HydroBlog March 23, 2020
DISCLAIMER; Nothing in this presentation is intended to diagose or treat any condition. This presentation is not intending to suggest that hydrotherapy may replace medical care from a qualified practitioner or that conventional methods of treatment are not necessary. Rather, only that hydrotherapy and other simple modalities may be a potentially useful as adjuvant therapies. Proper medical care of a qualified provider is always advised. In addition to consulting with your healthcare provider, carefully observe all PRECATIONS AND GUIDELINES when attempting to any hydrotherapy, and immediately stop and seek medical help if the condition worsens or does not improve. It should be noted that hydrotherapy treatments can result in serious injury or complications under some circumstances. Prior medical advice should always be sought and extreme caution taken when performing hydrotherapy for individuals with chronic diseases or decreased skin sensitivity. The information in this blog is not connected with any official sources, such as the CDC.
(Also please note; to enhance ease of reading, important points are highlighted throughout the post.)
As the novel coronavirus is sweeping around the globe causing COVID-19, many people are wondering what they can do to avoid serious illness. Disinfection and measures to avoid transmission primarily work for prevention, but what can you do to once the virus is already in your body? In addition to standard recommendations for prevention of disease spread there are some things that can be done to potentially reduce serious outcomes.
Although we don’t yet know everything about the behavior of the novel coronavirus, a key factor is that coronaviruses, similar to influenza, are unstable in heat. WHO says that Heat at 56°C (132.8 degrees Farenheit) kills the SARS coronavirus at around 10000 units per 15 min (quick reduction), (1, 2).
Other sources indicate that coronavirus and influenza viruses survive and transmit better in cool, dry environments such as temperate climates in winter and airconditioned settings like hospitals and hotels (7, 9) while warm, humid weather can make it harder for respiratory droplets to spread viruses because moisture droplets cause the particles to fall out of the air (8).
One study showed that SARS CoV can survive two weeks after drying at temperature and humidity conditions found in an air-conditioned environment, or up to 3 weeks at room temperature in a liquid environment, but was easily killed by heat of 56°C (132.8 °F) for 15 minutes. Researchers concluded that the results indicate that contaminated surfaces, objects (fomites) may play a major role in transmission of infection in the hospital and the community (19).
A new study out of china, which is not yet peer-reviewed, suggests that the contagiousness of COVID-19 goes down for each degree of temperature increase and each percent humidity increase (17). Another study published in the Journal of Hospital Infection which examined the lifespans of coronaviruses on surfaces showed that an 18 degree increase in temperature of 68 to 86 degrees Fahrenheit decreased how long SARS coronavirus lived on steel surfaces by half (17).
Additionally, cold, dry weather may weaken immunity (19), which further increases the likelihood of contracting pathogens. Low humidity increases the spread of viruses by preventing movement of the cilia, which are tiny hair-like structures lining the airways that remove viruses and mucus, and it limits the repair functions of those cells, as described by researchers in a Yale animal study (21). They also noted that dry air hampered the ability of infected cells to trigger an immune system response.
However, it would be premature to assume the virus will go away entirely with warmer weather or that it may become seasonal, so we must remain vigilant (8).
The following suggestions are not intended to suggest that we can prevent the virus from going to the lungs, since the virus often seems to infect the lower and upper respiratory tracts at the same time. It would be foolhardy to think that these or any natural methods could entirely eradicate the virus in your body or make you immune to it. We must still be extremely careful to follow social distancing and sanitizing practices, especially for those who are in high risk categories such as over 65 years old or having pre-existing conditions. These ideas are also not intended to reduce the seriousness of public health warnings and we must continue to do everything we possibly can to prevent the transmission of the novel coronavirus. There is no magic cure.
However, for those who are already sick here are some suggestions which are aimed at reducing the severity of the illness which may potentially enhance the immune system’s ability to fight infection, reduce the viral load by inhibiting viruses based on what we know about the behavior and viability of coronavirus, as well as assist with clearing out mucus that blocks respiratory passages.
Use of Heat
Thermal applications and heating modalities seem to hold realistic potential improve outcomes. Not only does heat and humidity have the potential to inhibit viruses, as previously discussed, but heating key areas of the body for short periods of time may also stimulate white blood cell action and increased WBC motility (chemotaxis), due to factors such as the fact that chemical reactions take place faster in heat.
