An Integral Analysis of COVID-19
Health positive Integrative and Herbal strategies to maintain mental and physical resilience and reduce vulnerability in these challenging times.
We are feeling extraordinarily grateful to be living where we do, where we can go outside whenever we want thereby maintaining our health, and keeping the kids from bouncing off the walls thereby preventing the loss of our own sanity.
All our of sessions can effectively be conducted on-line including herbal medicine consultations, psychotherapy, stress-management with HeartMath, and energy healing so if you feel that you need support of any kind we’re here for you.
I figured it was probably time to share my own perspective about COVID-19 and what you can do to take care of yourself, your friends and family, as well as those vulnerable individuals that you don’t even know. Though there is a glut of information available out there, the media have a tendency to report medical and scientific subjects poorly, typically taking a sensationalist perspective (spreading fear and panic) as opposed to a careful contextualizing of events and research. Those looking at empowering themselves beyond the widespread government recommendations may also find themselves drawn into the maze of the internet by promising, but often exaggerated claims of how you can “protect yourself from COVID-19” with this or that substance. So I would like to provide you with my own hopefully balanced Integral perspective. My main focus has been staying informed with the different perspectives on prevention and treatment by a number of health practitioners including doctors, integrative doctors, functional nutritionists, Western Herbalists, and practitioners of Traditional Chinese Medicine. I will provide you with suggestions to support the health and well-being of yourself and others and to cultivate resilience. My goal is to provide you with my own integral approach as inspired by my research and my own practical experience and to connect you to resources for reliable information if you wish to explore in further depths.
There is a list of free resources and reliable sources of information compiled at the end.
Also Hand Sanitiser is now being made and sold in bulk by Rutland Biodynamics, one of my main sources for herbal medicines. If you are interested let me know and I can place an order. It is made from a natural base of oil and alcohol and a blend of essential oils with known antiviral properties. One of my clients had the brilliant idea of practicing HeartMath techniques for stress-management while washing their hands, a practice well worth adopting.
This is meant to be a fairly comprehensive resource so we will use the the quadrant model of Ken Wilber’s Integral Theory in order to create a framework for organizing our understanding of the current situation. This will enable you to better contextualize the situation as it unfolds, and empower you to see where you can take measures that will benefit both yourself and others. So we will be exploring COVID-19, both the context within which it exists and its impact upon that context through 4 different “dimension-perspectives “ (the Quadrants). The focus of the inquiry is:
“How does COVID-19 impact mental and physical health and what can you/we do to protect vulnerable people, maintain health and build resilience?”
This tool is called a Quadrivial analysis and I use it to develop an integral understanding of any health subject I may be investigating. It’s all rather overwhelming, however if you see it as a glut of self-empowering opportunities for creating health-positive, stress-reducing, resilience-building, life-affirming, community connecting, growth-oriented changes in your life than you’re on the right track. It’ll give you lots to explore if you are feeling bored. My apologies if its complex, messy and repetitive, it’s inspired by life. If you have questions please throw them at me.
Map (so you can go to what interests you most).
1. Introduction to the Quadrants.
2. Overview of COVID-19 using the Quadrants
3. Lower Right Quadrant. Go here if interested in the big picture; epidemiology, socio-economic, environmental, public health.
4. Lower Left Quadrant. Go her for a cultural and interpersonal perspective, including ways of decreasing relational stress.
5. Upper Left Quadrant. Go here for practical approaches to addressing mental health, stress, anxiety, fear, and cultivating mental, emotional, and physical resilience.
6. Upper Right Quadrant. Head strait here for herbs, nutrition, and lifestyle recommendations for boosting general resilience, improving immune function, addressing COVID specific risk factors and prevention and treatment of infection.
7. Summary of Resources.
Introduction to the Quadrants of Integral Theory
Here is a very abbreviated summary of the Quadrants. Ken Wilber proposes that there are 4 fundamental perspectives which derive from the following distinctions. This is most easily understood visually so I’ve included a diagram below.
We have the subjective or interior on the left side and the objective or exterior on the right side. The individual or singular on the top and the collective or plural on the bottom.
This gives us the four Quadrants:
In Integral Medicine and Health we can fill in the diagram as follows with factors that must be taken into account in order to better understand an individual’s health.
Upper Left — interior-individual, subjective, 1st person (I)
> feelings, meanings, concepts, individual beliefs.
