When relevant, posts are sponsored or contain affiliate links. Read More

Could Budesonide Cure Covid? Let the Facts Speak! (Part One)

Last updated on July 18th, 2020

Dr. Richard Bartlett promotes Budesonide (a common asthma medication) to treat Covid19. Is his new protocol worth trying? Let’s check the facts.

This is Part One of a living document in response to Dr. Richard Bartlett’s interview on ThriveTime radio, his earlier interview on America Can We Talk, and his white paper. See my Notes and Disclaimers and Medical Review Update below, and the remainder of this article at Could Budesonide Cure Covid? (Part Two). All opinions are my own. This is not medical advice. I’d love your feedback (especially corrections or improvements to this post) – just add a comment to the sticky post on my Facebook business page.

Update July 18, 2020: Changed #7 & 8 to “True” and added a link to many more studies in support.

Overview

  1. Budesonide is a Safe, Common Asthma Medication (Fact Check: Appears to be true)
  2. Budesonide Delivered A 100% Clinical Success Rate (Fact Check: Insufficient data. But his at-risk patients call the procedure life-saving.)
  3. Budesonide Is A “Perfect Match” For Covid (Fact Check: Inconclusive. On the one hand Budesonide appears to be a good match for blocking the cytokines, on the other hand, some researchers don’t think cytokines are the issue.)
  4. Other Countries Are Using Similar Protocols (Fact Check: Sort of. Japan, Spain, Oxford, and China are testing similar protocols. But I couldn’t find any studies for inhaled steroids in Taiwan, South Korea, France, or NIH. France has studied anti-inflammatories, and South Korea’s Celltrion is working on a “therapeutic antibody treatment.”)
  5. Early Treatment With Inhaled Steroids Is Why Taiwan, South Korea, And Japan Have So Few Deaths (Fact Check: Empirical /clinical treatment data is hard to find; all three countries used strict isolation/quarantine/tracing measures to contain the virus.
  6. The Current Standard Of Care Globally Is Go Home And Tough It Out (Fact Check: True)
  7. Social Distancing, Protective Gear, And Masks Are Insufficient (Fact Check: True)
  8. Masks Increase Virus Exposure of Asymptomatic Wearers, Raising Risk of Illness (Fact Check: True. “Cloth mask wearers had higher rates of infection than even the standard practice [unmasked] control group of health workers.”)
  9. COVID Is A Rapidly Mutating Virus, Making Vaccine A Losing Strategy (Fact Check: Inconclusive. True that Iceland reported 291 mutations in April, but vaccine researchers say they’re all very similar, meaning significant change is slow.) [ACCESS PART TWO]
  10. Early Treatment with Budesonide via Nebulizer is the Current Best Strategy (Appears to be True.)
  11. The US Should Consider Making This Treatment Available Because It’s Already FDA-Approved For Asthma (Controversial, especially if the protocol is misrepresented. And it has been.)
  12. Naysayer: World Magazine Doctor Says Patients May Have Survived Without Treatment (Fact Check: Of the hundreds of cases Dr. Bartlett has treated, he prepared only two case studies. But as noted above his at-risk patients call the procedure life-saving.)
  13. Naysayer: Dr. Larry Wilson Says No Proven Benefit (Fact Check: Ignores Dr. Bartlett’s success. Bias exposed by comments to the article.)
  14. Naysayer: Midland Reporter-Telegram (Fact Check: Misrepresents comments.)
  15. Other Naysayers: Cheap Steroid Treatment Naysayers (Example of how naysayers criticize incomplete information while people are dying for lack of an effective treatment.)
  16. Supporters
  17. Contact Dr. Richard Bartlett
  18. Conclusion (Safe enough to warrant further exploration.)

