My opinion

By Dr. Deepak Gupta
Corresponding Author Dr. Deepak Gupta
Wayne State University, - United States of America 48201
Submitting Author Dr. Deepak Gupta

Advancing Age, Salt, Masks, Universal Precautions, Discrimination, SARS-CoV-2, COVID-19

Gupta D. Until Advancing Age Gets Reversed With A Pinch Of Salt, Usage Duration Of Mask Trinity As Universal Precaution Against Discrimination. WebmedCentral PUBLIC HEALTH 2020;11(12):WMC005670

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 12 Nov 2020 12:46:14 PM GMT
Published on: 03 Dec 2020 07:29:18 AM GMT

My opinion

I am raising the following questions: Can omnipotent cells in young age sera overcome aging to reverse the advancing age which has turned out to be a major risk factor for COVID-19 related morbidity and mortality? Can salt-impregnated masks inactivating pathogens make a case for salt itself as an administration vehicle to simplify mass vaccination programs against SARS-CoV-2? Can daily duration of mask use dilute SARS-CoV-2 repositivity in convalescent COVID-19 patients? Can mask use practiced as universal precaution reap benefits from mask trinity in the postulated tri-faceted role as protector-therapeutic-immunizer against SARS-CoV-2? Can mask use practiced as universal precaution take a stand against discrimination inflicted by COVID-19 pandemic secondary to morbid and fatal contagiousness of SARS-CoV-2?

Can Infusion Of Youth Counter Age-Associated COVID-19 Morbidity And Mortality?

My opinion is: If yet-not-known biochemical factors deteriorate with age, those yet-not-known factors producing omnipotent cells once harvested from young may be able to overcome the disadvantage of advancing age among the aged as related to their COVID-19 morbidity and mortality.

It has been observed that advancing age is associated with severe morbidity and mortality with COVID-19. Even though the effect of age on COVID-19 morbidity and mortality may not be as strong as initially thought [1], it seems like a certain fact that young are faring better in their fight against COVID-19 as compared to the aged. This begs the question whether youth has certain biochemical factors which are helping them to fight off SARS-CoV-2 better [2]. Even though it may be better to delineate these specific biochemical factors [3-4], the time constraints in the rapidly evolving COVID-19 pandemic may warrant urgent exploration into the omnipotent cells as therapy to see if “youth” may be injected into at-risk aged overcoming their bodies’ age-related wear and tear making them more susceptible to losing their fight against COVID-19 [5-6]. Omnipotent cells have been explored for numerous diseases and it is time to overdrive the cord blood donations in case the ongoing clinical trials succeed in finding the irrefutable evidence for omnipotent cells against SARS-CoV-2 and COVID-19 [7]. Until “youth” becomes medically amenable in finding its way back into our aging populations only if and only after irrefutable evidence has been generated in the ongoing clinical trials [8], we should be realistic in our research pursuits into youth as an antidote to SARS-CoV-2 while concurrently proactively protecting our aging populations.

Can There Be Sublingual Vaccine With A Pinch Of Salt For Mass Vaccination Against SARS-CoV-2?

My opinion is: If salt may be directly inactivating pathogens, vaccine “fortified” salt may be considered for futuristic exploration and investigation by futurist vaccinologists looking into novel ways for mass vaccination programs globally.


COVID-19 pandemic has revived the age-old adage making a case for saline irrigation and gargles to counter sinusitis and sore throat [9-10]. Some say that salt may be just relieving the symptoms while others say that salt may be directly inactivating pathogens [11]. The bottom-line is that mucosal salt has some unconfirmed role against pathologies. Therefore, while enthusiasts are delving into proving a pharmacological role for a product having physiological ingredients, it may be interesting for vaccinologists [12-13] to ponder, explore, investigate and prove/disprove then validate/refute if pathogen-inactivating salt can serve as an administration vehicle for mass vaccination against seasonal/epidemic/pandemic pathogens like influenza and SARS-CoV-2. If salt “fortified” with vaccine is futuristically demonstrated to be feasible and then irrefutably proven to be manageable, salt as a vaccine-administration vehicle may be able to keep the antigenic immunogenic pathological particles inactivated in vitro as packaged and delivered forms until they are ready to induce antigenicity and immunogenicity in vivo among populations potentially getting self-vaccinated with “a pinch of salt” sublingually. It can be decided in due course of time that although “a pinch of salt” sounds good to ears, it may be up to vaccinologists to discover if salt as vaccine-administration vehicle will have to be a tad/dash more or a smidgen/drop less. Summarily, extending explorations and investigations of salt as intranasal irrigations or as face-mask coatings against pathogens [9-11], vaccine “fortified” salt may be considered as futuristic exploration and investigation by futurist vaccinologists looking into novel ways for mass vaccination programs globally.

