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We know that viral infections colonise the body by reproducing inside of target cells, then releasing the viral payload when the cell dies, which goes on to infect more target cells.

We know that a virus like COVID-19 spreads to other hosts in cough droplets or even in the air.

We also know that COVID-19 attacks the lungs at multiple sites of infection. (https://www.usnews.com/news/health-news/articles/2020-03-22/covid-19-lung-patterns-show-few-clues-for-treating-pneumonia)

Does it not stand to reason then, that coughing can encourage the spread of viral payloads from one site to many more sites within a person's lungs, effectively 'metastasising' the infection and forcing the immune system to fight it on more fronts?

Would it not be beneficial to avoid coughing when possible, perhaps using cough suppressants like levomenthol to open the airways and keep the infection localised to as few sites as possible?

Perhaps the infection could be cleared away naturally by the cilia, using expectorants like guaifenesin to encourage production of more viscous mucus?

  • Does sufficient evidence exist to establish menthol as an effective cough suppressant? The only paper I could dig up in a quick search was this one from 2012, which had a sample size of only 12. Or so the authors say, they also seem to have issues with counting: "Thirteen healthy adults (7 women, 5 men; age 23–36 y) participated. Twelve subjects were non-smokers." – TheEnvironmentalist May 12 at 12:08
  • I edited your question and added the link you provided. In the future, when you're asked for supporting references, please edit the question and add them instead of posting in a comment. – Carey Gregory May 12 at 19:27
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Even if you could suppress cough completely with oral medication, which is doubtful, you still have the problem that virus can be exhaled just with breathing, and more so with talking and singing instead of just coughing. SARS-CoV-2 infects the nasal epithelium, tongue, nasooropharynx, so by breathing in the virus is being carried to the alveoli.

Moreover you also can't stop the virus from spreading to other organ systems by viremia which is how it is thought to infect the heart, bowel, kidneys and so forth.

Respiratory virus shedding in exhaled breath and efficacy of face masks https://www.nature.com/articles/s41591-020-0843-2

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  • Maybe worth mentioning that coughing has a protective function. – Carey Gregory May 13 at 4:52

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