1. Budesonide is a safe, common asthma medication

“Budesonide is safe enough for 2-pound premie babies in the  ICU, and fragile elderly patients in nursing homes. It’s got a safety profile is like no other. This medicine is a preventative for asthma. 25 million people in the US have asthma including second graders and they use it. The medicine is prescription but the nebulizer is not. The medicine is around $200 cash, the nebulizer is about $37.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: True. Budesonide has been used in neonatal care, is well tolerated in children with asthma, serious side effects are possible but rare. It is not recommended for children under age six.

Neonatal Use of Budesonide

Luo HJ et al. found budesonide can improve pulmonary ventilation and diffuse function in the treatment of neonatal aspiration pneumonia.15 For premature infants,16,17 budesonide nebulization can relieve mechanical ventilation induced airway inflammation and prevent the incidence of bronchopulmonary dysplasia.

Li B, Han S, Liu F, Kang L, Xv C. Budesonide Nebulization in the Treatment of Neonatal Ventilator Associated PneumoniaPak J Med Sci. 2017;33(4):997-1001. doi:10.12669/pjms.334.12907

Budesonide Safe for Infants and Children

In the United States the tolerability and efficacy of budesonide inhalation suspension were confirmed in 3 placebo-controlled multicenter trials. These studies demonstrated that both once- and twice-daily dosing of budesonide inhalation suspension (0.25-1 mg) improved pulmonary function and ameliorated asthma symptoms in infants and young children with persistent asthma.

Szefler SJ, Eigen H. Budesonide inhalation suspension: a nebulized corticosteroid for persistent asthmaJ Allergy Clin Immunol. 2002;109(4):730-742. doi:10.1067/mai.2002.122712

Short- and long-term treatment with budesonide inhalation suspension, using a wide range of doses, is safe and well tolerated in children with asthma.

NIH (July 2004): Safety Profile of Budesonide Inhalation Suspension in the Pediatric Population: Worldwide Experience (Ann Allergy Asthma Immunology. 2004 Jul;93(1):83-90. doi: 10.1016/S1081-1206(10)61451-2)

In summary, based on 25 years of experience with different doses and in different populations, inhaled budesonide therapy only in very rare cases appears to be associated with [side effects such as] an increased risk of adrenal crisis, reduction in final height, increases in the number of fractures or complications during pregnancy.

Christensson, C., Thorén, A. & Lindberg, B. Safety of Inhaled Budesonide. Drug-Safety 31, 965–988 (2008). https://doi.org/10.2165/00002018-200831110-00002

Efficacy and Safety of Budesonide is Well Supported

Budesonide is… now one of the most widely used lung medicines worldwide. Inhaled budesonide’s… properties allow it to reach a rapid and high airway efficacy… When absorbed from the airways and lung tissue, its moderate lipophilicity shortens systemic exposure.. [and it has] a low risk of adverse events. There is a large volume of clinical evidence supporting the efficacy and safety of budesonideBudesonide remains one of the most well-established and versatile of the inhaled anti-inflammatory drugs.

(NIH): Tashkin DP, Lipworth B, Brattsand R. Benefit:Risk Profile of Budesonide in Obstructive Airways Disease [published correction appears in Drugs. 2019 Nov;79(17):1911]. Drugs. 2019;79(16):1757-1775. doi:10.1007/s40265-019-01198-7

LactMed: Summary of the effect on breastfeeding (“The amounts of inhaled budesonide excreted into breastmilk are minute and infant exposure is negligible… Most experts consider oral and inhaled corticosteroids, including budesonide, acceptable to use during breastfeeding.”)

Budesonide Drug Info, Precautions and Side Effects

NIH: Drug Info for Budesonide (“Children younger than 6 years of age should not use this medication.”)

Medline Plus: Precautions for Budesonide (In addition to pregnancy status, known allergies, certain diseases, recent injuries, sores, or infections, “tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.”)

Medline Plus: Budesonide Possible Side Effects (“Some side effects can be serious [list omitted]. Talk to your child’s doctor if your child needs to use this medication for more than 2 months per year.”)

See also the Mayo Clinic’s article on Budesonide.

