In the war against the COVID – 19 pandemic, Medical sciences has to use all the weapons at its disposal. While, Modern Medicine is doing their best in containing the Corona Virus with all opathic drugs in their arsenal and developing a vaccine to protect the population from the corona virus, Traditional Indian Medicine is not far behind in the war against the virus.
Under the able guidance of the Ministry of AYUSH, Ayurveda, Yoga, Unani, Siddha, and Homeopathy streams of traditional doctors are working on a war footing to prevent the virus from spreading and nullifying its ill effects in a holistic way by building and boosting up the Immune system which in turn helps the body in resisting the Virus and cope with ill effects of the Corona Virus.
Role of Ayush on COVID 19 - LSW Feature
Although vaccines are being developed by modern medicine system, it will take quite some time to judge the success rate of treatment and cure. The other aspects of getting to know the efficacy and adverse effect caused by the vaccines also will take time.
Prevention is better than cure. This wisdom of thought is the best way to practise during this pandemic. The modern medicine does not have treatment for preventive care. This is where the traditional medicines come to the forefront.
The age old Ayurveda and other allied systems viz., Yoga & Naturopathy, Siddha, Unani and Homoeopathy have proven records with various preventive measures for any kind of infection, virus, illnesses and diseases
During this current pandemic, Ayurveda system of using inhaling steam, gargling and consumption of household cooking ingredients like ginger, pepper, turmeric etc have proved to boost immunity towards the corona virus as preventive measures.
The Ministry of Ayush has taken various steps towards combating this pandemic.
According to Advisory from Ministry of Ayush for meeting the challenge arising out of spread of corona virus (COVID 19) in India, the Ayush approach to manage the outbreak broadly comprise of:
Prevention,
Symptom management of COVID 19 like diseases and
Add-on Interventions to the conventional care.
During the very early stages of this pandemic, Ayush Ministry came out with the best methods for the boosting of immunity against the virus.
Recommended Measures
I General Measures
1. Drink warm water throughout the day.
2. Daily practice of Yogasana, Pranayama and meditation for at least 30 minutes as advised by Ministry of AYUSH (#YOGA at Home #Stay Home #Stay Safe)
3. Spices like Haldi (Turmeric), Jeera (Cumin), Dhaniya (Coriander) and Lahsun (Garlic) are recommended in cooking.
II Ayurvedic Immunity Promoting Measures
1. Take Chyavanprash 10gm (1tsf) in the morning. Diabetics should take sugar free Chyavanprash.
2. Drink herbal tea / decoction (Kadha) made from Tulsi (Basil), Dalchini (Cinnamon), Kalimirch (Black pepper), Shunthi (Dry Ginger) and Munakka (Raisin) - once or twice a day. Add jaggery (natural sugar) and / or fresh lemon juice to your taste, if needed.
3. Golden Milk- Half tea spoon Haldi (turmeric) powder in 150 ml hot milk - once or twice a day.
III Simple Ayurvedic Procedures
1. Nasal application - Apply sesame oil / coconut oil or Ghee in both the nostrils (Pratimarsh Nasya) in morning and evening.
2. Oil pulling therapy - Take 1 table spoon sesame or coconut oil in mouth. Do not drink, Swish in the mouth for 2 to 3 minutes and spit it off followed by warm water rinse. This can be done once or twice a day.
IV During dry cough / sore throat
1. Steam inhalation with fresh Pudina (Mint) leaves or Ajwain (Caraway seeds) can be practiced once in a day.
2. Lavang (Clove) powder mixed with natural sugar / honey can be taken 2-3 times a day in case of cough or throat irritation.
3. These measures generally treat normal dry cough and sore throat. However, it is best to consult doctors if these symptoms persist.
1 The above measures can be followed to the extent possible as per an individual’s convenience.
2 These measures are recommended by following eminent Vaidyas from across the Country as they may possibly boost an individual’s immunity against infections.
The Homoeopathy system recommends Arsenicum Album 30
Unani Medicine suggests Khameera Marwareed, Tiryaq Arba, Decoction of Behi dana (Cydonia oblonga) (3 gm), Unnab (Ziziphus jujuba) (5 pcs.), Sapistan (Cordia myxa) (9 pcs.)
Siddha system which is more of holistic approach states the Kaba sura kudineer and Jacom, a herbal preparation are found to effective aginst COVID 19.
The Ministry also published guidelines to the practitioners of Ayush system of medicine which mentions important information on managing the corona virus.