Sun Bath: UV rays also have some penetration into the tissues and thermal therapeutic effects on tissues and immune responses, and sunlight directly kills germs on the skin’s surface. Further, it causes the body to produce vitamin D which has many beneficial effects. Sun baths may be potentially useful for those who have viral illness. Lay in a private area or under an open window where sunlight streams in (indoors) for up 15-30 minutes two or three times daily, as tolerated.
CAUTIONS: Be careful not to fall asleep (set an alarm clock!). Avoid peak sun hours when sunburns more easily occur (10 am – 2 pm) and wear protective eyewear.
Inhalation: Can deliver heat and
moisture to the nasal and sinus passages to assist loosening secretions,
potentially inhibiting viruses and promoting the action of cilia to remove
viruses and mucus. There is some evidence to suggest that the virus
replicates in the nose and throat early in the course of disease, as
evidenced by the fact that loss of the sense of smell can often be an early
sign of COVID-19 prior to any other sign appearing (36). Beginning steam inhalation
two to five times daily might be a good measure to use when cases of the virus are going around in your community or
at the first sign of loss of sense of smell or other mild symptoms. Placing a humidifier in the room in between
treatments may also be helpful, or boiling a pot of water on the stove if you
don’t have one. To do steam inhalation, pour hot water
from a tea pot into a bowl on the table, sit in front of the bowl and bend your
head over it to breathe the steam while having your head covered with a
towel. A drop of eucalyptus oil may help in some cases (please see
precautionary notes and supporting research about eucalyptus oil**). Alternatively,
simply breathing the steam from a hot cup of herbal tea may have
CAUTIONS: Be careful to avoid burns. This
method may not be advisable for children due to the risk of burning from steam and
difficulty tolerating bending the head over a bowl of hot water.
Hot Pack/Fomentations: Moist heat to the chest creates a hot environment which may have the potential to slow or inhibit viral activity, improve immune responses and reduce deadly inflammation through the derivative effect (see also video “Hydrotherapy: Novel Virus… Novel Idea”).
CAUTIONS: Follow all precautions to avoid burns while preparing or administering hot packs.
Sauna: Traditional saunas use temperatures ranging from 180 to 210 degrees F while infrared saunas use milder temperatures between 120 to 140 degrees F. (list C) High temperatures coming into contact with the tissues of the sinuses and respiratory tract may potentially help reduce the viral load in these key areas. Further research should be done to examine this possibility. A Russian steam bath can also be done at home using a sheet wrapped around the body while having the feet in a hot foot bath, with ice cool rag to the forehead and neck. You must have someone to help you with this due to the potential for overheating and fainting, and observe all precautions. Hydroreference.com does not have a protocol for this yet, but it is listed in “Home Remedies” written by husband and wife medical doctors, Agatha and Calvin Thrash. A modified steam bath can also be taken inside of your shower with the steam from the hot water or by placing an electric tea pot on a chair, pointing the steam toward the gap in the shower curtain.
CAUTIONS: Never handle any electric appliance with wet hands or put it into the shower area where it could get wet. This could result in death by electrocution. For any use of sauna or steam bath hydration is extremely important and time should be limited to no more than a few minutes at a time to avoid causing mucus in the lower respiratory tract to become thickened by the hot, dry air which could worsen the condition. However, it is not advisable to use public saunas during times of infectious disease outbreaks, especially if you are ill, because of the risk of disease transmission. Small private saunas and steam rooms can be constructed without too much expense, if done with careful precautions in mind.
Heating Lamp: Another way to bring heat to upper and lower respiratory tissues that could increase blood flow and potentially allow faster white blood cell motility (chemotaxis) would be through using a lamp to heat the skin over the area. Infrared lamps can be used, but also light bulbs or heat lamps heat tissues of the nose, sinuses and chest. Some studies on the effects of penetration of infrared rays into human tissue have indicated that multiple structures and tissues impede the rays and result in penetration into the tissues of around 1 to 5 cm (4, 5). The therapeutic potential of using this for a few minutes at a time over respiratory tissues should be further studied. It cannot be advised as to whether this could be helpful without further research.
CAUTIONS: With any use of a lamp for heating tissues carefully observe all safety precautions, place moist cloths over your eyes and never look directly at a bright lamp, have someone assist you in order to avoid burning yourself on a hot lamp when you have your eyes closed (especially if you are sick or dizzy the risk of injury goes up). Avoid prolonged use of more than a few minutes at a time, several hours apart in order to avoid adverse reactions. Also avoid heating the great blood vessels of the neck, or heating directly over the heart.