Upper Right — exterior-individual, objective, 3rd person (it)
> organs, tissues, cells, behaviour
Lower Left — interior-collective, inter-subjective, 2nd person (you/we)
> shared meanings, cultural beliefs, shared world views, value subcultures
Lower Right — exterior-collective, inter-objective, 3rd person plural (its).
> social structures, families, tribes, ecosystems, communities.
Overview of COVID-19 using the Quadrants.
The table provides an overview of COVID-19 using the Quadrants.
Again our focus is:
“How does COVID-19 impact mental and physical health and what can you/we do to protect vulnerable people, maintain health and build resilience?”
| Upper Left: Interior-Individual .(Subjective) “I” – emotions/feelings – meanings – concepts – beliefs/attitudes – psychology – stress-management, meditation, HeartMath | Upper Right: Exterior-Individual. (Objective). “IT” – cells – tissues – organs – body – behavior – Nutrition, lifestyle, herbal medicine, supplements |
| Lower Left: Interior-Collective. (Intra-subjective) “We” – Shared meanings – Cultural beliefs (what are our cultural beliefs around illness) – Shared worldviews – Value subcultures. – interpersonal and relational | Lower Right: Exterior-Collective. (Intra-objective). “ITS” -social structures, socio-economic – organisations – NHS or other health care systems, insurance – ecosystems and environment – public health measures |
Lower Right: Exterior-Collective.
I’m starting with this as it provides us with the big picture: the statistical, epidemiological, public health, socio-economic, environmental and systems theory perspective. This is the context within which COVID-19 and its impact upon us is occurring. It differs sometimes dramatically between different countries with differing economic, social and political systems and their response to challenges/threats. The vast majority of the news is concerned with the LR Quadrant: the statistics for each country and the public health recommendations being made, the socio-economic factors, the availability (or not) of hospital facilities, tests, respirators, medical staff, etc. We also see how different countries (and their political and sociao-economic systems are responding with more or less effectiveness to the pandemic. We are also seeing an on-going analysis of the pandemic’s economic, lifestyle, and environmental impact and speculation as to how this may develop moving forward. There’s plenty about this available elsewhere as it’s the main focus of the media and the political response. I will be keeping my focus on more immediate mental and physical health aspects of the pandemic.
What I feel important to mention is the tension between Public Health and Individual Health. This is a broader topic with particular relevance in the case of a epidemic or pandemic (or any situation impacting the collective, the group, the species, the planet!).
Succinctly stated Public Health measures are taken, based on statistics data, to benefit the group, or sub-groups within the population. They therefore benefit “us” as a population (leading to a statistical reduction in disease, illness, suffering). In contrast personal health recommendations are measures that have an positive impact on an individual’s health and wellbeing, reducing suffering and disease for the individual. The statistical, large picture perspective of Public Health does not necessarily account for the impact Public Health measures may have on individuals. Generally, if a sufficient majority of a population is deemed to benefit, public health measures are taken that may be or detrimental to a minority of individuals. Alternatively a highly vulnerable minority is protected by a measure that is taken on-board by the majority. Essentially the ends justify the means and if a few individuals suffer for the benefit of the many (or a vulnerable minority) then it is deemed a worthwhile cost. If you’re trying to govern and care for a large group of people this is a justifiable and necessary perspective. However, the fact is that what is good for the group as a whole is not always of benefit to individuals.
In the case of COVID-19 we now have some epidemiological statistics for projection. The vast majority of individuals will either not be infected, will be asymptomatic, or experience mild symptoms akin to an other upper-respiratory infection, cold or flu. The statistics continue to evolve however, there is clearly no need to panic or worry for most of us. However a minority of individuals are highly vulnerable and public health measures are being taken for their sake. I personally am not worried for myself or my children. We are all in the low risk category and I have all the tools on hand to manage an infection and prevent the development of a severe response (if such occurs by a statistical fluke). In order to maintain perspective, without negating the serious nature of the current pandemic, Malaria (a disease mostly limited to “3rd world” countries), kills about 1 million people per year (according to estimates by the W.H.O.). This remains largely invisible unless you live for any amount of time in places such as West Africa.
You can go here for further details on COVID-19 and the epidemiological perspective.
However, and this is a big however, there are sub-group of individuals that are “high risk.” For a number of predisposing factors they are more likely to have a severe response to infection by COVID-19. The Public Health measures are in place for their protection and benefit. So though my individual response to social distancing is “I don’t need that, ” I am following the measures in order to protect those vulnerable people. Social isolation is an individual sacrifice for the benefit of a minority of the collective. So if you are healthy and chafing at the restrictions remember that they are not there to protect you, not for your own benefit and well-being (and in fact may have a negative impact on your health and wellbeing and financial situation) they are potentially protecting the lives of vulnerable individuals. The majority of you, as low-risk individuals, are being asked to make a personal sacrifice for the sake of a high-risk minority (who could lose their lives).
