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

patient choice

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The ‘International Chiropractors Association’ (ICA) has just issued a statement entitled “International Chiropractors Association Affirms Policy on Health Freedom“. On the background of the fact that US President Biden, issued a series of Executive Orders related to mandating federal employees and federal contractors to receive the COVID-19 vaccine, the ICA try to explain their position regarding vaccinations. Here are a few passages from this statement:

…In a world of public health that promotes evidence-based decision making, we see the importance of natural immunity being ignored and replaced with a totalitarian approach of compulsory vaccination.  At a time when the Surgeon General says misinformation has become an urgent threat to public health, misinformation is now being used in an attempt to discredit the chiropractic profession, the International Chiropractors Association, and all chiropractic patients who desire to focus on improving health naturally. After enduring 18 months of shutdowns, lockdowns, flattening the curve, masking, limitations of speech on social media; and a cancel culture environment that threatens the basic freedoms our country was founded upon in 1776, ICA will not compromise on the importance of protecting health freedom…

The ICA Policy on Immunization and Vaccination has remained unchanged for almost 50 years and clearly states:

“The International Chiropractors Association recognizes that the use of vaccines is not without risk and questions the wisdom of mass vaccination programs.  Chiropractic principles favor the enhancement of natural immunity over artificial immunization.

The ICA supports each individual’s right to select his or her own health care and to be made aware of the possible adverse effects of vaccines upon a human body.  In accordance with such principles and based upon the individual’s right to freedom of choice, the ICA is opposed to compulsory programs which infringe upon such rights.

The International Chiropractors Association is supportive of a conscience clause or waiver in compulsory vaccination laws, providing an elective course of action for all regarding immunization, thereby allowing patients freedom of choice in matters affecting their bodies and health.”

The International Chiropractors Association maintains that all healthcare interventions, including the chiropractic adjustment, are associated with some level of risk and that every individual is entitled to be informed of those risks, no matter how insignificant. All individuals must retain the freedom to accept or reject any healthcare product, procedure, or medication including vaccinations.  The International Chiropractors Association therefore strongly opposes the use of medical mandates that violate personal sovereignty, violate the principles of informed consent, and constrain the rights of patients to make their own health care choices…

The ICA encourages the recognition that natural efforts to enhance the innate immune system ability to adapt to novel viruses are grounded in science and rejects the notion that the patients’ freedom to rely on naturally acquired immunity is not based upon unscientific beliefs.

The ICA rejects the premise that the chiropractic profession’s long history of promoting health freedom and supporting conscientious exemptions is based upon unscientific or non-mainstream beliefs…

I find this statement clear as mud and have the following questions:

  • Do the ICA recommend vaccinations?
  • In particular, do they encourage their members to get vaccinated with the COVID-19 vaccines?
  • Do they advise to recommend COVID-19 vaccinations to their patients?
  • Or do they think that natural immunity is preferable and advise their members and patients accordingly?
  • Do they believe that spinal manipulation enhances natural immunity?
  • Do they think that spinal manipulations are an effective alternative to COVID-19 vaccinations?
  • Do they believe that scientific evidence trumps dogma or vice versa?
  • Which of the two should, according to their conviction, must influence the decision-making processes in healthcare?
  • If the ICA object to misinformation about COVID, why do they not stop their members from promoting it?
  • What makes them think that information about the possible adverse effects of vaccines upon a human body is unavailable?
  • If the ICA recognizes the risks of spinal manipulation, why do they not inform the public about them regularly and objectively?
  • If the ICA knows about the importance of informed consent, why do not all of their members adhere to it?
  • And finally, why do the ICA insist on the term ‘international’ in the name of their organization, if they purely deal with the US situation?

I do not expect the ICA to give me the answers to these questions. But perhaps their Wiki page goes some way towards answering some of them: “… The ICA supports the efforts of the National Vaccine Information Center (NVIC).[13] The NVIC is known for promoting false and misleading information about vaccines, in particular the discredited claim that vaccines cause autism.

The ICA’s annual conferences have featured anti-vaccination propaganda. In 2018 Guest Speaker Beau Pierce (Pierce co-produced a series entitled Vaccines Revealed) hosted a session entitled Vaccines Revealed.,[14] and Jeff Hays, known for producing the anti-Vaccine propaganda Vaccines Revealed, was invited to host a session the 2017 ICA Council on Chiropractic Pediatrics Annual Conference. In 2016 the widely discredited anti-vaccination propaganda film VAXXED was shown at a conference sponsored by the ICA’s Council on Chiropractic Pediatrics …”

SAY NO MORE!

