MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Monthly Archives: April 2020

Many experts are wondering whether it is possible to stimulate our immune system such that we are better protected against getting infected with the coronavirus. Several options have been considered.

An innovative approach, for instance, seems to be this one:

Recently, we showed that intravenous immunoglobulin (IVIg) treatment reduces inflammation of intestinal epithelial cells and eliminates overgrowth of the opportunistic human fungal pathogen Candida albicans in the murine gut. Immunotherapy with IVIg could be employed to neutralize COVID-19. However, the efficacy of IVIg would be better if the immune IgG antibodies were collected from patients who have recovered from COVID-19 in the same city, or the surrounding area, in order to increase the chance of neutralizing the virus. These immune IgG antibodies will be specific against COVID-19 by boosting the immune response in newly infected patients. Different procedures may be used to remove or inactivate any possible pathogens from the plasma of recovered coronavirus patient derived immune IgG, including solvent/detergent, 60 °C heat-treatment, and nanofiltration. Overall, immunotherapy with immune IgG antibodies combined with antiviral drugs may be an alternative treatment against COVID-19 until stronger options such as vaccines are available.

Another suggestion involves monoclonal antibodies:

The therapeutic potential of monoclonal antibodies has been well recognized in the treatment of many diseases. Here, we summarize the potential monoclonal antibody based therapeutic intervention for COVID-19 by considering the existing knowledge on the neutralizing monoclonal antibodies against similar coronaviruses SARS-CoV and MERS-CoV. Further research on COVID-19 pathogenesis could identify appropriate therapeutic targets to develop specific anti-virals against this newly emerging pathogen.

These and several further options have in common that they are not backed by robust clinical evidence. Such a lack of data rarely bothers charlatans who use the corona-panic for promoting their bizarre concepts. Numerous promoters of so-called alternative medicine (SCAM) are trying their very best to mislead the public into thinking that their particular SCAM will do the trick.

In comes the PYROMANIAC IN A FIELD OF (INTEGRATIVE) STRAW-MEN, Dr Michael Dixon who recently proclaimed that ‘boosting immunity against coronavirus: ‘Now’s the time to turn to antioxidants and polyphenols’. Specifically, he recommended:

‘Eat dark greens, broccoli, spinach or any coloured root vegetable such as beetroot or carrots and any fruit ending in the word berry; black, blue… The alliums, such as leeks and garlic and onions, are very strong in the same sort of chemicals and also even things like dark chocolate and certain teas, particularly green tea. Those who want a glass of red wine, well that’s something that’s very much permitted too.’

Inspired by such positive thinking, I ventured to find some evidence for Dixon’s infinite wisdom. It could be that I am not very gifted at locating evidence – or perhaps there isn’t any?

Well, not quite; there is some on garlic that Dixon praises for its immune-boosting activity. Here is the abstract of a Cochrane review:

Background

Garlic is alleged to have antimicrobial and antiviral properties that relieve the common cold, among other beneficial effects. There is widespread usage of garlic supplements. The common cold is associated with significant morbidity and economic consequences. On average, children have six to eight colds per year and adults have two to four.

Objectives

To determine whether garlic (Allium sativum) is effective for the prevention or treatment of the common cold, when compared to placebo, no treatment or other treatments.

Search methods

We searched CENTRAL (2014, Issue 7),OLDMEDLINE (1950 to 1965),MEDLINE (January 1966 to July week 5, 2014), EMBASE(1974 to August 2014) and AMED (1985 to August 2014).

Selection criteria

Randomised controlled trials of common cold prevention and treatment comparing garlic with placebo, no treatment or standard treatment.

Data collection and analysis

Two review authors independently reviewed and selected trials from searches, assessed and rated study quality and extracted relevant data.

Main results

In this updated review, we identified eight trials as potentially relevant from our searches. Again, only one trial met the inclusion criteria. This trial randomly assigned 146 participants to either a garlic supplement (with 180 mg of allicin content) or a placebo (once daily)for 12 weeks. The trial reported 24 occurrences of the common cold in the garlic intervention group compared with 65 in the placebo group (P value < 0.001), resulting in fewer days of illness in the garlic group compared with the placebo group (111 versus 366). The number of days to recovery from an occurrence of the common cold was similar in both groups (4.63 versus 5.63). Only one trial met the inclusion criteria, therefore limited conclusions can be drawn. The trial relied on self reported episodes of the common cold but was of reasonable quality in terms of randomisation and allocation concealment. Adverse effects included rash and odour.

