Importance of Traditional Chinese Medicine in combating COVID-19
Writer’s note: It’s a manuscript that was written on 1st June. Since we have developed the vaccines successfully (which is outrun of experts’ previous expectations), there is no need to publish it in an official journal. But, I still believe that traditional Chinese medicine is a powerful cure in combating unknown viruses or diseases, such as COVID-69. The readers may find it’s interesting to read my science fiction: COVID-69: https://socialsciences.nature.com/posts/covid-69-science-fiction
Image credit: iStock.
Since the global pandemic of coronavirus disease (COVID-19) in 2019, more than 6.2 million people have been infected and more than 360,000 people have died from the disease. Currently, at least 60 drug companies and universities worldwide are working overtime to develop vaccines and drugs to treat COVID-19. However, the predicted time for vaccine development is from a year to 18 months as indicated by a molecular virologist Peter Hotez (1). Therefore, owing to the inherent long duration required for vaccine development and subsequent time-consuming clinical trials (2), modern medical technology is proving insufficient to treat patients (3). This implies that COVID-19 will continue to pose a serious disease burden and a threat to life. Here, I suggest that all countries, governments, and medical institutions should emphasize the treatment of COVID-19 with traditional Chinese medicine (TCM) (4, 5), especially "Three Medicines & Three Formulas" (3M3F), which are mainly based on the below mentioned three practical considerations.
(1) 3M3F have been proven to have good and safe therapeutic effects and have almost no adverse side effects. In contrast, some clinical drugs used to treat COVID-19 have been shown to significantly increase arrhythmia and sudden cardiac death risk (6). Statistics from the World Health Organization (WHO) show that approximately 6% to 10% of patients with mild COVID-19, who did not receive any treatment, developed a severe form of the disease; however, at the Jiangxia Hospital of Wuhan, patients who received the 3M3F treatment did not show progression to severe disease. A National Administration of Traditional Chinese Medicine report shows that of the 1,261 patients with COVID-19 in 10 Chinese provinces who were administered the "Lung Cleaning and Detoxifying Decoction," 1,102 were cured, 29 showed symptom resolution, and 71 showed symptom improvement. In China, more than 90% of 74,187 patients who received 3M3F treatment, showed significant improvement. In contrast, a randomized, double-blind, placebo-controlled, multi-center clinical trial has shown that remdesivir is not very effective (7).
(2) 3M3F can reduce the financial burden of patients, especially in underdeveloped areas. The cost of COVID-19 treatment for eight western medicine candidates is estimated at ＄1.50 per day per person and from ＄0.30 to ＄31 for the full course of treatment (10–28 days) (8). The price of “Lung Cleaning and Detoxifying Decoction” is ＄5.91 per day per person and of “HuaShiBaidu Formula” and “Xuanfeibaidu Granule” is ＄3.41 and ＄3.07 per day per person, respectively. According to our survey in five China’s cities (see Table S1 of supplementary materials), the prices of these TCMs are quite stable. In contrast, the price of western medicine varies widely, ranging from ＄0.20 to ＄510 per course in countries that strictly hold down drug costs, such as India and Pakistan, but between ＄19 and ＄18,610 per course in the United States. In the past 2 weeks, COVID-19 has been alarmingly rampant in India, Africa, and South America, where the medical conditions are poor and population density is high. In some African countries, approximately 60% of the urban population lives in informal residences or slums, which increases vulnerability to COVID-19. If such economically backward areas adopt western medicines, they may greatly increase the risk of economic collapse and familial bankruptcy, which will subsequently lead to a series of other dire social consequences (9).
(3) The plants used for formulating 3M3F are common herbal medicines (10) with sufficient availability. These plants are cultivated in China, which is a responsible and a permanent member of the United Nations. Till date, the Chinese government has provided medical supplies to 127 countries and 4 international organizations in a humanitarian spirit. During the fight against this pandemic, China will ensure sufficient supply of 3M3F, and it is unlikely to raise prices following the surge in global demand. Moreover, it will not provide 3M3F to other nations under any political or economic conditions.