In October 2020, the Ministry of Health & Family Welfare and the Ministry of Ayush jointly released the National Clinical Management Protocol based on Ayurveda and Yoga for the management of COVID 19.
According to a statement from Ministry of Ayush, an Interdisciplinary AYUSH Research and Development Task Force with a group of senior experts to formulate and develop strategies for this initiative. The Ayush Ministry has undertaken many clinical, observational studies to understand the role of AYUSH intervention in mitigation and management of COVID 19. It has also setup a Interdisciplinary Committee for Integration of Ayurveda and Yoga Interventions in the 'National Clinical Management Protocol: COVID-19.
Under the prevailing situation, many countries are working on the integration of traditional methods and modern medicine system to combat the current pandemic situation. In India, it is found out that Ayurveda and Yoga can play a prominent role in the prevention of COVID 19.
The five Central Research Councils under the Ayush Ministry which are Central Council for Research in Ayurvedic Science(CCRAS), Central Council for Research in Yoga and Naturopathy(CCRYN), Central council for Research in Unani Medicine(CCRUM), Central Council for research in Siddha(CCRS) and Central council for Research in Homoeopathy(CCRH) are engaged in ongoing research and studies in their respective system of medicines.
LSW sought exclusive inputs from Siddha and Unani Council:
Dr. K Kanakavalli, Director General, Central Council for Research in Siddha(CCRS). - Potential Role of Siddha therapeutics to Mitigate COVID-19
Preamble
Prevention of outbreaks of emerging and re-emerging diseases, control of non-communicable diseases, the health impact of environmental degradation and climate change are some of the great challenges being faced by every health care systems of the world. The National Health Policy (NHP) 2017 has strongly advocated mainstreaming the potentials of AYUSH systems there by and re-emphasizing the need for integrating AYUSH in the National Health Mission, Research and Education.
History and Background
Siddha system of medicine, one of the oldest indigenous systems of medicine, popular among the Tamil speaking people around the world. Eighteen Siddhars remain the core elite who have contributed to its literature. Siddha is one among the AYUSH systems of medicine recognised in India. Siddha medicines and lifestyle practices are largely therapeutic and preventive in nature.
Fundamental Principles of Siddha
Human body being is considered the microcosmic replica of the macrocosm (universe) and composed of five primordial elements. Holistic approach is the cornerstone of Siddha treatment. Treatment procedures in Siddha help in normalizing the altered vital life factors. Taste of food and medicine has been accorded lot of importance in the principle of treatment. Every taste is constituted by the combination of two basic elements. Moreover, the Siddha literature displays the profound knowledge and intellect of the ancient sages with meticulous cues of medicine preparations, its usage with various adjuvants for treating of different spectrum of diseases along with dietary-lifestyle practices combined (Pathyam-Apathyam). The skill of reasoning is exhibited through the “Alavai”, a ten-pronged unbiased approach of evaluation.
An apt definition of Siddha Medicine contemporary to definition of health provided by the World Health Organization is as follows: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Personalized medicine and disease prevention are the core concepts of Siddha system of medicine which is also emphasized in P4 medicine – the future trend of health care. P4 is an approach to make medicine more Predictive, Preventive, Personalized and Participatory. Its two major objectives are to quantify wellness, predict and prevent disease. Siddha system of medicine emphasizes the quality of life through various preventive and promotive healthcare measures.
Siddhars have also recommended certain basic lifestyle guidelines for healthy life. Besides various holistic treatment methodologies, “Kayakarpam” is one of the important disease preventing and health promoting concept in Siddha. They recommend simple lifestyle practices, daily regimen and seasonal regimens for prevention of diseases and promotion of health. These disease preventing practices are aimed to increase the immunity towards both physical and mental illness.
AYUSH and Government Schemes in India
Decades before, the Siddha system was confined to particular tenet, but now with edge of new schemes, advent of technology and initiatives by Governments, the Siddha system is able to steadily expand its tenets to other parts of the country. Siddha has been playing an inevitable part in providing basic healthcare needs through National AYUSH Mission (NAM), National Rural Health Mission (NRHM), Swasthya Rakshan Programme (SRP) and various other schemes under the Ministry of AYUSH. The state Directorates of Indian systems of Medicines play a major role in taking the Ministry schemes to the masses. Ministry of AYUSH had taken major steps in popularising Siddha, through Establishment of CCRS with its 8 peripheral Institutes/Units and Educational support through National Institute of Siddha. Many instances where Siddha worked together as integrative medicine is witness to the fact, it is of Public health importance. One example to quote, is that the Siddha COVID Care centres (SCCC) in current pandemic scenario working round the clock to treat COVID-19 positive patients through exclusive Siddha treatment. The results have been highly encouraging with the number of early recoveries and sero-negative conversion among the highly symptomatic positive patients.
