|Year : 2020 | Volume
| Issue : 4 | Page : 68-72
The Ayurvedic approach toward COVID - 19 pandemic
Monika Priya, AC Kar
Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
|Date of Submission||13-Aug-2020|
|Date of Decision||18-Oct-2020|
|Date of Acceptance||26-Oct-2020|
|Date of Web Publication||28-Dec-2020|
Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: In the wake of an unprecedented pandemic of Novel Corona Virus Disease (COVID-19), the entire mankind is drenched in deaths and miseries. The inexorable inter-continental spread of this infection has trapped almost 185 countries and has massively afflicted the human health. Despite having strong backup of advanced technology and modern science, the consistent worldwide researches have not been able to yield any clinically proven prophylaxis and therapeutic strategy. This calls for the need to include plural systems of knowledge within the domain of our consideration so as to break the chain at the earliest. Herein, Ayurveda, the oldest indigenous medicine system of India, can be a potent option for its prognostic and therapeutic implications. The present study is an attempt to highlight the potential role of Ayurveda in management of COVID-19. Methods: A sincere study of classical Ayurveda textbooks and their available commentaries along with modern texts, websites and articles has been done to showcase the prognostic and therapeutic implications of Ayurveda. Results: Amidst this crisis of COVID 19 pandemic, Ayurveda needs to be merged in the mainstream health care to benefit the nation from its prognostic, prophylactic and therapeutic implications. Conclusion: Evidence-based insights should be highly encouraged to strengthen the scope of Ayurveda beyond preventive health care and care for lifestyle disorders or non-communicable diseases. It's high time for we Indians to take up the baton with wisdom and show the world the caliber of our rich traditional medicine system.
Keywords: COVID-19, Pandemic, Ayurveda, Janpadodhwansa
|How to cite this article:|
Priya M, Kar A C. The Ayurvedic approach toward COVID - 19 pandemic. J Ayurveda 2020;14:68-72
| Introduction|| |
The unfortunate outbreak of novel coronavirus disease (COVID-19) in December 2019 in Wuhan has been a morbid curse that has endangered massive afflictions toward human health worldwide and has drenched the entire humankind in deaths and miseries. It is caused by an RNA virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its transmission among humans takes place directly through respiratory droplet/saliva and indirectly by contact with contaminated objects. It primarily circulates among the reservoirs of animals such as cats, pigs, camels, and bats and has emerged thrice as COVID-19, MERS, SARS-COV in the 21st century. This unprecedented infection has inexorably spread across the continents and has trapped almost 185 countries. It has caused 741,000 deaths and more than 20.3 million confirmed cases worldwide (as of August 10, 2020). The current estimated mortality of COVID-19 for the overall infected population is 0.25%–3.0%, whereas it increases to >14% among the elderly (over 80 years), 10% in associated cardiovascular disease, and 7% in associated diabetes. The presence of respiratory diseases like asthma/chronic obstructive pulmonary disease; reduction in peripheral capillary oxygen saturation <90%; comorbid conditions such as hypertension, diabetes, coronary heart; immune-compromised state; as well as old age, womanhood and childhood appears to be the risk factors. As per the WHO, the most common symptoms include dry cough, fever, and tiredness; less common symptoms include sore throat, body ache, diarrhea, headache, conjunctivitis, loss of taste or smell, skin rashes and discoloration of fingers or toes and serious symptoms include breathlessness, chest pain, loss of speech, or movement. About 80% of COVID-19 cases presenting mild symptoms require only primary medical care, 15% of cases require urgent medical attention at secondary health-care centers and the rest 5% are critical cases requiring intensive care in tertiary health-care units. In the last case, the disease progresses gradually, i.e., it takes about 9–10 days to convert from symptoms of upper respiratory tract infection to acute respiratory distress syndrome, which is often followed by un-correctable hypotensive shock, multi-organ failure and eventually death.
Currently, there is no clinically proven prophylaxis and therapeutic strategy worldwide, despite the consistently ongoing researches strongly backed up with advanced technology and modern science. The current therapy of COVID-19 is devoid of targeted approach and includes only supportive care, symptomatic treatment, and prevention of complications. Except hydrochloroquine (HCQ) and steroids, all other repurposed experimental drugs like Remdesivir are costly and involve complex production procedures. They may also cause serious adverse events. The Drug Controller General of India has approved the Indian Council of Medical Research (ICMR) recommended protocol for the prophylactic use of HCQ even when its pharmacokinetic studies lack scientific proof. On the other hand, in such trying times, China successfully included its traditional Chinese medicine (TCM) system into its mainstream health care and eventually gained control over it. Realizing the need to include plural systems of knowledge within the domain of our consideration and in coherence with the success of TCM, it is logical and essential to explore how Ayurveda (science of life) can help in addressing the COVID-19 challenge, so as to break the chain at the earliest.
