Yesterday I read a graph that predicts Seattle, where I live, will have our peak of Coronavirus cases from April 7th-21st. It varies city-to-city, state-to-state and country-to-country depending on when the disease arrived and how (or if) it is being contained. So I know this will get worse before it gets better. The fear we are all living with is real.
I read another article that said people are scared of the coronavirus but they are more scared of what is going to happen to the economy. There are so many unknowns. I have been out of work for almost 2 weeks. When I walk my dog around our bright and bustling neighborhood, there are few people on the street. Restaurants are boarded up. “Rent Strike” signs are everywhere.
I don’t know which to be more scared of either.
My offering here is information in the hopes of keeping people healthy and out of the hospital so those that really need that level of care and equipment have access to it. So that we can get through this efficiently, with as few lives lost as possible, and quickly, so we can get back to the interactions that allow us to work, socialize and thrive.
TCM treatment of COVID19
In a webinar I listened to recently on how to treat COVID19 with Traditional Chinese Medicine, highly esteemed acupuncturist, Chinese herbalist and western pharmacologist Dr. John Chen began the lecture by talking about epidemics. He pointed out the number of epidemics present in the last 2000 years of China’s history- roughly 320 large-scale epidemics in 2000 years. That’s one every 4-6 years. Most of them fizzle out before they reach pandemic proportions. Some don’t.
COVID19 does not impact everyone in the same way, although it has key symptoms that allow us to understand its characteristics and disease progression. Like acupuncturists have been taught to do with any illness seen through a Chinese medical lens, we must make a pattern diagnosis based on signs and symptoms.
Based on the observation of SARS-1 and treatments that were effective during that outbreak, much has been inferred about how to effectively treat SARS-2. The cellular structure of the two viruses is similar, as is how it attaches to and enters host cells. There is a lot we do not know about SARS-CoV-2, and the variation between the two viruses, but in Chinese medicine individual diagnoses can be made based on symptoms. Beneficial treatment principles are applied even with the unknowns.
There is no cure for COVID19 or vaccine for SARS-CoV-2. COVID19, or “Coronavirus disease 2019” is the name of the disease, caused by the virus SARS-CoV-2 or ”Severe Acute Respiratory Syndrome Coronavirus 2” . With western or Chinese medicine, we can only treat the symptoms and support the patient.
There are four phases to the disease progression, beginning with prevention and ending with recovery. The middle two, early-stage and pneumonic stage, represent the active phases of the disease, where most symptoms are experienced. My hope is that this article will offer some insight into each of these four phases and what you can do to take care of yourself and your loved ones to prevent getting sick, if you do get sick and as you recover.
I can’t help but draw a parallel between the phases of disease progression and the impact COVID19 is having on the world around me. We are still in the preventative phase here in the United States, doing everything we can as a society to set ourselves up for the best possible outcome medically and economically. We keep our distance. We wash our hands. We share informative articles and buy gift certificates or take out from our favorite restaurants. We apply for unemployment or set up home offices. We learn about telemedicine and virtual dance classes. We hope our government will freeze rent and mortgage payments, offer assistance to small businesses, stop displacing people living without homes. We hope prisoners in jail for minor offenses will be released or sent to house arrest so they can protect themselves.
Soon we will enter the active phase, where our population will reach its peak of known and active cases and we will do everything in our power to keep the number of deaths as low as possible. This will be dependent on the medical system and it will be heavily taxed by the demand. There may not be enough ventilators, masks, gowns or beds. We don’t know what that will look like yet.
Then will come the Recovery Phase. It is unlikely that “normal life” will look the same as it did before. Fear changes us. Not all businesses will reopen. Not all workers will be rehired. But through mutual aid efforts, many new networks are being formed. Those will remain once we can come face to face again. Once homeless camp sweeps have been halted, unemployment benefits have been expanded and minor offense prisoners have been taken out of the prison industrial complex, they can’t tell us it can’t be done. We can’t unsee what we have seen. It is impossible to know the outcome of this, but we can be compassionate and tender as we recover. We can treat our society as a person in need of nourishment and strengthening. We can be stronger, eventually, and more informed because of all we have been through.
