A ‘Cure’ for the Common Cold - and Other Respiratory Diseases

Since we are now well past the 2nd anniversary of the first UK Covid lockdown (March 23rd), I thought it might be useful to review what we've learnt from the pandemic over the last two years, and make some suggestions as to how to apply some of this to help us all prevent respiratory infections in future.

Most of us generally suffer from 2-3 bouts of common cold symptoms each year. If we assume that each bout involves symptomatic discomfort for 8-10 days before the infection subsides, this equates to between 16 and 40 days of (albeit mild) illness per year.

A ‘cure’ for the common cold would thus be a major prize for humanity – as indeed it would be for the Pharmaceutical Industry.

Unfortunately, despite much scientific effort, no one has yet come up with one, and for very good reason. The origin of most of these infections is viral, and as we have seen with SARS-CoV-2, viruses are resourceful adversaries and are positively legion in their type and properties.

To give you an idea of the breadth of the problem, there are no less than four Coronavirus strains already endemic to our population which are known to cause common cold-like symptoms. These, together with a multitude of different Rhinoviruses, etc., are adept at infecting us, and all of them are capable of mutating away from our existing natural immunity, which in any case naturally fades within 2-3 months of an infection. And, of course, there is the perennial threat from Influenza, which is potentially fatal, particularly in older age groups. This is sufficient even in these straitened times to justify the NHS providing free annual flu jabs in vulnerable groups in attempt to minimise the ‘natural’ death toll from seasonal epidemics. Vaccination, however, is just not a practicable way of dealing with the whole gamut of different respiratory viruses out there, so we need to find another way….

One thing the Covid19 pandemic has taught us is that it is possible to minimise your risk of infection by changing your own behaviour. My own experience has been a useful lesson, which I think might benefit others….

I caught Covid19 in February 2020 at the start of the pandemic and fortunately managed to survive it without major issues at the time or, mercifully, any evidence of 'Long Covid'. Prior to March 2020 I had been plagued with full blown colds on a regular basis between 2 and 3 times per year, together with many intermediate bouts of ‘the sniffles’, which didn’t progress beyond early symptoms. On each occasion where the infection progressed, I suffered the usual discomfort for up to 10 days before shaking off the virus.

In the 21/2 years since then I have not succumbed to a single respiratory infection, and have only experienced a few short bouts of the sniffles. Although I have been triple-vaccinated against SARS-CoV-2, this would not be expected to protect completely against Covid infection or even mild symptoms. It would certainly not account for the complete absence of other viral infections. So what else could account for this rather startling observation ?

The answer is almost certainly changes in behaviour, both my own, and that of others.

We were all subject to several lockdowns in UK, which of course did help reduce personal contact and hence transmission. After the lockdown ‘era’ came to an end last March, there has been a slow return to what I would call more ‘normal’ behaviour with few people now wearing masks in shops and other busy indoor public venues, or even on public transport. It’s noteworthy that there has been a significant increase in Covid case rates over time, and this has been superimposed on a high starting level. Current estimates for England (July 2022) are that approximately 1 in 15 people has the virus, with Scotland and NI considerably worse off than this. There has also been a parallel, if slightly delayed, rise in hospital admissions, and, sadly, this time round in the death toll. This is almost certainly due to a combination of increased infectivity of the Omicron B.2, and more recently B.4 and B.5 variants, waning immunity and the relaxation of preventive behaviour.

Homo Sapiens is noteworthy for its ability to adapt to its circumstances…and learn from its mistakes. Perhaps we should take the opportunity to do so now…….

Changing our behaviour will not only reduce the risk of Covid rearing its ugly head again, resulting in (perish the thought !) yet more lockdowns, but it could also help minimise our exposure to the multitude of other viruses and bacteria to which we have little or no immunity. A de facto ‘cure’ for the common cold could actually already be at our disposal – in the form of active prevention.

There is plenty of common-sense Covid guidance available on Government and local authority websites, much of which is very relevant to controlling the spread of other respiratory viruses, and I won’t attempt to re-hash all this here.

Here are some additional practical tips which I have adopted since Day 1 of the pandemic, and I believe have stood me in good stead over the past 2 years. You won’t necessarily find all of these in general guidance:

1) Public Transport: As a pensioner without alternative means of transport, and a bit too old now to cycle everywhere as I once did, I regularly find myself having to use public transport. This has enabled me to see at first hand how other passengers behave - and tailor my own behaviour accordingly. On balance, the message I would give at this moment in time is:

If If you don’t have to use PT, then don’t……you will be sharing your bus or train (or aircraft !) with significant numbers of potentially infected individuals during the course of your journey, and although bus and train companies have done their best to provide hand-sanitisers, regular cleaning of handrails & interiors, etc, it’s just not practicable to decontaminate everything continuously. Aircraft are also a particular infection risk, given that cabin air is continually recirculated. It is also very dry and supplied at reduced pressure, which causes additional stress to nasal and bronchial mucosa, thus increasing susceptibility to infection. Masks do help a little in reducing viral shedding via droplets, but won't usually protect the wearer against infection.

