What do we lose as a nation if we try Neem & Hibiscus Tea for COVID-19?

Medical Mall Model: a consideration for Ghana?
Dr. Raphael Nyarkotey Obu---Professor of Holistic Medicine-Vinnytsia State Pedagogical University, Ukraine

Our cases are skyrocketing as well as the death rates. The question: What do we lose as a nation if we try our herbal medicines in this public health emergency? Interestingly, the father of modern medicine we celebrate today respect the profession of naturopathic medicine. Not only was Hippocrates a medical doctor and a surgeon, but he delved into natural remedies.

This was demonstrated on the island of Cos where there was a white willow tree and Hippocrates realized that the bark and leaves from this tree was a good analgesic.  Interestingly, in the 21st century, scientists examined the bark from this tree and revealed that, the active ingredient is what is found in Aspirin. Hippocrates was 2,300 years far ahead of Bayer Aspirin! The Hippocratic School was patient oriented, and not state oriented!

COVID 19 and China Protocol

Cheng, 2020, demonstrated the significant impact integrative medicine adoption played on taming COVID-19 in China. Litscher, 2020, agrees that, in Wuhan, in a temporary hospital in which, according to official information from the People’s Republic of China, 564 patients with mild symptoms of COVID-19 were treated with traditional herbs.

During the COVID-19 outbreak, China sent more than 3200 medical staff members from its 600 TCM hospitals to Hubei province. The State Administration for TCM also sent a team of experts under the leadership of the 3 professors and academicians Boli Zhang, PhD, Luqi Huang, PhD, MD, and Xiaolin Tong, PhD, MD, to the main site of the epidemic. The Chinese National Plan guided the clinical practice of COVID-19 TCM treatment in the early stages of the illness, reducing fever, cough, shortness of breath, and gastrointestinal symptoms.

This combination of TCM and Western medicine effectively helped alleviate the fever, dry cough, headache, sore throat, fatigue, diarrhea, and other symptoms of patients with mild COVID-19. For the treatment of moderate and severe symptoms, this integrative treatment also appeared beneficial to reduce lung exudation and to inhibit development of the disease.

In the numerous revisions of the Chinese National Plan, a lung cleansing and detoxifying herbal decoction was listed as the first choice among the TCM agents.  As of March 13, 2020, according to Chinese state television, 1261 patients in 10 different provinces received this herbal preparation. The Chinese herbs were adjusted according to mild–moderate, severe–critical, and recuperative phases of the disease.

In particular, the transition from mild–moderate to severe–critical phases of COVID-19 occurred in 10% of the patients receiving only Western medicine (WM), compared to 4.1% of patients who were treated according to an integrative approach with both WM and TCM. These data were confirmed by the academician Dr. Zhang.

A total of 16 temporary hospitals were built in Wuhan, but only one called Jiangxia primarily specialized in TCM. The 564 patients in this hospital received TCM and a few intravenous infusions, according to the experts from China.

In addition, Taiichi, Ba Duan Jin (a kind of medical Qigong), acupuncture, massage, acupressure-pressing pills on ear acupuncture points, and acupressure were part of the therapeutic efforts. The recommended acupoints for moxibustion and acupoint application were Zusanli (ST 36), Guanyuan (CV 4), Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Zhongwan (CV 12), and Shenque (CV8). The acupuncture reduced poor appetite, coughing, insomnia, and headaches of the patients who had COVID-19.

COVID-19 and India Ayurvedic Approach

Payyappallimana et al., 2020, explained that,  in India, The National Interdisciplinary Research and Development Task Force for AYUSH research in COVID-19 was constituted in India on April 2020 to streamline AYUSH’s COVID-19 response (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy).

The primary rationale was that all AYUSH interventions for COVID-19 should be rigorously built on robust research for which systematic cooperation between AYUSH and biomedical physicians and scientists is necessary. Clinical trials have been initiated to evaluate the efficacy of Asvagandha (Withania somnifera (L.) Dunal) and AYUSH 64 in prophylaxis, Guduci/Pippali (Tinospora cordifolia (Thunb.) Miers/Piper longum L.), and Yashtimadhu (Glycyrrhiza glabra L.) for the management of COVID-19. In some Indian states and specific sublocalities, there are reports of Ayurveda protocol-based interventions being administered for prophylaxis and care of COVID-19.

One study by  Joshi  and  Puthiyedath , 2020, reports for the first time, the outcomes of Ayurvedic intervention in a COVID-19 patient with severe hypoxia requiring supportive oxygen therapy. The patient was administered Ayurvedic medicines while undergoing oxygen therapy at the hospital. The patient refused to take Fabiflu recommended by the treating physician and discontinued other allopathic drugs except for Vitamin C. The patient showed clinical improvement within a day of administration of Ayurvedic medicines and was able to talk, eat, and sit on the bed without breathing difficulty.