Practitioners of so-called alternative medicine (SCAM) regularly claim with great pride that they treat the ROOT CAUSES of disease. The claim has at least 4 effects:

  1. It distracts from the true causes of disease which are often multifactorial.
  2. It attracts customers to SCAM.
  3. It implies that conventional medicine is at best symptomatic and thus far inferior to SCAM.
  4. It encourages the patients of SCAM practitioners to turn their backs on mainstream healthcare.

The notion that SCAM practitioners treat the root causes is based on the practitioners’ understanding of etiology:

  • If a traditional acupuncturist, for instance, becomes convinced that all disease is the expression of an imbalance of life-forces, and that needling acupuncture points will re-balance these forces thus restoring health, he must automatically assume that he is treating the root causes of any condition.
  • If a chiropractor believes that all diseases are due to ‘subluxations’ of the spine, it must seem logical to him that spinal ‘adjustment’ is synonymous with treating the root cause of whatever complaint his patient is suffering from.
  • If a Bowen therapist is convinced that “the Bowen Technique aims to balance the whole person, not just the symptoms“, he is bound to be equally sure that the root cause of “practically any problem can potentially be addressed” by this intervention.
  • If a homeopath is convinced that all illness stems from a weakness of the ‘vital force’ and that only homeopathic remedies can revitalize it, they are likely to believe that their remedies tackle the root cause of all diseases.
  • Etc., etc.

So, are SCAM practitioners correct when they claim to treat the root causes of disease?

When a root cause has been eliminated, the disease has been eliminated by its root. Treating a root cause, therefore, means that the disease is permanently cured. The above question can therefore be re-phrased as follows:

Is there any SCAM that cures any disease permanently?

I think the answer is NO. (At least, I know none. I would, however, be most grateful if someone could name one together with the evidence)

Even demonstrably effective forms of SCAM are effective only in terms of alleviating the symptoms. The one with the best evidence is probably St John’s wort. It works fine for mild to moderate depression. Yet, it does not cure depression: if we discontinue the treatment, the depression is likely to return.

And what about conventional medicine? Does it offer any permanent cures?

I have been searching and have to admit that I cannot find many either. Here is my list so far of diseases that are potentially curable (meaning they are unlikely to come back once the treatment has stopped and excluding disease prevention) with conventional medicine – and again, I would be really grateful if readers could add to my preliminary list:

  • Acute emergencies, like anaphylaxis, cardiac arrest, etc.
  • Bacterial infections (well most of them)
  • Cancer (some), like Hodgkin lymphoma
  • Malnutrition like beriberi of iron-deficiency anemia
  • Phobias (some)
  • Fungal infections (some)
  • Poisonings (some)
  • Many surgical indications such as appendicitis, gall stones, carpal tunnel syndrome, etc.

Not a long list, I admit (but better than nothing!) – so, please help me to prolong it by adding diseases that I did not mention.

THANKS

 

So-called alternative medicine (SCAM) use has been increasingly prevalent among Americans, whereas its relationship with medical non-adherence is unknown. Using the National Health Interview Survey, this analysis evaluated the use of SCAM modalities and their association with cost-related nonadherence to medical care (CRN) among older Americans by gender strata.

Americans, aged 50 or above in the 2012 National Health Interview Survey, were included to evaluate the use of SCAM modalities and their association with CRN. SCAM modalities were categorized as the use of the following in the past 12 months:

  • 1) herbal supplements;
  • 2) chiropractic or osteopathic manipulations;
  • 3) massage;
  • 4) Yoga, tai chi, or qigong;
  • 5) Mantra/mindfulness/spiritual meditation,
  • 6) acupuncture;
  • 7) mind-body therapy;
  • 8) other SCAM modalities including homeopathy, naturopathy, traditional healers, energy healing therapy, biofeedback, hypnosis, and craniosacral therapy.

CRN was defined as needing medical care but not receiving it due to costs and/or having medical care delayed due to costs in the past 12 months. The investigators developed a multivariable logit model to assess the association of the use of SCAM modalities and CRN controlling for patients age, gender, race, ethnicity, insurance status (Medicare, Medicaid, VA/Tri-care, no-insurance, or private insurance), and comorbid conditions (diabetes, arthritis, back and neck problems, heart condition, stroke, lung and breathing problems, and cancer).