Can Daily Duration Of Mask Use Dilute SARS-CoV-2 Repositivity In Convalescent COVID-19 Patients?

My opinion is: Masks and their usage duration may have to be explored for their potential (if any) as ex vivo “antibodies” complementing in vivo antibodies and T-cells to counter and control SARS-CoV-2 even during and after convalescence from COVID-19.

Very common (>10%) SARS-CoV-2 repositivity among convalescent COVID-19 patients per Landi et al adds further to the SARS-CoV-2 repositivity incidence related biomedical literature as reported by Gao et al [14-15]. However, there are few questions. If positivity for SARS-CoV-2 per real-time reverse transcription-polymerase chain reaction (RT-PCR) tests categorized COVID-19 patients as contagious at their initial diagnosis, why are Landi et al questioning their patients’ contagiousness after discovering repositivity on the same type of RT-PCR tests [14]? If severity of clinical COVID-19 symptoms and quantitative SARS-CoV-2 viral loads seem better determinants for SARS-CoV-2 infectiousness before quarantining patients, why were Landi et al exploring RT-PCR repositivity in the first place among “asymptomatic” convalescent COVID-19 patients [14]? While erring on the safer side with indoor mask use being practiced by all repositive patients during their second quarantine periods, did Landi et al explore the incidence and daily duration of mask use (indoor or outdoor) among their repositive patients after their first quarantine periods had been discontinued and before their patients’ second quarantine periods had been initiated [14]? If convalescent COVID-19 patients’ mask use data is available, can Landi et al analyze if there is a difference between repositive and non-repositive patients in terms of their daily durations of mask use during their convalescent periods [14]? With the presumptions of being “disease-free” per two negative RT-PCR tests for SARS-CoV-2 at least 24 hours apart, discontinuations of first quarantine periods can lead convalescent COVID-19 patients to drop their guards in terms of practicing mask use (indoor or outdoor). Therefore, it will be interesting if Landi et al are able explore the comparative differences (if any) in daily durations of mask use among repositive and non-repositive patients [14]. I have a hypothesis that the efficaciousness of masks’ “therapeutic” role secondary to created hot and humid microenvironments may correlate to the daily duration of mask use which could have deterred the redetection of SARS-CoV-2 per RT-PCR tests among non-repositive convalescent COVID-19 patients [16-18]. My understanding is that universal mask use by population irrespective of their COVID-19 status may make detection and redetection of SARS-CoV-2 irrelevant unless individuals’ intermingling social life, their line of work or their symptoms warrant RT-PCR tests for detecting and redetecting SARS-CoV-2 to make a case for stricter quarantining at home away from work while effective therapeutics can resolve their symptoms (if any). Essentially, masks may be the ex vivo “antibodies” complementing in vivo antibodies and T-cells to counter and control SARS-CoV-2 literally.

Can Barrington-Snow Compromise To Unify Under Mask Trinity As Herd Immunity?

My opinion is: Barrington-Snow Compromise may have to unify under mask trinity (protective-therapeutic-immunizer) for the sake of natural herd immunity until artificial herd immunity can be generated with laboratory-made vaccines.


The questions raised by Great Barrington Declaration and John Snow Memorandum overlap even when their proponents may not seem to [19]. It is my opinion that they can compromise once they realize masks’ tri-faceted role against SARS-CoV-2. Masks protection role against exposure is unquestionable [20]. Masks creating therapeutic hot and humid micro-climates have been implored [18]. Masks being imperfect thus allowing smaller dose exposures repeatedly may be generating immunity with milder symptoms [21]. Essentially, when both sides of aisle negotiate, they may agree that when masks are being worn to prevent contagious SARS-CoV-2, potentially treat SARS-CoV-2 and unsuspectingly immunize against SARS-CoV-2, the populations can return to work with masks’ role in herd immunity at work.