Prevention Phase
There are three main strategies in how to prevent SARS-COv-2 from spreading.
Try not to be exposed to it. That means social distancing and distance from potential fomites, the objects that may carry the virus.
The virus is thought to travel most effectively from infected droplets that are sneezed or coughed into the air and land in mouths, noses and eyes or are inhaled into the lungs. It is also possible for the virus to live on objects that are touched by hands that then touch mouths, eyes and noses.
To do: keep 6 feet from anyone who is not in your “unit” whenever possible. Wipe or spray down groceries and other objects that come into your home with a disinfectant wipe, rag, spray or bleach water.
Wash your hands, wash your body, wash your hair, change your clothes when you get home if you have been around other people.
I know this is a tough one because not everyone has access to sanitary conditions. So those of us who do must do our best for everyone.
Saline nasal rinses or neti pot use can help wash virus cells out of your nose and keep the mucus membranes moist.
Do your best to make your body inhospitable to the virus. Hydration is extremely important for many reasons and can be protective. Sleep, nourishing food, a minimum of sugar and processed food, exercise and joy are essential for a healthy immune system.
If you have known vitamin or mineral deficiencies, be sure to keep up on your supplements so your body is not taxed. Stress will always bring down the immune system and stress comes in many forms, including when the body does not have what it needs to function and thrive.
Generally most people will benefit from taking Vitamin D (especially if you live in the PNW and/or have more melanin), Fish Oil (high-quality only), Vitamin C and a probiotic or probiotic foods, in addition to a nourishing diet with plenty of vegetables and protein.
Acupuncture points: The intention of this protocol is to strengthen the immune system, help alleviate early symptoms and shorten the duration of the virus. This is the protocol that was done for many at-risk patients in Wuhan, alongside the use of western medicine. Moxa was used on the points, but you can use acupressure to stimulate them if you have not been trained in how to use moxa.
*hint, a “cun” is around an inch, or the distance between the first and second knuckle on your index finger
ST36 –bilateral with moxa for 15 minutes twice a day, in the afternoon and evening
REN6- once a day with moxa for 10 minutes in the afternoon or evening
REN12- once a day with moxa for 10 minutes in the afternoon or evening
Herbs: There are a number of good western and Chinese herbs and herbal formulas that benefit the immune system, but I believe in diagnosis and treatment based on the individual. In my training, immune-building formulas are modified for each person, especially if they have pre-existing or autoimmune conditions. Please contact me if you are curious for more information.
See the CDC website for more preventative information:
CDC website
and Kate Paxton, CNM, CPM’s Home Care and When to Seek Help Guide for more:
Home Care Guide
This article I wrote on seasonal changes offers some suggestions for foods that are nourishing to the lungs and immune system:
Article
Early Stage
Signs and symptoms of early stage COVID19 are very similar to those of a cold or flu: fever, dry cough, sneezing, nasal symptoms, shortness of breath, lethargy, muscle pain. You may not know which it is and that’s okay, just avoid exposing anyone and take care of yourself. Because there is still limited testing and we are trying to keep people out of an overburdened hospital system, do as much home care as you can, but call your doctor if you are concerned. If you are in the high-risk category, do not hesitate to call your doctor if you are having symptoms.
In Chinese medicine this phase is called wind-cold or wind-heat. The understanding is that the disease is still in the exterior layers of the body. The muscles and fascia are affected but the virus cells have not made their way deeper into the organs of the body.
Home Remedies: This is a good time to drink lots of fluids, have ginger, cinnamon, lemon and honey tea, eat miso soup and other warm, fluid-based and easy to digest foods.
