President Trump’s remarks late last week about potentially ingesting or injecting disinfectants, such as bleach, and shining ultraviolet light on or in the body to kill SARS-CoV-2, the coronavirus that is responsible for the COVID-19 pandemic were so divorced from reality and science that I thought I wouldn’t have to deal with them a second time. After all, just because a disinfectant or UV light can kill a virus on inanimate surfaces doesn’t mean that it will work internally. At the time, I expressed concern that Trump’s words would embolden the quacks who tout Miracle Mineral Solution (which releases chlorine dioxide, a form of industrial bleach, when mixed with dilute acid) as a cure all (they did) and the quacks who use UV blood irradiation, which involves circulating a patient’s blood through a devide that shines UV radiation on it through the clear tubing (it emboldened them too). What I did not anticipate (but should have) is that poison control centers would be flooded with calls about people ingesting Lysol, bleach, and other disinfectants in New York, Chicago, and elsewhere. Nor did I expect a company hawking a device called Healight to promote its dubious product, leading to Twitter lighting up:
You might ask why I’m not featuring Tweets by the company developing Healight, Aytu Bioscience. Simple. Twitter deleted the Tweets featuring the video and suspended the company’s official Twitter account, while YouTube removed the video as well. Unsurprisingly, Breitbart and other pro-Trump sources portrayed this ban as “censorship.” Ultimately Aytu’s account was reinstated, and you can now find its promotion of its device back on Twitter:
Let’s look at the claims made for the device. However, before we do that, let’s look at what was being said about Healight before Trump’s Thursday press conference. Three days before Trump’s ill-fated COVID-19 daily briefing, there were Tweets like this:
After the conference, of course, not everyone was enthusiastic:
So what are the claims being made by Aytu Bioscience through its CEO Josh Disbrow and its scientists Drs. Mark Pimentel, Ruchi Mathur, Gil Melmed, and Ali Rezaie, who are working with Cedars Sinai Medical Center in Los Angeles? What is Healight? Basically, it’s a catheter with an LED emitting UV-A light. We even know that an abstract has been presented at a gastroenterology conference:
An abstract led by the team at Cedars-Sinai Medical Center was published in the United European Gastroenterology Journal, October 2019, titled “Internally Applied Ultraviolet Light as a Novel Approach for Effective and Safe Anti-Microbial Treatment.” Here, the authors show that UVA light exhibits significant in vitro bactericidal effects in an array of clinically important bacteria. Additionally, this is the first study using intracolonic UVA application, which reports that UVA exposure is not associated with endoscopic or histologic injury. These findings suggest that UVA therapy can potentially provide a safe and effective novel approach to antimicrobial treatment via phototherapy on internal organs.
You’d really think that actual doctors would know better than this. First, this abstract claims bactericidal effects. (SARS-CoV-2 is a virus.) Next, you would think that actual doctors would understand that, just because shining a UV light on an inanimate surface can kill microbes, that doesn’t necessarily mean that shining it on a living organ from the inside will do the same, nor does it mean that it will kill viruses. In a press release issued April 20, the inventors of Healight proclaimed:
Led by Mark Pimentel, MD, the research team of the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai has been developing the patent-pending Healight platform since 2016 and has produced a growing body of scientific evidence demonstrating pre-clinical safety and effectiveness of the technology as an antiviral and antibacterial treatment. The Healight technology employs proprietary methods of administering intermittent ultraviolet (UV) A light via a novel endotracheal medical device. Pre-clinical findings indicate the technology’s significant impact on eradicating a wide range of viruses and bacteria, inclusive of coronavirus. The data have been the basis of discussions with the FDA for a near-term path to enable human use for the potential treatment of coronavirus in intubated patients in the intensive care unit (ICU). Beyond the initial pursuit of a coronavirus ICU indication, additional data suggest broader clinical applications for the technology across a range of viral and bacterial pathogens. This includes bacteria implicated in ventilator associated pneumonia (VAP).
“Our team has shown that administering a specific spectrum of UV-A light can eradicate viruses in infected human cells (including coronavirus) and bacteria in the area while preserving healthy cells,” stated Dr. Pimentel of Cedars-Sinai. Ali Rezaie, MD, one of the inventors of this technology states, “Our lab at Cedars-Sinai has extensively studied the effects of this unique technology on bacteria and viruses. Based on our findings we believe this therapeutic approach has the potential to significantly impact the high morbidity and mortality of coronavirus-infected patients and patients infected with other respiratory pathogens. We are looking forward to partnering with Aytu BioScience to move this technology forward for the benefit of patients all over the world.”
The company believes the Healight platform technology has the potential to positively impact outcomes for critically ill patients infected with coronavirus and severe respiratory infections.