Hot Foot Bath: May relieve deadly internal blood congestion from inflammation through the “derivative effect.” The blood vessels in the skin which help regulate body temperature are capable of holding large amounts of blood, when your skin becomes pink or red from hot water that color is from blood it has drawn away from the congested internal organs. Ideally, have someone help you. If you are alone, sit on a chair in the bath tub and fill a basin from the faucet (or just fill the tub a few inches if you don't have a basin), adding hot water whenever it starts to feel cool. Continue for 15 to 30 minutes, end with a cool rinse.
CAUTIONS: Drink cool water, put a cool cloth dipped in a bowl of ice water to your forhead, stop if you feel dizzy, towel-dry well and avoid chilling. Take a nap afterword. Contraindicated for those with diabetes, numbness in the feet or circulation problems.
Additional PRECAUTIONS With any use of heat be sure to cool the forehead with ice rag, wipe the face with cool cloth if sweating begins, avoid accidentally heating the central nervous tissues (head and spine), and drink plenty of fluids. Check pulses every few minutes and put a bag of ice wrapped in a pillow case over the heart if it rises over 100. Stop immediately if uncomfortable or dizzy, use cooling measures and elevate the feet while resting. It is not advised to do strong heating treatments without having someone else present or within ear shot, especially if you are sick. See more precautions and potential contraindications here.
Reducing the Viral Load
Every virus is a living particle which seeks a host cell to infect. So, theoretically, even after you get sick you still want to do battle against all potential viruses that you may shed into your bedroom or onto objects you touch, as well as get rid of as much virus-filled mucus as possible, in order to reduce the viral load which your own immune system has to deal with. Reducing the burden of viruses you may come into contact with may potentially give your immune system a better chance of dealing with the disease.
Not only could these practices potentially help your own body fight any viral illness, but also will help prevent the spread of illness to non-infected individuals who might accidentally come into contact with you or come in to your room help you for brief periods of time (though that is not advisable, it is an acknowledgment of the fact that this may inadvertently happen from time to time).
For those who are ill or those caring for them, such as health care professionals, it is good to be aware that viral loads of COVID-19 appear to peak after 5 to 6 days from symptom onset, according to research from Wuhan, China published in The Lancet Infectious Diseases (26).
The foremost important measures include continuing to practice the CDC’s recommended measures (34) which have been shown to reduce transmission of respiratory illnesses by 21%, according to a 2008 meta-analysis in the American Journal of Public Health;
NOTE; In order to avoid confusion, please note that these recommendations were based on information from the CDC with a few insignificant changes in wording, but previous and subsequent paragraphs are not connected with the CDC.
In regard to handwashing, and, to clear up some panic about the limited availability hand sanitizer, it is important to note that because the coronavirus capsule is made of lipids (fats), regular soap and water not only removes but also destroys and inactivates the virus with 20 seconds of washing. But regardless of the fact that heat kills viruses, you should avoid using hot water to wash your hands as it may cause your skin to dry and crack, putting you at risk for other infections or blood-borne diseases (especially if you work where you are exposed).
If you do not have a tissue, cough into your shoulder or elbow in an emergency, but do then be aware that there may be viruses present in that spot and avoid allowing anyone to touch you there until you can get home to change and bathe. The coronavirus that causes COVID-19 is so easily transmissible that it is necessary to consider things in that kind of detail.
Wearing a mask may potentially reduce the viral load that you are exposed to if you are not sick, but you also be aware that it may create a false sense of security which causes you to come closer to people who are sick. Surgical masks will not protect against tiny suspended virus particles which may easily go around the mask. N-95 respirator masks should be used by healthcare workers or anyone who is closely working with someone ill with COVID-19, especially when doing any procedure that may produce aerosolization of mucus (such as suctioning). Any mask also needs to be dry to be effective. Dust masks can be hand-made of acceptable material if they are not available in stores, but N-95 respirator masks cannot be hand-made.
Additionally, when you are sick practice respiratory hygiene frequently by getting mucus out of your nose, sinuses and respiratory passages. Up to every 20 minutes, while awake, cough and deep breath as well as gently blow your nose to clear out virus-filled mucus which could potentially block respiratory passages. Then sanitize or wash your hands after applying lotion or Vaseline to nose. However, avoid deep breathing and coughing so hard that it could cause trauma to the lungs, which could lead to pneumothorax or other critical complications.