The moral of the story?
Follow the governments call for social-distancing, self-isolate if deemed necessary based on the guidelines, and take this in as an act of care and compassion. Compassion cultivates coherence which improves physiological measures of health and resilience (as we will see when discussing HeartMath).
Regarding masks. The initial information on the media was that they are not effective at preventing infection. However this was apparently a statement made in part to prevent panic purchase of masks so they could remain available to the front-line individuals (nurses and doctors). Based on my sources masks, even breathing through a scarf or piece of fabric, may slightly decrease the chance of infection. More importantly if you are infected they reduce the probability of you spreading the infection to others – so for “low risk” individuals that is the take home message.
Lower Left – Interior-Collective
The Lower-Left Quadrant comprises the cultural facets of the situation; the collective attitudes, beliefs and world-views, ethics, morals. These are highly influenced by religious systems, and may vary dramatically between countries and their accompanying culture. It is also the interpersonal realm. All of these comprise the context within which we understand and experience health and disease, in this case COVID-19, and reciprocally how we are impacted by the on-going situation.
Here in Ullapool the community seems to have taken the situation on-board, adopting the government measures and organising food deliveries for those who need to self-isolate. In France my mother says many youth have been voluntarily delivering groceries to at risk individuals. One of the Scottish Men’s Sheds has begun using their 3D printer to produce face shields for local health care workers and D’Addario, who make my guitar strings, has converted their factory to the production of face shields out of drum heads.
There are some interesting studies out there showing that under duress human’s are actually more likely to pull together, support each other, tighten community bonds, and make personal sacrifices for the benefit of others than to regress into anarchy and self-serving actions (though this can happen to!). This is one of our inherent strengths as a species, that we can extend our care and compassion beyond our own skin (egocentric) in ever-expanding circles to family and tribe/nation (ethnocentric) to all of humanity and even other species (world-centric) and beyond to the more-than-human beings and the planet (ecocentric). So our capacity to take on-board drastic social and economic change for the sake of a vulnerable minority is a hopeful demonstration that we have the capacity as a country (the UK) and as a species to transform our lifestyles and the socio-economic systems that support them for the benefit of other vulnerable populations (human and more-than-human), and ecosystems and address the many aspects of our planetary crisis. Ultimately our will to create a better world must result in individual changes in behaviour and worldview, otherwise we shall not survive and thrive as a species. Technological and political steps are necessary but no where close to sufficient. Yet our response to COVID-19 demonstrates irrevocably that we, as individuals comprising a planetary society, are capable of the dramatic lifestyle changes necessary to address the wicked problems besetting our Earthly home.
This leaves us with the life or death question: why can we as societies and individuals across diverse cultural, socio-economic and political systems make drastic changes in response to COVID-19 when the majority of individuals, countries and corporations fail to take meaningful action on a threat of far greater magnitude? I’ll leave you to ponder this on your own and maybe share my own thoughts at a later date.
In the LL Quadrant we also feel the impact of social distancing and isolation and how being cooped up together may effect interpersonal relationships in both difficult and beneficial ways. There is a possibility of both increased coherence and and connection as well as tension and friction. Maybe this is an opportunity to cultivate deeper relationships with your children and partners, learn new communication and interpersonal skills? One option is to practice some HeartMath for reducing stress and increasing individual and collective coherence. HeartMath can help reduce the prevalent fear and anxiety that permeates us collectively thereby easing our individual experience and releasing the tension that may accumulate between family members and partners. It also has a measurable impact on physiological parameters of health including immune function. We’ll go into more details later.