It pains me to ask:

  1. Why don’t opponents understand protective role of masks unless they are waiting for masks to turn perfect in an imperfect world?
  2. Why don’t skeptics explore therapeutic role of hot and humid in-mask microclimates when Department of Homeland Security, Science and Technology directorate has documented the role of hot and humid environments in accelerating the decay of airborne and surface SARS-CoV-2 [22]?
  3. Why don’t partisans accept slow and steady role of masks in creating herd immunity while awaiting laboratory-made vaccines unless they mistakenly believe that herd immunity requires large dose exposures to SARS-CoV-2 inducing full spectrum of COVID-19 symptoms leading to either protracted convalescent periods or multiple casualties?
  4. Why don’t investigators investigate whether hot and humid in-mask microclimates can alleviate COVID-19 symptoms like cough to further mitigate the spread of SARS-CoV-2?
  5. Why don’t laypersons recognize that by invariably making it difficult to talk, masks are containing the spread of SARS-CoV-2 by talkative populations?
  6. Why don’t scientists overcome their over-reliance on measurement of dwindling antibodies which as an indicator for poor long-term immunity against SARS-CoV-2 may discourage vaccine development unless they switch gear to measuring memory T-cell responses because if natural infection is not “measurably” inducing long-term immunity how the vaccine will produce “measurable” immunity [23-24]?
  7. Why don’t epidemiologists advise COVID-19 contacts and patients against completely abandoning their mask use during quarantine and isolation periods because therapeutic role of in-mask microclimates (anti-viral and/or symptom control roles being duration-dependent potentially) may continue to work even during their lonesome quarantines and isolations?


Summarily, Barrington-Snow Compromise may have to unify under mask trinity (protective-therapeutic-immunizer) for the sake of natural herd immunity until artificial herd immunity can be generated with laboratory-made vaccines.

Are AIDS-Warriors Teaching COVID-19-Warriors "Universal Precautions Against Discrimination"?

My opinion is: Universal precautions (masks, shields and small talks’ restrictions) may mitigate discrimination that may get incited among the ignorant commoners in response to testing, tracing, isolating and quarantining when knowledge about individual’s infectivity an essentiality primarily for caregivers managing diseased and epidemiologists controlling pandemics.

Blood-borne HIV/AIDS-pandemic may enlighten about respiratory-borne SARS-CoV-2/COVID-19-pandemic. Firstly, diseases’ naivety catches host by surprise. Secondly, fast-evolving pathogens force hosts to catch-up while strategizing. Finally, pathogens and hosts must learn to cohabit ecosystems without eradicating each other [25]. 

So, can absence of vaccines despite preponderance of therapeutics against HIV make case for therapeutics’ primary role against SARS-CoV-2 irrespective of vaccines against SARS-CoV-2 getting developed and embraced? Is evolutionary hypervirulence induced by vaccinated masses more drastic compared to that induced by treated few [26]? Do universal precautions (gloves, condoms and transfusion products’ screenings) against HIV make case for universal precautions (masks, shields and small talks’ restrictions) against SARS-CoV-2 [27]? Can universal precautions barricade inadvertently perpetuated discrimination among hosts when they miscalculate symptom-specific- (disease-stage-specific-), case- and infection- fatality rates [28]? Can passive barrier modalities induce hypo-virulence among pathogens which are able to persist when hosts do not actively resist?

Essentially, as monk-like abstinence from sex plus silence in conversation may not be practical among “super-spreader” commoners [29-30], universal precautions may mitigate discrimination that may get incited among the ignorant commoners in response to testing, tracing, isolating and quarantining when knowledge about individual’s infectivity an essentiality primarily for caregivers managing diseased and epidemiologists controlling pandemics. Seemingly, the end game may be the therapeutics reversing symptoms without inducing pathogens’ hypervirulence while barrier modalities containing spread without disconcerting hosts’ livelihood. Henceforth, research and development should focus on efficacious therapeutics plus comfortable barriers [31]. In the interim, virtual pleasure industry booming in response to AIDS-pandemic makes case for virtual socialization industry zooming in response to COVID-19-pandemic.


Essentially, the answer to my questions can be that it may not be possible to validate until we investigate and to my limited understanding, the above-mentioned avenues seem worth exploring to possibly (if validated) better evolve and adapt to the rapidly evolving COVID-19 pandemic.