COVID-19 has already had a great impact on the global economy, which will gradually show its direct or indirect negative health effects in the future. According to the latest poll published by Gallup, one in seven American adults admitted that if they or a family member developed symptoms related to COVID-19, they would give up treatment because they were afraid they could not afford it. If COVID-19 caused an impact of the same strength in India and Africa as it did in the United States (>1.8 million infected as of June 1), it would be a disaster for humanity. Even if vaccines and specific treatments for COVID-19 are developed in the future (8, 11), it will create a large economic burden or these treatments might not be easily procured by some economically backward countries (12). If we lose any African county in the battle against this pandemic, we are destined for failure (12). At present, there are only 29 WHO-certified vaccine manufacturers globally. Even if they reach their maximum production efficiency, it is unlikely they will produce enough vaccines to meet the global demand of 7.7 billion people in a short period (Yu Wang, personal communication).
Currently, testing and quarantine are still the most important approaches to stop the spread of the virus. In a direct face-off with COVID-19, 3M3F should be valued by all countries because of its efficacy, price stability, and reasonable cost. Therefore, I call on all countries, including China, which is the largest producer of 3M3F and has successfully used it combating the pandemic and which took the initiative to create awareness regarding the use of 3M3F, to pay attention to its production, promotion, and application (5, 13).
REFERENCES AND NOTES
1. N. Akpan, Why a coronavirus vaccine could take way longer than a year. Natl. Geogr. Mag. (2020), (available at https://www.nationalgeographic.com/science/2020/04/why-coronavirus-vaccine-could-take-way-longer-than-a-year/).
2. S. Jiang, Don’t rush to deploy COVID-19 vaccines and drugs without sufficient safety guarantees. Nature. 579, 321–321 (2020).
3. Z. Jin et al., Structure of Mpro from COVID-19 virus and discovery of its inhibitors. Nature (2020), doi:10.1038/s41586-020-2223-y.
4. National Health Commission, “Diagnosis and Treatment Protocol of COVID-19 (Seventh Edition)” (Beijing, 2020), (available at https://www.who.int/docs/default-source/wpro---documents/countries/china/covid-19-briefing-nhc/1-clinical-protocols-for-the-diagnosis-and-treatment-of-covid-19-v7.pdf?sfvrsn=c6cbfba4_2).
5. R. Li et al., Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2). Pharmacol. Res., 104761 (2020).
6. E. Chorin et al., The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin. Nat. Med. (2020), doi:10.1038/s41591-020-0888-2.
7. Y. Wang et al., Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet (2020), doi:10.1016/S0140-6736(20)31022-9.
8. R. Service, Would-be coronavirus drugs are cheap to make. Science. (2020), doi:10.1126/science.abc1943.
9. M. McKee, D. Stuckler, If the world fails to protect the economy, COVID-19 will damage health not just now but also in the future. Nat. Med. (2020), doi:10.1038/s41591-020-0863-y.
10. D. Zhang, K. Wu, X. Zhang, S. Deng, B. Peng, In silico screening of Chinese herbal medicines with the potential to directly inhibit 2019 novel coronavirus. J. Integr. Med. 18, 152–158 (2020).
11. J. Grein et al., Compassionate Use of Remdesivir for Patients with Severe Covid-19. N. Engl. J. Med. (2020), doi:10.1056/NEJMoa2007016.
12. J. Nkengasong, Let Africa into the market for COVID-19 diagnostics. Nature. 580, 565–565 (2020).
13. X. Cao, COVID-19: immunopathology and its implications for therapy. Nat. Rev. Immunol. (2020), doi:10.1038/s41577-020-0308-3.
Note: Yu Wang is a Professor at the Department of Earth System Science of Tsinghua University.
I am grateful to Hui Liu (Chinese Academy of Sciences), Jing Yang (Fudan University), Fudi Wang (Zhejiang University School of Medicine) and Dan Liu for their help in investigating the prices of "Three Medicines & Three Formulas" (3M3F) which is crucial for the writing of the manuscript.