If you cannot access paper products use handkerchiefs or soft cloths to blow your nose and cough in, but wash them often with soap then place in direct, hot sunlight for up to an hour or more after they are already dry to kill remaining viruses if you are not able to heat-dry them in a drier. Using a steam iron on them may also be a good idea, to kill viruses.
Sunlight and fresh air should be allowed to freely flow into the room in order to kill viruses, carry and them out of the room in air currents. Additionally, negatively charged ions in the air produced by sunlight cause suspended particles to fall out of the air.
Due to the fallout of virus particles, avoid laying on or touching the floor in the room where someone is sick with COVID-19, and do not allow infants, toddlers or children to come in the room and play on the floor.
Place your bed under the window, if possible, and lay open the sheets to allow sunlight to kill germs and dry out moisture throughout the day to prevent mold growth. Avoid making your bed up when you first get up in the morning and then keeping it in the dark all day until you come home at night.
Patients with COVID-19 have developed gastrointestinal symptoms, such as diarrhea, more than with other coronaviruses therefore it is important to consider that feces and urine may also be a potential route of transmission. 6, 12. Wash your hands after going to the bathroom.
Frequently wash your clothing, bedding, towels and wash cloths in hot water and dry in a hot drier, if possible, or in direct sunlight.
Gargle hot saline water to potentially inhibit some viruses that are irritating the throat. Drink hot herbal tea or non-sugary hot liquids for the same reason, as well as to provide hydration and help raise body temperature to assist with immune responses.
Practice good oral hygiene 2-3 times daily, brush your teeth then swish and spit antimicrobial mouth wash.
Shower and wash your hair with soap once or twice a day because germs are shedding from your body and may also adhere to your hair. This can also act as a form of hydrotherapy which potentially boosts immunity. You can take a contrast alternating hot and cold shower (3 to 5 cycles of 3 minutes hot/15 seconds cool or cold, ending with cold), or simply take a warm to hot shower and finish with a cold rinse for up to 15 seconds. Note: you do not have to use very cold water if it feels cold to you or makes you shiver. Listen to your body – make sure you are adequately warm first. How hot or cold a person can tolerate depends on the weather and time of year as well as age, state of health and individual differences. Never force uncomfortable temperatures on anyone or you could cause an adverse reaction, burn or severe chilling that reduces immunity.
Get plenty of rest to enhance immunity and promote healing. Try to sleep on your abdomen, or at least turning side to side every few hours, in order to allow postural drainage of the lower lung areas and to prevent nasal mucus from running down the back of your throat into your lungs throughout the night. Prone positioning (laying on abdomen) has also been shown to reduce the mortality rate among ventilated patients with Acute Respiratory Distress Syndrome (ARDS), (35).
Wrap your neck at night with scarf or heating compress, and wear a hoodie, sweat pants
and warm socks to sleep in. This will allow good blood circulation to flow to key areas throughout the night. A heating compress involves placing a thin layer of cold, wet cotton cloth around your neck followed by wrapping it with a strip of wool or flannel, then a scarf if needed, fastening all with a safety pin. When I was a child and had a sore throat it would often be greatly improved by the next morning after my mom did this for me. Heating compresses stimulate the body to respond to the cold cloth after which the layers trap the heat stimulated by the response. They can be put on any body part that has a problem, including the chest.
Get a little exercise in the sunshine during the day, as tolerated, to boost immunity and balance your blood circulation, as well as to encourage you to take deep breaths and fully expand your lungs.
Avoid letting your head, neck, hands or feet get chilled in order to prevent imbalances of blood circulation or suppressed immunity. Dress your extremities warmly if going out in chilly weather.
Boost nutrients such as vitamins, phytochemicals and minerals that support the immune system. Ideally obtain these from food sources, if possible, rather than synthetic or pill-based supplements. However, do take supplements if there is any question about the adequacy of any nutrient intake. Avoid sugar which has been shown to inhibit immune responses.
Ideally also avoid substances such as caffeine, alcohol, tobacco and drugs which may interfere with the healing process. However, if you are at risk for going into withdrawal symptoms you may need to consult a professional to assist you to slowly wean down in order to avoid complicating recovery of your already weakened system by adding severe withdrawal symptoms.