2. Budesonide delivered a 100% clinical success Rate

Dr. Bartlett says he’s had a 100% success rate, even with people who are obviously at-risk. He and other doctors have used the therapy since March, treating hundreds of high-risk patients, with zero deaths, 100% recovery. Doctors in a town south of San Antonio saw his interview and read his white paper with 51 qualified sources, used the protocol and cleared every case out of their ICU. They emptied the ICU in a day. (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: Inconclusive. I have not confirmed the story with the hospital yet and will update if I can reach someone willing to comment on or off the record. But at News9West: COVID patients defend Dr. Bartlett’s ‘silver bullet’ medicine regimen. His at-risk patients call the procedure life-saving.

Dr. Bartlett’s Testimonials

More testimonials: Jaime Rodriguez, Eric Rodriguez, Francisco  Vejarano, Kathy Loller. (I haven’t been able to track these down yet.)

Dr. Bartlett says: Kathy spent five days in bed with a fever that wouldn’t break. She was already being treated for two kinds of cancer. “She called me Friday night with shortness of breath could not breathe, her granddaughter had tested positive for Covid. She said “I think I have it.” I said “I’m sure you do.” She began the treatment that night. That night the fever broke and Monday she worked an eight-hour day. Since then she continues to undergo cancer treatments. She’s had two negative Covid tests since completing treatment. (This appears to be Patient #1 of the case studies, but the case study does not mention shortness of breath.)

3. Budesonide is a “perfect match” for Covid

“There is tons of research on Budesonide showing that it blocks the inflammatory release of these cytokines which are in Covid. It blocks the release of these inflammatory cytokines that are in Covid all of them, all 30 of them. If you overlay the enzymes and cytokines that are released with Covid with what this blocks, it’s a perfect match. It’s simple enough for them to self administer to protect themselves from asthma, an inflammatory respiratory disease. Covid is a super-inflammatory respiratory disease. And for 20% of people it could be a killer.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: Inconclusive. On the one hand Budesonide appears to be a good match for blocking the cytokines, on the other hand, some researchers don’t think cytokines are the issue (I read another article besides the two listed here, but forgot to record it).

In conclusion, budesonide and fluticasone propionate, in concentrations that probably occur in the airway lining fluid during inhalational therapy, inhibited cytokine release from human lung epithelial cells (IL‐6, IL‐8) and alveolar macrophages (TNF‐α, IL‐6, IL‐8). In vitro , the onset of this effect was rapid.

Ek, A., Larsson, K., Siljerud, S. and Palmberg, L. (1999), Fluticasone and budesonide inhibit cytokine release in human lung epithelial cells and alveolar macrophages. Allergy, 54: 691-699. doi:10.1034/j.1398-9995.1999.00087.x

Cytokine profile of COVID-19

News Medical: Common cytokine profile in ARDS, severe COVID-19 and sepsis (“In other words, say the researchers, “these data suggest that a “cytokine storm” in COVID-19 that is distinct from other critical illness (e.g., sepsis and ARDS) is unlikely.” Instead, they suggest, the elevated cytokines are merely what should be expected in any critically ill patients.” However, this study was done on severely ill patients, and Dr. Bartlett’s protocol works best with early intervention, so this study may be moot.)

4. Other countries are using similar protocols

“Taiwan is using this. South Korea is doing the same thing they’re doing the research to prove that works after the fact. Taiwan has 24 million people on a tiny island, they don’t have the space for social distancing they’d be bobbing in the ocean with their masks on. They’re studying a variety of inhaled steroids and using a strategy of early treatment with steroids. In South Korea, a country of over 50 million people, they’ve had less than 300 deaths during the entire pandemic.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

“Other countries are doing the study to back it up but they’re not waiting until the study is completed to use it. Because it is safe. They’re studying this in France, they’re studying it with the NIH. The results will be out in October but I’m not gonna wait until October to treat my patient who needs to breathe today. The patients are not experimental rat lab rats. They’re people and they’re trying to do what they can to help them breathe.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: Japan, Spain, Oxford, and China are testing similar protocols. But I couldn’t find any studies for inhaled steroids to treat Covid19 in Taiwan, South Korea, France, or by NIH. France has studied anti-inflammatories, and South Korea’s Celltrion is working on a “therapeutic antibody treatment.”

