Who thought in our life time we would live through a world pandemic? Certainly not me, but here we are finding ourselves wondering…. What in the world is going on.  Are you like many people who are uncertain of the accuracy of information being poured all over the news and social media. Are you scared and not sure what your best options are to stay heathy. Recently a live webinar hosted by Dr. John Chen, Ph.D., Pharm. D., O.M.D., L.Ac. was made available to people in the medical community focusing on Traditional Chinese Medicine (TCM). My goal with this blog is to summarize and break down the information in the webinar, explaining what the Coronavirus (Covid-19) is, the pathology, symptoms and treatment options that are being discussed today in both Western conventional medicine and TCM and then focus on TCM’s role in treatment, prevention and recovery.

The biggest fear surrounding the COVID-19 pandemic is developing pneumonia and what is sometimes called severe acute respiratory syndrome (SARS) or acute respiratory distress syndrome (ARDS). It is not the coronavirus which is actually killing people, it is the acute respiratory syndrome resulting from a cytokine storm, leading to sepsis, hypoxia, the inability to breathe and organ failure that can follow it. Most people that get coronavirus will have a mild case; some will have the virus and not have any symptoms at all and for many others it will feel like the flu. We don't have an accurate figure of how many people are infected because so many have mild or no symptoms and are not getting tested. The people most at risk of developing ARDS and dying tend to be the elderly and those that are immune-compromised.

Deepak Chopra does the best job I’ve found outlining the disease process and what makes COVID-19 so debilitating. A link to his webpage is here. He says that it is not just the virus that harms the infected, but their own immune systems.

• “The pneumonia which accompanies COVID-19 is not directly caused by the virus but rather through fibrosis caused by runaway cytokine storms within the respiratory system. The virus sabotages the infected person’s normal immune response with a scorched earth strategy, destroying antibody cells while it is being destroyed itself. The resulting chaos elicits an ever-increasing intensity of inflammatory immune reactions, which eventually begin damaging the person in addition to the virus.
  
  
• The cyclical nature of the infection/inflammation feedback loop means that recovery from the virus can take many weeks until the immune system succeeds at clearing the viral load, and during that time the inflammatory response can spiral out of control at any time. Recovery from COVID-19 is not necessarily gradual progress, especially in the most severe cases. A cytokine storm resulting in respiratory damage can occur at the end of the infection as easily as the beginning.
  
  
• Acute respiratory distress syndrome (ARDS) and septic shock ensue. These potentially fatal conditions are not caused by the virus itself, but rather the immune system’s inflammatory response to the virus, with older groups possessing more chronic conditions that increase inflammatory load, thus more rapidly spiraling into complications that require hospitalization.
  
  
• Critical condition rates are also spread among demographic groups, with a significant increase in older groups and those with preexisting conditions. This is likely because higher rates of inflammation accelerate the progression to cytokine storms that damage the respiratory system and require critical care.
  
  
• Mortality rates are dramatically skewed toward the elderly and those with preexisting conditions, which is in keeping with the premise that a heightened inflammatory load is the deciding factor in whether the patient’s immune system is able to rebalance and clear the virus without fatally damaging the patient. Those with systemic inflammation are the most likely to die because their systems are already out of homeostasis.
  

The official statement of the American Association of Naturopathic Physicians (AANP), for which I am a member, states emphatically that “All healthcare providers should refrain from making health claims or proclamations about a "cure" or product that can "prevent" or successfully treat COVID-19. There are currently no nutrients, botanicals, vaccines, pills, lozenges or other prescription or over the counter products available to prevent, treat or cure COVID-19 specifically”. They also advise naturopathic doctors to follow public health guidelines, and standard preventive medicine protocols, including basic naturopathic and lifestyle protocols that can support the immune system and mitigate the risk of exposure to infectious diseases.

I agree with the above assertions. As the COVID-19 is a novel virus, this means there has been very little proven research with this particular virus. However, we are learning a lot about how this virus works and how it can cause quite a lot of harm to a number of individuals. Most medical doctors and the profession of conventional medicine look to pharmaceuticals, a major arsenal in their tool bag to treat and help their patients. As a naturopathic physician, I don’t want to shy away from using the tools I have been trained in and have been using successfully to help patients over the last 16 years I have been in practice. As a primary care physician in Washington and soon to be licensed in Idaho as such, there are recommendations I can make based on experience and also looking at the science behind the disease process of this current pandemic and on extrapolating research on botanical extracts and neutraceuticals which have already been learned on similar viruses to the COVID-19. As “There are currently no nutrients, botanicals, vaccines, pills, lozenges or other prescription or over the counter products available to prevent, treat or cure COVID-19 specifically.” I believe in embracing the founding principles of naturopathic medical practice during this time of disruption and uncertainty and I see this as an essential service to the community in which I deeply care about.