Many service buses and coaches have all their windows firmly shut especially in the winter months despite exhortations by bus companies to keep them all open. Not surprising, perhaps, when it’s snowing and the temperature is close to freezing, but certainly not conducive to infection control. The continuous flow of passengers on and off buses in particular, and the high prevalence of Covid I’ve already discussed, ensures a high risk of coming into contact with the virus. If you do really need to use buses or trains:

a) a) wear a mask at all times,

b b) wear a thin pair of gloves when getting on and off the bus or train to avoid touching potentially contaminated handrails and seat backs with bare hands, and

c) c) avoid sitting next to anyone on a double seat if at all possible.

If If you spot anyone sitting near you (especially in the seat immediately behind you) with obvious respiratory symptoms, move to another part of the bus. If a bus or train looks particularly crowded as it approaches you, think about waiting for the next one.

The golden rule is – assume everything you touch or breathe in is contaminated and try to minimise any ‘dose’ you might receive from that source. Most viral infections are dose-dependent – there is generally a threshold dose below which your innate immune system will manage to ward off infection.

2) Personal contact: We are a social species and used to frequent personal contact. Generally, during a pandemic it’s best to avoid physical contact altogether with anyone you don’t actually live with. This may still appear unnatural, but we have come to accept the need for it now as a result of Covid, so continuing the habit shouldn’t cause any embarrassment going forward. Minimise contact and close approach wherever possible and again, keep an eye out for anyone exhibiting respiratory symptoms.

Now that legal restrictions have gone, we should expect the return of widespread coughing and sneezing in public, and the best course is – keep clear ! If you have symptoms yourself, stay at home – your colleagues and friends will be grateful for your consideration in not passing the infectious agent on to them, particularly in the workplace. I realise much of this will be difficult for those living with others to put into practice, particularly multi-generational households or families with small children. As many parents will already know, young kids are acknowledged experts at passing on infections to their elders, and have an irritating habit of bouncing back while their parents suffer for weeks thereafter with the same bug (commonly known as the ‘playgroup syndrome’). We are social animals after all, but keeping a weather eye out for obvious sources of infection and taking basic precautions can make a significant difference even in these circumstances.

3) Shopping: Most of our larger supermarkets in UK are extremely well ventilated and have become much more conscious of infection control over the past 2 years. You are unlikely to pick up anything airborne, unless the aisles are very crowded, or checkout queues become too close-packed. Smaller shops are more of a problem, but minimising the time spent in-store should help. There is one obvious potential contamination source, however which most shoppers seem unaware of – touch screen-controlled checkout terminals.

Despite the heroic efforts of staff to keep these ubiquitous devices clean that I’ve seen in some venues, it’s virtually impossible to decontaminate each screen after every customer. Also, because of the way the software is designed, users must all touch the screen within the same small area, thus maximising their risk. Look at the next screen you use and note the smudges in certain well-defined areas of the screen - this should convince you.

A A good practical solution is to carry a touch pen, and use this when checking out. You can make one of these yourself very simply and cheaply – I’ve added an illustration at the end of this article to show you how (see Appendix 1). You can also use the pen for other venues using ‘communal’ touch-screens. Supermarket basket handles are another potential source of contamination – use hand sanitiser when you leave the store if it’s available and remember to wash your hands thoroughly when you get home. If in doubt, wear thin gloves during your shop, as suggested above for PT.

4) Entertainment Venues: These vary widely in their layout and popularity, as do the risks associated with them. Although most have done their best to install and maintain infection controls, including more effective ventilation, there is always an enhanced risk where people crowd together, particularly where alcohol is freely available and our ‘guard’ is relaxed as a result. Now that legal restrictions on numbers and behaviour in such venues are no more, expect a gradual loosening of controls, and the inevitable changes in behaviour that will accompany it. Night clubs and discos probably constitute the greatest risk – avoid these wherever possible. If you must frequent them, use your common sense to minimise your exposure.

Vaccination: Our principal defence against SARS-CoV-2 and seasonal influenza is vaccination. We know from our 2 years experience so far with Covid that immunity to this virus fades rapidly and requires 'topping up' every 6 months. As already discussed, it is likely that the current resurgence of Covid throughout UK is at least in part due to waning immunity. DOH instituted a new booster campaign in Spring 2022, but unfortunately this only applied to the over 75s and other groups deemed particularly vulnerable. DOH have just announced an Autumn booster campaign in which as many over 50s as possible will be offered the latest flu vaccine and the recently approved bivalent Moderna Covid vaccine.This is certainly sensible and opportune, but may run into logistic delivery problems due to Moderna's limited production capacity (see my recent blog for more details). Since most over 60s will have had their 1st boosters in mid to late autumn 2021 and will be well over a year without a boost, it is important that everyone possible is re-immunised. It goes without saying that if you are eligible you should take anything offered without delay to help preserve your immunity.