Aims and objectives
To appreciate the magnanimous role of Ayurveda in the management of COVID-19.
| Materials and Methods|| |
A sincere and deep analysis of various classical Ayurveda textbooks and their available commentaries have been done. They were critically reviewed and interpreted for this study. Modern texts, websites, articles have also been explored for the same.
Ayurveda, the oldest indigenous medicine system of India, has documented epidemics/pandemics under the context of Janpadodhwansa in the 12th chapter (Nirdesha chatushka) of Charak Samhita, Sutra sthana. Polluted air (Vikrita vayu), polluted water (Vikrita jala), polluted habitat (Vikrita desha) and polluted season (Vikrita kala) are more lethal in their consecutively increasing order and can devastate human settlements in the entire country or even worldwide. Vitiation of these four factors is caused by Adharma or unrighteousness, which is led by Pragyaparadha (intellectual blasphemy). A disease may be transmitted directly through close contact or droplet infection (Sansargaja) or indirectly through contaminated surfaces (Upsargaja).
The promising insights of Ayurveda on preventive care and prognostic aspects of a disease can be implied to maintain optimum health and immunity, and longevity. Hence, the age-old but evergreen concepts of “Dinacharya” (daily regimes), “Ritucharya” (seasonal regimes), “Rasayana” (rejuvenation and revitalization therapy) and “Panchakarma” (five internal bio-cleansing therapy) can be incorporated with a vision to boost the immunity of local risk-prone community and thereby minimize the chances of infection. Rasayana drugs like Guduchi (Tinospora cordifolia) and Ashwagandha (Withania somnifera) can constitute the core of strategy as they act as anti-oxidant, anti-inflammatory, anti-microbial, anti-stress, vaccine adjuvant, immune-modulator, and potent rejuvenator., The plausible use of Medhya Rasayana (intellectual enhancer) can not only arrest mental health degradation due to reverberating effects of lockdown but can also abate the recurrence rates. Shodhana and Rasayana therapy can be explored as a reasonable option for rehabilitation. The Ministry of AYUSH, Government of India, has issued several advisories like daily practice of Yogasana (balanced body postures), Pranayama (control of breathing), meditation, consumption of Rasayana drugs with the main focus on immune-modulation, symptomatic treatment, and self-care amidst this COVID-19 crisis. The isolated or quarantined patients may be advised to practice Pratimarsha Nasya (low dose medication through nasal route), Shiro-Padabhyanga (therapeutic massage of head and soles of feet), Gandusha (liquid/oil pulling), and Shirodhara (pouring of medicated liquids over the forehead) through automated machines. Abiding by the recommendations of Ayurveda on Ahara (diet/food), Nidra (sleep), and Achara rasayana (behavioral regimen) can also aid in future prospects of management. The meticulous cogitation of Dosha prakopa awastha (aggravation or accumulation of toxins) and Prakriti (individual constitution) can provide accurate insights on the disease pathogenesis.
The viral infections flare-up during a specific period of the year in which either the weather favors the viral potency, or the potent vectors start infecting the immune-compromised individuals. Advanced technologies in geo-ecology and climatology can predict changes in weather and environment so as to allow adequate planning to further minimize the morbidity and risks.
The alarming epidemiology and pathogenesis of SARS-COV-2 demands for a credible, pragmatic, and integral model of health care involving both prophylactic and therapeutic approaches for which Ayurveda can be sought for. The judicious use of Ayurvedic medicines can be done by rectifying the criteria of safety, potency, efficacy, availability, affordability, experimental basis of clinical use, and broad-spectrum applicability. The overall population can be segregated into four distinct categories i.e., Unexposed asymptomatic group (persons who currently do not have any related symptom nor have any associated risk factor and co-morbidities), Exposed asymptomatic group (persons who need to be quarantined as they are without apparent symptoms but are at risk due to contact history), group found positive to SARS-CoV-2 with mild COVID-19 symptoms and group found positive to SARS-CoV-2 with moderate-to-severe COVID-19 symptoms. The proposed Ayurvedic interventions, according to the above four mentioned groups have been proposed in an original article written by S. Rastogi et al. in April 2020, which is illustrated in [Table 1].