A total of 16,360 older Americans were included in the analysis, with 11,278 (68.9%) reporting at least one SCAM modality use, and 1,992 (12.2%) of them reported CRN. Among the 8 SCAM modalities, compared to those not using SCAM, those who used chiropractic were 94% more likely (p=0.01), those who used Mantra/mindfulness/spiritual meditation were 106% more likely (p<0.01), and those using other modalities were 42% more likely (p=0.07) to report CRN. In contrast, those who used mind-body therapy were 43% less likely (p=0.04) to report CRN. The other 4 modalities did not achieve statistically significant levels although the odds ratios were mostly greater than 1.

The authors argue that the differential association between the SCAM modality use and CRN suggested a complex relationship between the utilization of SCAM and patients’ non-adherence to medical care. It is possible that the out-of-pocket payments for those services significantly increased patients’ cost burden and thus made the use of other medical care unaffordable, and it’s also possible that those who already had low resources were more likely to seek SCAM to substitute for more expensive conventional care. Either of these scenarios would present a serious challenge.

The authors concluded that both men and women are more likely to report financial distress while using various SCAM modalities.

These findings are not easy to interpret. To me, they suggest that, in the US, many consumers have been persuaded to prioritize SCAM over conventional medicine, even if they can ill afford it. It throws a dim light on the US society where some folks seem to struggle to pay for what is essential while continuing to afford the superfluous.

In my view, in a just and non-decadent society, conventional healthcare must be free for everyone at the point of delivery, and SCAM is at best an extra that those who want it should pay out of their own pocket.

I was alerted to an interesting article about homeopathy in Switzerland. Its author points out that homeopathy is paid for by health insurance in Switzerland because of anything remotely related to evidence but because of a referendum in 2009. At the time, one of the arguments of the proponents was that health care costs would tend to decrease if more so-called alternative medicine (SCAM) would be paid for by the public purse. This is what Jacques de Haller, the president of the medical association, claimed: because SCAM is comparatively cheap and helps to prevent more expensive consultations, the total cost of health care would decrease.

This rather naive assumption was also one made in 2005 by the ‘Smallwood-Report’, commissioned by Charles and paid for by Dame Shirley Porter, specifically to inform health ministers. It stated that up to 480 million pounds could be saved if one in 10 family doctors offered homeopathy as an alternative to standard drugs. Savings of up to 3.5 billion pounds could be achieved by offering spinal manipulation rather than drugs to people with back pain. (Because I had commented on this report, Prince Charles’ first private secretary asked the vice-chancellor of Exeter University, Steve Smith, to investigate. Even though I was found to be not guilty of any wrongdoing, specifically of violating confidentiality, all local support stopped which led to my decision to retire early.)

In Switzerland, the assumption that SCAM saves money was refuted in 2019 by the Swiss health insurance association Santésuisse in a proper cost analysis. According to this analysis, doctors who also prescribed homeopathy caused 22% more costs per patient than those practicing conventional medicine. As it turned out, SCAM would be charged in addition to existing conventional medical services. Consequently, from a point of view of health economics, SCAM should not be called “alternative”, but rather “additive”, Santésuisse wrote at the time.

More evidence comes from a German study (authored by proponents of homeopathy!) that confirms these findings. Integrated care contracts for homeopathy by German health insurers were shown to result in higher costs across all diagnoses.

The recognition that homeopathy lacks sound evidence has already led to an end of reimbursement in the UK and France. Both in Germany and Switzerland, strong pro-homeopathy lobbies have so far succeeded in preventing similar actions. Yet, there is no doubt that, in these and other countries, the writing is on the wall.

Prior research has generated inconsistent results regarding vaccination rates among patients using so-called alternative medicine (SCAM). Given that SCAM includes a wide range of therapies – about 400 different treatments have been counted – variable vaccination patterns may occur within consultations with different types of SCAM practitioners.

A recent analysis aimed to evaluate differences between categories of SCAM regarding vaccination behavior among US adults.

Data from the 2017 National Health Interview Survey (NHIS; n = 26,742; response rate 80.7%) were used. Prevalences of flu vaccination, consultations with SCAM practitioners in the past 12 months, and their potential interactions were examined. 42.7% of participants had received the flu vaccination in the past 12 months, 32.4% had seen one or more SCAM practitioners. Users of any type of SCAM were as likely as non-users to have received a flu vaccination (44.8% users versus 41.7% non-users; p = 0,862; adjusted odds ratio [AOR] = 1.01, 95% confidence interval [CI] = 0.95–1.07).