On March 14, 2020, the Washington State Department of Health (DOH) announced the first cases of COVID-19 in Spokane County. At this time, Spokane Regional Health District (SRHD) encourages community members to follow CDC recommendations for preventing illness. If you have questions about COVID-19, please call the DOH call center at 1.800.525.0127 and press #.

The Panhandle Health District has a hotline dedicated to assisting the public. If you have any questions about coronavirus or think you may be displaying symptoms, call 1-877-415-5225.  Please call this number before visiting a physician’s office or emergency department, they will direct you where to get testing.

Think you may have coronavirus?
Here’s what to do. 

• Process for Screening for COVID-19 (as of 3/2/2020) 
  • If you have:
    • Fever (greater than 100.4) and lower respiratory illness (cough, shortness of breath and difficulty breathing) and have traveled to affected areas within the previous 14 days or have had close contact with lab-confirmed COVID-19 patient within previous 14 days, please call the Panhandle Health District hotline at 1-877-415-5225.
  • If you believe you have Coronavirus/COVID-19 based on meeting all of these criteria and need emergency care, please call the KMC Emergency Department prior to arrival at (208) 625-5700. Staff will direct you to our screening tent on the south side of the hospital, near the emergency department. 

I am pasting a link to a pdf article written by Dr. Mercola. In it, he describes how the focus of care is to support the lungs and boost your immune system.  He describes research done on SARS virus with quercetin, resveratrol, n-acetyl-cysteine (NAC), vitamin D3 and other support. I have put together a protocol I am using with my family and the supplements I am recommending to patients. Dr. Toby's Immune Support. You can use this link here or go to the handout section of this website to download other supporting materials.

Dr. Mercola's article - Essential Nutrition to Protect Yourself From The Corona Virus.

He says According to Peter Horby, professor of emerging infectious diseases and global health at the Centre of Tropical Medicine and Global Health at the University of Oxford, Novel Coranavirus Infected Pneumonia (NCIP) has the hallmark signs of "classic viral pneumonia," and since there are currently no antivirals available for NCIP, the focus of care is to support the lungs and other organs until the patient recovers.

I pasted an abstract below which looks at the importance of Vitamin D status and viral pneumonia in children. Even though children are effected less by the Covid-19 virus, this supports the idea that vitamin D3 sufficiency is very important to help decrease the chances of developing viral pneumonia.

There are things you can do to reduce your chances of getting COVID-19. These steps are a good idea for everyone, but especially for people age 65 years or older or who have other health problems:

●Wash your hands with soap and water often. This is especially important after being in public and touching other people or surfaces. Make sure to rub your hands with soap for at least 20 seconds, cleaning your wrists, fingernails, and in between your fingers. Then rinse your hands and dry them with a paper towel you can throw away.
If you are not near a sink, you can use a hand gel to clean your hands. The gels with at least 60 percent alcohol work the best. But it is better to wash with soap and water if you can.

●Avoid touching your face with your hands, especially your mouth, nose, or eyes.

●Try to stay away from people who have any symptoms of the infection.

●Avoid crowds if possible. If you live in an area where there have been cases of COVID-19, try to stay home as much as you can.

●Experts do not recommend wearing a face mask if you are not sick, unless you are caring for someone who has (or might have) COVID-19.

If someone in your home has COVID-19, there are additional things you can do to protect yourself:
●Keep the sick person away from others – The sick person should stay in a separate room and use a separate bathroom if possible.

●Use face masks – The sick person should wear a face mask when they are in the same room as other people. If you are caring for the sick person, you can also protect yourself by wearing a face mask when you are in the room. This is especially important if the sick person cannot wear a mask.

●Be extra careful around body fluids – If you will be in contact with the sick person's blood, mucus, or other body fluids, wear a disposable face mask, gown, and gloves. If any body fluids touch your skin, wash your hands with soap right away.

