Why aren't we all using Taffix?

post by ChristianKl · 2021-02-26T23:09:35.968Z · LW · GW · 25 comments

This is a question post.

Taffix is a nasal powder spray that builds up a protective mechanical barrier against viruses and allergens in the nasal cavity. The EMA allowed them to write on their packaging insert to advertise it's clinical effects by saying: 

Taffix was found highly effective in blocking several respiratory viruses including SARS-CoV-2 in laboratory studies. 

The idea was conceived in March and they did a study during the Jewish New Year event which was as expect a superspreader event (orthodox Jewish people gathering in close proximity while a lot of them were infected). Among the 83 people who received the intervention only the two people who reported not consistently using the spray (you have to apply it every 5 hours) got infected while in the control group 16 out of 160 got infected. Nobody reported any side-effects. 

It seems that the information took month to tickle through to us at LessWrong with ejacob [LW(p) · GW(p)]writing in his shortform. Living in Europe I could simply order my Taffix on Amazon and had it delievered soon after. In the spirit of more dakka, it would make sense to everyone to get their Taffix. Maybe we could have even prevented the winter lockdown if everybody would have gotten their Taffix. 


answer by Bucky · 2021-02-27T13:13:42.509Z · LW(p) · GW(p)

Looking at the study it doesn’t look like the participants in the trial were randomised - rather if you wanted to use Taffix you could.

If I’m right I’m not sure what to make of it - you could have selection bias either way. More conscientious/concerned people took it or people with jobs where they had higher exposure levels took it. I would guess the former effect would be larger but not sure.

answer by Gerald Monroe · 2021-02-27T10:40:08.607Z · LW(p) · GW(p)

Well, it may in fact work, but - you can also buy masks that have been used for decades to protect against asbestos and lead paint dust.  They are rated to let through 0.3% of the 0.3 micron particles, which according to a chart on wiki on the subject, is typically the most difficult to filter particle size.  Note that Covid travels in droplets and cannot travel as naked virions.  They also tend to seal better to your face, and you can buy these masks from Amazon and they are made by 3M.  

The drawback of them is you look like you Mean Business wearing them, and it's hard to talk to anyone else.  But in terms of protection, this spray is like choosing to wear homemade body armor rather than commercial grade.  It may work but it would be stupid to go into a gunfight wearing it if you have a choice of gear actually rated to protect you.

comment by Yoav Ravid · 2021-02-27T19:40:37.480Z · LW(p) · GW(p)

You can use both [? · GW].

comment by ChristianKl · 2021-02-28T01:16:58.752Z · LW(p) · GW(p)

Well, it may in fact work, but - you can also buy masks that have been used for decades to protect against asbestos and lead paint dust.  

Masks that are designed for that usecase don't have filters that protect other people from inhaling virus particles that you exhale. If you only interact with other people wearing a mask that might be fine, but if some of your interactions are unmasked such as with people in your household, it's asocial to wear those masks in contexts where other people expect you to be masked because while you look like you are masked you have wents that mean that other people get your unfiltered air. 

Even then it's uncomfortable to wear those masks for social interactions and even if you do wear them more dakka applies.

Replies from: Davis_Kingsley
comment by Davis_Kingsley · 2021-02-28T10:42:48.032Z · LW(p) · GW(p)

I use a P100 mask and have recently taken to stretching a cloth mask over the exhaust valve -- I figure that way my exhalations are filtered about as well as they would be with an ordinary cloth mask, while my inhalations are far more protected.

The quality of these filters is really good, by the way -- at one point I was standing near a small fire in a trash can and could not smell it in the slightest, to the point where I was quite surprised to smell the fire after pulling down the mask to be more clearly audible on a phone call!

answer by Yoav Ravid · 2021-02-27T19:39:13.311Z · LW(p) · GW(p)

It doesn't seem like it had wide publicity. Even though it's an Israeli development and I'm Israeli i only heard of it from ejacob's post. [LW(p) · GW(p)]

comment by ChristianKl · 2021-03-02T14:56:29.470Z · LW(p) · GW(p)

Somehow the story of how a company developed a drug that's able to stop COVID-19 infection was completely uninteresting for all the news networks who were more interested into just rehearing what the WHO/FDA/CDC say. The level of civilisationary inadequacy we have here is amazing. 

comment by ejacob · 2021-02-27T20:13:30.185Z · LW(p) · GW(p)

I'm Israeli-American living in the US, btw. I heard about it from my mom.