You might get the impression that all these precautions are somewhat OTT and perhaps even a little alarmist. The sad fact is that they aren't….

As social animals, we naturally tend to interact physically and this is the ‘stock in trade’ of most viruses. If they were sentient beings rather than just incredibly devious molecular machines, they would regard us as ideal hosts to inhabit. This is because of the ease with which our close interactions allows them to carry out their principal task, which is to hijack our cells to produce more copies of themselves...and then make us spread these to other hosts. As the most numerous mammalian species on the planet, we're also the most widely available host, and of course the most capable of spreading them far and wide.

Because of this, we are now, unfortunately, at an ever-increasing risk of future pandemics going forward. Not only is our population already far too large to sustain comfortably at its current levels on our small planet, but it is still increasing uncontrollably, and our economic situation is worsening by the day. This is due to a combination of climate change, dwindling natural resources and food stocks, and more recently, war on our own doorsteps in Europe.

The resulting increasing in stress on our populations will inevitably weaken their defences against opportunistic pathogens of all descriptions. Even if SARS-CoV-2 becomes endemic and doesn’t mutate to generate more damaging variants, and we are able to maintain our immune defences against it effectively with boosters, we can expect a new pandemic to occur within the next few years.

Statistically, this is most likely to be respiratory, and originate in China or South East Asia, where traditional practices involving the handling of exotic animal species are still widespread. It could, however, 'break out' anywhere, given our continued obsession with unrestricted and affordable long-distance passenger air travel. The next pandemic virus is also likely to be much more severe in its effects - SARS-CoV-1 (China, 2003) had a 'kill rate' of ca 10%, while MERS-CoV (Middle East, 2011) was even more devastating at 35%, and is still circulating in some areas of the Middle East. We were extremely lucky that SARS-CoV-2 has (so far !) had such a low kill rate (ca 0.5%) in comparison with the first two.

Existing bacterial diseases are also starting to rear their ugly heads again in antibiotic-resistant forms e.g. Tuberculosis. Drug developers and governments alike are only now starting to wake up to the fact that our existing stock of antibiotics has barely changed in the last 30 years, and is rapidly being outrun by bacterial resistance. Let's hope the Pharmaceutical Industry's research effort becomes more directed towards where it's really needed in future, and isn't determined by profit expectations alone.

Basic personal precautions such as those I’ve outlined above will help provide at least a temporary shield against anything new and nasty that appears, and will also help you ward off the usual 'milder' irritants like colds and ‘flu.

If you live with others, it's even more important that you consider precautions when out and about. The reasoning is simple - it's virtually impossible to avoid catching a infection if you live with someone who is infected. By not bringing a viral or bacterial infection in to the household through outside contact, you will be protecting both yourself and those you live with from avoidable suffering......and minimising the risk of further spread through your community.

You can find a more detailed discussion of Covid vaccine design on my Covid19 page.

Update: A very recent article in the news has confirmed my suspicions that the type of precautions I've suggested may not just help ward off respiratory diseases.

Published research has shown a marked drop-off in GI tract infections such as Norovirus during the first few months after Lockdown 1 (see https://www.bbc.co.uk/news/health-60819716).

We've all learnt to avoid our bad habits of the past as a result of Covid - let's not lose the advantage and go back to them again.....

I hope these thoughts will prove useful – remember, governments can't (and shouldn't !) legislate for everything – it’s really up to us now…..

Revised 20.8.22

Appendix 1: Preparing a Simple Touch Pen

You’ll need only the 4 items shown in Figure 1 for this task: an old ballpoint pen, a small section of aluminium foil (can be new or even recycled provided it’s grease free), A roll of clear adhesive tape and a pair of scissors.

1) Remove the used ink refill from the pen body. This is usually possible with fingers but you may need a pair of pliers if it is firmly embedded.

2) Cut the aluminium foil to size as shown in Fig. 2 such that you have enough to encircle the pen body completely 2-3 times. Leave enough at either end to cover the ends of the pen.

3) Roll the foil firmly round the pen body without tearing it. Press in the ends to give an even surface – this will prevent scratching of plastic screen surfaces.

4) Use the adhesive tape to keep the foil in place – remember to leave enough bare foil to make contact with your fingers when using the pen.

You should find this simple device works on most touch screens – these usually work by detecting the static charge which normally accumulates on your fingers. The pen will channel this to a point at its contact with the screen. It will even work when wearing thin gloves if you wear them and avoids having to take them off when paying.

One caveat – I’d recommend you don’t attempt to use this design of touch pen on mobile phone or tablet touchscreens. The plastics used for these are often very sensitive to scratches, and the aluminium foil used can scratch the surface. Use a commercial touch pen variant with a rubber tip instead. This doesn’t normally apply to commercial touchscreens such as those used by automated tills.

Figure 1: Items Needed