Garlic has shown promise as a preventative and treatment measure for viral illnesses (11). A few studies have shown garlic extract to be active in vitro against influenza A and B, cytomegalovirus, rhinovirus, HIV, herpes simplex virus 2 and 2, viral pneumonia and rotavirus. The compounds Allicin, diallyl trisulfide and ajoene have all been shown to be active (24). Fresh garlic extract was viricidal to herpes simplex virus type 1, herpes simplex virus type 2, parainfluenza virus type 3, vaccinia virus, vesicular stomatitis virus, and human rhinovirus type 2 (25). Garlic has also been shown to be inversely associated with liver cancer, possibly indicating inhibitory effects on Hepatitis A and B viruses which cause liver cancer (23). Garlic oil supplementation showed preventative effects on cigarette smoke-induced airway inflammation in mice (29). Inflammation is a key factor in the course of severe COVID-19 cases, so garlic should be further studied about potential effectiveness of reducing inflammation related to the viral illness.
However, garlic may interact with some medications such as protease inhibitors (by up to 50% reduction in effectiveness (29) or other medications. That is significant because protease inhibitors are one of the pharmaceutical categories which are being explored for the treatment of COVID-19.
An article from the Taiwan News reported that it may be possible to become infected with COVID-19 a second time, which resulted in heart failure related to heart damage from medications taken for the illness (15). But it is of note that wild garlic was shown to be protective against isoproterenol-induced myocardial necrosis in wistar rats (29), so perhaps the cardio-protective effects of garlic should be further researched for this condition if it turns out to be a significant problem with COVID-19.
Garlic supplements also could increase the risk of bleeding among those taking blood thinners. Medical advice should be sought before taking garlic concurrently with medications and it may not be appropriate during the time of treatment with medications for COVID-19, but perhaps garlic could be taken before and after finishing a course of medications for the illness in order to help.
Other nutraceutical supplements may also show promise, as highlighted in an article Progress in Cardiovascular Diseases (published by Elsevier) which suggests that some over the counter supplements such as n-acetylcysteine (NAC) spirulina, beta-glucan, glucosamine may help to reduce inflammation in the lungs from RNA viruses. It discusses the inflammatory storm in the lungs that leads to acute respiratory distress, organ failure and death with both influenza and coronavirus. It says that some of the supplements considered may also help boost type 1 interferon response to these viruses, which helps the body to create antiviral antibodies that fight the infection.
NAC is also used to thin mucus and help reduce bronchitis exacerbations. The article highlights how there is evidence from randomized clinical studies that NAC, as well as elderberry extracts, shorten the duration of influenza by two to four days and reduce the severity of infection, and notes that nutraceutical supplements such as spirulina, beta-glucan, glucosamine, and NAC have been found to reduce the severity of infection and sometimes cut the rate of death in half among animals infected with influenza (27).
Always consult a doctor or qualified primary health care provider prior to using alternative medicines or essential oils. Also, avoid excessive doses especially of concentrated substances, such as essential oils, which has been known to create severe sun sensitivity and other sensitivity syndromes. Caution and moderation is always advised.
It is important to promote trust and cooperation with health care professionals and public health messages, as well as to be wary of the over-reaching claims of “natural cure” scams which try to hitchhike on national crises such as the coronavirus pandemic.
The answers are seldom as simple as just taking a little garlic or doing hydrotherapy to get over it. We must be vigilant in fighting this outbreak and work as a community in cooperation.
While some of these modalities show promise as potentially beneficial adjunctive therapies for the treatment of COVID-19, further research is needed to establish their effectiveness as well as important contraindications and precautions. We should be extremely careful to avoid making exaggerated claims about the potential benefit of any of these methods or taking an extremist viewpoint that they should be adequate without seeking medical attention.
COVID-19 is very serious and highly transmissible, any carelessness could lead to rapid spread of the disease.
** Caution is always advised with the use of oils such as eucalyptus and other essential oils. It is important to monitor responses and cease use immediately and seek medical attention if there is any worsening of symptoms. Research shows conflicting results. One study showed that volatile aromatics such as eucalyptol, eucalyptus oil, camphor and menthol demonstrated surfactant-like effects which improved lung compliance values in vivo in rabbits, (30). Another study concluded that a product containing eucalyptus and other volatile oils had irritating effects on respiratory passages of a toddler which resulted in greater mucus obstruction of small airways and increased nasal resistance, 31. However, another study demonstrated that eucalyptus oil significantly reduced pro-inflammatory mediators, enhanced phagocytic activity and pathogen clearance, (32).
