There are elaborate descriptions of the causation and management of epidemics [janapadodhwamsa], in Ayurveda classics, although clinical profiling of COVID-19 is necessary to provide preventative and therapeutic insights.
Research efforts have now established clinical profile, although there is no unanimity as yet. One of the most important efforts by a team of vaidyas and physicians from the biomedical system suggests that the disease should be considered as vātakapha dominant sannipātajvara of āgantu origin with pittānubandha.
This study also described the asymptomatic, pre-symptomatic, mild, moderate, severe, and critical stages of COVID-19, along with differences in clinical presentations on the basis of nidāna, doṣha, dūṣya, nidānapañcaka, and ṣaṭkriyākāla.
Many studies have arrived at similar conclusions. Another important study by the team of vaidyas and scientists from the National Institute of Ayurveda has suggested that COVID-19 has an analogy with the rajayakshma with suboptimal immune response.
The Scope For Ayurveda: Ayurveda against COVID-19
Apropos of the scope for Ayurveda against COVID-19, as elucidated in one of the earliest publications on the subject, a plan for graded response, depending on the stage of infection among individuals, in a population, was proposed.
This pragmatic strategy classified people into four groups — unexposed asymptomatic, exposed asymptomatic and quarantined, with mild COVID-19 symptoms, and with moderate-to-severe COVID-19 symptoms — and, accordingly provided a management regime.
It has also been argued that the supremacy conferred on biomedicine, notwithstanding the fact that it does not have a proven cure, required that Ayurveda interventions must be allowed on similar principles.
Despite having a large potential and kept India reasonably healthy for 5,000 years, if, we, in India, fail to extensively employ the world’s longest surviving healthcare system to treat COVID-19, it will be a great loss to humanity.
There are a reasonable number of publications that provide enough guidance and evidence that Ayurveda may, indeed, be helpful in the treatment of COVID-19 patients.
These publications include both prophylaxis and therapeutic interventions. On prophylactic, or preventive, aspects, scientific evidence based on long-term research indicates that Ayurveda rasayanas and other Indian medicines can be a potential candidate for the management of COVID-19 cases.
A protocol along with supporting evidence has been presented on prophylaxis which also analyses and supports the guidelines issued by the Ministry of AYUSH, Government of India.
The potential usefulness of Ayurvedic and Unani herbs against COVID-19 has also been described. The evidence of a known case of a COVID-19-positive patient treated entirely with Ayurveda is also available. Thus, there is every reason that Ayurveda ought to be employed for the treatment of COVID-19.
Studies On COVID-19: Ayurveda against COVID-19
While there are a large number of studies on various medicinal herbs and formulations that have been published, clinical studies are currently limited because clinical trials in Ayurveda did not receive the required facilitation from the early days of the pandemic.
There are a large number of clinical trials registered in the Clinical Trials Registry of India, and it is expected that the outcome of these researches would become available in public domain soon. However, a few studies that have already appeared provide useful insights into the usefulness of Ayurveda and integrative approach.
That known case of a COVID-19 positive patient who was the first to be treated entirely with Ayurveda should have actually encouraged the healthcare policymakers to quickly use Ayurveda to bring the COVID-19 pandemic under control in India, as they seemed to have demonstrated it in China with Traditional Chinese Medicine [TCM].
Another case report on the outcomes of Ayurvedic care in a COVID-19 patient with hypoxia may provide useful guidance. The report provides for the first time, the successful outcomes of Ayurvedic intervention in a COVID-19 patient with severe hypoxia requiring supportive oxygen therapy.
This provides hope that Ayurveda care may be useful as a first-line, cost-effective and efficacious option for COVID-19 patients presenting with hypoxia in an integrative setup. Since the patient had a high risk for progression to severe disease condition because of many co-morbidities, favourable outcomes with Ayurvedic treatment are significant.
Yet another useful prospective clinical study of an Ayurveda regimen in COVID-19 patients has recently appeared. In this study, 112 patients were screened as per the inclusion criteria, 11 failed the screening, and, finally, 101 patients were recruited in the trial.
Two patients complained about difficulty in swallowing the tablets and were discontinued on day three. Ultimately, among those 99 patients that completed the study, 60 patients received Ayurveda regime as add-on, and 39 patients received only standard care.
The study found that the median day of admission from the onset of symptoms was 6th [range: 1st–12th] in the treatment group, while it was 5th day [range 1st–16th] in the control group. Patients with co-morbidities, such as diabetes and hypertension, were 90.04 per cent. Asthma and hypothyroidism were observed as other co-morbidities among the rest.
The patients suffering from breathlessness fell from 53 per cent to 16 per cent to 1.6 per cent on days 1, 3, and 7, respectively, in the treatment group. In the control group, the percentage fell from 46 per cent to 38 per cent to 28 per cent only. Ageusia reduced from 75 per cent to 25 per cent to 3.3 per cent in the treatment group.
In the control group, it dropped from 46 per cent to 36 per cent to 26 per cent. Overall, prompt clinical improvement in breathlessness was seen with the add-on Ayurveda regimen. The duration of hospital stay was also reduced. Thus, insights from this study demonstrate the potential of Ayurvedic therapy in treating COVID-19 patients.
Even the widely promoted non-pharmaceutical interventions against COVID-19 including quarantine, cordon sanitaire, and social distancing and healthy lifestyles have their origin in Ayurveda. These are erroneously thought to date back to the 14th-century Europe. In reality, these originated in India in the 5th century BC.
In a city now known as Varanasi, a legendary teacher and king of Kashi, Lord Dhanvantari explained to a class of his students, about how infectious diseases spread and what needs to be done to contain social spread of infections. The renowned scholar of Ayurveda and surgery, Suśruta, was one of the students in the class. He compiled one of the most ancient scientific treatises of surgery and the science of life known to humanity.
This treatise, now known as Suśruta Samhita, made Suśruta, the father of surgery. About the infectious diseases, as Suśruta notes, contact with the body of the infected person; breathing in the air containing the exhaled air of patient; eating, sleeping, and sitting together; and, using cloths, garlands, and cosmetics used by an infected person — all these actions transmit diseases, such as skin infections, fever due to infections, pulmonary tuberculosis, ophthalmia, or conjunctivitis, and other contagious diseases, from one person to the other.
Consequently, the complete avoidance of these actions is necessary to prevent the transmission of infectious diseases in the community.
Way Forward
Scientific advancements occur only when the knowledge produced by a scientific enterprise is robust, irrefutable, replicable, and unequivocal. This applies equally to Ayurveda and conventional medicine. This is important to understand that every healthcare system existing and practiced in the world has a primary motive of providing optimal healthcare to their followers.
A healthcare system having an uninterrupted history of its practice and knowledge transference for over five millennia itself, such as Ayurveda, speaks about the potential utility it may possess.
There can be epistemological differences of looking at the same phenomena which may be understandable on the basis of historical evolution of the knowledge, but knowledge cannot be refuted simply for the reason that it is not understandable by the people who believe in another set of philosophy.
It is now high time that perpetual animosities between vaidyas and conventional physicians [allopaths] should end for the common good of the humanity.
The solutions to resolve the COVID-19 pandemic are complex, multifaceted, and recalcitrant; they, therefore, require evidence-based decision-making on multiple fronts.
A way forward would be to acknowledge that scientific research strengthens and augments evidence base, yet if Ayurveda was non-scientific, it would not have survived for 5,000 years.
Any denial of this evidence, as well as evidence from the contemporary studies, is, indeed, a form of pseudoscience. We must draw on all systems of knowledge, rather than be enslaved by Western medicine that currently lacks evidence as also direction.
