Int J Med. Public Health. 2020; 10(4):166-168.
A Multifaceted Peer Reviewed Journal in the feld of Medicine and Public Health
www.ijmedph.org | www.journalonweb.com/ijmedph
Original Article
International Journal of Medicine and Public Health, Vol 10, Issue 4, Oct-Dec, 2020 166
Sumita Shankar
1
, Arunava
Saha
2,
*, Limalemla Jamir
3
,
Rakesh Kakkar
3
1
Plastic Surgery, Rangaraya Medical
College, Guntur, Andhra Pradesh, INDIA.
2
Christian Medical College, Vellore,
Tamil Nadu, INDIA.
3
Department of Community and Family
Medicine, AIIMS Mangalagiri, Guntur,
Andhra Pradesh, INDIA.
Correspondence
Dr. Arunava Saha
Junior Clinical Assistant, Christian
Medical College, Vellore-632004, Tamil
Nadu, INDIA.
Mobile no: +91-8754923454
Email: saha.arunava100@gmail.com
History
• Submission Date: 15-05-2020
• Revised Date: 19-06-2020
• Accepted Date: 25-08-2020
DOI : 10.5530/ijmedph.2020.4.36
Article Available online
http://www.ijmedph.org/v10/i4
Copyright
© 2020 Phcog.Net. This is an open-
access article distributed under the terms
of the Creative Commons Attribution 4.0
International license.
Cite this article : Shankar S, Saha A, Jamir L, Kakkar R. Protection at Portal of Entry (PPE) with Povidone Iodine for
COVID-19. Int J Med Public Health. 2020;10(4):166-8.
ABSTRACT
Background: The current Coronavirus pandemic has infected more than 15 million people
worldwide and has been responsible for more than 630,000 deaths worldwide, a signifcant
number of which has been healthcare professionals. Povidone-iodine (PVP-I) has been known
as microbicidal agent since the past few decades and it has also demonstrated better anti-viral
activity than other antiseptics in a few in vitro studies against other coronaviruses (SARS-
CoV and MERSCoV). Povidone iodine has also been found to be a safe and effective solution
to be used as a gargle or intranasally. Aim and Objectives: Through our study, we would
like to propose the application of PVP-I in appropriate and safe concentration through nasal
application and oropharyngeal wash to limit the spread of the virus from infected patients to
healthcare workers and thus reduce the transmission of COVID-19. Methods: This application
is to be done according to the proposed protocol, which has been devised keeping in mind
the feasibility, safety and ef fcacy of PVP-I application. This should be used regularly by
patients with a suspected or confrmed COVID-19 infection to not only prevent the spread,
but also by healthcare workers prior to treating such patients, or performing perioral or nasal
procedures during the pandemic, regardless of the status of the patient. Patients undergoing
such procedures should also be treated with PVP-I. The total iodine exposure according to the
proposed protocol has been found to be within previously recorded safe limits. Conclusion:
We hypothesize that usage of PVP-I as a personal protective equipment at the portal of entry
would help decrease the rates of transmission of the SARS-CoV-2 infection.
Key words: Betadine, Coronavirus, Gargle, Povidone Iodine, Pandemic.
Protection at Portal of Entry (PPE) with Povidone Iodine for
COVID-19
Sumita Shankar
1
, Arunava Saha
2,
*, Limalemla Jamir
3
, Rakesh Kakkar
3
BACKGROUND
Te COVID-19 pandemic, caused by the novel
coronavirus SARS-CoV-2, an enveloped non-
segmented positive-sense RNA viruses, belonging to
the family Coronaviridae and the order Nidovirales,
has infected more than 15 million people worldwide
and has been responsible for more than 630,000
deaths.
1
Signifcant portion of those afected have
been healthcare workers, with a Chinese study
showing that this particular group represents
about 4 percent of the infected cases, so far about
1700 bedside clinicians being infected.
2,3
Tese are
dynamic numbers and are constantly increasing on
an hourly basis.
A severe supply-demand mismatch for proper
personal protective equipment, triggered by
panic buying, misuse and hoarding, has led to the
frontline workers being dangerously ill-equipped
while taking care of such infected patients.
3
Tis has
placed an unforeseen extra burden on the healthcare
system at such a crucial time due to lack of health
personnel who are themselves succumbing to the
infection. Additionally, a signifcant risk has been
found for non-infected patients who are already
hospitalised and remain in close proximity to these
infected patients, due to a suspected nosocomial
transmission. An Intensive care unit carries one
of the highest risks of transmission, as procedures
such as non-invasive ventilation, intubation and
suction have been known to generate tremendous
amounts of bio-aerosol. Tese particles remain
suspended in air and viable on surfaces for longer
duration and have much higher chances of causing
contact transmission to healthcare professionals and
other patients.
3
Patient saliva has also been found
to have a high viral load in COVID-19,
4
and it is
the need of the hour to ensure adequate prevention
and prophylaxis for healthcare professionals to
prevent further spread of the disease amongst
them. In a more recent study it was noticed that the
nasopharynx appears to have a higher viral
load than that found in the oropharynx.
4,5
Te
recommended diagnostic testing requires collection
of nasopharyngeal and oropharyngeal swab
specimens that necessitates close contact between
healthcare workers and the patients.
4
According to the CDC, in-depth knowledge of the
portals of entry and modes of transmission can help
to develop appropriate control measures, which are
usually directed against the segment in the infection
chain that is most susceptible to intervention, which