Japan Budesonide Inhalation Study

These results suggest that inhalation of BUD after viral infection has beneficial effects on asthma. Conclusion: Late addition of BUD may benefit among patient with viral infection and type 2 allergic airway disease such as asthma.

Homma, T.; Fukuda, Y.; Uchida, Y.; Uno, T.; Jinno, M.; Kishino, Y.; Yamamoto, M.; Sato, H.; Akimoto, K.; Kaneko, K.; Fujiwara, A.; Sato, H.; Hirai, K.; Miyata, Y.; Inoue, H.; Ohta, S.; Watanabe, Y.; Kusumoto, S.; Ando, K.; Suzuki, S.; Yamaoka, T.; Tanaka, A.; Ohmori, T.; Sagara, H. Inhibition of Virus-Induced Cytokine Production from Airway Epithelial Cells by the Late Addition of BudesonideMedicina 202056, 98.

Spain Inhaled Budesonide Pneumonia Therapy Trial

Treatment With Inhaled Corticosteroids in Patients Hospitalized Because of COVID19 Pneumonia (Randomized, prospective, controlled open label clinical trial aimed at investigating if the addition of inhaled corticosteroids (budesonide) reduces treatment failure…)

Sara Varea, Fundacion Clinic per a la Recerca Biomédica, Inhaled Corticosteroid Treatment of COVID19 Patients With Pneumonia, ClinicalTrials.gov Identifier: NCT04355637

OXFORD INHALed Budesonide Study

Early data from multiple studies in China, where the virus originated, show that severe cases of CoVID-19 are not as prevalent in patients with chronic lung diseases as expected. This data has been confirmed by the Italian physicians. The investigators think that the widespread use of inhaled corticosteroids reduces the risk of CoVID-19 pneumonia in patients with chronic lung disease. Early microbiological data also shows that these corticosteroids are effective at slowing down the rate of coronavirus replication on lung cells.

Intervention/treatment: Budesonide inhaled via dry powder inhaler, 400 micrograms per inhalation, 2 inhalations twice a day

University of Oxford, STOIC study, ClinicalTrials.gov Identifier: NCT04416399

CHINA TCZ INHALATION THERAPy

Journal of Medical Virology (China 4/6/2020): Tocilizumab treatment in COVID‐19: A single center experience (TCZ appears to be an effective treatment option in COVID‐19 patients with a risk of cytokine storms. And for these critically ill patients with elevated IL‐6, the repeated dose of the TCZ is recommended.)

Anti-Inflammatory Studies

Science Direct (May 2020): The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China (“Inflammatory cytokine storm was common in patients with severe COVID-19. A timely anti-inflammation treatment at the right window time is of pivotal importance.”)

The Lancet (2/27/2020): COVID-19: combining antiviral and anti-inflammatory treatments (“Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are characterised by an overexuberant inflammatory response and, for SARS, viral load is not correlated with the worsening of symptoms… Baricitinib, fedratinib, and ruxolitinib are potent and selective JAK inhibitors approved for indications such as rheumatoid arthritis and myelofibrosis. All three are powerful anti-inflammatories that, as JAK–STAT signalling inhibitors, are likely to be effective against the consequences of the elevated levels of cytokines (including interferon-γ) typically observed in people with COVID-19… Use of this agent in patients with COVID-19 over 7–14 days, for example, suggests side-effects would be trivial.”)

