Don't Inject Bleach (Sigh)

Don't Inject Bleach (Sigh)
Photo: Drew Angerer (Getty Images)

Did the president just tell people to inject themselves with bleach? Not exactly. But he did wonder aloud—and on camera!—about whether it might work. And in doing so, he gave us a great lesson in why you can’t use gut feelings to extrapolate from lab bench research.

The fiasco occurred at a press conference last night (transcript here), an administration official, Bill Bryan, presented some findings about the efficacy of temperature, humidity, ultraviolet light, bleach and rubbing alcohol at killing the coronavirus in the lab. Bryan has a military and logistics background and currently leads the Science and Technology division of the Department of Homeland Security.

Bryan presented results like this (all quotes are taken directly from the White House transcript):

We’re also testing disinfectants readily available. We’ve tested bleach, we’ve tested isopropyl alcohol on the virus, specifically in saliva or in respiratory fluids. And I can tell you that bleach will kill the virus in five minutes; isopropyl alcohol will kill the virus in 30 seconds, and that’s with no manipulation, no rubbing — just spraying it on and letting it go. You rub it and it goes away even faster. We’re also looking at other disinfectants, specifically looking at the COVID-19 virus in saliva.

Note that “in saliva” means that they’re looking at the virus in droplets of saliva on surfaces or in aerosols. Not in the human body. He also discussed temperature, humidity and ultraviolet radiation:

And thirdly, the virus dies the quickest in the presence of direct sunlight under these conditions. And when you — when you look at that chart, look at the aerosol as you breathe it; you put it in a room, 70 to 75 degrees, 20 percent humidity, low humidity, it lasts — the half-life is about an hour. But you get outside, and it cuts down to a minute and a half. A very significant difference when it gets hit with UV rays.

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It’s hugely important that we learn more about how long the virus lives on various surfaces, and what can be done to affect its survival. In our Q&A yesterday with epidemiologist and infection preventionist Saskia Popescu, many of you had questions relating to how much we should worry about the virus on surfaces around us and in the air. The same question appears in the DHS’s Science & Technology Master Questions List.

But experiments only answer questions narrowly. We’ve confirmed bleach (in a certain formulation, applied a certain way) can reduce the amount of virus that’s present on a surface. Great! But that doesn’t mean that you can collapse the understanding that “bleach kills the coronavirus” and apply it to all other contexts. Including, like, you know, the inside of the human body.

I mean, there are some weird things that can happen within our bodies. But if you want to know what scientists are considering testing as a medical treatment, you should ask scientists to speak about that. The president started off by wondering. And Bryan—who is not a microbiologist, nor a doctor—didn’t outright reject the idea. It’s unclear if that’s because he didn’t understand Trump’s point, or just because he was put on the spot and wasn’t sure what to say.

THE PRESIDENT: Thank you very much. So I asked Bill a question that probably some of you are thinking of, if you’re totally into that world, which I find to be very interesting. 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.

ACTING UNDER SECRETARY BRYAN: We’ll get to the right folks who could.

THE PRESIDENT: Right. And 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 with. But it sounds — it sounds interesting to me.

So we’ll see. But the whole concept of the light, the way it kills it in one minute, that’s — that’s pretty powerful.

We’re living through a pandemic. People are scared and desperate, and most of us are entirely without a sense of control over our day-to-day health and circumstances. We don’t know exactly where the virus is right now, or exactly how risky each of our actions and potential exposures are. Even the doctors treating COVID-19 are still figuring out the full range of its symptoms and the best way to treat an infection. Things are new and mysterious and we’ve been told the best we can do is just sit at home and wash our hands.

It’s the perfect situation to entice desperate people to take desperate measures in order to feel a sense of control. We saw with chloroquine that if the President suggests a drug is promising, huge numbers of people will go out of their way to obtain it, even if it’s a prescription drug. People poisoned themselves, and patients who were already taking that drug for other conditions were warned that shortages meant they might have to stop.

So when the President speculates about treatments that are even easier for people to try out at home—bleach, alcohol, UV light—it seems like another recipe for disaster. Weeks ago, I heard about someone I know gargling with rubbing alcohol. More recently, USA Today reported that Christine Cuomo bathed in diluted bleach while recovering from COVID-19. (Bleach baths are sometimes recommended for eczema, so this isn’t as dangerous as it may sound. Still, consult a real doctor before using any household chemicals on yourself.)

