Trump takes good news on disinfectants and gives it an insane spin

The daily pandemic press briefings held by the White House have had some very unusual moments, with medical experts often asked to correct misinformation or bad advice, some of it offered or favored by President Trump himself, standing just feet away. But those somewhat surreal scenes had become so commonplace that the events may have started to seem routine. But any normalcy changed yesterday when, after receiving some good news from the research community, Trump suddenly suggested that we should test the idea of irradiating people internally or injecting them with disinfectant.

Before the day was over, the maker of Lysol disinfectant was issuing statements saying there are no circumstances in which its products should be ingested or injected.

We’ll do the good news first

The trouble was triggered by a rare bit of good news amid this global pandemic, delivered by Bill Bryan, the head of the Department of Homeland Security's Science and Technology Directorate. Bryan was brought on to discuss the survival of the virus under various environmental conditions. (You can watch his presentation here.)

Viruses need to balance a number of competing needs. They have to spread both in the warm, water-rich environment of the human body and between humans through environments that may be much cooler and/or drier. They have to be robust enough to damage from the environment, but still flexible enough to unload their genome into cells. Different viruses balance these compromises in different ways, which leaves them more or less susceptible to different environmental conditions.

To this point, we've not known how SARS-CoV-2 balances its competing needs, so we couldn't tell what environments might enable the virus to spread more readily. Bryan said the Department of Homeland Security had been doing testing in a safety-focused facility and was ready to discuss some key take-homes.

First, as spring shifts into summer, the outdoor environment will become increasingly unkind to SARS-CoV-2. In a room temperature environment with low humidity (24°C75°F and 20 percent humidity), the half life of the virus is 18 hours. That means it takes nearly a day before half of the viruses on a surface will no longer be able to infect anyone. At 35°C (95°F) and 80 percent humidity, however, the virus has a half life of one hour.

Sunlight was even more effective in disabling the virus. At levels of light typical of summer sunlight, the virus had a half life of only 1.5 minutes, presumably due to the ultraviolet portion of the spectrum damaging its RNA and proteins.

Bryan also said that testing had revealed that the decay and damage caused by the environment can be accelerated by common disinfectants. Simply spraying some bleach onto a surface with droplets containing SARS-CoV-2 would cut the half life to five minutes; isopropanol would drop it to only 30 seconds. Mixing the materials by wiping the surface afterward accelerated the deactivation of the virus further.

Bryan ended his presentation by thanking the President, the scientists at Homeland Security, and the larger scientific community for its contributions.

And then the wheels came off

What followed was an instance of what might charitably be called "Trump thinking aloud." Trump suggested there was a question a lot of people were probably thinking, so he'd go ahead and ask it.

So, supposing we hit the body with a tremendous—whether it’s ultraviolet or just very powerful light—and I think you said that that hasn’t been checked, but you’re going to test it. And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way, and I think you said you’re going to test that too. It sounds interesting.

Then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that. So that, you're going to have to use medical doctors. But it sounds interesting to me. ”

Now, to be clear, this is not Trump suggesting we should go out and inject bleach (or figure out how to irradiate ourselves internally). It's not even that he's suggesting that Bryan might want to test injecting bleach into people. It's more that Trump is indicating he's already discussed doing these sorts of tests with Bryan, who, presumably out of politeness, said they'd test the ideas—or Trump had taken whatever Bryan had said as indicating they would test the ideas.

They will not be testing these ideas.

Bleach is an effective disinfectant because it chemically damages proteins. Isopropyl alcohol is effective because it disrupts the membranes of viruses. Human cells, as you may remember from your biology classes, also have membranes and proteins, which will also be damaged by these chemicals. That's why these chemicals are toxic to humans.

It's a similar story with UV light. It disables viruses because it damages their proteins and RNA. It will just as easily damage the proteins and nucleic acids of our cells, which is why we have to be careful about managing our sun exposure through clothing and sunblock. Intentionally exposure won't cause immediate effects except at extraordinary high levels, but it will clearly raise the risks of future cancers. And that's before we get into the issue of figuring out how to direct the light to the tissues, like the lungs, intestines, and blood vessels, that seem to be the virus' targets.

There are at least three issues with Trump's off-the-cuff theorizing. The first is that it detracted from the information provided by Bryan, which was both hopeful and provided details that every citizen could use to potentially increase their safety. Second, it may raise false hopes that a therapy could be derived from this information. Finally, recent history has shown that people take Trump's health-related ramblings as serious directives, occasionally with lethal consequences.

Before the day was over, Administration officials were putting various spins on Trump's statements. The FDA commissioner went on TV to suggest that Trump was simply echoing the sorts of questions that MDs might get from their patients, which ignores the "you're going to test that" portions of his exchange with Bryan. Meanwhile, a White House spokesperson said that Trump has repeatedly advised people to consult with doctors before treatment, and that the media was being irresponsible for attaching negative headlines to their stories on the press conference.

Presumably, she was upset that the headlines implied that Trump suggested we should ingest bleach, when Trump had actually suggested we research the effects of ingesting bleach-like substances.

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