●Clean often – It's especially important to clean things that are touched a lot. This includes counters, bedside tables, doorknobs, computers, phones, and bathroom surfaces. Some cleaning products work well to kill bacteria, but not viruses, so it's important to check labels. The United States Environmental Protection Agency (EPA) has a list of products here: www.epa.gov/sites/production/files/2020-03/documents/sars-cov-2-list_03-03-2020.pdf. See earlier blog for info on Thymol products.

●Wash hands – Wash your hands with soap and water often (see above).

Thymol botanical disinfectants are a safe alternative to chemical hand sanitizers like Purell. We are using CleanWell, Benefect and Seventh Generation products currently in the office. These products are in shortage in stores right now. We should be having some Benefect available for patients to purchase in the coming days. I am pasting below some info from the sister companies Benefect and CleanWell below.

Do Disinfectants Protect Against Novel Coronaviruses?
Per the EPA, coronaviruses, including SARS-CoV-2, the virus responsible for the COVID-19 outbreak, are enveloped viruses. That means they’re one of the easiest to kill with the appropriate disinfectant product. Under the EPA Emerging Pathogen Guidance, EPA-registered disinfectant products that have registered efficacy against at least one large or one small non-enveloped virus are eligible for use against an enveloped emerging viral pathogen.

The EPA list referenced by the CDC includes disinfecting products that have the Emerging Pathogen Claim designation. The list is updated as products are added to it. CleanWell has submitted for approval to be added to this list.
CleanWell®’s Disinfectants Kill 99.99% of Germs and Cold and Flu Viruses. *Thymol, the active ingredient in our Botanical Disinfecting Wipes and Disinfectant Sprays, is EPA-approved and proven to kill over 99.99% of common household germs. *Specifically – Influenza A virus, (including the Pandemic 2009 H1N1 Influenza A virus), Influenza A Avian (H3N2) virus, Norovirus, Rhinovirus type 37, Salmonella enterica, Staphylococcus aureus, Methicillin Resistant S. aureus (MRSA), Escherichia coli, Pseudomonas aeruginosa, and others on hard, nonporous surfaces.

Does CleanWell® Protect Against Novel Coronavirus?
CleanWell® has recently submitted our Disinfecting Wipes and Disinfectant Sprays for approval under the Emerging Pathogen Claim to cover SARS-CoV-2.

CleanWell® personal careUse on skin (FDA regulated)Hand Soap Is Your First Line of DefenseThe CDC and WHO recommend washing your hands with soap and water as the first and best defense against fighting germs and viruses. If soap and water are not available, they recommend using an alcohol-based (60% or more) hand sanitizer. This guidance is not new for the current Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) situation; it has always been their recommendation for fighting germs in an effort to stay healthy.

What About CleanWell® Hand Sanitizers?
CleanWell® Botanical Hand Sanitizers are proudly free of alcohol and harsh chemicals (including: Triclosan, Benzalkonium Chloride, Parabens) and are non-flammable. Our products provide consumers with an alternative that moisturizes with aloe and oats and is great for kids or those with sensitive skin.

How Effective Are CleanWell® Hand Sanitizers?
Thymol, the plant-based active ingredient in our hand sanitizing products, does kill germs botanically. We have 3rd party data to support the effectiveness of our products against many types of organisms; however, we cannot publish the specifics of this testing as the FDA prohibits manufacturers from making viral reduction claims, particularly about novel coronavirus. This applies to all brands, even those with the CDC recommended 60% alcohol active. Additionally, testing for this novel coronavirus is unavailable, so no hand sanitizer can make a kill claim at this time. We continue to work with the FDA as it implements its regulatory plan for hand sanitizers as a product category.

Tips for Reducing Your Risk of Infection.
It is important to keep in mind that while hand sanitizer does reduce the most common germs and bacteria, no hand sanitizer kills them all. The most effective methods for combating germs and viruses remain the same—wash your hands, disinfect surfaces, refrain from touching your face, and avoid contact with those who are sick

What is COVID-19?
Coronavirus disease 2019, or "COVID-19," is an infection caused by a specific virus called SARS-CoV-2. It first appeared in late 2019 in the city of Wuhan, China. People with COVID-19 can have fever, cough, and trouble breathing. Problems with breathing happen when the infection affects the lungs and causes pneumonia.
 
Coronaviruses are a large family of viruses that get their name for spikes on their surface, resembling a crown (or “corona”, in Latin). Coronaviruses can cause mild illnesses, such as the common cold, and occasionally, coronaviruses are associated with more severe illnesses. We have had a few coronaviruses move across the globe, including SARS (Severe Acute Respiratory Syndrome), first recognized in 2003, and MERS (Middle East Respiratory Syndrome) in 2012-14, and now COVID-19.