Another  study conducted by   Girijan and Sivan, 2020, report on a  patient, who was familiar with the use of Ayurvedic medicines, fully aware that no proven cure exists in conventional medicine, decided to entirely rely on the limited Ayurvedic medicines that he had in his possession at the time of falling ill. The patient was healed with the ayurvedic medication. There are other reports on a groundbreaking interim result of a clinical trial of COVID-19 patients which has given rise to new hopes.

The patients were undergoing natural treatment for COVID-19 in three hospitals and it was found that the combination treatment of Ayurvedic remedy was able to relieve some of the symptoms of COVID-19 earlier when compared to the conventional route of allopathic treatment. The clinical trial was conducted in three different hospitals and the COVID-19 patients were given the combination treatment of an Ayurvedic remedy known as “Immunofree” by the Corival Life Sciences, and ‘Reginmune’ by Biogetica which is a Nutraceutical.

As per the reports, the combination of these natural remedies produced better results when compared to the conventional treatment approved by the government for COVID-19. These hospitals include Lokmanya Hospital Pune, Maharashtra, Government Medical Hospital, Srikakulam Andhra Pradesh, and Parul Sevashram Hospital, Vadodara, Gujarat.

On April 24 2020, the Ministry of AYUSH promoted an herbal formulation called AYUSH Kwath for ‘immunity boosting’ of the masses for the COVID-19 pandemic.   Ayurvedic kadha contains Fresh turmeric, Cloves, Black peppercorns, Tulsi, Cinnamon, Ginger, Munakka , Honey or jaggery

Anytime any argument suffices for herbal medicine, I believe that, our leaders should take a second look at some of the herbs we have promoted so far to help the fight against COVID-19. Neem Tree and Hibiscus Tea have been promoted. There is some scientific evidence in these medicines to help the fight. No one is saying they are curative!

Neem Tree and COVID-19

For instance, Baildya et al., 2020, study agrees that, there is some evidence that neem tree has some effect on SARS-CoV-2. Another study by Maurya et al., 2020, also found that, curcumin, nimbin, withaferin A, piperine, mangiferin, thebaine, berberine, and andrographolide have significant binding affinity towards spike glycoprotein of SARS-CoV-2. Another study Subramanian, 2020, assess and evaluate compounds present in leaves of Neem tree (Azadirachta Indica) as potential inhibitors for COVID-19. The compounds Hydroxychloroquine and Remdesivir were used for comparative study.

The study found, meliacinanhydride, nimocinol, isomeldenin, nimbolide, zafaral, nimbandiol, nimbin, nimbinene, desacetylnimbin in neem tree. The compounds from Neem leaves may be a potential treatment option against COVID-19, the study found.  In addition to that the leaves contain others compounds like Quercetin, Zinc, Vitamin A, Vitamin B1, B2, B6, Vitamin C, Vitamin E etc., which may boost immunity also (Garba, 2019) .

Roy and  Bhattacharyya, 2020, asserts that, neem has been reported to have antiviral potential against bovine herpes virus type-1, poliovirus type 1, duck plague virus, dengue virus type-2, newcastle disease virus, infectious bursal disease virus, avian influenza virus, and group B coxsackievirus. Neem is widely used as Ayurvedic medicine to treat fever, cough, asthma, and diarrhoea, which are also reported as the common clinical symptoms of COVID-19.

Hibiscus Tea

A recent 2021 study by Sharma et al., confirmed the potency of hibiscus tea (Hibiscus sabdariffa) to help fight COVID-19.  The researchers are also of the view that, Ocimum sanctum, Azadirachta indica, contain flavonoids which can be exploited for the development of the active compounds against COVID-19.

It should be noted that increased inflammatory responses occurs in the patients with COVID-19 which increases the death rate of the patients; therefore anti-inflammatory herbal drugs like Withania somniferaZingiber officinaleCamellia sinensis , Nigella sativa Moringa oleifera Agrimonia PilosaMomordica charantia  can be investigated in supportive treatment against COVID-19 and can be incorporated in daily routine diet of patients, which could produce a reduction in the severity and mortality rate of the patients suffering from the disease.

A study on herbal formulas also suggested that immunomodulators might show preventive effects against viral infections and likely COVID-19. Edible herbs and nutraceuticals such as Allium sativum, Zingiber officinale, Glycyrrhiza glabra, Olea europaea, Cicer arietinum, Camellia sinensis can boost immune system, preventing the body from invading viruses. Takeda et al., 2020, also agrees that, hibiscus Tea has antiviral ability.

Additionally, Agarwal et al., 2020, also support the drinking of hibiscus tea as complementary therapy against COVID-19. Yang et al., 2020, recent research and widely documented and peer reviewed journals also support the use of these recommendations. For example, in one research paper, coronavirus patients were successfully treated with Chinese herbal medicines including the use of hibiscus leaves and other roots. Hibiscus contains high levels of vitamin C along with anti-bacterial properties.