Authors’ conclusions

There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. A single trial suggested that garlic may prevent occurrences of the common cold but more studies are needed to validate this finding. Claims of effectiveness appear to rely largely on poor-quality evidence.

Of course, this is not about corona but about the common cold. As for green tea, a recent review found a lack of reliable clinical data demonstrating its immune-boosting activities, a deficit also noted for chocolate.

But where IS the evidence that any of the above claims are true?

Could it be that there is no sound evidence to support Dixon’s recommendations?

Impossible!!!

That would mean that Dixon, advisor to Prince Charles, is stating nonsense in the name of his COLLEGE OF MEDICINE AND INTEGRATED HEALTH. This organisation has many very respectable people as members and officers. They would never allow that sort of thing to happen!

Or would they?

Am I the only one who suspects that China is using the current pandemic for promoting Traditional Chinese Medicine? I see many signs for that being so. To me, this seems not better than pushing homeopathy for that purpose. The fact is, I fear, that there is no robust evidence that TCM works for corona or any other viral infection. In case you think I am wrong, please show me the studies.

Anyway, in this context, it seems relevant to ask to what extend TCM has been used so far in the battle against the current pandemic. I came across this website which gives us some clues. I have no idea how reliable the data are, so perhaps one needs to take them with a pinch of salt. Here they are (% figures depict the usage of TCM):

US – 1%

Europe – 2%

Italy – 3%

Spain – 2%

UK – 0%

France – 6%

Germany – o%

China – 67%

Korea/Taiwan/Japan – 10%

Rest of the world – 3%

And what do these figures tell us?

Probably not a lot!

But they are nevertheless interesting, I think, in that they suggest that China’s promotion of TCM has had some moderate successes at least in some countries; notably France and Asian regions seem to have succumbed to the Chinese sales techniques to some degree . Remarkable, in my view, is also the German’s absolute resistance to use TCM. Considering that Germany has an enviably low death rate, this fact seems to somewhat dispel the notion that TCM offers an effective way out of the current health crisis.

This study investigated the effects of reflexology and homeopathy as an addition to conventional treatment on different markers of airway inflammation in asthma. Eighty-four patients with asthma were randomized to receive one to three different treatments:

  1. conventional treatment alone,
  2. conventional treatment with addition of homeopathy,
  3. conventional treatment plus reflexology.

The study was a single centre, investigator-blinded, controlled trial with a treatment period of one year.

During the study period, patients regularly consulted their general practitioner for evaluation and asthma treatment. At randomization, and after 6 and 12 months, methacholine challenge test and measurement of exhaled nitric oxide were performed. Blood samples were collected for eosinophil count and measurement of serum eosinophil cationic protein.

No significant differences were found between groups for any of the inflammatory markers were demonstrated. Methacholine responsiveness improved in all three groups but improvements were not statistically significant within and between groups.

The authors concluded that this randomized controlled study of reflexology and homeopathy failed to show significant improvement on selected markers of inflammation and airway hyperresponsiveness in asthma.

I would argue that the results imply that homeopathy and reflexology are not merely ineffective but have negative effects on the outcome. As this trial followed the infamous ‘A+B versus B’ design, one would have expected that the two add on treatments generate a placebo response – at least in terms of subjective endpoints. The only such measure is the medication use in this particular trial; it showed no inter-group differences. To me, this implies that homeopathy and reflexology might have generated slightly detrimental effects on subjective outcomes.

Ah yes, do I hear the fans of so-called alternative medicine (SCAM) claim that this study must have been conducted by the enemies of SCAM in order to defame it? For them, this acknowledgement might be enlightening:

This study was supported by The Knowledge and Research Centre for Alternative Medicine, Denmark. The authors thank registered homeopath Anne Hammer Langgaard for homeopathic treatments, registered reflexologists Pia Løbner Jeppesen and Pia Stolarzcyk for reflexology treatments, Pia Pedersen for secretarial assistance and randomization procedure, laboratory technician Anne-Marie Toft for handling blood samples, specialist nurses Anne Dorte Vindelev Kristensen and Jytte Møller Kjemtrup for help with clinical procedures.

