In the early months of this pandemic I often read comments about how the flu killed many thousands of vulnerable people every year and that the threat from coronavirus disease 2019 (COVID-19) would probably turn out to be no more serious. That was despite the increasingly disturbing evidence coming out of China where it originated, and later Italy and the US.

Comparisons are often made with the Spanish Flu of 1918, and the drastic measures that were needed to stem the high mortality rate. The Spanish Flu was in fact a variant of the H1N1 Flu which is still with us, regularly causing outbreaks, one more seriously in 2009. This demonstrates the difficulty of finding effective treatment for microorganisms that can readily change form and evade the immune system. The two main treatment approaches in the US during 1918-19 were the use of high-dose aspirin or homeopathy, which represented the two main-stream competing medical schools at the time.

So what makes this current virus (SARS-CoV-2) different from those already circulating in the population? After all, the common cold consists of many strains of viruses including rhinoviruses, influenza viruses, enteroviruses and several human coronaviruses (SARS, MERS etc.).

These viruses generally effect the upper respiratory tract and can travel down to the lungs to cause bronchitis or pneumonia in those more susceptible. An infection of the lungs with inflammation and consolidation can lead to a secondary bacterial infection that causes pneumonia. SARS-CoV-2 is unfortunately more dangerous because it is more contagious, and better at infecting lung tissue.

SARS-CoV-2 is actually an animal corona virus which resembles one first identified in horseshoe bats in Wuhan, China, in 2013. This virus was noted down and promptly forgotten until a new one resembling both it and SARS began to circulate in humans in December 2019 as noted by the WHO. It is thought by some scientists that the bat virus crossed with another host animal virus (pangolin, civet) before jumping to humans in a ‘wet’ market.

This potential transfer between species (zoonosis) demonstrates the age-old vulnerability of dense and often squalid urban populations living closely with birds, pigs, bats and rodent as observed in pandemics throughout history.¹ The fact that a coronavirus emerged in Wuhan with specificity for human-to-human transfer in the vicinity of a lab specialising in gain-of-function research using engineered coronaviruses (WIV) suggests a breach of containment.

SARS-CoV-2 displays a genetic feature which adapts it to successful human-to-human transmission, thus making it very infectious and dangerous. The virus readily binds to ACE2 receptors on the surface of lung tissue and other cells using a spike protein. This enables the virus to cross the membrane and use the cell’s machinery to replicate.

Despite the virulence of the micro-organism, affecting mostly the elderly and infirm, it still appears to be selective in its effect on the broader population. This indicates the importance of considering the constitutional susceptibility of the individual, for example variations in gene coding for ACE2, as well as the presence of any underlying health conditions or a case history of respiratory weakness. Smoking would also play a role in weakening lung defences as would malnutrition, dehydration, atmospheric pollution, stress and lack of regular exercise.

Symptoms in the early stage are those of an upper respiratory tract infection: fatigue, a dry cough, fever, aches and pains, shortness of breath, headache, loose bowel, nausea and vomiting. The second stage is marked by dyspnoea and pneumonia as the infection goes deeper into the lung. The degree of reaction to the virus can then worsen into a ‘cytokine storm’ where the immune system contributes to viral damage through excessive inflammation in its attempt to stop the virus spreading. The lungs become inflamed and fill with fluid in serious cases and the patient requires a respirator. A loss of smell or taste may also be symptoms; however, the above list of early symptoms is common to other respiratory tract infections.

Infections can also be asymptomatic, with 17.9% of infected people on the cruise ship Diamond Princess testing positive without symptoms.² Furthermore, a previously infected patient can still shed the virus after becoming symptom free.

The fact that humans have been living with viruses for millennia points to the use of traditional, as well as modern methods for both preventing infection and treating it before an effective vaccine is distributed. Vaccine development is elusive and fraught with difficulties due to viral mutation.

The modern arsenal of drugs under test also includes an Ebola drug called remdesivir, tamiflu, chloroquine, steroids, the BCG vaccine for tuberculosis and ivermectin. Dexamethasone (steroid), tocilizumab (immune modulator) and lopinavir (antiviral) are now considered the best approach.³

Treatment

General suggestions

Naturopathic advice follows the general principles used to manage any cold or flu, without the necessity for offering a specific remedy for this particular virus strain. This article offers no such thing; specific treatment is the purpose of vaccine development.

Vaccines are intended to stimulate the immune system to recognise and destroy a particular micro-organism by safely introducing it to the attenuated virus or its analogues, a process which produces antibodies or heightened white blood cell activity. Antibodies produced by B-cells then circulate in the blood offering protection against unintended exposure to the wild virus.

It is now known that recovered patients may not carry significant amounts of antibodies to the virus, indicating uncertain ongoing immunity. This is because a T-cell response may have been sufficient to stem the virus without activating antibody production to any great extent. This also illustrates why antibody tests may not give an accurate measure of infection or future protection.⁴

Colds and flu often share similar symptoms to novel virus infections that appear from time to time. In this particular case, the incubation period is about 1 week so good hygiene measures such as regularly washing hands, guarding coughs and sneezes, social distancing and the avoidance of touching your face are general measures promoted by the authorities which are very effective at preventing spread.

Fortunately 95% of those infected experience only mild symptoms when they become sick; however, they are still very contagious and need to practice self-isolation. The biggest factors which helped contain the SARS virus were improved hygiene and isolation.