Regarding specific SCAM types,

  • individuals consulting with naturopaths (p < 0.001; AOR = 0.67, 95 %CI = 0.54–0.82),
  • homeopaths (p < 0.001; AOR = 0.55; 95 %CI = 0.44–0.69)
  • chiropractors (p = 0.016; AOR = 0.9, 95 %CI = 0.83–0.98)

were less likely to be vaccinated. Other SCAMs showed no significant association with flu vaccination behavior. Independent predictors for a flu shot were prior diabetes, cancer, current asthma, kidney disease, overweight and current pregnancy. As well, higher educational level, age, ethnicity, health insurance coverage, and having seen a general physician or medical specialist in the past 12 months were also associated with a higher vaccination rate.

The authors concluded that SCAM users were equally likely to receive an influenza vaccination compared with non-users. Different SCAM therapies showed varied associations with vaccination behavior. Further analyses may be needed to distinguish influencing factors among patients’ vaccination behavior.

This survey confirms what we have discussed repeatedly on this blog (see, for instance here, here, here, here, and here). The reason why consumers who consult naturopaths, homeopaths, or chiropractors get vaccinated less regularly is presumably that these practitioners tend to advise against vaccinations. And why do they do that?

  • Naturopaths claim that vaccines are toxic and their therapeutic options protect against infections.
  • Homeopaths claim that vaccines are toxic and their therapeutic options protect against infections.
  • Chiropractors claim that vaccines are toxic and their therapeutic options protect against infections.

Do these ‘therapeutic options’ – detox, nosodes, spinal manipulation – have anything in common?

Yes, they are bogus!

Conclusion:

Many naturopaths, homeopaths, and chiropractors seem to be a risk to public health.

Cannabis seems often to be an emotional subject where more heat than light is generated. Does it work for chronic pain? This cannot be such a difficult question to answer definitively. Yet, systematic reviews have provided conflicting results due, in part, to limitations of analytical approaches and interpretation of findings.

A new systematic review is therefore both necessary and welcome. It aimed at determining the benefits and harms of medical cannabis and cannabinoids for chronic pain. Included were all randomised clinical trials of medical cannabis or cannabinoids versus any non-cannabis control for chronic pain at ≥1-month follow-up.

A total of 32 trials with 5174 adult patients were included, 29 of which compared medical cannabis or cannabinoids with placebo. Medical cannabis was administered orally (n=30) or topically (n=2). Clinical populations included chronic non-cancer pain (n=28) and cancer-related pain (n=4). Length of follow-up ranged from 1 to 5.5 months.

Compared with placebo, non-inhaled medical cannabis probably results in a small increase in the proportion of patients experiencing at least the minimally important difference (MID) of 1 cm (on a 10 cm visual analogue scale (VAS)) in pain relief (modelled risk difference (RD) of 10% (95% confidence interval 5% to 15%), based on a weighted mean difference (WMD) of −0.50 cm (95% CI −0.75 to −0.25 cm, moderate certainty)). Medical cannabis taken orally results in a very small improvement in physical functioning (4% modelled RD (0.1% to 8%) for achieving at least the MID of 10 points on the 100-point SF-36 physical functioning scale, WMD of 1.67 points (0.03 to 3.31, high certainty)), and a small improvement in sleep quality (6% modelled RD (2% to 9%) for achieving at least the MID of 1 cm on a 10 cm VAS, WMD of −0.35 cm (−0.55 to −0.14 cm, high certainty)). Medical cannabis taken orally does not improve emotional, role, or social functioning (high certainty). Moderate certainty evidence shows that medical cannabis taken orally probably results in a small increased risk of transient cognitive impairment (RD 2% (0.1% to 6%)), vomiting (RD 3% (0.4% to 6%)), drowsiness (RD 5% (2% to 8%)), impaired attention (RD 3% (1% to 8%)), and nausea (RD 5% (2% to 8%)), but not diarrhoea; while high certainty evidence shows greater increased risk of dizziness (RD 9% (5% to 14%)) for trials with <3 months follow-up versus RD 28% (18% to 43%) for trials with ≥3 months follow-up; interaction test P=0.003; moderate credibility of subgroup effect).

The authors concluded that moderate to high certainty evidence shows that non-inhaled medical cannabis or cannabinoids results in a small to very small improvement in pain relief, physical functioning, and sleep quality among patients with chronic pain, along with several transient adverse side effects, compared with placebo.