  1. Romero Starke K, Petereit-Haack G, Schubert M, et al. The Age-Related Risk of Severe Outcomes Due to COVID-19 Infection: A Rapid Review, Meta-Analysis, and Meta-Regression. Int J Environ Res Public Health. 2020;17(16):5974.   
  2. BBC Three: The super rich are injecting blood from teenagers to gain ‘immortality’.
  3. Gan KJ, Südhof TC. Specific factors in blood from young but not old mice directly promote synapse formation and NMDA-receptor recruitment. Proc Natl Acad Sci U S A. 2019;116(25):12524-12533.
  4. Castellano JM, Mosher KI, Abbey RJ, et al. Human umbilical cord plasma proteins revitalize hippocampal function in aged mice. Nature. 2017;544(7651):488-492.
  5. Meng F, Xu R, Wang S, et al. Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial. Signal Transduct Target Ther. 2020;5(1):172.
  6. Shu L, Niu C, Li R, et al. Treatment of severe COVID-19 with human umbilical cord mesenchymal stem cells. Stem Cell Res Ther. 2020;11(1):361.
  7. Be The Match. Cord Blood FAQs. https://bethematc
  8. National Institutes Of Health: Mesenchymal Stem Cells. ved-products/mesenchymal-stem-cells/  
  9. Farrell NF, Klatt-Cromwell C, Schneider JS. Benefits and Safety of Nasal Saline Irrigations in a Pandemic-Washing COVID-19 Away. JAMA Otolaryngol Head Neck Surg. 2020;10.1001/jamaoto.2020.1622.
  10. Ramalingam S, Graham C, Dove J, Morrice L, Sheikh A. Hypertonic saline nasal irrigation and gargling should be considered as a treatment option for COVID-19. J Glob Health. 2020;10(1):010332.
  11. Quan FS, Rubino I, Lee SH, Koch B, Choi HJ. Universal and reusable virus deactivation system for respiratory protection. Sci Rep. 2017;7:39956.
  12. Papania MJ, Zehrung D, Jarrahian C. Technologies to Improve Immunization. Plotkin's Vaccines. 2018;1320-1353.e17. 5761-6.00068-7
  13. Vela Ramirez JE, Sharpe LA, Peppas NA. Current state and challenges in developing oral vaccines. Adv Drug Deliv Rev. 2017;114:116-131.
  14. Landi F, Carfì A, Benvenuto F, et al. Predictive Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From COVID-19. Am J Prev Med. 2020;S0749-3797(20)30393-7.  
  15. Gao Z, Xu Y, Guo Y, et al. A systematic review of re-detectable positive virus nucleic acid among COVID-19 patients in recovery phase. Infect Genet Evol. 2020;85:104494.
  16. Gupta D. "Therapeutic" facemasks. Med Hypotheses. 2020;143:109855.
  17. Gupta D. Living with in-mask micro-climate. Med Hypotheses. 2020;144:110010.
  18. Gupta D. Does mask use affect the quantitative severe acute respiratory syndrome coronavirus 2 load in the nasopharynx? J Pediatr. 2020;S0022-3476(20)31242-7.
  19. Prasad V: Op-Ed: Great Barrington vs John Snow Is A False Choice – Should whomever gets the most signatures decide our fate? New York, NY: MedPage Today, October 16, 2020. y-prasad/89177
  20. Wayne State University: School of Medicine News. WSU team’s study shows COVID-19 viral load declined as pandemic progressed. -shows-covid-19-viral-load-declined-as-pandemic-progressed-40736
  21. Gandhi M, Rutherford GW. Facial Masking for Covid-19 - Potential for "Variolation" as We Await a Vaccine. N Engl J Med 2020;10.1056/NEJMp2026913.
  22. Science and Technology: Probabilistic Analysis for National Threats Hazards and Risks (PANTHR). Washington, DC: U.S. Department of Homeland Security, 2020. panthr
  23. Swadling L, Maini MK. T cells in COVID-19 - united in diversity. Nat Immunol 2020;21(11):1307-1308.
  24. Science Media Centre: Expert reaction to a preprint from the REACT-2 study looking at prevalence of antibody positivity to SARS-CoV-2. ction-to-a-preprint-from-the-react-2-study-looking-at-prevalence-of-antibody-positivity-to-sars-cov- 2/
  25. Saad-Roy CM, Wingreen NS, Levin SA, Grenfell BT. Dynamics in a simple evolutionary-epidemiological model for the evolution of an initial asymptomatic infection stage. Proc Natl Acad Sci U S A. 2020;117(21):11541-11550.  
  26. Mackinnon MJ, Gandon S, Read AF. Virulence evolution in response to vaccination: the case of malaria. Vaccine. 2008;26 Suppl 3(48-5):C42-C52. .012
  27. Broussard IM, Kahwaji CI. Universal Precautions. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
  28. The Center for Evidence-Based Medicine. Global COVID-19 Case Fatality Rates. -19/global-covid-19-case-fatality-rates/
  29. Stein RA. Super-spreaders in infectious diseases. Int J Infect Dis. 2011;15(8):e510-e513.
  30. Asadi S, Wexler AS, Cappa CD, Barreda S, Bouvier NM, Ristenpart WD. Aerosol emission and superemission during human speech increase with voice loudness. Sci Rep. 2019;9(1):2348.
  31. Perencevich EN, Diekema DJ, Edmond MB. Moving Personal Protective Equipment Into the Community: Face Shields and Containment of COVID-19. JAMA. 2020;10.1001/jama.2020.7477.

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