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Ayush Research and Development Task Force sees that the COVID-19 pandemic has posed several challenges to Indian healthcare. With a rise in cases and fatalities, India’s resource-poor healthcare system with persistent shortages of personnel and equipment, may not sustain an emergency response to manage the pandemic. Hence, effective prevention, early control and less resource-intensive management are most essential.
Currently, only modern medicine therapies are used on an empirical basis, however, the same principle is not considered to introduce Ayush systems. Ayush doctors should be allowed to work with allopathic experts under a national integrative protocol to manage COVID-19, said Dr Bhushan Patwardhan, Chairperson, Interdisciplinary Ayush Research and Development Task Force, Ministry of Ayush.
Teaming up with a panel of experts, Prof Patwardhan suggests that in the ethics context and in the interest of the public, simple and safe measures from Ayush systems need to be included in the integrative protocols for prophylaxis and treatment of COVID-19. The experts are Sarika Chaturvedi, Dr D Y Patil Vidyapeeth, Pune, Nandini Kumar, former deputy director-general, ICMR and vice president, Forum for Ethics Review Committees in India, Girish Tillu, Ayush Centre of Excellence, Centre for Complementary and Integrative Health, Savitribai Phule Pune University, Sharad Deshpande, former professor and head, department of philosophy, University of Pune and Prof. Patwardhan.
Decision on treatment is confronted with limited information. It ought to be based on scientific knowledge and ethical considerations, said the experts in an article published in the Indian Journal Medical Ethics titled ‘Ayush and modern medicine in COVID-19 pandemic’. The current therapy for COVID-19 includes hydroxychloroquine (HCQ), remdesivir, lopinavir/ritonavir, in combination with or without Interferon beta ß 1, convalescent plasma, manipulated cells and high dose steroids. These drugs, except HCQ and steroids, are expensive and known for serious adverse events, they noted.
Although the Union government mandates an integrative approach involving traditional and modern medicine, a lot needs to be done. However, COVID-19 patients are offered only modern medicine barring Kerala and Gujarat that have used Indian traditional medicine. Ayurveda recommends systemic prophylaxis for respiratory diseases that may benefit COVID-19 prevention but is kept out of the purview. Rasayanas have immunomodulation and rejuvenation properties in COVID-19 management. Several in vitro, animal and clinical studies have demonstrated the immunomodulatory effects of Rasayana drugs like Ashwagandha Guduchi, Amalaki among many others.
Specifically Ashwagandha and Guduchi are strong candidates for COVID-19 prophylaxis. Classical formulations like Sudarshan ghana vati and Sanshamani vati are used as safer symptomatic fever. Despite the evidence, these are not considered for clinical use during the pandemic, said the experts.
However the Union government is still making serious efforts to promote interdisciplinary collaboration. The Interdisciplinary Ayush Research and Development Taskforce on COVID-19 is a positive step. At this juncture, Ayush, Sowa Rigpa,and Naturopathy interventions showing evidence with minimal potential for harm can be used.
While intensive care should be left to allopathy specialists, Ayush doctors can be permitted to treat mild to moderate COVID-19 cases. This can be based on the WHO framework for Monitored Emergency Use of Unregistered Interventions (MEURI) supported with by Indian guidelines. MEURI evolved during Ebola, when unregistered synthetic drugs were approved to treat. This framework was recommended for future epidemics and applicable to traditional medicine with safety and efficacy evidence. When China successfully integrated Traditional Chinese Medicine for COVID-19, India should adopt the Ayush drugs as immunomodulators, noted the panel.
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