Let’s just take a look at why this proposal is so implausible. First of all, let’s say Healight works exactly as claimed by Aytu (in vitro, at least) and killed only the cells infected with coronavirus while sparing the surrounding normal cells. (Never mind that the majority of the cells in the respiratory epithelial lining of the bronchial passages are likely to be infected when the disease is severe enough to require intubation, the method by which Healight is designed to be introduced into the lungs.) Let’s further assume that it does the same thing that Aytu claims it does in cell culture when the light is inserted into the trachea via endotracheal tube hooked up to the ventilator. First of all, shining a light inside the trachea is likely to all those infected cells within range of light of high enough energy to do it is likely to kill them all en mass, rather than in a random fashion (as the virus likely does as it replicates in one cell, killing it and releasing virus in the vicinity to kill other cells). What does that mean? It means that, instead of cells lining the inside of the trachea and bronchial tubes being killed over time by the immune system and through dying as virus is released, there will be a wave of cell death over a much shorter period of time, thus greatly exacerbating the inflammatory response that has damaged the lungs to the point where the patient needs to be on a ventilator.
Of course, that’s being generous and assuming that the light’s selectivity for virus-infected cells is perfect and that it doesn’t damage normal cells as well. In medicine, there is no such intervention, be it drug or light (as in radiation therapy) that is perfectly selective for the target cells. Radiation therapy is selective for cancer cells because they replicate faster than normal cells and their DNA repair mechanisms are impaired, but still can damage and destroy normal cells that are replicating. The same is true of chemotherapy. The same is likely true of Healight.
Then there’s the issue of delivery. Let’s give Aytu every benefit of the doubt possible and assume that their Healight is perfectly selective for coronavirus-infected cells and doesn’t damage surrounding cells in human beings. Let’s even assume that it is 100% effective killing infected cells within its range. Now look at the video on the Aytu Bioscience website. Here are three screenshots I took from the video:
Aside from the disclaimer at the bottom of each screenshot, do you notice anything? The catheter only reaches the upper reaches of the trachea. It doesn’t even go past the bifurcation of the trachea into the right and left mainstem bronchi. Of course, I’m sure it could be pushed further down into the mainstem bronchi and even maybe into some of the larger bronchi that branch off from that. Let’s say that’s possible to do that and that the light kills all the coronavirus-containing infected cells lining the trachea and the larger bronchi. (Of course, given how many branches there are, it would be a painfully tedious process to treat them all.) What then? Because guess what? It’s not just the tracheal and bronchial epithelial cells that are the target of SARS-CoV-2. It’s the type 1 and 2 pneumocytes, in the alveoli of the lungs. (The alveoli are the air sacs where oxygen and CO2 exchange occurs.) There’s no way a catheter gets that far down the respiratory passages and kills infected cells there, and even if it did it would likely result in more fluid, more inflammation, and worse gas exchange. Again, I’m assuming that the Healight works exactly as Aytu Bioscience claims that it does.
Let’s take it one step further. Let’s say that you could somehow use Healight to kill all the infected cells in the lungs. (That’s a huge stretch, but, again, I’m giving Aytu every benefit of the doubt.) What about the rest of the body? We now know that SARS-CoV-2 infects a wide variety of organs, resulting in, for instance, GI symptoms (OK, I guess you could stick Healight into the colon, but what about the entire lenght of the small bowel?), renal failure, CNS symptoms, and clotting abnormalities? Even if you could sterilize the lung of SARS-CoV-2 without causing more damage, there’s the rest of the body. Remember, we’re talking about seriously ill COVID-19 patients here, not mild disease.
Unsurprisingly, right wing media is latching on to the existence of Healight to defend Donald Trump’s scientifically ignorant remarks last week:
President Trump has been mocked relentlessly for suggesting that ultraviolet light could be brought “inside the body” to kill the coronavirus, but there is ongoing research to do just that.
For example, the pharmaceutical firm Aytu BioScience announced on April 20, four days before the Trump remarks, that it has signed an exclusive licensing deal with Cedars-Sinai Medical Center in Los Angeles. The center has developed and is testing a UV-A “Healight” designed to be inserted via a catheter inside the trachea to kill pathogens, including the coronavirus.
Guess what? Healight doesn’t make what Trump said any less scientifically ignorant or ridiculous. Regardless of what Trump said or whether he knew about it before his disastrous briefing last week, from a scientific standpoint, Healight just doesn’t make sense if you understand basic anatomy and physiology, as well as how viruses work. It could well make some doctors rich before its failure becomes apparent. Twitter and YouTube were perfectly justified in deleting Aytu’s videos. Just because physicians and an academic medical center are supporting a dubious device doesn’t make it any less ridiculous, and, make no mistake, Healight is risibly dubious.