It is reiterated that the National Health Policy (NHP) 2017 has strongly recommended mainstreaming of AYUSH. This facilitates Healthcare access with affordability among the rural masses and goes an extra mile in prevention strategies. AYUSH therapies are complimentary to each other rather than being competitors. Siddha system is more suited to paediatric and geriatric population in terms of their herbal source and palatability and comparatively lower side effects.
Research Activities of CCRS
Central council for Research in Siddha (CCRS) under the aegis of Ministry of AYUSH, emphasises meticulous research, capacity building, adoption of newer approaches to aid the need for expositing scientific basis of the Siddha philosophy. This is done through selection of appropriate research study methods, applied technology and appreciation of trans-disciplinary collaborative research among others. The research activities of the organisation have been prioritised to the current COVID-19 pandemic scenario. In this connection, several preclinical drug and clinical interventional studies have been initiated.
The phytoconstituents of Kaba sura Kudineer (KSK) and JACOM, a novel herbal preparation for treating viral fever and respiratory infections were found to be effective against COVID-19 spike protein with good binding affinity and interactions. Pharmacological studies have proved immunomodulatory, thrombolytic and significant anti-viral activity of KSK, which has been widely advocated for prevention and management of COVID-19 infections. Further KSK had showed significant inhibitions of Viral replication of COVID-19 similar to that of the standard drug Remdesivir, substantiating its use.
The preliminary results of a large-scale prophylactic study titled “a prospective Non-randomized Open label Controlled Interventional study on the effect of Siddha intervention – Kabasura Kudineer (KSK) as a Prophylactic measure among high risk population (Health Care Workers / Containment Zone population) exposed to COVID-19 (SIDDHALION)” has been encouraging and will be published in a peer reviewed journal.
The results from prospective, non-randomised single arm interventional study conducted to assess the safety and efficacy of Siddha Sasthric medicines – Fixed regimen in the prevention of COVID-19 disease progression of asymptomatic and mild at Siddha COVID care centre, Chennai have been in the positive note (SSM-FiRe). Results are to be published in a peer-reviewed journal. The case series’ study conducted at Tripathi COVID Centre has shown that KSK fares satisfactorily as add-on therapy. A cross sectional study was conducted to observe the general awareness, practices regarding COVID-19 related prevention, control and promotive measures in Tamil Nadu.
A double-blinded RCT research trial has been initiated in collaboration with the Government Institute of Medical Sciences (GIMS), Greater Noida, SCRU, New Delhi to evaluate the efficacy of NVK and KSK in symptomatic COVID -19 patients and the interim results are encouraging. A clinical trial to ascertain the immuno-modulatory potential of the KSK in asymptomatic contacts of Covid-19 cases in association with Sri Ramachandra Institute of Higher Studies, Chennai is in pipeline.
The question whether Siddha can address the problem of Pandemic is well-addressed by the success reaped through the effective functioning of the 29 exclusive Siddha COVIDcare centres (SCCC). The holistic Siddha treatment at the in-patient care facilities delivered free of cost and the diligent efforts of the Siddha fraternity have been a boon for the economically needy sections of the society. This proves that Siddha as a part of the AYUSH systems has evolved as a convenient health care substitute given the current scenario.
The research activities seek to substantiate the antiviral activity and respiratory immunity boosting potential of the Siddha drugs coupled with the anti-inflammatory potency has worked for the early response rate and clinical improvement as suggested by the retrospective survival analysis done to assess the length of COVID positive patients at Government Medical College and ESIC, Coimbatore under the Integrated medicine protocol.
The Department of India Medicine and Homoeopathy, Government of Tamil Nadu
The Department of Medicine and Homeopathy, Government of Tamil Nadu has been continuously giving master COVID training to Doctors, Pharmacists and other staffs. Siddha medicines, NVK and KSK are being dispensed for Home-quarantine patients. KSK is dispensed for the Patients at isolation wards in government hospitals for early recovery. AYUSH cells have been formed at State, District and block levels for implementation of the AAROKYAM plan initiated by the Government of Tamil Nadu.