DD Palmer, the founder of chiropractic, famously claimed that 95% of all diseases are caused by subluxations of the spine and the rest by subluxations of other joints. He said and stated this theory in different forms not once but dozens of times, and it thus quickly became the mantra of chiropractic. When it was noted that subluxation, as imagined by Palmer and his son BJ, did not exist, chiropractors found themselves with a considerable amount of egg on their faces.

Ever since, they have tried to cover up the blemish, some by repeatedly re-defining subluxation, others by claiming that they do not believe in Palmer’s theory anyway. The issue was and is fiercely fought over even threatened to break up the profession. At present, we are being told incessantly that large chunks of the profession are reformed, have come to terms with their profession’s foundation in a fictional concept, and have now abandoned subluxation altogether.

Critics, in turn, are quick to point out that, if that is so, chiropractors lack a ‘raison d’être’. The best chiropractors of this persuasion could do, they say, is to re-train as physiotherapists who also use spinal manipulation but without the nonsensical chiropractic ‘philosophy’.

While this debate is ongoing and shows no sign of subsiding, it is relevant, of course, to ask what proportions of the chiropractic profession belongs to which persuasion. This paper evaluated the issue of the professional identity within the profession of chiropractic based on the literature from 2000 to 2019. Initially 562 articles were sourced, of which 24 met the criteria for review.

The review confirmed three previously stated professional identity subgroups:

  • a vitalistic approach pro subluxation,
  • a approach contra subluxation,
  • a centrist or mixed view.

Whilst these three main chiropractic identity sub-types exist, the terminology used to describe them differs. Research aimed at categorising the chiropractic profession identity into exclusive sub-types found that at least 20% of chiropractors have an exclusive vertebral subluxation focus. However, deeper exploration of the literature shows that vertebral subluxation is an important practice consideration for up to 70% of chiropractors.

The review also found that practising chiropractors consider themselves to be primary care or primary contact practitioners with a broad scope of practice across a number of patient groups not limited to musculoskeletal management.

So, if I understand these findings correctly, they confirm that chiropractors like to see themselves as physicians who are able to treat most conditions that present themselves in primary care. At the same time, their majority considers that vertebral subluxation is an important practice consideration. This clearly suggests they are likely to treat most conditions by adjusting spinal subluxations. In turn, this implies that DD Palmer’s dictum, ‘95% of all conditions are caused by subluxations of the spine’, is still adhered to by about 70% of all chiropractors.

If this is so, the best advice I can give to the general public is this: if you have a health problem, the last person you should consult is a chiropractor.

I know Dr Thompson personally since many years. She is one of the UK’s leading homeopaths and we rarely agreed on anything. Yet I had always considered her to be on the responsible side of the homeopathic spectrum. I am sorry to say that I just changed my mind.

The reason is this video and letter.

In the video, she explains that she has been infected with the coronavirus, has self-treated the condition with homeopathy and promptly recovered. In the letter to all patients, she states the following:

… In terms of Homeopathic Medicines, the medicine Anas Barb 200c, two tablets twice weekly, can be used during this time, increasing to two tablets once a day if you do have exposure to the virus or have symptoms and have to self-isolate.

Other Homeopathic Medicines that are being recommended include:

  • Arsenicum Album 30c: three times daily if anxiety is strong
  • Gelsemium 30c: twice daily if weakness and headache predominate
  • Bryonia 30c: two-three times a day for dry cough particularly if movement aggravates the cough.

If cough becomes more problematic you can use Antimonium Tartaricum 30c three times daily.

If fevers are a problem and particularly if they are periodic (coming at certain times of the day) use China officinalis 30c three times daily…

I find this amazing and alarming. There is, of course, not a jot of evidence that any homeopathic treatment will effectively treat or prevent any viral infection, and certainly no evidence that it cures coronavirus infections. To claim or imply otherwise displays a staggering ineptitude and lack of professionalism. To extrapolate from a personal experience to a quasi recommendation for patients is, in my view, ridiculously unscientific and overtly unethical. As a doctor Thompson should be able to differentiate between experience and evidence and has the professional duty to go by the latter.

I am truly glad to hear that Dr Thompson has had a mild course of the disease and recovered swiftly. But we know that all too often this is not the case and that patients can become seriously ill and some even die of the coronavirus. To give the impression that homeopathy can keep them safe is clearly both incorrect and irresponsible.

