Like many of you, I’ve been closely tracking the spread of the coronavirus. It's been surprising how this new outbreak has seemingly taken the world by storm, generating hysteria, quarantines, airport shutdowns, stock market plummets, and school and industry closings. Not a lot is known about this particular strain of coronavirus, given its novelty, and so the landscape of information is changing daily, if not hourly. (I follow the global Coronavirus COVID-19 tracker from Johns Hopkins for accurate daily numbers.)
I'm adding my voice to the maelstrom of news we've been receiving simply because I believe there is much more we can do beyond sneezing into our elbows and washing our hands for 20 seconds. If you'd like to scroll directly to possible prevention and treatment strategies for COVID-19 you'll find these towards the end of this article. Keep in mind the naturopathic recommendations are theoretical for COVID-19 and are based on current anti-viral protocols.
In the interest of calming panic and getting the ground underneath our feet, facts do help. Over days of researching for this article, I've come across some writings I'd like to share with you that I’ve found helpful and empowering.
On March 5th I received news from my teacher, Dr Liu Lihong, one of the preeminent physicians in China. He is at this moment at the Hankou Hospital No.8, in Wuhan, on the front lines of the outbreak. There he’s been seeing 20+ patients in all stages of COVID-19 pneumonia. He’s working with a team of other physicians, who are using a combination of Western and traditional Chinese medicine to treat the patients currently afflicted with the virus. I find his report fascinating, specifically because these are observations from ground zero. It takes us out of the realm of abstraction and fear into the reality of understanding what these patients are experiencing, what is happening in their bodies, the nature of the epidemic and how they are responding to combination therapies with Chinese herbal medicine. (In China, Chinese herbal medicine is fully integrated into their medical system and is practiced in hospitals alongside western medicine.)
Dr. Elisa Song, a well-known pediatrician wrote this great piece that includes facts, thoughts and possible prevention/treatment options. I’d recommend reading this article in full. I’ll include below the prevention and treatment recommendations she makes based on what we know and what we might, with good reason, assume about COVID-19. You can find this below.
Who's Getting Sick:
Children are being diagnosed with the virus but do not seem to be exhibiting symptoms. Preliminary data from household transmission studies in China suggest that children are infected from adults, rather than vice versa. Previously healthy adults who’re getting the virus seem to be exhibiting mild flu-or common cold-like symptoms. However, with age, the risk of more severe symptoms does increase, with the highest risk of severe respiratory symptoms and complications (including death) being in people over 80 who have pre-existing respiratory or cardiovascular conditions. These are the people in our community we want to protect.
The data direct from China (as reported in JAMA) is as follows: most patients were 30 to 79 years of age (87%), 1% were aged 9 years or younger, 1% were aged 10 to 19 years, and 3% were age 80 years or older. Most cases were diagnosed in Hubei Province (75%) and most reported Wuhan-related exposures (86%; ie, Wuhan resident or visitor or close contact with Wuhan resident or visitor). Most cases were classified as mild (81%; ie, non-pneumonia and mild pneumonia). 14% were severe (ie, dyspnea, respiratory frequency ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio <300, and/or lung infiltrates >50% within 24 to 48 hours), and 5% were critical (ie, respiratory failure, septic shock, and/or multiple organ dysfunction or failure).
Worldwide 65,787 people who've contracted the virus have recovered, while 4,287 have died. (Click here for Johns Hopkins Coronavirus update center for latest statistics).
Common symptoms to watch for (from a recent report in JAMA) are:
· 98% exhibit a fever
· 76%-82% have a dry cough with little to no mucus production
· 11%-44% exhibit exhaustion and fatigue
Dr. Liu Lohong mentions from what he’s seeing at Hankou Hospital is that the initial stage of the infection is not characterized by the typical pneumonia symptoms such as fever and coughing. He is seeing little to no cough, while X-ray images show clear evidence of pathological changes in the lungs due to COVID-19 pneumonia. This seems contradictory, it's difficult to say why these reports are conflicting.
Other news coming from practitioners in China of success using traditional Chinese medicine in hospitals to treat patients with diagnosed COVID-19 can be found here. During the infamous SARS outbreak 18 years ago, Dr. Deng Tietao demonstrated that Chinese medicine treatment proved more effective than standard hospital procedures by saving the lives of all patients in his care at the Affiliated Hospital of Guangzhou University of TCM (See reports here). SARS, while being a different strain, and certainly less concerning than COVID-19, is also a coronavirus.
If you have further concerns, questions or needs, please do not hesitate to reach out. My schedule is available here and you are welcome to make a direct appointment with me, either in-office or by phone. Thank you for letting me be of service.