The reporters at the briefing were appropriately skeptical:

Q But I — just, can I ask about — the President mentioned the idea of cleaners, like bleach and isopropyl alcohol you mentioned. There’s no scenario that that could be injected into a person, is there? I mean —

ACTING UNDER SECRETARY BRYAN: No, I’m here to talk about the findings that we had in the study. We won’t do that within that lab and our lab. So —

THE PRESIDENT: It wouldn’t be through injection. We’re talking about through almost a cleaning, sterilization of an area. Maybe it works, maybe it doesn’t work. But it certainly has a big effect if it’s on a stationary object.

Note that the president, moments before, had said “by injection inside.” Still, does this mean that people will now consider applying bleach or alcohol to their skin? (Please don’t do this.)

The experiments about heat, humidity and ultraviolet light were also prone to a similar misinterpretation: Scientifically, it’s good to know whether a hot, humid, sunny surface is less hospitable to the virus than one that’s cold or indoors. It could tell us if playgrounds are relatively safe. This data can tell us if, maybe, in the summer, an outdoor birthday party would be slightly less risky than an indoor one.

But this also plays into an existing speculative narrative about how summer weather might somehow save us from the current pandemic. (There’s no reason to believe that it will.) The president returned to that idea, correctly qualifying it by saying he was only talking about surfaces. Okay, good. But in the context of an elected official speaking to a public searching for reasons to feel optimistic, it sure sounds like he’s priming people to think that the summer will be safe and that treatments based on heat, light and disinfectants are just around the corner.

Q Yes, Mr. President, after the presentation we just saw about the heat and the humidity, is it dangerous for you to make people think they would be safe by going outside in the heat, considering that so many people are dying in Florida, considering that this virus has had an outbreak in Singapore, places that are hot and —

THE PRESIDENT: Yeah, here we go.

Q — are humid?

THE PRESIDENT: Here we go. The new — the new headline is: “Trump Asks People to go Outside. That’s Dangerous.” Here we go. Same old group. You ready? I hope people enjoy the sun. And if it has an impact, that’s great. I’m just hearing this — not really for the first time. I mean, there’s been a rumor that — you know, a very nice rumor — that you go outside in the sun, or you have heat and it does have an effect on other viruses.

But now we get it from one of the great laboratories of the world. I have to say, it covers a lot more territory than just this. This is — this is probably an easy thing, relatively speaking, for you.

I would like you to speak to the medical doctors to see if there’s any way that you can apply light and heat to cure. You know — but if you could. And maybe you can, maybe you can’t. Again, I say, maybe you can, maybe you can’t. I’m not a doctor. But I’m like a person that has a good you know what.

Q But, sir, you’re the President.

THE PRESIDENT: Deborah, have you ever heard of that? The heat and the light, relative to certain viruses, yes, but relative to this virus?

DR. BIRX: Not as a treatment. I mean, certainly fever —

THE PRESIDENT: Yeah.

DR. BIRX: — is a good thing. When you have a fever, it helps your body respond. But not as — I’ve not seen heat or (inaudible).

THE PRESIDENT: I think it’s a great thing to look at. I mean, you know. Okay?

Q But respectfully, sir, you’re the President. And people tuning into these briefings, they want to get information and guidance and want to know what to do.

THE PRESIDENT: Hey — hey, Phil.

Q They’re not looking for a rumor.

THE PRESIDENT: Hey, Phil. I’m the President and you’re fake news. And you know what I’ll say to you? I’ll say it very nicely. I know you well.

Q Why do you say that?

THE PRESIDENT: I know you well.

Because I know the guy; I see what he writes. He’s a total faker.

Q He’s a good reporter.

THE PRESIDENT: So, are you ready? Are you ready? Are you ready? It’s just a suggestion from a brilliant lab by a very, very smart, perhaps brilliant, man. He’s talking about sun. He’s talking about heat. And you see the numbers. So that’s it; that’s all I have. I’m just here to present talent. I’m here to present ideas, because we want ideas to get rid of this thing. And if heat is good and if sunlight is good, that’s a great thing as far as I’m concerned.

You can’t speculate about possible treatments and give people reasons to believe they might be safe, and then absolve yourself of responsibility with attacks and caveats.

So, just to be clear:

Stay safe out there.

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