As THE TIMES stated yesterday, homeopaths are ‘risking lives with bogus coronavirus treatments’.

It’s high time to stop them.

When John Ioannidis publishes a paper, it is well worth, in my view, to pay attention. In the context of this blog, his latest article seems particularly relevant.

The researchers identified the top 100 best-selling books and assessed for both the claims they make in their summaries and the credentials of the authors. Weight loss was a common theme in the summaries of nutritional best-selling books. In addition to weight loss, 31 of the books promised to cure or prevent a host of diseases, including diabetes, heart disease, cancer, and dementia.

The nutritional advice given to achieve these outcomes varied widely in terms of which types of foods should be consumed or avoided and this information was often contradictory between books. Recommendations regarding the consumption of carbohydrates, dairy, proteins, and fat in particular differed greatly between books.

To determine the qualifications of each author in making nutritional claims, the highest earned degree and listed occupations of each author was researched and analyzed. Out of 83 unique authors, 33 had an M.D. or Ph.D degree. Twenty-eight of the authors were physicians, three were dietitians, and other authors held a wide range of jobs, including personal trainers, bloggers, and actors. Of 20 authors who had or claimed university affiliations, seven had a current university appointment that could be verified online in university directories.

The authors concluded that this study illuminates the range of the incongruous information being dispersed to the public and emphasizes the need for future efforts to improve the dissemination of sound nutritional advice.

The authors also provide a ‘sample of claims that appear disputable and/or unsubstantiated according to our expertize and opinion’:

1. “Carbs are destroying your brain”—Grain Brain

2. “Have high blood pressure? Hibiscus tea can work better than a leading hypertensive drug-and without the side effects. Fighting off liver disease? Drinking coffee can reduce liver inflammation. Battling breast cancer? Consuming soy is associated with prolonged survival.”—How Not to Die

3. “Zero Belly diet attacks fat on a genetic level, placing a bull’s-eye on the fat cells that matter most: visceral fat, the type of fat ensconced in your belly.”—Zero Belly Diet

4. “SKIP THE CRUNCHES: They just build muscle under the fat…LESS (EXERCISE) IS MORE”—This Is Why You’re Fat (And How to Get Thin Forever)

5. “Eating pasta, bread, potato, and pizza will actually make you happier, healthier, and thinner—for good”—The Carb Lovers Diet

6. “Skip breakfast, stop counting calories, eat high levels of healthy saturated fat, work out and sleep less, and add smart supplements”—The Bulletproof Diet

7. “Modern “improvements” to our food supply—including refrigeration, sanitation, and modified grains—have damaged our intestinal health. Dr. Axe offers simple ways to get these needed microbes, from incorporating local honey and bee pollen into your diet to forgoing hand sanitizers and even ingesting a little probiotic-rich soil”—Eat Dirt

8. “Overeating doesn’t make you fat; the process of getting fat makes you overeat.”—Always Hungry?

9. “Do you have an overall sense of not feeling your best, but it has been going on so long it’s actually normal to you? You may have an autoimmune disease, and this book is the “medicine” you need.”—The Immune System Recovery Plan

10. “Shows you how to grow new receptors for your seven metabolic hormones, making you lose weight and feel great fast!”—The Hormone Reset Diet

11. “The world’s foremost expert on the therapeutic use of culinary spices, takes an in-depth look at 50 different spices and their curative qualities, and offers spice “prescriptions”–categorized by health condition–to match the right spice to a specific ailment.”—Healing Spices

12. “The idea that people simply eat too much is no longer supported by science”—The Adrenal Reset Diet

13. “Most of us think God is not concerned with what we eat, but the Bible actually offers great insight and instruction about the effects of food on our bodies”—Let Food Be Your Medicine

14. “Dieters can actually lose weight by eating foods, nutrients, teas, and spices that change the chemical balance of the brain for permanent weight loss—a major factor contributing to how quickly the body ages. In fact, everyone can take years off their age by changing their brain chemistry.”—Younger (Thinner) You Diet

15. “Weight gain is not about the food, but about the body’s environment. Excess weight is a result of the body being in a toxic, inflammatory state. If your body is not prepared or ‘primed’ for weight loss, you will fight an uphill biochemical battle”—The Prime

16. “Throwing ice cubes in your water to make it more “structured”. Skipping breakfast, as it could be making you fat. Eating up to 75 percent of your calories each day in fat for optimal health, reduction of heart disease, and cancer prevention”—Effortless Healing

To call these statements ‘disputable’ must be the understatement of the year!

