Drinking Bleach to Prevent COVID-19 Infection—Did This Really Happen?

Authored by: Venkat Rao

This story consists of two parts: Part One is the sensational information widely circulated, in 2020, including a June 2020 study published by the US Centers for Disease Control and Prevention (CDC) that nearly 30% of respondents in a survey reported engaging in high-risk practices that include putting bleach on skin, inhaling and ingesting household cleaners and disinfectants with the intent of preventing the COVID-19 infection. This report was part of the CDC’s Morbidity and Mortality Weekly Report, the authoritative weekly summary from the nation’s premier public health agency at a time when the entire nation was gripped with the fear of an unknown viral disease pandemic in progress. This turned out to be not true based on a evidence from recent studies.

Part Two is the more relevant scientific fact that bleach in various forms, hydrogen peroxide and other disinfecting chemicals and formulations have been tested as an oral, nasal and throat spray as countermeasure to managing symptoms of the upper respiratory tract infections. Scientific investigators have recommended a low concentration of bleach as a throat lavage to control and manage upper respiratory tract infections caused by viruses and bacteria. Note that early symptoms of SARS-CoV-2 infections are primarily nose and throat related symptoms, in a vast majority of COVID-19 patients, which is also the reason the diagnostic sampling is focused on swabs from nose and throat areas to detect the presence of the virus.

Part One:

A new study published a few weeks ago concluded there was no evidence Americans consumed bleach or other disinfectant as a cure or prevent COVID-19 infection in the early phase of the pandemic. Some Americans drinking bleach as a cure to COVID-19 was sensationalized by the news media. CDC published the results of an internet survey, in June 2020, reporting approximately one third of survey respondents engaged in high-risk practices such as using bleach on food products, applying household cleaning and disinfectant products to skin, and inhaling or ingesting cleaners and disinfectants to prevent getting infected with SARS-CoV2 virus and prevent its transmission. Note that the CDC survey reported a third of a randomly selected 502 US adults aged 18 and above in the survey engaged in these sorts of dangerous behaviors. This is by no means a fringe of the survey respondents, as it extrapolates to a staggering number of individuals at the national population levels. Did this really happen? Did such a large percentage of the US population resort in desperation to such high-risk behaviors to prevent COVID-19 infection?

Results of the recent survey published last week makes a stunning conclusion that survey respondents who are non-attentive respond randomly or misrepresent their responses on behavioral related survey questions impacting the outcome of surveys. Although the June 2020 CDC study results reported a third of the survey responded ingesting or improperly using bleach and other disinfectants, the latest report finds 100 percent of the self-reported ingestion of household cleaners were made by problematic respondents. When these inattentive, acquiescent, and careless responders were removed from the sample, the authors found no evidence that people ingested cleaning products to prevent a COVID-19 infection. The study with an academic posture concludes that best practices methodologies are necessary to identify and eliminate problematic respondents in self-reported online surveys.

Specifically, authors of the recent survey study state that participants who are inattentive and mischievous provide intentionally false response or responding to all survey questions “yes” in self-reported surveys yield poor quality results with unreliable data.

Self-reported surveys conducted in 2020 during the early phase of COVID-19, when psychological fear of the unknown was a dominating factor, the rate of respondent bias on self-reported behavior such as ingesting cleaning products are prone to misleading conclusions. A crucial flaw in self-reported surveys performed online concluded a high probability of invalid response, based on a collection of online surveys comprised of 6,995 students on violence and intimidation in college campus found careless response and exaggerated response as two key areas rendering the data as unreliable. Compared with honest responders, invalid responders were significantly more likely to report forms of victimization and a greater negative impact from physical abuse or sexual assault on college campus, which significantly skews the results to wrongly overestimate the nature and scope of the problem under study.

Tragically, these misleading studies, including the 2020 CDC survey study results. were amplified in the national mainstream media and social networks without due consideration for invalid and careless responders. Given the anomalous response from survey participants, it is safe to assume that CDC investigators were aware of the problematic responders who could alter the study results, as considerable historical data exists since the 1970s, in survey studies, on self-reported illicit drug use where 4% of responders named consuming non-existent drugs, and that these respondents were much more likely to report using other drugs (when they actually were not drug users) is an indication of the propensity for careless responding and acquiescence bias in self-reported surveys.