Theoretically, it should continue to be investigated as to whether results may have to do with the level of purity of the product, potential adulterating ingredients or plastics from the container, age, the amount of product used as well as individual responses to the product.
Further, eucalyptus oil should never be taken internally as it could be toxic (33).
(Numbers are omitted where
citation was not used).
1. Duan SM1, Zhao XS, Wen RF, Huang JJ, Pi GH, Zhang SX, Han J, Bi SL, Ruan L, Dong XP; SARS Research Team. Stability of SARS coronavirus in human specimens and environment and its sensitivity to heating and UV irradiation. Biomed Environ Sci. [Internet]. 2003 [cited 2020, Mar 23] Sep;16(3):246-55. Available at; https://www.ncbi.nlm.nih.gov/pubmed/14631830
2. First data on stability and resistance of SARS coronavirus compiled by members of WHO laboratory network [Internet]. [cited 2020, Mar 23]. Available at; https://www.who.int/csr/sars/survival_2003_05_04/en/
4. Ash, C., Dubec, M., Donne, K., Bashford, T. Effect of wavelength and beam width on penetration in light-tissue interaction using computational methods. Lasers Med Sci.[Internet] 2017; 32(8): 1909–1918. Available at; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653719/
5. Henderson, T.A., and Morries, L.D. Near-infrared photonic energy penetration: can infrared phototherapy effectively reach the human brain? Neuropsychiatr Dis Treat. 2015; 11: 2191–2208. Published online 2015 Aug 21. Available at; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552256/
6. Rothin, H.A., Byrareddy, S. N. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity, Available online 2020 Feb 26, 102433. Available at: https://www.sciencedirect.com/science/article/pii/S0896841120300469
7. Gray, R. Covid-19: How long does the coronavirus last on surfaces? Future (BBC) [Internet] 17 March 2020. Available at; https://www.bbc.com/future/article/20200317-covid-19-how-long-does-the-coronavirus-last-on-surfaces
8. Gunia, A. Will Warmer Weather Stop the Spread of the Coronavirus? Don't Count on It, Say Experts Time [Internet] 2020, Feb 28. Available at; https://time.com/5790880/coronavirus-warm-weather-summer/
9. Explained: Does heat kill the coronavirus? Too early to say. Indian Express [Internet] 2020, Mar 23. Available at; https://indianexpress.com/article/explained/explained-coronavirus-heat-kills-6299227/
11. West, H. How Garlic Fights Colds and The Flu. Health Line [Internet] 2016, Mar 17. Available at; https://www.healthline.com/nutrition/garlic-fights-colds-and-flu
13. Covid-19: BMA calls for rapid testing and appropriate protective equipment for doctors. BMJ [Internet] 2020, Mar 17; 368:m1099. Available at; https://doi.org/10.1136/bmj.m1099
15. Quartly, J. Exclusive: Chinese doctors say Wuhan coronavirus reinfection even deadlier. Taiwan News [Internet] 2020, Feb 14. Available at; https://www.taiwannews.com.tw/en/news/3876197
16. Geggel, L. These 5 mistakes could worsen the coronavirus outbreak. LiveScience [Internet] 2020, Mar 4. Available at; https://www.livescience.com/mistakes-could-worsen-new-coronavirus-spread.html
17. Woodward, A. High temperatures and muggy weather might make the new coronavirus less contagious, a group of experts says. 2020, Mar 18. Available at; https://www.businessinsider.com/coronavirus-cases-flu-like-drop-linked-with-high-heat-humidity-2020-3
19. K. H. Chan , J. S. Malik Peiris, S. Y. Lam, L. L. M. Poon, K. Y. Yuen, and W. H. Seto. The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus. Advances in Virology [Internet] Volume 2011 |Article ID 734690 Available at; https://doi.org/10.1155/2011/734690