News Medical (Singapore 7/10/2020): Laboratory testing confirms effectiveness of BETADINE antiseptic products against SARS-CoV-2

France: has studied an anti-inflammatory drug, Anakinra (Kineret®) – a “Disease modifying Anti-rheumatic Drug” (American Society of Health-System Pharmacists: ASHP Assessment of Evidence for COVID-19-Related Treatments: Updated 7/2/2020)

Reuters (3/14/2020): France warns against use of anti-inflammatory drugs to tackle coronavirus

5. Early Treatment with Inhaled Steroids is Why Taiwan, South Korea, and Japan have so few deaths

Dr. Bartlett points to low mortality numbers in Taiwan, South Korea, and Japan as evidence his protocol works, saying that similar protocols are being tested there. (Source: Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: Inconclusive. That’s not the whole story. All these countries used early contact tracing and aggressive isolation measures to limit the spread. And, as noted above, Japan, Spain, Oxford, and China are testing similar protocols but I couldn’t find any in Taiwan or South Korea. I’ve been unable to find data on what they’re doing in hospitals.

Taiwan

Stat (6/30/2020): Learning from Taiwan about responding to Covid-19 — and using electronic health records (“The availability of almost immediate data on patient visits allowed the country to efficiently identify, test, trace, and isolate cases. This has dramatically reduced Covid-19 spread without the need for extensive lockdowns.”)

NIH (3/25/2020): Initial rapid and proactive response for the COVID-19 outbreak — Taiwan’s experience (“At the early stage of the outbreak, the strategy in Taiwan had three pillars: real-time surveillance with rapid risk assessment, border control and quarantine, and laboratory capacity building.”) (Citation: Cheng HY, Li SY, Yang CH. Initial rapid and proactive response for the COVID-19 outbreak – Taiwan’s experience. J Formos Med Assoc. 2020;119(4):771-773. doi:10.1016/j.jfma.2020.03.007)

NIH (2/12/2020): The outbreak of COVID-19: An overview, Section 6. Treatment: “Because of the potential mortality of COVID-19, many investigational treatments are underway: Remdesivir… Convalescent therapies (plasma from recovered COVID-19 patients)…Antiviral drugs… Vaccine [none yet]” (Citation: Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020;83(3):217-220. doi:10.1097/JCMA.0000000000000270)

The mortality rate as measured against positive cases is still 1.5 percent in Taiwan. That’s better than the USA overall, but it’s comparable to Midland, Texas.

South Korea

Science Mag (3/17/2020): Coronavirus cases have dropped sharply in South Korea. What’s the secret to its success? (“Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts.”)

CDC (October 2019): Community Treatment Centers for Isolation of Asymptomatic and Mildly Symptomatic Patients with Coronavirus Disease, South Korea (From the Abstract: “As a part of measures to decrease spikes in coronavirus disease (COVID-19) cases and deaths outside of hospitals, the government of South Korea introduced a plan for community treatment centers (CTCs) to isolate and monitor patients with mild COVID-19 symptoms… Among all patients, 75.7% remained asymptomatic while at the CTCs.” From the study: “Extensive and aggressive testing was performed on close contacts of SARS-CoV-2–infected patients in Daegu, especially among members of a specific religious group in which a large outbreak occurred, which possibly contributed to the exceptionally high proportion of asymptomatic cases.”) (Citation: Choi WS, Kim HS, Kim B, Nam S, Sohn JW. Community treatment centers for isolation of asymptomatic and mildly symptomatic patients with coronavirus disease, South Korea. Emerg Infect Dis. 2020 Oct [date cited]. https://doi.org/10.3201/eid2610.201539)

Reuters (May 31) South Korea’s Celltrion aims to start in-human COVID-19 drug trial in July Celltrion is working on a “therapeutic antibody treatment.”

Japan

Japan: “Japan has a generally good healthcare system… took cluster tracing and containment very seriously from a much earlier stage than western nations… and had already-strong norms of hygiene and health – with widespread mask-wearing and use of hand sanitizer being reinforced by the country’s previous near-misses with epidemics like SARS.”

