in-patients. A few months after introducing nasal decolonization, rates of surgical site infections caused by prevalent bacteria called Staph aureus (including antibiotic-resistant MRSA) and Staph-related bloodstream infections decreased by 50 percent. The hospital also achieved significant financial savings due to the reduction of infection-related testing and treatment. We even saw improved staff response times to patients’ needs and higher patient satisfaction scores.

I believe we can parlay the success of nasal sanitization in the health care setting into other relevant, non-health care industries. Sanitizing the nose is a missing, critical piece in the infection prevention puzzle.

Even beyond the current pandemic, I encourage my friends and community to consider adding nasal sanitization into their personal routines. You will be surprised at how easy it is and how confident you’ll feel in your own personal infection prevention strategy after taking a few seconds out of your day to sanitize your nose.

Anusha Belani, MD, is an infectious disease specialist in Frederick who has more than 35 years of experience in the medical field. She is a consultant for Frederick Health Hospital and an unpaid adviser for the Sanitize Your Nose initiative. For Dr. Belani’s full bio and more information about nasal sanitization, visit sanitizeyournose.org.

(11) comments

miaow

So we should put hand sanitizer in our nose?

threecents

I have not heard of nasal sanitizers. While they may be useful for some immune deficient individuals and in a hospital setting, they do not sound like a good idea for general use, as Gabe pointed out.

phydeaux994

There has been a marked decrease of the regular Flu because of the mask wearing and now people with allergies to all of the Spring pollens are finding a benefit too. A simple solution to all the airborne threats.

gabrielshorn2013

Interesting opinion from Dr. Belani, and may be applicable in a clinical (hospital) situation, but surely not for common every day home use. Sanitizers do not specifically target the pathogenic (bad) bacteria, leaving the "good" normal bacterial population behind as a protective barrier to pathogen colonization. No, they kill everything. When that happens, it leaves the area available for colonization by pathogenic (bad) bacteria, causing infection and disease. Maintaining a healthy microbiome is critical in preventing infection, hence the use of probiotics to maintain gut health, or eating yogurt after a course of antibiotics. Any medical professional knows this, and would not promote such indiscriminate use of sanitizers on sensitive areas of the body.

Greg F

Tending to agree with you here. I know a few that used Neti Pots for this purpose who got infections that were rather serious. I also think this may lead to resistance as well...and for some it is just an intolerable process.

gabrielshorn2013

Using a Neti pot with an isotonic (0.9% w/v) saline solution may be indicated for periodic (not daily) flushing of the sinuses and mucous membranes to remove excessive mucous or allergens. Using a hypertonic solution may lead to what you describe GregF, as the hypertonicity causes osmotic imbalances in some bacteria, leading to their lysis (death). When that happens, the microbiome is altered, causing colonization by different, and potentially unhealthy new replacements. Save such recommendations to your physician. Use of the 61% ethanol solution in a Neti pot as mentioned below is fraught with potential complications.

Trellis

Unfortunately, this is an unabashed advertisement for a name brand nasal product masquerading as a Letter to the Editor. An extremely expensive product currently available OTC to consumers online only. The main ingredient? 61% alcohol. Their science may be sound, but the company behind the product should have purchased advertising space rather than slither into the FNP in such a disingenuous and self-serving manner.

Dwasserba

I use a neti pot. You can get it at the drug store. You use salt packets and previously boiled and cooled water which is then reheated to irrigate the nose. It is said to flush out germs and viruses, allergens and irritants as it shrinks nasal membranes. Good for allergies. Easy to get, easy to do.

Greg F

They may help, but can be dangerous also. Remember...1/2 of everyone you meet on a typical day is below average intelligence. Not sure they'd be able to do things right. https://www.medicalnewstoday.com/articles/249460#what-is-a-neti-pot

phydeaux994

Wow, that is very close to the Political Divide in our Country. Interesting.

msmith6276

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