Viruses attack cells by attaching to receptors on the outside of the cells. Some individuals may have more of the type of receptor that the virus latches onto to get into the cell than other individuals. Some people might not even have any of the receptors that the virus targets which could make them immune to attack by that particular virus. This genetic variability in people may explain why some people who are seemingly healthy are at greater risk and get sick.
Underlying factors such as the presence of lung disease where lung tissue is already damaged such as emphysema can increase the likelihood of both getting the infection and of having it be more severe. In China most of the serious cases and deaths have reportedly been in men over the age of 65. A friend from China told me he believes this is likely because around 50% of men in China smoke while only about 2% of women smoke. For many infections like the influenza virus the very young and the very old are often at the most risk. This is because their immune systems do not work as well. For older individuals the risk of severe complications is also increased if there are other medical problems such as heart or kidney disease.

How is COVID-19 spread?
COVID-19 mainly spreads from person to person, similar to the flu. This usually happens when a sick person coughs or sneezes near other people. Doctors also think it might be possible to get sick if you touch a surface that has the virus on it and then touch your mouth, nose, or eyes.
COVID-19 began in China. But it has spread quickly, and there are cases in many other countries, too, including the United States. Most of these happened when people got the infection and then traveled to another country. But in some cases, the virus then spreads to other people. Because of this, there are now smaller outbreaks in several different countries.

From what experts know so far, COVID-19 seems to spread most easily when people are showing symptoms. It is possible to spread it without having symptoms, too, but experts don't know how often this happens.

What are the symptoms of COVID-19?
Symptoms usually start a few days after a person is infected with the virus. But in some people it can take even longer for symptoms to appear.
Symptoms can include:
●Fever
●Cough
●Feeling tired
●Trouble breathing
●Muscle aches

Most people have mild symptoms. Some people have no symptoms at all. But in other people, COVID-19 can lead to serious problems like pneumonia, not getting enough oxygen, or even death. This is more common in people who are older or have other health problems. While children can get COVID-19, they seem less likely to have severe symptoms.

Should I see a doctor or nurse?
If you have a fever, cough, or trouble breathing and might have been exposed to COVID-19, call your doctor or nurse. You might have been exposed if any of the following happened within the last 14 days:

●You had close contact with a person who has the virus – This generally means being within about 6 feet of the person.

●You lived in, or traveled to, an area where lots of people have the virus – The United States Centers for Disease Control and Prevention (CDC) has information about which areas are affected. This can be found on their website: www.cdc.gov/coronavirus/2019-ncov/travelers/index.html.

●You went to an event or location where there were known cases of COVID-19 – For example, if multiple people got sick after a specific gathering or in your workplace, you might have been exposed.
If your symptoms are not severe, it is best to call your doctor, nurse, or clinic before you go in. They can tell you what to do and whether you need to be seen in person. If you do need to go to the clinic or hospital, you will need to put on a face mask. The staff might also have you wait some place away from other people.
If you are severely ill and need to go to the clinic or hospital right away, you should still call ahead. This way the staff can care for you while taking steps to protect others.

Will I need tests?
If you are suspected of having COVID-19, they will take samples of fluid from inside your nose and mouth and send them to a lab for testing. They might also test a sample of mucus that you cough up, as well as your urine and stool. These tests can show if you have COVID-19 or another infection. The doctor might also order a chest X-ray or computed tomography (CT) scan to check your lungs.

How is COVID-19 treated?
Most people with COVID-19 have only mild illness and can rest at home until they get better. People with mild symptoms seem to get better after about 2 weeks, but it's not the same for everyone. If you have COVID-19, it's important to stay home from school or work until your doctor or nurse tells you it's safe to go back.
If you have more severe illness, you might need to stay in the hospital, possibly in the intensive care unit (also called the "ICU"). While you are there, you will most likely be in a special "isolation" room. Only medical staff will be allowed in the room, and they will have to wear special gowns, gloves, masks, and eye protection. There is no specific treatment for COVID-19, but the doctors and nurses in the hospital can monitor and support your breathing and other body functions and make you as comfortable as possible.

You might need extra oxygen to help you breathe easily. If you are having a very hard time breathing, you might need to be put on a ventilator. This is a machine to help you breathe.