Essential Oils: Essential oils like peppermint, eucalyptus, tea tree, clove and fir can be dissolved in salt in a bath, or inhaled by putting a couple drops in boiling water and leaning over the steam. You can diffuse them in a room for prevention or to treat early stages of cold, flu or coronavirus symptoms
Acupuncture points: The purpose of these points for mild or moderate conditions is to reduce severity of symptoms, shorten the duration of the illness and alleviate emotional burden. Apply moxa to LI4 and LV3 bilaterally for 15 minutes or apply pressure, moxa ST36 bilaterally for 10 minutes or apply pressure. Do this twice a day, once in the morning and once in the afternoon
Chinese Herbal Formulas: Several herbal formulas prove to be very effective at mitigating symptoms of the early phase of COVID19, but you should be under the care of a licensed practitioner while taking them
Pneumonia Phase
This phase is marked by disease progression leading to more internal symptoms. The virus has made its way to the lungs, where mucus and phlegm have built up, making it harder to breathe.
Signs and symptoms of the pneumonia phase vary with severity, but are marked by more difficulty breathing, potential digestive symptoms, irritability, chest and abdominal distention and eventually can lead to fibrotic damage to the lungs and other organs and at its most sever, organ failure and death.
This is the phase that may present like a bad cold or flu for some, and may require emergency medical intervention for others. Do not hesitate to call your doctor or clinic if you are having severe symptoms or have pre-existing conditions.
Continue with the previous acupuncture points if symptoms are mild. Check in with your acupuncturist or herbalist for a formula that fits your symptoms and disease progression and call your doctor if symptoms start to worsen.
From Kate Paxton: Monitor for emergency signs: if you can't keep your fever below 102F with Tylenol, you have new-onset shortness of breath, new-onset difficulty completing a sentence, coughing more than 1 tsp of blood, new pain or pressure on chest (other than pain with coughing), unable to keep down liquids, or ongoing diarrhea that leads to dehydration, dizziness when standing or mental confusion (less responsive or very confused with conversation). Wear a mask and call ahead to let them know you’re coming.
Effective acupuncture points vary greatly depending on how the disease manifests and therefore I urge you to consult with an acupuncturist if you are interested in a personalized diagnosis, herbs and point prescription for moderate cases. Severe cases should be treated in the ICU.
Recovery Phase
There are a lot of statistics about how many people are released from the hospital after treatment for COVID19, but not a lot of information about the condition they are in when released. Some patients have experienced irreversible lung damage while others fully recovery. The recovery phase will also vary, but the treatment principles of nourishing the lung yin and qi will apply to everyone. We all know how long it can take to recover from a bad cold or flu. The body has to rebuild its resources.
Signs and symptoms may include a dry cough, shortness of breath, shortness of breath with exertion, chest stuffiness, dry mouth and weakness
During this phase, nourishing the deep resources of the body will be important
Herbs: Chinese herbal formulas during this phase focus on astringing and preserving the body’s resources, nourishing the fluids and yin tissues of the body and rebuilding the qi that is depleted from fighting off the virus
Acupuncture Points: Points for recovery represent the four phases of illness. Moxa all points for 15 minutes once a day or apply pressure: DU14, BL17, BL13, ST36, LU6
Congee: Congee is a rice porridge traditionally used to treat the infirm. It is a flexible recipe that can use any grain and water cooked at a low temperature for a long time. Different additional ingredients can be added to congee to nourish the body. Find a simple congee recipe with ingredient suggestions here: Congee Recipe
Rest: It is tempting when one has been sick and restricted for a long time to jump back into life as it was. But that can exhaust us further and lead to more illness and weakness. Resting and slowly easing back into activity is advised.
Recovery for our economy and our spirits may be slow, too. There will be a new normal and we don’t know what- or when- it will be. My hope is that we grow from this. Some of the serious dysfunction of our society is being exposed and we can never unsee it. But we can all work to change it. Perhaps this will be the call we all answer.
I will be keeping the homepage of my website updated with resources in many forms. Please check there regularly if you like: Twelve Rivers Medicine. I am here for you! Reach out with questions: twelveriversmedicine@gmail.com