6. The Current standard of care globally is go home and tough it out

“In the US our current standard of care for people who test positive is “take two aspirin and tough it out.” The CDC and the World Health Organization are repeating what China said, “If you test positive tough it out at home. We don’t want to see you unless your symptoms are severe because we don’t wanna overwhelm our hospitals. But early treatment is the key.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: True. CDC’s “When to Seek Emergency Medical Attention” directs those with Covid to stay home unless emergency medical care is needed.

If you have a fever, cough or other symptoms, you might have COVID-19. Most people have mild illness and are able to recover at home. If you think you may have been exposed to COVID-19, contact your healthcare provider.

Keep track of your symptoms.

If you have an emergency warning sign (including trouble breathing), get emergency medical care immediately.

CDC Coronavirus Disease 2019 (COVID-19) What to Do If You Are Sick (Updated May 8, 2020)

7. Social Distancing, Protective Gear, and Masks are Insufficient

Dr. Bartlett says, “Let’s talk about the current strategy of using a mask and social distancing. How did it work in China, Italy, France, and New York City? [30,000 deaths in each country.] In Italy a strategy of extreme protective gear was followed (full lab gear, shoe protection, masks, gloves) and 40% of the medical personnel tested positive for COVID – If all that gear couldn’t protect them, why are we focusing on masks? Let’s focus on helping people get well!” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: True. Respiratory experts reviewed the data.

On the other hand, death counts are widely acknowledged to be inflated and unreliable as documented by Senator Scott Jensen in a recent Facebook post (transcript) and YouTuber An0maly’s newest video, Covid Case Counting: EXPOSED! Shocking Truth WITH CLEAR PROOF.

Death Counts

For the sake of this article, here are the “official” numbers of deaths as of July 14, 2020:

China – 4634 – Then again, who knows?

Italy – 34,984

France – 30,029

New York City – 32,462

Protective Gear Inadequate

I haven’t found anything about 40% of health care workers in Italy getting testing positive for COVID despite protective gear. But China did a study that found 40% aerosol concentration of Covid-19 in the ICU despite both health care workers and patients wearing masks.

Journal of Pediatrics, 1981: The use of gowns and masks to control respiratory illness in pediatric hospital personnel (“both illness and RSV infection were significantly associated with longer hours of exposure in the isolation rooms… we believe that we have shown that the cumbersome and expensive use of gowns and masks serves little if any function in protecting personnel.”)

The Spokesman-Review: Cloth mask increases risk (“fourth-year student doctor… shares research showing that cloth masks increase risk of infection… 2015 randomized trial found that the rates of viral infection were significantly higher with cloth masks compare to medical masks and that 97% of particles go through cloth masks… increased moisture retention [leads to] increased risk of infection… The general public should not be mandated to breathe through virus-infested material. Research shows wearing a mask outside of direct patient care has more to do with reducing anxiety than it does with reducing infection rates.”

Center for Infectious Disease Research and Policy: Data do not back cloth masks to limit COVID-19, experts say (April 9, 2020) (“there is no evidence [cloth masks] impede the transmission of aerosols implicated in the spread of COVID-19… Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy (CIDRAP), who contributed to the paper… said in his weekly CIDRAP podcast yesterday that, because aerosols likely play an important role in coronavirus transmission, cloth masks will do little, if anything, to limit spread of the disease… he worries that encouraging cloth masks is emboldening people to try to get surgical masks for better protection, taking them away from frontline healthcare workers, who desperately need them.”)

MedPage Today (6/17/2020): Mask Hysteria: Are We Going Too Far? [Dr.] Kevin Campbell believes media and politicians use masking as a way to fear monger

Journal of Pediatrics, 1981: The use of gowns and masks to control respiratory illness in pediatric hospital personnel (“both illness and RSV infection were significantly associated with longer hours of exposure in the isolation rooms… we believe that we have shown that the cumbersome and expensive use of gowns and masks serves little if any function in protecting personnel.”)