In health, happiness and staying calm
Dr. Kelly Jennings
Naturopathic Prevention Strategies:
Naturopathic anti-viral prevention protocols are designed to mobilize our internal army of natural killer cells and other anti-viral cytokines, optimize our immune system defense, and particularly, in the case of respiratory viral conditions or flus, to strengthen our lungs. Please note: As this particular coronavirus strain is new to the world, it is unknown if these protocols will be effective in the prevention of COVID-19. However, given the little evidence and research that's been done to date, it would seem savvy to consider these options. Where possible I have listed resources and references. I do not receive any commissions or money for any of the products I recommend. These happen to be my favorites - you may have your own. I use Emerson Ecologics for all my naturopathic natural pharmacy needs. (*click here to create an account for yourself to order these products directly).
Naturopathic Anti-Viral Prevention Protocols Include:
Vitamin D: at least 5,000 IU daily. I like D-Mulsion for ease of administration.
Vitamin A: at least 20,000 IU daily - this is short term, this dosage is for adults only. Don't use for longer than 6 weeks. I use A-Mulsion.
Probiotics: your choice of a multi-strain, high parts per billion (ppb) quality probiotic. I use a heaping teaspoon of HMF SuperPowder.
Lomatium dissectum tincture: To use as an antiviral treatment for flu-type symptoms take 1/4 tsp every 3 to 4 hours for 5 days in 1 cup of hot water. It can also be used for prevention, 30 drops daily in water. Lomatium dissectum is "a powerful antiviral plant that was used by Native Americans to survive the 1918 influenza epidemic and may prove to be a strong modern-day cold and flu remedy" according to a report from the University of California. The root’s anti-viral action is combined with a respiratory clearing action that is especially useful for dealing with the secondary infections caused by many strains of influenza.
Exercise regularly. The general recommendation is to get your heart rate elevated at least 30 mins 3x/week. Shoot for some dedicated movement daily, something that gets your heart moving and your body sweating. I do at least 20 minutes of Qi Gong shaking every morning.
Eat a diet of nutritious, fresh, whole unprocessed foods. And please sit down at least once a day for one of these meals!
Manage your stress levels. Deep breathing (100x daily), meditation, stretching, looking at the stars, anything that reminds you that you are a human being, not a work machine.
Get enough sleep. 8 quality hours is the usual recommendation. This is essential restore and repair time. If insomnia plagues you, come in and let's talk about. Don't ignore this!
Other Supplement Considerations. Use proven immune boosters that have been shown to help prevent colds and flu. Vitamin C (at least 3,000 mg daily), selenium is a great flu fighter (400-800 mg), as is zinc and NAC. Dosages vary per individual.
Chinese herbal medicine: possible prevention and treatment strategies
All information is based on what is currently being used by physicians and Chinese medicine practitioners currently in China, as well as recommendations from Heiner Fruehauf.
The articles I reference here have specific herbal formula prescriptions for prevention and acute treatment. In Chinese medicine, the syndrome picture is of utmost importance to clarify which herbs and formulas to use. Please click here for these specific traditional Chinese herbal applications. These can be prescribed by a licensed practitioner trained in Chinese herbal medicine.
I include Heiner Fruehauf's recommendations below. This is what our family is currently using for prevention as well as the naturopathic anti-viral recommendations given above.
Prevention (for airplane travel, etc): Thunder Pearls 2 capsules per day
Exposure: 2 Perilla Pearls + 2 Lightning Pearls 3x/day
Treatment: 3 Ease Pearls + 2 Lightning Pearls + 1 Feng Sui Dan 4x/day
You can order these remedies either from me or directly from any local practitioner who carries Classical Pearls formulas. Please go to this website and click on Find A Practitioner. https://www.classicalpearls.org
CDC Recommendations for Prevention - click here for the full article
Avoid close contact with people who are sick.
Avoid touching your eyes, nose, and mouth.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
Dr Elisa Song's Prevention Ideas for Coronavirus (from Dr. Elisa Song article, please refer to her article for references). These are theoretical possibilities that are based on naturopathic anti-viral protocols and other relevant research.
"Sambucus Formosana Nakai (a species of elderberry similar to Sambucus nigra or black elderberry that has been found to have anti-flu activity) was found to have strong activity against Human coronavirus NL63 (HCoV-NL63). See reference here. NOTE: This is NOT the same as the elderberry syrup you’ll find on shelves). The caffeic acid component of Sambucus Formosana Nakai seemed to be responsible for most of the anti-HCoV-NL63 activity, and significantly inhibited replication and blocked attachment of HCoV-NL63. Caffeic acid is NOT related to caffeine, but is found in many foods such as coffee, wine, turmeric, basil, thyme, oregano, sage, cabbage, apples, strawberries, cauliflower, radishes, mushrooms, kale, pears, and olive oil."