The Ayurveda fraternity as well as the research professionals and scientists worldwide should be encouraged to conduct experiments and retrospective studies on Prakriti (individual constitution), Ahara (diet), Vihara (lifestyle), and Agni (digestive power) to rule out the variation in morbidity and recovery rate in COVID positive patients. They should be to generate threads of evidence regarding food safety, critical preparedness, clinical care, readiness and response, health services, planning of resources, risk communication, prevention and control of infection, epidemiological protocols, etc. At the very outset, the Ayurveda practitioners should be geared with access to modern diagnostic facilities and should be well trained for patient screening, monitoring, data keeping, genuine prescription and precise dose fixation of Ayurvedic medicines after examining the Roga and Rogi bala. The Ayurveda hospitals may also be turned into primary health care and quarantine centers. With the infrastructure comprising 2818 Ayurveda hospitals, 15,291 Ayurveda dispensaries, 4.28 lakh registered Ayurveda practitioners and 7718 licensed Ayurveda pharmacies, it is pertinent to reiterate that participation of Ayurveda in addressing the COVID-19 challenge in India instead of employing the conventional Western approach alone.
| Result|| |
Amidst this crisis of COVID 19 pandemic, Ayurveda needs to be merged in the mainstream health care to benefit the nation from its prognostic, prophylactic and therapeutic implications. This amalgamation of plural medicine systems will complement each other and fill the voids existing in the current scenario of healthcare.
| Discussion|| |
In the wake of an unprecedented pandemic of novel COVID 19, the entire humankind is drenched in sufferings due to its inexorable spread and lack of emergence of evidence-based targeted treatment module. Under these testing situations, Ayurveda, stemming from the rich treasure of ancient Indian knowledge base, need to be merged into mainstream healthcare to benefit the nation through its prognostic, prophylactic, and therapeutic implications. Ayurveda has documented the importance of Ahara (diet), Nidra (sleep), Rasayana therapy (rejuvenation and revitalization therapy), Panchakarma, Ritucharya (seasonal regimen), Dincharya (daily regimen), Achara rasayana (rejuvenation through right code of conduct), individual's Prakriti (individual's constitution), Roga and Rogi balapariksha. The Ayurvedic therapeutic principles of Shamana (palliative procedure) and Shodhana (bio-cleansing therapy/detoxification therapy) have got promising results as the former alleviates vitiated Doshas (regulatory and functional factors of the body) and the latter cures the disease permanently. The judicious use of Rasa aushadhis in later stages of the disease can bring prompt response and buy more time as these nano-particles have good bioavailability and fast absorption power. Several clinical, animal, and in vitro studies have demonstrated the immune-modulatory and rejuvenating properties of Rasayana drugs like Ashwagandha (Withania somnifera), Guduchi (Tinospora cordifolia), and Amalaki (Emblica officinale). Some classical formulations like Sudarshan ghanvati and Sanshamani vati are used to treat conditions like fever and coryza. These Ayurveda interventions are not yet used for clinical purposes during pandemic despite the empirical evidence. The National Taskforce on COVID-19 constituted by the ICMR has recommended a protocol for the prophylactic use of HCQ, and the Drug Controller General of India has approved it even when its pharmacokinetic study is devoid of any scientific proof. On the one hand, there is insufficient evidence to recommend HCQ, and on the other hand, the participation of AYUSH resources has not been actively incorporated in tackling this pandemic. There should be a sense of moral obligation to use all available resources, but the lack of people's interest appears to be denying the empirical evidence in support of measures recommended by Ayurveda. Recently, the AYUSH ministry has received good support from the central government, but still, a lot of policy reforms are required for the greater good. The whole AYUSH fraternity must join hands with the clinicians of other medicine systems, research professionals, and scientists to work towards finding evidence in support of the statements of Ayurveda. Furthermore, sincere efforts must be made both by the Ayurveda professionals and the government bodies to benefit the population by serving them with the best possible healthcare system fortified by the annexation of both modern and traditional medicine systems. The integration of simple and safe Ayurvedic measures in the protocols for prophylaxis and treatment in the early stages of COVID-19 while adhering to the scientific standards is reasonable and justified.
| Conclusion|| |
Among the current COVID-19 crisis for which the consistent worldwide researches have not been able to yield any clinically proven prophylaxis and therapeutic strategy, Ayurveda, the oldest indigenous medicine system of India, can be employed as a potent option for its prognostic and therapeutic implications. Evidence-based insights should be highly encouraged to strengthen the scope of Ayurveda beyond preventive health care and care for lifestyle disorders or noncommunicable diseases. Its high time for we Indians to take up the baton with wisdom and show the world the caliber of our rich traditional medicine system.
Financial support and sponsorship
Department of Vikriti Vigyan, Faculty of Ayurveda, Banaras Hindu University.
Conflicts of interest
There are no conflicts of interest.
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