This is a high-quality review. Its findings will disappoint the many advocates of cannabis as a therapy for chronic pain management. The bottom line, I think, seems to be that cannabis works but the effect is not very powerful, while we have treatments for managing chronic pain that are both more effective and arguably less risky. So, its place in clinical routine is debatable.

PS

Cannabis is, of course, a herbal remedy and therefore belongs to so-called alternative medicine (SCAM). Yet, I am aware that the medical cannabis preparations used in most studies are based on single cannabinoids which makes them conventional medicines.

Health Canada is a government agency responsible for helping Canadians maintain and improve their health. It ensures that high-quality health services are accessible, and works to reduce health risks. Health Canada regulates consumer health products that are sold directly to consumers and do not require a prescription or the oversight of a health care professional. In the past, Health Canada has approved more than 8,500 homeopathic products. A recent survey by Health Canada showed that 11% of parents and guardians believe that alternative practices such as homeopathy or naturopathy can replace vaccines.

Now, Health Canada is proposing changes to the labelling and evidence requirements for homeopathic products, as part of the proposed guidance document: Labelling Requirements for Natural Health Products. These changes would require that all homeopathic products that are sold over the counter include on the front panel of their label the statement “This claim is based on traditional homeopathic references and not modern scientific evidence.” Health Canada is also consulting on the introduction of risk-based evidence standards for homeopathic products, which would align requirements with those of other natural health products. The public consultation opens June 26, 2021 and closes September 4, 2021. For more information on how to participate, visit Consultation – Proposed Amendments to the Natural Health Products Regulations.

I hope you agree with me that it might be worth participating in this public consultation with a view of preventing regulations that could open the door to quackery in Canada. So, please do have a look at the documents and make sure that Canadian consumers are adequately protected.

Spinal manipulation therapy (SMT) is widely used worldwide to treat musculoskeletal and many other conditions. The evidence that it works for any of them is weak, non-existent, or negative. What is worse, SMT can – as we have discussed so often on this blog –  cause adverse events some of which are serious, even fatal.

Spinal epidural hematoma (SEH) caused by SMT is a rare emergency that can cause neurological dysfunction. Chinese researchers recently reported three cases of SEH after SMT.

  1. The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT. Her symptoms persisted after 3 d of conservative treatment, and she was admitted to our hospital. Magnetic resonance imaging (MRI) demonstrated an SEH, extending from C6 to C7.
  2. The second case was a 55-year-old man with sudden back pain 1 d after SMT, numbness in both lower limbs, an inability to stand or walk, and difficulty urinating. MRI revealed an SEH, extending from T1 to T3.
  3. The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT. He was unable to stand or walk and experienced mild back pain. MRI revealed an SEH, extending from T1 to T2.

All three patients underwent surgery after failed conservative treatment and all recovered to ASIA grade E on day 5, 1 wk, and day 10 after surgery, respectively. All patients returned to normal after 3 mo of follow-up.

The authors concluded that SEH caused by SMT is very rare, and the condition of each patient should be evaluated in full detail before operation. SEH should be diagnosed immediately and actively treated by surgery.

These cases might serve as an apt reminder of the fact that SMT (particularly SMT of the neck) is not without its dangers. The authors’ assurance that SEH is VERY RARE is a little puzzling, in my view (the paper includes a table with all 17 previously published cases). There is, as we often have mentioned, no post-marketing surveillance, surgeons only see those patients who survive such complications long enough to come to the hospital, and they publish such cases only if they feel like it. Consequently, the true incidence is anyone’s guess.

As pointed out earlier, the evidence that SMT might be effective is shaky for most indications. In view of the potential for harm, this can mean only one thing:

The risk/benefit balance for SMT is not demonstrably positive.

In turn, this leads to the conclusion that patients should think twice before having SMT and should inquire about other therapeutic options that have a more positive risk/benefit balance. Similarly, the therapists proposing SMT to a patient have the ethical and moral duty to obtain fully informed consent which includes information about the risk/benefit balance of SMT and other options.

Bernie Garrett is a professor of nursing at the University of British Columbia. He is being mentioned here because he has written a book entitled THE NEW ALCHEMISTS which deals (mostly) with so-called alternative medicine (SCAM). It is a well-written, informative, critical, and evidence-based text that I can recommend wholeheartedly. It will be available in the UK on 29 July but you can pre-order it already.