What is acquiescence bias? Acquiescence bias, also known as the agreement bias, is a tendency among some respondents in interviewer-administered surveys to agree with a survey statement, without actually being a true reflection of their own position. Stated differently, a survey participant when asked to confirm or deny a statement with a “yes/no,” “agree/disagree” type binary choices. Several publications report careless response and acquiescence bias in surveys on mental health, job satisfaction, and drug use compromising the legitimacy and quality of research findings particularly those holding crucial public health and health security significance.

According to the just published study cited above, problematic responders in the 2020 surveys responding the way they did at a juncture when the horror of SARS-CoV-2 virus transmission and risk of contracting COVID-19 was at its highest was beyond statistical terminologies such as acquiescence bias and belong more in the category as an arsonist who intentionally sets a fire in order to destroy a valuable.

Part Two:

In fact, disinfectants are used in various forms to manage upper respiratory tract infections. Use of disinfectants to treat viral and bacterial infections is not particularly abnormal. This might sound strange, but we apply disinfectants of various kinds and in different formulations mostly as a measure to prevent infection. Here are some well-known examples:

Hydrogen Peroxide: Frequently used both at home and hospitals, hydrogen peroxide, like bleach is part of many home-use products at homes for cleaning, disinfection, and to treat minor cuts and scrapes. As a topical irritant and antimicrobial, hydrogen peroxide is used to wash and disinfect wounds. Popular mouth washes such as Listerine, Colgate Peroxyl and Cepacol with 1 to 1.5 percent hydrogen peroxide when properly used as a mouth rinse as part of oral hygiene prevents gum infection and inflammation.

Published literature is replete with benefits of hydrogen peroxide gargle to prevent or manage sore throat infections. Many commercial throat sprays and gargles containing hydrogen peroxide are available to relieve pain and symptoms associated with sore throat. A recent comprehensive review of the published research studies on the effects of hydrogen peroxide on nasal surface concluded that its use as nose/mouth/throat wash may enhance natural physiologic defensive responses to viral infection and help protect against the ongoing coronavirus pandemic.

On the contrary, a prospective clinical pilot study on the effects of 1% hydrogen peroxide when used as a mouthwash against SARS-CoV-2 on 98 COVID-19 positive patients concluded that the mouthwash did not have any significant antimicrobial effect on the virus, although the infectivity (meaning viability) of the mouthwash treated virus could not be established. The results were ambivalent and the procedure was not recommended for SARS-CoV2 infection prevention.

Sodium Hypochlorite (Bleach): Sodium hypochlorite is generally referred to as bleach. Sodium hypochlorite is the active ingredient of liquid bleach. Unlike household bleach, which yields 3 to 5% available chlorine for disinfectant effect, sodium hypochlorite is extremely powerful yielding up to 95.2% available chlorine. Sodium hypochlorite (bleach) based nasal sprays have demonstrable infection control properties.

A clinical study on use of sodium hypochlorite solution as a nasal spray to treat Staphylococcus aureus infection in the nose and throat used 0.05% sodium hypochlorite. Patients receiving 0.05% sodium hypochlorite as a nasal lavage (spray) twice daily for three months had significantly improvements in nasal swelling and secretion and were in a much better condition compared to those in the control group. The results indicated sodium hypochlorite as a nasal spray is a good alternative for clearing nose and pharynx in patients with upper respiratory tract infections. Note, that early clinical symptoms of the SARS-CoV-2 infection are predominantly upper respiratory tract related manifestations.

It is unclear if subject matter experts at CDC approved release of a fallacious self-reported survey results without adequate peer-reviews when an abnormally high percentage of nearly 30% reported applying, inhaling and ingesting bleach to prevent coronavirus infection; and release the report at a time when the fear over the spread of coronavirus entirely consumed the national psyche in the early phase of the COVID-19 pandemic. It is safe to assume CDC biostatisticians were aware of acquiescence bias in self-reported surveys as a serious confounder when interpreting surveys with serious health security implications such as public consuming and inhaling bleach to prevent COVID-19, and when misinformation and disinformation was rampant on the social media and mainstream media sources. No other federal entity other than CDC is more relevant and considered trustworthy compared to other agencies by the public facing a dangerous public health crisis such as the COVID-19 pandemic. Science-based policy making is the steadfast principle set by the federal government when it comes to setting policies and decision making to protect human health and the general environment. Unfortunately, response to COVID-19 pandemic in some ways did not live up to the laudable aim of using science as evidence in pandemic response.