My thoughts here: Sambucus formosana is synonymous with Sambucus chinensis. I haven't yet found any sources online for this plant. However, it is possible that Sambucus nigra, black elderberry syrup, has similar action. A recent study done in Australia had travelers take elderberry capsules or placebo before and during travel and then compared people in both groups who came down with respiratory viral colds. Elderberry reduced the severity of the symptoms and reduced recovery time by two days on average. Does that mean elderberry will stop you from getting coronavirus? No one has done that research yet. If you'd like to read the original source for this study, click here.
"Vitamin D has been called a “pro-survival molecule.” Vitamin D not only helps the immune system to be dampened during an excessive or chronic reaction (anti-inflammatory potential) but also to rapidly reach its completion or exhaustion, helping innate cells to kill bacteria or viruses. In this sense, vitamin D maintains its pivotal role as a pro-survival molecule. Cathelicidin produced by Vitamin D can neutralize LPS (lipopolysaccharides) that are responsible for so much of the damage that we see in sepsis, and also has antimicrobial and immunomodulatory effects. Vitamin D deficiency may actually be considered a risk factor for sepsis and inflammatory disorders, so please ensure that you and your child’s vitamin D levels are optimized.
Treatment Ideas for Coronavirus (from Dr Elisa Song article)
"COVID-19, sepsis & cytokine storm: When patients with COVID-19 die, it is often due to sepsis, in which the immune system goes haywire and overreacts in what is called a “cytokine storm.” Natural agents that are immunomodulatory and immunoregulatory, and bring BALANCE to an overactive immune system, may be one of the best options to support patients with sepsis. Here’s what the literature shows for what may be helpful for critically ill patients with sepsis. In life-or-death critical situations like sepsis where conventional medicine does not offer significant success, I would urge researchers to consider all potential treatment options for further investigation.
Vitamin C, 1.5 grams IV every 6 hours (6 grams total daily), given with hydrocortisone and thiamine was found to significantly decrease mortality and prevent progressive organ failure in patients with sepsis. In fact, patients treated with the vitamin C protocol had an 8.5% death rate compared with 40.4% in the control group! Thankfully, there is currently a research trial underway to investigate vitamin C infusions for the treatment of severe 2019-nCoV infected pneumonia where patients in the treatment group will receive 24 grams of Vitamin C daily for 7 days.
Other Natural Agents: A journal article from 2014, Therapeutic interventions in sepsis: current and anticipated pharmacological agents by Shukla P, et al, is probably the best article I’ve found on evidence-based yet outside-the-box thinking of potential natural treatment options for sepsis that warrants further investigation. Here are just a few of the fascinating findings:
Curcumin has been found to inhibit NF-kB – potent activator of inflammation in sepsis. Curcumin was also found to inhibit binding of LPS and suppress the LPS-induced inflammatory response and damage seen in sepsis, while improving survival, in a mouse model of sepsis.
Quercetin has also been found to inhibit the NF-kB pathway, and to improve survival and decrease cellular damage in a mouse model of sepsis.
Naringin, a flavonoid found in the skin of citrus fruit, ameliorated LPS-induced sepsis in mice, via the NF-κB pathway, and reduced LPS-induced acute lung injury.
The probiotic Bacillus sp strain LBP32 has extracellular polysaccharides (EPS) that were found to inhibit the LPS-induced release of many pro-inflammatory mediators (such as NO, ROS, IL-6, and TNF-α) by inhibiting the NF-κB pathway. Researchers were able to demonstrate that EPS could greatly improve the outcome of mice with LPS-induced endotoxic shock. [Please note: this particular Bacillus strain is not available commercially that I can find. I included it for research purposes. I do not know if other strains would have similar benefit but we do know that probiotics have amazing immune-supporting properties in general…]
Boswellia (Frankincense) can inhibit LPS-induced inflammation in sepsis. This study found that Casperome® (Casp), an orally bioavailable soy lecithin-based formulation of standardized frankincense extract, was able to ameliorate the systemic effect and multi-organ damage induced by severe systemic inflammation using a mouse model of sepsis.
Lomatium dissectum is a Native American traditional root that was claimed to have prevented the Washoe Indian tribes from dying during the 1918 influenza pandemic (also called the Spanish flu pandemic). In SARS-CoV sepsis, one of the inflammatory chemokines involved is CXCL10. Poor prognosis with Influenza A is also associated with CXCL10 dysregulation. Lomation dissectum, used by Native Americans in Western US to treat influenza, was found to inhibit CXCL10 secretion by lung cells and may explain why during the 1918 influenza pandemic, L. dissectum was hailed as the cure for influenza and influenza-associated pneumonia."