These elements combine to provide a strong foundation and boost to your immune in order to protect you from catching the flu or a cold. If you already have the flu, hibiscus can help fight your symptoms and provide you with needed relief acting as a natural source of hydration while your body fights off the virus. In one study, hibiscus leaves were reported to have high anti-viral properties which fight flu causing viruses and also prevents flu and flu-like symptoms of which the coronavirus is part.

The best form is the tea form and not the juicy one on the market is what had been documented in scientific trial for the support. The Tea form such as Nyarkotey Hibiscus Tea is very standardized with other immune boosting herbs.

Conclusion & Way Forward

Integrative medicine supports vaccination as an important pillar of our public health approach to COVID-19. Besides, any well trained Naturopathic doctor is not against vaccination in this public health emergency.  However, each system of medical practices has their own followers. True medical science translates into clinical practice. Today, acupuncture has solid science. What are the science in using antibiotic for viral infections? But several scientific studies attest to the antiviral properties in neem and hibiscus plant. Who cares when one uses neem or hibiscus tea and feels well the following day?

The researcher believes that, it is not unscientific to use herbs. It is rather unscientific to deny their use when there is extensive scientific data to support them. Unlike, pharmaceutical drugs that contain one single ingredient, herbal products are full of numerous ingredients. It is also unscientific not to visit Pubmed to evaluates the scientific information’s on natural medicines before commenting on them publicly that they have no scientific information. Market power should additionally speak to rationalists as well.

In India, there are Over 700,000 Ayurvedic physicians and their patients use ayurvedic herbs. clinicians and epidemiologists in the Cochrane Collaboration agrees that double-blind, placebo-controlled, randomised-clinical-trials are not the best way to judge true definition of all treatments, but they surrender with, ‘it is what we have’. They also admit that placebo-control designs are biased in support of pill-based interventions, which can be single-, double-, triple –blinded. The defense of peer reviewed of journals in modern medicine is also debunked due to the fact that many scientific publishers have admitted that many scientific studies have been financially influenced, leading to manipulated data, and not grounded on science or scientific gold standard.

For instance, in 2020, two prestigious leading journals retracted two high-profile papers after a company failed to make the underlying data for both available for an independent audit, following questions being raised about the research. The journals are The Lancet and The New England Journal of Medicine (NEJM).

The Lancet paper, which claimed an antimalarial drug touted by President Donald Trump for treatment of COVID-19 could cause serious harm without helping patients, had had a global impact, halting trials of one of the drugs by the World Health Organization (WHO) and others. This means that, political and scientific powers are always at loggerheads.

For instance, scientists and medical community also claimed that homeopathic medicine has no science and has a result linked to placebo effect. Several studies also attest to the fact that homeopathy works.  The problem is that, the physicist and scientists have not been able to evaluates the medical physic of the concept of water and dilutions. The problem is that, how can we assess the effectiveness of natural medicines if the government is not ready to invest and fund for scientific research into these remedies but rather relies on hearsay without taking drastic actions to test them.

In a nutshell, the patient is the best describer of complementary alternative medicines. For policy makers and political leaders, this is the time to try our herbal medicines. This is emergency and we need solution; not Marxist ideas now.

This is the time to embrace postmodernist ideas and give natural medicine a chance; incorporate their professionals in the COVID-19 management pathway as natural medicine and public health are analogous! Managing the current global pandemic requires utilizing all available treatments and resources both within conventional medicine and within the field of Traditional and Complementary Medicine (T&CM).

Postmodernist believes that, health or medical practice has evolved and therefore it is time to think beyond the box of conventional approach to healthcare. They believe that, it is time to look at new ways of approaching healthcare such as employing complementary alternative medicines into our primary healthcare delivery system.  Postmodernist also believe that, conventional views on health is not supreme and can be contested.

I believe that, the COVID-19 pandemic though exposed the lacuna in our healthcare system in Ghana and Africa in entirety, it further presents the best opportunity to having a national dialogue on Naturopathic medicines in Public health emergency in the delivery of primary healthcare.

The writer is on a mission to provide you and your family with the highest quality nutrition tips, scientific herbs and healthy recipes in the world.

DISCLAIMER This post is for enlightenment purposes only and should not be used as a replacement for professional diagnosis and treatments. Remember to always consult your healthcare provider before making any health-related decisions or for counselling, guidance and treatment about a specific medical condition.

The writer is an honorary Professor of Holistic Medicine & Naturopathic Physician-Vinnytsia State Pedagogical University, Ukraine. Nyarkotey is also a chartered Management Consultant(ChMC), Chartered Institute of Management Consultant, Canada.  President, Nyarkotey College of Holistic Medicine and currently, LLB law student. Contact: 0241083423/0541234556

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