Sweeping mask recommendations—as many have proposed—will not reduce SARS-CoV-2 transmission, as evidenced by the widespread practice of wearing such masks in Hubei province, China, before and during its mass COVID-19 transmission experience earlier this year. Our review of relevant studies indicates that cloth masks will be ineffective at preventing SARS-CoV-2 transmission, whether worn as source control or as PPE. 

… even masks that fit well against the face will not prevent inhalation of small particles by the wearer or emission of small particles from the wearer.

Kellogg,21 seeking a reason for the failure of cloth masks required for the public in stopping the 1918 influenza pandemic, found that the number of cloth layers needed to achieve acceptable efficiency made them difficult to breathe through and caused leakage around the mask. We found no well-designed studies of cloth masks as source control in household or healthcare settings.

In sum, given the paucity of information about their performance as source control in real-world settings, along with the extremely low efficiency of cloth masks as filters and their poor fit, there is no evidence to support their use by the public or healthcare workers to control the emission of particles from the wearer.

Clinical trials in the surgery theater have found no difference in wound infection rates with and without surgical masks.26-29

These data suggest that surgical masks worn by the public will have no or very low impact on disease transmission during a pandemic.

Recent meta-analyses found that N95 FFRs offered higher protection against clinical respiratory illness49,50 and lab-confirmed bacterial infections,49 but not viral infections or influenza-like illness.49

Lisa M Brosseau, ScD, and Margaret Sietsema, PhD, COMMENTARY: Masks-for-all for COVID-19 not based on sound data (April 1, 2020) University of Minnesota Center for Infection Disease Research and Policy

Note: The COMMENTARY by Brosseau and Sietsema was updated on July 16, 2020. That led me to discover the study on mask efficacy following the 1918 Spanish flu.

8. Masks Increase Virus Exposure of Asymptomatic Wearers, Raising Risk of Illness

“There’s a scientific term called a fomite, which refers to an inanimate object that’s collecting germs, bacteria, viruses. There’s research that shows 1000 Covid viruses are breathed out every minute when someone is infectious. So the infectious person is collecting in 30 minutes 30,000 viruses.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

“Another medical term is inoculation dose. If you step on a nail and it has one bacteria on if that’s a problem. If you step on a nail and it has 10,000 bacteria on it that’s a much bigger problem. So what happens when you put a mask on your face and start collecting viruses there? Wearing a cloth mask raises the asymptomatic wearer’s exposure to the virus.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: True. Respiratory experts reviewed the data.

Nature: Mounting evidence suggests coronavirus is airborne — but health advice has not caught up (“The authors calculated6 that for SARS-CoV-2, one minute of loud speaking generates upwards of 1,000 small, virus-laden aerosols 4 micrometres in diameter that remain airborne for at least 8 minutes.)

The Centre for Evidence-Based Medicine: SARS-CoV-2 viral load and the severity of COVID-19 (“The initial dose of virus and the amount of virus an individual has at any one time might worsen the severity of COVID 19 disease.”)

A randomized trial comparing the effect of medical and cloth masks on healthcare worker illness found that those wearing cloth masks were 13 times more likely to experience influenza-like illness than those wearing medical masks.38

Lisa M Brosseau, ScD, and Margaret Sietsema, PhD, COMMENTARY: Masks-for-all for COVID-19 not based on sound data (April 1, 2020) University of Minnesota Center for Infection Disease Research and Policy

BMJ Open (this is the study cited by Brosseau and Sietsema above): A cluster randomised trial of cloth masks compared with medical masks in healthcare workers (“The study found that cloth mask wearers had higher rates of infection than even the standard practice [unmasked] control group of health workers, and the filtration provided by cloth masks was poor compared to surgical masks… the physical barrier provided by a cloth mask may afford some protection… The cloth masks may have been worse in our study because they were not washed well enough – they may become damp and contaminated.”) As a matter of fact, the HCW using cloth masks were 13 times more likely to develop influenza. Very scary results!