Conclusion
Siddha provides customised treatment modules according to the body constitution and presenting symptoms. Siddha medicines enable one’s ability to fight diseases and hence early recovery without development of major complications. Many Modern Hospitals introduced KSK as part of the patient’s routine medication during hospital stay and had advised it for health care workers. This is the impact the Siddha medicines has created. In conclusion, it is noteworthy to point that Siddha system has gained steady resolute among people in mitigating the pandemic mainly due to the perseverance and continuous efforts of the Siddha community.
Prof. Asim Ali Khan, Director General, Central Council for Research in Unani Medicine (CCRUM). - Current activities in Unani Medicine’
In India, the Corona virus pandemic has presented both opportunities and challenges for the AYUSH systems of Medicine namely Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy. The Government of India has taken several initiatives to utilise the vast potential of AYUSH in this pandemic. Ever since the coronavirus pandemic began, major emphasis has been laid by the Government on immune enhancement modalities. The Ministry of AYUSH, has released a set of guidelines for boosting immunity and measures for self-care. The Ministry has also launched a three-month “AYUSH for Immunity’ campaign on 14.08.2020, aimed at increasing awareness about affordable and easy practices that can be adopted for enhancing immunity and preventing any disease. The key objective of the campaign is to acquaint the people with valuable information about the strengths of various AYUSH-based solutions for enhancing immunity and preventing diseases.
Unani System of Medicine is an Integral part of India’s healthcare delivery system. It is based on the specific principles put forward by Hippocrates. Unani Medicine recognizes the influence of surroundings and ecological conditions on the state of health of human beings. Apart from treating disease conditions, Unani Medicine lays great emphasis on the prevention of disease and promotion of existing health through principles of six essential factors (Asbab-e-SittaZarooriyah) of life. It lays great emphasis on the maintenance of a proper ecological balance and on keeping air, water and food free from all possible pollution and pathogens.In Unani Medicine, prevention has been preferred to treatment. Its classical literature mentions that Quwwat-i-Mudabbira-i-Badan / Tabi'at (Medicatrixnaturae) is the supreme power, which controls all the physiological functions of the body and provides immunity against diseases. The disease conditions are considered to occur due to weakened medicatrixnaturae and may be cured by its strengthening (including immunomodulation).
As per Unani classical wisdom, improving immunity with immune boosters is one of the key approaches for prevention of disease and maintenance of health. Therefore, a strategy to enhance immunity and provide symptomatic relief in upper respiratory tract infection is advocated.
The Central Council for Research in Unani Medicine, (CCRUM) an autonomous organization, under the Ministry of AYUSH, has brought out advisory for immunity boosting measures during thepandemic. A strategy to enhance immunity and provide symptomatic relief in upper respiratory tract infection is advocated in these guidelines for qualified Unani Medicine practitioners. The Guidelines also describe the General Measures for enhancing Immunity, tips to maintain health based on six essential factors (Asbab-e-SittaZarooriyah) of life, special care for maintaining health in elderly and immunity enhancing drugs. These guidelines are available on the websites of the Council (www.ccrum.res.in) and Ministry of AYUSH (www.ayush.gov.in)
The CCRUM is participating hand in hand with the Ministry of AYUSH in the “AYUSH for Immunity”, campaign by creating awareness on the importance of immunity in the times of Covid-19 pandemic. The Council along with its network of 22 peripheral institutes across India is spreading information about the strengths of Unani medicine and its advises for enhancing immunity and preventing diseases. Daily tips on immunity enhancement are being given to the patients attending Unani OPD’s at the peripheral Institutes. Other activities include guest lectures, display of posters, pamphlet distribution, Writoskill, slogan writing competition etc. The AYUSH Unani Facebook page is active with regular posts onusage of immune enhancement diet, drugs and measures.
The Council has also launched population-based interventional study and add on studies on the impact of Unani intervention for prevention of COVID-19. The population based studies are being carried out in high-risk population in six cities across India through the Council’s centers in Lucknow, New Delhi, Mumbai, Aligarh, Srinagar and Bangalore. The add on studies are being conducted in collaboration with dedicated COVID management centers in Delhi. It is anticipated that the studies will be able to generate evidence-based data in the support of Unani Intervention for the prophylaxis against Covid 19 and pave new horizons in understanding the preventive potential of Unani Medicine.