21. Waymer, J. New research suggests heat, humidity could put a damper on coronavirus. Florida Today [Internet] 2020, March 21. Available at; https://www.floridatoday.com/story/news/local/environment/2020/03/21/new-research-suggests-heat-humidity-could-put-damper-coronavirus/2873866001/
23. Liu X, Baecker A, Wu M, Zhou JY, Yang J, Han RQ, Wang PH, Liu AM, Gu X, Zhang XF, Wang XS, Su M, Hu X, Sun Z, Li G, Jin ZY, Jung SY, Mu L, He N, Lu QY, Li L, Zhao JK, Zhang ZF. Raw Garlic Consumption and Risk of Liver Cancer: A Population-Based Case-Control Study in Eastern China. Nutrients [Internet]. 2019 Aug 31;11(9). pii: E2038. doi: 10.3390/nu11092038. Available at; https://www.ncbi.nlm.nih.gov/pubmed/31480423
24. Bayan, L, Koulivand, PH, and Gorji, A. Garlic: a review of potential therapeutic effects. Avicenna J Phytomed [Internet]. 2014 Jan-Feb; 4(1): 1–14. Available at;
25. Weber ND, Andersen DO, North JA, Murray BK, Lawson LD, Hughes BG. In vitro virucidal effects of Allium sativum (garlic) extract and compounds. Planta Med [Internet]. 1992 Oct;58(5):417-23. Available at; https://www.ncbi.nlm.nih.gov/pubmed/1470664
26. Van Beusekom, M. Studies profile lung changes in asymptomatic COVID-19, viral loads in patient samples. CIDRAP News [Internet], 2020, Feb 25. Available at; www.cidrap.umn.edu/news-perspective/2020/02/studies-profile-lung-changes-asymptomatic-covid-19-viral-loads-patient
27. NAC, Spirulina, Other Nutraceuticals May Play Role On Coronavirus Treatment. Science Blog. 2020, Feb 25. Available at; https://scienceblog.com/514404/nac-spirulina-other-nutraceuticals-may-play-role-on-coronavirus-treatment/
28. Murugesan S, Pandiyan A, Saravanakumar L, Moodley K, Mackraj I. Protective role of wild garlic on isoproterenol-induced myocardial necrosis in wistar rats. J Ethnopharmacol. [Internet] 2019 Jun 12;237:108-115. doi: 10.1016/j.jep.2019.03.049. Epub 2019 Mar 21. Available at; https://www.ncbi.nlm.nih.gov/pubmed/30905788
29. Garlic and Saquinavir Interactions. The Body Pro. [Internet] 2002, Feb 8. Available at; https://www.thebodypro.com/article/garlic-saquinavir-interactions
30. Zänker KS, Tölle W, Blümel G, Probst J. Evaluation of surfactant-like effects of commonly used remedies for colds. 1980;39(3):150-7. Available at; https://www.ncbi.nlm.nih.gov/pubmed/6893231
31. Abanses JC, Arima S, Rubin BK. Vicks VapoRub induces mucin secretion, decreases ciliary beat frequency, and increases tracheal mucus transport in the ferret trachea. Chest [Internet]. 2009 Jan;135(1):143-148. Available at; https://www.ncbi.nlm.nih.gov/pubmed/19136404
32. Yadav N, Chandra H. Suppression of inflammatory and infection responses in lung macrophages by eucalyptus oil and its constituent 1,8-cineole: Role of pattern recognition receptors TREM-1 and NLRP3, the MAP kinase regulator MKP-1, and NFκB. PLoS One [Internet]. 2017 Nov 15;12(11). Available at; https://www.ncbi.nlm.nih.gov/pubmed/29141025
33. Waldman W, Barwina M, Sein Anand J. [Accidental intoxication with eucalyptus oil--a case report]. [Article in Polish]. Przegl Lek. 2011;68(8):555-6. Article available at; https://www.ncbi.nlm.nih.gov/pubmed/22010466
34. Coronavirus Disease 2019 (COVID-19): How to protect yourself. Centers for Disease Control and Prevention [Internet]. Page Last Reviewed: 2020, Mar 18. Available at; https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html
35. Nickson, C. Prone Position and Mechanical Ventilation LITFL [Internet] Last update 2019, Mar 30. Available at; https://litfl.com/prone-position-and-mechanical-ventilation
36. Rabin, R. C. Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection. New York Times [Internet]. 2020, Mar 22. Available at; https://www.nytimes.com/2020/03/22/health/coronavirus-symptoms-smell-taste.html?fbclid=IwAR1NPduJR6XYoAY91v7e9MPv3ObNthIQlV1kLJN4dUWUOfYDzqjlyMHnklY