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comment by ejacob · 2021-02-27T00:53:44.007Z · LW(p) · GW(p)

I'm glad someone noticed! I was hoping by writing that quick shortform post I would get a some discussion going.

comment by ChristianKl · 2021-03-16T22:21:02.300Z · LW(p) · GW(p)

Spain did move to ban Taffix sales. This seems to be enough for Amazon.de (the German website) to ask me to send mine back but I will keep using mine. 

comment by Richard_Kennaway · 2021-03-02T14:08:48.623Z · LW(p) · GW(p)

I notice that Taffix is no longer available on Amazon co uk. It's still available on eBay co uk for around twice what it was on Amazon.

Replies from: ChristianKl
comment by ChristianKl · 2021-03-02T14:28:29.017Z · LW(p) · GW(p)

On Amazon.de it rose 20% in price since I bought it but is still available: https://www.amazon.de/-/en/Taffix-Nasal-Powder-Spray-Milligram/dp/B08KHR5B4M/ref=sr_1_3?crid=E2NN4USFR7WF&dchild=1&keywords=taffix+nasenspray&qid=1614695012&sprefix=taffix+na%2Caps%2C182&sr=8-3

comment by Larks · 2021-03-01T18:40:40.396Z · LW(p) · GW(p)

Thanks for writing this; ordered.

comment by Dorikka · 2021-02-27T18:49:13.781Z · LW(p) · GW(p)

I'm curious if anyone knows of research comparing effectiveness of this to povidone iodine nasal spray? I make a 0.8% solution of that and use it in nose and gargle before going out (in addition to mask)

comment by pjeby · 2021-02-27T00:06:33.521Z · LW(p) · GW(p)

So how do you get it in the US? Searching for Taffix on amazon (.com) brings up various unrelated nasal sanitizer products that are basically just alcohol, and amazon (.co.uk) says they can't ship to the US.

Info on the package (at amazon (.co.uk)) indicates the ingredients are:

  • Hypromellose (HPMC powder) (89.9%)
  • Citric Acid (6%)
  • Sodium Citrate (4%)
  • Benzalkonium Chloride (0.1%)
  • Menthol (<0.1%)

But it's not clear how you might make your own from that, nor which ingredients are most critical. Benzalkonium Chloride is described by Wikipedia as a biocide, so that might be important.

Replies from: Richard_Kennaway, ChristianKl, Dorikka, Baisius
comment by Richard_Kennaway · 2021-02-27T11:20:16.918Z · LW(p) · GW(p)

As far as I can make out from internet browsing, the ingredient that does the work is hypromellose (short for hydroxypropyl methylcellulose). It's a cellulose compound whose powder, in humid conditions, takes up water and turns into a gel. This gel on the inside of your nose forms a barrier against infection.

I am not a chemist, pharmacist, or doctor, but here are my best guesses for the functions of the other ingredients. Benzalkonium chloride is a surfactant, which might help the hypro form a gel layer, and also an antimicrobial agent. I do not know if it would affect viruses. Citric acid + sodium citrate might be a buffer against pH changes. Or perhaps an anti-caking agent. I would guess that the menthol is to give a pleasant sensation, and so you can "feel it working".

Being in the UK I can order Taffix from Amazon co uk, though I'm not sure I will, as there appears to be a far cheaper product that does the same thing. That is "Nasaleze Cold & Flu Blocker", which is also mainly hypromellose. Another hypromellose product is "Vicks First Defence Nasal Spray". Those products make no mention of Covid, so it's possible that the Very Serious People have not yet noticed that they should be stopping people from buying them. There is also "Nasaleze Travel – Germ and Virus Prevention", but I can't see how it differs from the other Nasaleze. Same price, same ingredients.