I have long been concerned about the dangerous rubbish published in so-called ‘self-help books’. In 1998, we assessed for the first time the quality of books on so-called alternative medicine (SCAM) [Int J Risk Safety Med 1998, 11: 209-215. [for some reason, this article is not Medline-listed]. We chose a random sample of 6 such books all published in 1997, and we assessed their contents according to pre-defined criteria. The findings were sobering: the advice given in these volumes was frequently misleading, not based on good evidence and often inaccurate. If followed, it would have caused significant harm to patients.

In 2006, we conducted a similar investigation the results of which we reported in the first and second editions of our book THE DESKTOP GUIDE TO COMPLEMENTARY AND ALTERNATIVE MEDICINE. This time, we selected 7 best-sellers in SCAM and scrutinised them in much the same way. We found that almost every treatment seemed to be recommended for almost every condition. There was no agreement between the different books which therapy might be effective for which condition. Some treatments were even named as indications for a certain condition, while, in other books, they were listed as contra-indications for the same problem. A bewildering plethora of treatments was recommended for most conditions, for instance:

  • addictions: 120 different treatments
  • arthritis: 131 different treatments
  • asthma: 119 different treatments
  • cancer: 133 different treatments

This experience, which we published as a chapter in the above-mentioned book entitled AN EPITAPH TO OPINION-BASED MEDICINE, confirmed our suspicion that books on SCAM are a major contributor to the  misinformation in this area.

The new paper by Ioannidis et al adds substantially to all this. It shows that the problem is wide-spread and has not gone away. Since such books have a huge readership, they are a danger to public health. Now that the problem has been identified and confirmed, it is high time, I think, that we do something about it … but I wish I knew what.

ANY SUGGESTIONS?

It is hard to believe that the largest professional organisation of UK homeopaths, the ‘British Homeopathic Association’ (BHA), can be so irresponsible as to publish this on their website under the title ‘Coronavirus – advice from the UK homeopathic Community‘:

Can homeopathy help?
Homeopathic medicines have been used extensively for flu-like symptoms and in epidemics around the world. If you decide to take a homeopathic medicine, this should be in addition to the various measures outlined above and should not be your only approach. Selection of the most appropriate homeopathic medicine is based on an individual’s unique symptoms. However, Gelsemium 30c and Bryonia 30c are commonly used for flu-like symptoms and have a long-established, traditional usage over many years.

Homeopathic options can form one part of your approach to the current Covid-19 outbreak but should always be used alongside other measures. If you have current symptoms or are concerned that you may have been exposed to coronavirus, it is important to call 111 to seek appropriate advice, in keeping with current guidelines.

As though this would be not enough, the BHA also provided a link on facebook to this information in relation to the corona pandemic:

You start to feel internally very cold and suddenly pretty unwell – Aconite 30c
You have flu with stomach upset, your body is hot but you feel cold; you are better being warm and are
mentally restless and anxious – Arsen alb 30c
You have a raging hot temperature, a red face and a cold body – Belladonna 30c
Everything aches, especially when you move and you want to be left alone in bed with the curtains drawn –
Bryonia 30c
You are ‘wiped out’, have no energy, droopy eyelids and are feeling shivers up and down your spine –
Gelsemium 30c
With the flu you have great sensitivity to noise and touch, are worse for the slightest uncovering: it is as if you
have a hangover – Nux vomica 30c
You have aching and restlessness, are better moving around, yet worse on continued exertion and much worse
in the cold and damp, much better for heat – Rhus tox 30c
In later stages of the illness, the medicine may change, for example:
Your head feels congested when you are up and about but is better lying down – Natrum carb 30c
Your sinuses are blocked and painful – Hepar sulph 30c
You feel very low and the slightest thing can provoke tears – Pulsatilla 30c

This is, in my view, not just stupid, it is dangerous, unethical, reckless and in no way compatible with the responsibility of a professional organisation of a healthcare profession.