Maintain regular exercise which helps to raise mood, bolster immunity and manage stress. Also ensure adequate sleep to support the maintenance of all aspects of immune defences and general health.

Nutrition

• Drink plenty of water to keep the barrier defences of the lungs in optimal condition.
• Avoid refined sugar and ultra-processed factory foods. Sugar supresses immunity.
• It is important to eat wholesome foods rich in vitamins and antioxidants that support immunity.
• Vitamin C and zinc are especially good for building immune health and can be taken in supplement form.

Herbs

Garlic is a very effective antiviral herb and should be crushed or chewed to activate it. Echinacea can be used to build immunity as with Siberian ginseng and andrographis. Siberian ginseng and Indian ginseng will help with stress and immune defences.

Liquorice has been the subject of a lot of research and glycyrrhizic acid was found to bind the spike glycoprotein, as well as inhibit viral entry into the host cell.⁵ A combination of liquorice, curcumin (turmeric) and vitamin C can be used to regulate the immune response and inhibit a cytokine storm.⁶

White horehound and inula helenium are used for treating wet infected coughs. Thuja is antibacterial and antiviral in activity. Thyme is good for early cold symptoms.

Tissue Salts

Ferrum Phos— Used to treat early inflammations: eyes red, inflamed, with burning sensation; cheeks sore and hot; ulcerated sore throat, tonsils red and swollen; eustachian tubes inflamed. Congestion of the lungs.

Kali-s— Protracted chest cold, violent croupy cough, coarse rattle, yellow expectoration. Yellow slimy tongue, loss of taste and smell. Profuse sweat. Bronchitis or asthma.

Kali-p—nerve depletion after mental and physical exhaustion, easily tired. Mental depression, nervous dread, starts, can’t cope. Loss of memory.

Homeopathy

In contrast to vaccines which are matched to specific diseases, homeopathic remedies are matched to specific patterns of symptoms, which may be shared by different diseases. It is for this reason that accurate diagnosis is not crucial to remedy selection, and that five patients may each require a different homeopathic remedy for the same disease. Even so, one or two particular remedies usually become the most useful in a particular epidemic.

The key remedies found very effective against the Spanish flu in 1918 were Bryonia and Gelsemium. These two remedies have been consistently used  in clinic for two hundred years when matched correctly to the symptom picture of the patient.

In this flu season the remedies for coughs and colds will most likely be a choice from Aconite, Antimonium-t, Arsenicum-a, Bryonia, Eupatorium and Gelsemium. These remedies will be found useful just as often in 2020 as in any other flu season.

For example:

• When exposure to cold dry winds causes the sudden appearance of cold symptoms we think of Aconite. There is a fever with hot flushed face alternatingly pale, the nose is stuffed or runs. The patient is anxious and tosses about. A dry, hot, constricted throat makes the patient thirsty. Hoarse dry cough. Drenching sweat, chills in waves.
• An early onset cold with sneezing, restlessness and anxiety around midnight will respond to Arsenicum-a. The nose runs with a thin burning discharge and the patient sneezes. The mouth is dry, the throat is swollen, the patient can’t bear food and tends to sip water. Colds frequently go to the chest.
• A patient with a dry painful cough, tight chest worse for deep breathing or coughing usually responds to Bryonia. Discharges are scanty and there may be bloody expectoration. High fever, great thirst and inflammation of the lungs are covered by this remedy. The patient is irritable, apathetic and prefers to be left alone. Coughing or the least movement disturbs the patient.
• A patient with an advanced flu, fever, and aching bones and muscles that make them feel as if beaten, may respond to Eupatorium. The patient is very weak and has shaking chills.
• A patient with an established flu, shivers up and down the spine, dullness, drowsiness and lethargy should be given Gelsemium. In addition, the after-effects of a respiratory infection, something known as ‘never well since’, can last a long time and a dose of Gelsemium will often clear them up.
• Pneumonia may respond to Lycopodium where there is a tickling cough, rattling breathing and greenish expectoration. There is a tight chest with burning respiration and shortness of breath. Pneumonia is worse on the right side.
• Phosphorus treats pneumonia with bloody expectoration, oppressed breathing, hoarse voice and a painful larynx. There is burning in the airways, and pneumonia is worse in the left lower lung.

Disclaimer: this article is intended for the purpose of general education only, and is not a substitute for diagnosis, treatment advice, or a prescription that is given in a consultation with a qualified physician. I lay no claim to any specific treatment for covid-19.

References:

1.         Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med 2020;1–3.

2.         Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance 2020;25:2000180.

3.         Grein J, Ohmagari N, Shin D, et al. Compassionate Use of Remdesivir for Patients with Severe Covid-19. N Engl J Med 2020;

4.         Wu F, Wang A, Liu M, et al. Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications. medRxiv 2020;2020.03.30.20047365.

5.         Sinha SK, Prasad SK, Islam MA, et al. Identification of bioactive compounds from Glycyrrhiza glabra as possible inhibitor of SARS-CoV-2 spike glycoprotein and non-structural protein-15: a pharmacoinformatics study. J Biomol Struct Dyn 2020;1–15.

6.         Chen L, Hu C, Hood M, et al. A Novel Combination of Vitamin C, Curcumin and Glycyrrhizic Acid Potentially Regulates Immune and Inflammatory Response Associated with Coronavirus Infections: A Perspective from System Biology Analysis. Nutrients 2020;12.