The Spokesman-Review: Cloth mask increases risk (“fourth-year student doctor… shares research showing that cloth masks increase risk of infection… 2015 randomized trial found that the rates of viral infection were significantly higher with cloth masks compare to medical masks and that 97% of particles go through cloth masks… increased moisture retention [leads to] increased risk of infection… The general public should not be mandated to breathe through virus-infested material. Research shows wearing a mask outside of direct patient care has more to do with reducing anxiety than it does with reducing infection rates.” (This appears to reference the BMJ Open study, see above.)

9. Covid is a rapidly mutating virus, making vaccine a losing strategy

“Fauci and Berks want us to wait for a magical vaccine but my patients who are dying of Covid cannot wait for some magical vaccine in the future. Covid is a rapidly mutating virus.. over 243 mutations as of April in the study in Iceland. The reason they can’t get a vaccine for HIV is because it’s rapidly mutating. This is not the right strategy… You may make a vaccine today but it may not work two months from now because it’s changing so fast.” (Source: pieced together from Dr. Richard Bartlett’s interview on ThriveTime radio)

Fact Check: Inconclusive. Iceland reported 291 mutations in April, but vaccine researchers say they’re all very similar, meaning significant change is slow.

Currently 291 mutations have been found in the country that have not been identified elsewhere.

PR News Wire (4/14/2020) – Iceland Provides a Picture of the Early Spread of COVID-19 in a Population With a Cohesive Public Health Response

The new coronavirus is an RNA virus… RNA viruses, like the flu and measles, are more prone to changes… We expect RNA viruses to change frequently… SARS-CoV-2 is no exception… But the virus has mutated at a very slow pace. And when it does mutate, the new copies aren’t far off from the original virus.

A new study from the Scripps Research Institute in Florida suggests the new coronavirus has mutated into a variant that’s more infectious.

Healthline: The new coronavirus is mutating, but very slowly 

It’s hard to make the right vaccine for flu because there are different strains that circulate every year,” he says. “With SARS-CoV-2, there are some small mutations, but nothing to lead us to suspect that if you have immunity here in Maryland that you won’t have it anywhere else.

MedicalXpress (6/10/2020): SARS-CoV-2 is mutating slowly, and that’s a good thing

End of Part One. Click to see Part Two.

Notes and Disclaimers

One key to living a life of Smarter Joy is giving others the benefit of the doubt (holding them “innocent until proven guilty”). Dr. Bartlett makes some claims in his interview for which I could find little or no proof. But that doesn’t disprove them. I am not a professional researcher. “Inconclusive” results reflect a lack of significant evidence in support, not a preponderance of evidence against. Could Budesonide Cure Covid? Let the Facts Speak is a work in progress at Smarter Joy with Morgan Reece. More research will be added as I find it. Subscribe to be notified of major changes to this post or related news.

This post is my attempt at fact-checking the points raised in Dr. Richard Bartlett’s interview on ThriveTime radio. I rearranged some points from the audio to connect similar thoughts and put them into a logical progression. Each point’s summary paragraph(s) may not be verbatim but are my good-faith attempt to accurately represent Dr. Bartlett’s statements.

Also, America Can We Talk interviewed Dr. Bartlett, and hosts two PDFs including the white paper he referenced in the Thrive Time interview. I haven’t listened to the ACWT (earlier) interview yet.

Medical Review Update 07/14/2020

Last night I sent my first draft of this article to a physician friend for his review. Here is his response (some parts redacted for privacy and brevity; don’t worry about nebulizers being sold out, you can always make a homemade asthma nebulizer for pennies if you had to): 

Great podcast! If I get any respiratory symptoms [I will] immediately ask for this treatment. Very convincing!! This medication is found both in handheld inhalers (Expensive~ $200 Pulmicort) or in solution that is administered through a nebulizer as already explained. 

I do agree that side effects and risks are extremely minimal because of short duration the inhalation treatments would be used. Inhaled steroids have been studied extensively for years and I believe are very safe in “bursts” of treatment as described.

I just gave our nebulizer away several months ago to my daughter-in-law. I just may go pick one up before they get sold out!