Sorry, but this post is unrelated to so-called alternative medicine (SCAM), the usual topic of this blog

The deaths caused by the corona-virus differ from country to country. Germany’s fatalities have been widely acknowledged to be unusually low, while those of the UK seem worryingly high. On 9 April, Germany had just over 2600 deaths and about 118000 cases of infection. In the UK, these figures were around 8000 and 57000 (these data are from here).

This translates to hugely different rates of death per active case. But, as the Germans test many more people than the UK, this difference in rates can easily be explained. The more tests one does, the more likely it is that new cases will be identified. This obviously results in higher total case numbers. In turn, the proportion of fatal cases will be smaller.

But what about the absolute numbers of deaths?

What might they tell us?

Assuming that medical care is similarly competent in both countries (and knowing that a causal therapy does not exist), should there not be a lower fatality figure (proportional to the number of cases) in the UK compared to Germany? To me, it does not make sense that the opposite is true: in the UK, we have a total of 8000 fatalities, while Germany has 2600. Similarly, on 9 April [to just pick one day at random] there were 881 deaths in the UK and 337 in Germany.

Should it not be the other way round?

I know these figures are far from precise (and I am here only interested in estimates and trends), but the difference is clear enough and the trend has been consistent.

If that is so, what is the reason?

The only explanation that I can think of is that the UK numbers of active cases are wrong,  – not just slightly wrong, but very profoundly wrong.

As the UK did not test extensively, we know the UK case numbers are an underestimate. Some say they are higher by a factor of two or three.

Most people seem to think that the German case figures – because of the German programme of adequate testing – might be about right. Assuming that UK doctors are as good at saving the lives of corona patients as their German colleagues, and assuming that everything else is roughly equal, one might extrapolate from the UK fatality numbers the level of infection in the UK.

If 2600 death in Germany correspond to 118000 cases, 8000 deaths in the UK should, according to this logic, correspond to about 363000 cases. This is roughly 6 times the number I see in the official statistics!

I know this is a very simplistic calculation, but is it fundamentally wrong?

If not, should we not get some explanations or transparent data from our government?

I am truly puzzled.

Can someone PLEASE enlighten me?

 

Wouldn’t it be wonderful, if we had a treatment that reduces the risk of getting infected with the corona-virus? Well, this paper claims that there is one. Here is its abstract:

Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies.

Methods

Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.

Results

The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi’s Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24–0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao).

Conclusions

Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.

So, what should we make of this conclusion?

To provide an evidence-based answer, I tried to look up the original studies cited in the article. The links provided by the authors seem to be all dead except one which leads to a paper published in the infamous JCAM. Here is its abstract:

Objectives: To investigate the efficacy of an herbal formula in the prevention of severe acute respiratory syndrome (SARS) transmission among health care workers. The secondary objectives are to investigate quality of life (QOL) and symptomology changes among supplement users, and to evaluate the safety of this formula.

Design: Controlled clinical trial.

Settings: Hong Kong during epidemic of SARS.

Subjects: Two cohorts of health care workers from 11 hospitals in Hong Kong, 1 using an herbal supplement for a 2-week period (n = 1063) and a control cohort comprising all other health care workers who did not receive the supplement (n = 36,111) were compared prospectively.

Interventions: Taking an herbal supplement for a 2-week period.

Outcome measures: SARS attack rates and changes in quality of life and influenza-like symptoms were also examined at three timepoints among herbal supplement users.

Results: None of the health care workers who used the supplement subsequently contracted SARS compared to 0.4% of the health care workers who did not use the supplement (p = 0.014). Improvements in influenza-like symptoms and quality of life measurements were also observed among herbal supplement users. Less than 2% reported minor adverse events.

Conclusion: The results of this pilot study suggest that there is a good potential of using Traditional Chinese Medicine (TCM) supplements to prevent the spread of SARS.

How can I be polite and still say what I think about this article? Perhaps by stating this: THIS STUDY WAS INCAPABLE OF INVESTIGATING THE ‘EFFICACY’ OF ANYTHING AND ITS RESULTS ARE NOT CONVINCING.

So, are the Chinese authors correct when concluding that Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population?

No, I don’t think so! And I even feel that it is irresponsible in the current situation to misguide consumers, patients, scientists and decision-makers into believing that TCM offers an answer to the pandemic.