Prices: As of today, Taffix is £51.99 for 1000mg. Nasaleze Cold & Flu Blocker is £8.95 for 800mg, less than a quarter the price of Taffix. The Vicks is a liquid, not a powder, but the price is £6 for 15ml of 1% hypro = 150mg, more than three times the cost of Nasaleze. Given that these are all basically the same thing, it looks like what you're paying extra for with Taffix is the field-testing against Covid. As for how many doses these represent, the Nasaleze says that the 800mg bottle is 30 days supply, but that would depend on how often you use it.

Obviously, these only protect against infection through the nasal tissues, and do not affect the result of breathing viruses into the lungs. I have not seen any information about which route is more important.

I have ordered the Nasaleze; it should arrive tomorrow.

Replies from: ChristianKl, ChristianKl, gilch
comment by ChristianKl · 2021-02-28T10:16:25.608Z · LW(p) · GW(p)

Preventing airborne infection with an intranasal cellulose powder formulation (Nasaleze Travel®) is an interesting paper. 

It's worth that noting that Nasaleze is around for over a decade and the website advertises "Nasaleze products are an all-natural formula that do NOT contain antihistamines, steroids or oxymetazoline and have no known side effects."

This suggests that either Taffix or Nasaleze is a low cost way to cut down on infection risk.

Given that these are all basically the same thing, it looks like what you're paying extra for with Taffix is the field-testing against Covid. 

I'm completely fine with paying money to people who run crucial studies to fight COVID-19 to reward them for their research efforts when those result in me getting risk reduction.

Replies from: korin43
comment by korin43 · 2021-03-01T03:07:52.006Z · LW(p) · GW(p)

It's really frustrating that the paper has no control group and they inexplicably only had 52 people in the study. Maybe I'm crazy, but when I see an underpowered study design, it makes me assume the product doesn't work. Companies with working products don't need to run sketchy studies..

comment by ChristianKl · 2021-03-01T15:57:16.348Z · LW(p) · GW(p)

The people at Nasaleze used hypromellose alone as the placebo in their study for Nasaleze Travel. It might very well be that garlic + peppermint in Nasaleze works just as well as Citric Acid (6%) + Sodium Citrate (4%) + Benzalkonium Chloride (0.1%) + Menthol (<0.1%) but it's not the same intervention. 

Obviously, these only protect against infection through the nasal tissues, and do not affect the result of breathing viruses into the lungs. 

The theory of action laid out in the Nasaleze paper is that if you breath through your nose, the nasal tissues do filter air before it enters the lungs. 

Interestingly, Nasaleze does seem to hold a patent on administering hypromellose + other things nasally expiring in 2027. It's for:

1. A dry powder intranasal composition comprising:

hydroxypropylmethylcellulose powder with a viscosity of approximately 10-20 Pas:

one or more therapeutic agents; and

a signaling agent, which together form a dry powder characterized in that the signaling agent allows a user to sense administration of the composition in the nasal cavity and is mint, spearmint, peppermint, eucalyptus, lavender, citrus, lemon, lime or any combination thereof and wherein the dry powder composition transforms to a gel upon contact with a nasal cavity.

It looks to me like Taffix gets around the patent by not using menthol instead of any of the listed signaling agents.

comment by gilch · 2021-02-27T22:40:11.126Z · LW(p) · GW(p)

Benzalkonium chloride is a surfactant, which might help the hypro form a gel layer, and also an antimicrobial agent. I do not know if it would affect viruses.

From previous discussion, BZK appears to effective against the coronavirus [LW(p) · GW(p)]

comment by ChristianKl · 2021-02-27T08:42:51.272Z · LW(p) · GW(p)

I don't know what the best way to get it in the US happens to be. It's however worth noting that all the ingridients seem to be available and there are compounding pharmacies like Mix Pharmacy that are legal in the US. 

comment by Dorikka · 2021-02-27T09:59:27.975Z · LW(p) · GW(p)


comment by Baisius · 2021-02-27T00:34:45.612Z · LW(p) · GW(p)

Huh. A sister (chemical) plant to mine manufactures HPMC in Belgium. That's probably what's making the actual barrier. I wonder how necessary the other ingredients are.

Replies from: ChristianKl
comment by ChristianKl · 2021-02-27T08:48:48.544Z · LW(p) · GW(p)

I think the other ingridients are there to kill the virus cells that make it onto the barrier.