On Amazon, It is being advertised with the following words:

How to identify and see through deceptive and unethical health marketing practices Health scams come in all shapes and sizes-from the suppression of side-effects from prescription drugs to the unproven benefits of ‘traditional’ health practices-taking advantage of the human tendency to assume good intentions in others. So how do we avoid being deceived? Professor of Nursing, Bernie Garrett explores real-world examples of medical malpractice, pseudo and deceptive health science, dietary and celebrity health fads, deception in alternative medicine and problems with current healthcare regulation, ending with a simple health-scam detection kit. And he looks at how these practices and ineffective regulations affect our lives.

The book is written for the interested layperson. But I am sure that healthcare professionals will like it too, not least because it is fully referenced. Its aim is to inform and prevent consumers from being deceived and exploited by charlatans, an aim shared with this blog – while reading the book, I often got the impression that Bernie Garrett might be a regular reader of my blog.

This does not mean that I did not learn a lot from reading Bernie’s book. On the contrary, there was a lot that I did not know before and that is worth knowing. For instance, were you aware that you can earn a ‘Doctor of Naturopathic Medicine, Advanced Diploma’ or Reiki master qualification for $ 12.99 in a 6-hour online course (if you want to know where you’ll have to get Bernie’s book)?  Well, I didn’t.

Yes, I did enjoy reading this book, and I share Bernie’s views on SCAM. In his overall conclusions, he writes: “The sad truth is, many health fraudsters are highly skilled manipulators, and do not always end up being held to account for their crimes, and many continue to profit from them.” Because this is so, it is good to have another splendid book that will help us in our struggle to inform the public responsibly.

It was recently reported that about one-third of people who had been infected with COVID report suffering from long COVID:

  • Some 37% of people experienced at least one symptom lasting 12 weeks or more
  • Almost 15% said they had three or more symptoms for at least 12 weeks
  • Long-term problems were more common in women, and with increasing age
  • Higher weight, smoking, lower incomes, having a chronic illness, and having been hospitalized with Covid were linked to a higher chance of experiencing long-lasting symptoms
  • Tiredness was one of the most common symptoms, and in people who were severely ill with Covid, shortness of breath was a dominant long-lasting symptom

These are worrying figures indeed. Common symptoms of ‘long COVID’ include persistent breathlessness, fatigue, and cough; less common symptoms are chest pain, palpitations, neurological and cognitive deficits, rashes, and gastrointestinal dysfunction. Several research papers describe abnormalities confirming pathophysiological damage ranging from abnormal blood tests to organ damage seen on MRI imaging or in postmortem findings.

Yes, there are good reasons to be worried. Yet others might see this situation as an opportunity. One does not need to be clairvoyant to predict that, in so-called alternative medicine (SCAM), long-COVID will be the next big thing. Whenever there is a new, common, difficult-to-treat condition, SCAM practitioners and SCAM entrepreneurs fall over themselves claiming that their therapy is the solution. Gwyneth Paltrow’s bizarre was one of the first with her methods of easing long Covid symptoms. The Hollywood star and snake oil saleswoman said she had embarked on a “keto and plant-based” regime on the advice of an alternative medicine doctor. And, of course, it did her a world of good … Gwyneth approves of anything that is alternative.

On Medline, we already find an abundance of articles such as this one:

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO2), was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient’s breath rate, SpO2, heart rate, ratio of neutrophil/lymphocyte (NLR), ratio of monocyte/lymphocyte (MLR), C-reactive protein (CRP), and chest computed tomography were monitored. Acupuncture significantly improved the patient’s breathing function, increased SpO2, and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable; the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.

A telephone survey included 495 COVID patients in India. 26% of them said they had people used 161 SCAM products and home remedies during and after COVID infections. More than half of the participants (59.6%) among them had consumed Ayurvedic Kadha. Many respondents consumed more than one SCAM product or home remedy.

A recent review evaluated the effect of SCAM on COVID patients. A total of 14 studies performed on 972 COVID patients were included. The results suggested that different SCAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) of COVID patients. The authors concluded that various SCAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.

This conclusion is, of course, pure wishful thinking; the available evidence is in fact more than flimsy, and claims of effectiveness are not justified. But will this stop SCAM enthusiasts to make such claims? I fear not. My prediction is that, as this homeopath already indicated, they will see COVID as an opportunity: For homeopathy, shunned during its 200 years of existence by conventional medicine, this outbreak is a key opportunity to show potentially the contribution it can make in treating COVID-19 patients. 

 

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