 

Bioresonance is an alternative therapeutic and diagnostic method employing a device developed in Germany by the scientology member Franz Morell in 1977. The bioresonance machine was further developed and marketed by Morell’s son in law Erich Rasche and is also known as ‘MORA’ therapy (MOrell + RAsche). Bioresonance is based on the notion that one can diagnose and treat illness with electromagnetic waves and that, via resonance, such waves can influence disease on a cellular level. Bioresonance instruments are akin to the scientologists’ ‘E-meter’ which essentially consists of an electronic circuit measuring skin conductivity.

Until recently, just three studies of bioresonance had been published.

  1. The first was from Germany and suggested that it is effective for treating GI symptoms. This trial was, however, tiny and its findings are likely to be false-positive.
  2. The second study is from Turkey and suggested that it works for smoking cessation. It is a ‘pilot study’ that has never been followed by a definitive trial.
  3. The third trial was a double-blind, parallel group study in children with long-lasting atopic dermatitis. Over a period of 1.5 year, 32 children were randomised to receive conventional inpatient therapy and either a putatively active or a sham (placebo) bioresonance treatment. Short- and long-term outcome within 1 year were assessed by skin symptom scores, sleep and itch scores, blood cell activation markers of allergy, and a questionnaire. The results showed that bioresonance had no effect on the outcome.

Now a most ingenious study can be added to this list. Unfortunately, I was published in German, but bear with me, I will explain below. First the original abstract for those who can read German:

Hintergrund

Trotz aller Aufklärungsarbeit wird die Bioresonanz weiter benutzt. Seit einigen Jahren sind modifizierte Geräte auf dem Markt, die auch in Reformhäusern zum Einsatz kamen.

Methoden

Zwei moderne Bioresonanzgeräte, Bioscan-SWA und Vieva Vital-Analyser, wurden untersucht: Neun freiwillige Probanden (vier Frauen, fünf Männer), zwei männliche Patienten, eine Leiche, jeweils frischer Leberkäse (Fleischbrät) und ein feuchtes Tuch nahmen teil. Unter gleichen oder fingierten Angaben von Namen, Geburtsdatum, Geschlecht, Körpergröße und Gewicht der Probanden beziehungsweise Patienten wurden wiederholt Einzelmessungen und Vergleichsuntersuchungen von Proband/Patient, Leberkäse und feuchtem Tuch durchgeführt (nach den Angaben der Hersteller).

Ergebnisse

Bestehende Diagnosen schwer erkrankter Patienten wurden nicht erkannt, der Leiche beste Gesundheit neben einer Fülle potenzieller Gesundheitsrisiken attestiert, ebenso wie allen Probanden. Messungen an frischem Leberkäse sowie an einem feuchten Tuch unter verschiedenen Angaben zu Alter, Geschlecht, Körpergröße, Gewicht und Namen führten zu unterschiedlichsten Befunden mit relativen Standardabweichungen bis über 200 %. Andererseits waren Ergebnisse, die unter gleichen Probanden- beziehungsweise Patientendaten am feuchten Tuch und dem Fleischbrät gewonnen wurden, nahezu identisch mit denen, die von den Probanden beziehungsweise Patienten erzielt wurden.

Schlussfolgerung

Die Gerätschaften waren nicht imstande, die jeweiligen Testmaterialien zu unterscheiden. Es wird vermutet, dass die Überbrückung der beiden Pole der Untersuchungssonde durch schwach leitende Materialien eine Software aktiviert, die gesundheitsrelevante Befunde erzeugt. Wir empfehlen als einfache Tests für die Validität von Bioresonanzergebnissen den Leberkäse- oder verwandte Tests.

And here is my explanation.

The study tested the diagnostic validity of two different bioresonance machines commercially available in Germany. The tests were carried out on:

  • 9 healthy volunteers
  • 2 seriously ill patients
  • 1 human corpse
  • 1 liver pate
  • 1 wet towel

The results show that the bioresonance method

  • failed to diagnose serious diseases in the patients,
  • produced a clean bill of health for the corpse,
  • diagnosed a host of health risks in the volunteers,
  • produced variable results for the liver pate and the wet towel with standard deviations for repeated tests exceeding 200%,
  • generated no real differences between the wet towel and the healthy volunteers.

This study was published in 2019. It would be interesting to monitor whether the sales figures for bioresonance machines will now dwindle. Even though I am an incorrigible optimist, I shall not hold my breath.

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