COVID-19 Pandemic: The Ayurvedic Perspective.

The mankind is facing an unprecedented pandemic of Novel CoronaVirus Disease (COVID-19). In the 21st century alone, the coronavirus outbreak has emerged thrice - as COVID-19, MERS, SARS-CoV - from animal reservoirs to cause global concerns. Corona virus chiefly circulates among animals primarily pigs, camels, bats, and cats.  The transmission of COVID-19 virus is directly through respiratory droplet/saliva and indirectly by contact with contaminated objects. Comorbid conditions in general and respiratory diseases like Asthma/COPD as well as old age appear to be the risk factors at the individual level including Women and children  No specific drug or vaccination against the virus is available at present and intense research is going on to find a vaccine against the disease across the globe. Although some drugs have been used empirically, the present emphasis is more on prevention of the spread of the infection. Home isolation for the suspected cases, quarantine of the positive cases, social isolation, and self-imposed curfew are some adopted strategies, showing promising results. Most common symptoms as per WHO are fever, dry cough, and tiredness. Less common symptoms are aches and pains, sore throat, diarrhea, conjunctivitis, headache, loss of taste or smell, a rash on the skin, or discoloration of fingers or toes. Serious symptoms includes difficulty in  breathing or shortness of breath, chest pain, loss of speech, or movement. Most of the infected people are found to develop mild to moderate symptoms and recover without medical interventions.  In Ayurvedic literature, the communicable diseases are mentioned under Janapadoddhvamsa (~communicable diseases affecting an entire country or the whole world) impairment of Vayu (~air), Udaka (~water), Desha (~land) and Kala (~season) and are more lethal in their consecutively increasing order. Adharma (~unrighteousness) is the root cause of  vitiation of all factors and is led by Pragyapradha (~intellectual error). Sansargaja (~diseases transmitted directly through close contact or droplet infection) and Upsragaja (~diseases transmitted indirectly through contaminated surfaces), are also mentioned in Ayurveda. Ayurvedic management of these infectious diseases can be preventive and curative.  Changes in weather and environment can be predicted with geoecological and climatology advanced technologies. Adequate arrangements and planning can be made before starting epidemics, which are most likely to occur in that specific weather, to minimize the morbidity and quick identification of various vectors that could worsen the impact or facilitate the spread of infections. In newly emerging COVID-19, where there is limited scientific knowledge, a vigilant observation can help prepare plan and management in future outbreaks. Further, early detection may help for rapid implementation of effective measures, which are the key to reduce the risk of disastrous spread.  Enhancement of immunity plays an important role in maintaining optimum health and preventing such communicable diseases. Ayurveda’s insights of  preventive care are based on the concepts of “Dinacharya” (~daily regimes)  and “Ritucharya”(~seasonal regimes). These help in maintaining health, immunity and longevity. Panchakarma (~bio-purification) and Rasayana (~immunomodulators) can be planned for people in the risk-prone areas to improve immunity and minimize the risk of infection. It is noted that certain viral infections occur in a specific period of the year when either the weather is favorable for viral potency or there are potent vectors to primarily infect individuals with low immunity.  The Ministry of AYUSH, Government of India has issued an Ayurvedic immunity-boosting advisory for self-care during COVID- 19 crisis. Ayurvedic immunity promoting medicine like Chyavanprash, turmeric powder with milk, herbal tea/decoction (~Kadha/Kwath) made from Basil(Tulsi), Cinnamon, black pepper, dry ginger and procedures like Gandusha (~oil pulling), application of Sneha (cow’s ghee) within nostrils and daily practice of Yogasana, Pranayama, and meditation have been advised. Above advisory and guidelines mostly focuses on immunomodulation and symptomatic treatment of the diseases. Further investigation into the treatment protocols based on Dosha Prakopa Awastha (~aggravation or accumulation of toxins) and Prakriti (~constitution)  may play a vital role in the management of COVID-19. Sodhana and Rasayana therapy is well advocated for Janapadoddhvamsa in Ayurveda. Self-taught Partimarsha Nasya (~errhine therapy), Shiro-Padaabhyanga (self oil massage of head and soles of feet), Gandusha (~ oil pulling), and Shirodhara through automated machines are some of the options that can be explored for the benefit of patients under isolation or quarantine. As most of the countries are busy tackling the peak of COVID-19, the long term adverse effects of lockdown and information overload on mental and physical health must not be ignored.  Use of Medhya and Balya Rasayana therapy for the prevention of recurrence in recovered patients and Sodhana and Rasayana therapy as a rehabilitation can be explored  to help restore the original state. Invariably, Ayurveda advises proper Ahara (~diet) and Nidra (~sleep) to maintain the state of health. Complement with  the advisory of Nidra (~sleep) and Achara Rasayana (~behavioural therapy of Ayurveda) can be further prospective for managing Post-COVID non communicable syndromes.  To generate threads of evidence, the Ministry of AYUSH  conveyed that scientists, researchers, clinicians of any recognized Indian system of medicines can conduct research on COVID-19 through Ayurveda. To enhance the Ayurveda treatment in more precise way some retrospective studies based on Prakriti (~individual constitution), Ahara (diet), Vihara (~lifestyle), and Agni (~digestive power) can be conducted to rule out the variation in  morbidity and recovery rate in COVID positive patients. These research can incorporate generation of evidence towards prophylactic measures, interventions during quarantine, asymptomatic and symptomatic cases of COVID- 19, public health research, survey, lab-based research, etc. Evidence on COVID-19 should be adopted by the AYUSH fraternity. These can include, but is not limited to, Animal-human interface and food safety, clinical care, critical preparedness, readiness and response, health services, resources planning, infection prevention and control, risk communication and community engagement epidemiological protocols, travels, points of entry and mass gatherings, vulnerable populations, and fragile settings. Invariably a serious effort is needed in present time to prevent such pandemics in the near future. Meanwhile there are a lot of expectations from the world community from India to handle this critical situation by using its indigenous medical system Ayurveda. It’s high time to show the strength of Ayurveda and other AYUSH systems to combat this disastrous condition.