Interpersonal Neuroscientist Rick Hanson has great resources for addressing individual and relational stress, below he explores how the impact of quarantine on relationships. I find his weekly newsletter very inspiring and worth subscribing to.
https://www.rickhanson.net/being-well-podcast-coping-with-quarantine/
This is also the realm of meaning-making. For example I’ve begun my own process of meaning making by exploring how our response to COVID-19 shows our capacity for individual and collective change . This provides me with hope grounded in reality for our species and the other denizens of this planet whose lives we impact. This can be a constructive or a destructive process. The key here is that meaning-making is growth-oriented, life-affirming and not oriented towards blame, conspiracy theories, and fundamentalism. Meaning-making must walk the fine line between taking individual and collective responsibility and falling into blame, scape-goating, and the hubris of over-responsibility. For me meaning must be held lightly, not as absolutes to impose upon others, but as a means of contextualizing my experience in a way that provides me with hope, a sense of purpose and empowerment, and orients me in taking “right action.” For some this meaning may be created through actions of service, for others a religious perspective, or taking this as opportunity to slow down and spend more time with family, to live a simpler less consumerist lifestyle. I find myself hopeful that we now have a precedent for rapid lifestyle change in order to address a pressing problem and that the actions are generally a sacrifice for the benefit of others. I also find that the Mythopoetic perspective of mythologist and storyteller Michael Meade touches me deeply and you can listen to his podcasts here:
https://www.mosaicvoices.org/podcast
https://www.mosaicvoices.org/episode-143-myths-of-loss-and-renewal
Compassion!
There is a wealth of evidence that compassion, enacted through acts of kindness and volunteering promotes HRV coherence and improve health outcomes. People who volunteer are happier and live longer. By contributing your efforts to helping in the current situation or other causes you can find a sense of personal purpose, and improve social coherence and resilience (LR) while improving the physiological parameters of health (UR), and a sense of well-being and self-worth (UL).
Upper Left – Interior-Individual
The Upper Left Quadrant comprises the individual’s subjective experience, including their psychology, emotions, feelings, and attitudes/beliefs. How are you reacting to the situation: denial? anxiety? fear? panic? depression? acceptance? How do your past experiences and your psychological type effect your reactions?
“Tetra-arising”
Before entering deeper into the Upper-Left I will take the opportunity to elucidate a basic principle of Integral Theory. All the four Quadrants “tetra-arise”, in other words they are all occurring simultaneously. Though we can discern them as distinct dimensions they are all arising simultaneously and explantation of an occurrence/phenomena from one quadrant perspective will have correlated explanations from the other quadrants. For example, if you are feeling anxious (UL) you may be worrying (mental activity also in the UL). This anxiety will be accompanied by a physical state including a distinctive pattern of muscle tensions, body posture, sensations in the gut (butterflies in the stomach), an incoherent HRV pattern and beta brain waves, elevated adrenaline and cortisol levels all in the UR (Individual-Objective). These can all be observed using using the senses, sometimes with the assistance of technology such as HRV biofeedback and lab tests. The anxiety arises within a context in the LR (exterior-collective) – the socio-economic and political and environmental aspects of the situation. In this case it’s possible that you are not able to work and so the anxiety is partially related to your financial situation and the stress of navigating the bureaucracy of the social system in order to receive financial support.
This anxiety is impacting your relationships as your behaving in a snappy or contracted way towards your children and partner and the atmosphere within the house is tense and charged (the LL- interior-collective). Expanding out from your small family circle the state of shared anxiety that permeates the nation also influences you – the boundary between self and other is necessarily permeable and you pick up some of the collective fear which amplifies your own personal anxiety. In this example we can see how the tetra-meshing of the Quadrants can result in a “positive feedback loop” where they mutually reinforce each other in a potentially damaging spiral. However, as a health practitioner the capacity to unpack these four dimensions allows me to spot points of leverage and how an intervention in one Quadrant will always resonate within the others.
Receiving information from the Government on how to apply for financial aid and taking action (LR) might alleviate your anxiety, which will in turn, reduce the tense atmosphere in the household, and be accompanied by a physiological shift (decreased muscle tension, drop in cortisol levels, improved HRV coherence, disappearance of butterflies in stomach. Or one might decide to relieve the tension in the household by owning and sharing one’s concerns and asking for support (LL). No longer feeling a sense of lone responsibility your breathing slows, your shoulders drop, your anxiety dissipates and you’re able to research the situation with the support of your partner. Or you take a moment to slow down, regulate your breathing and conduct a gratitude practice such as HeartMath (UL). You instantly feel calmer and this is correlated with changes in your Heart-Rate Variability patterns from incoherent to coherent that are measurable with a biofeedback monitor, along with lower levels of adrenaline and cortisol (UR).
Finally you might go for a UR solution, addressing your state of anxiety by taking a few millilitres of Skullcap (Scutellaria lateriflora) which has a GABAnergic effect, down-regulating your Autonomic Nervous System and is also a skeletal-muscle relaxant relieving the tension in your shoulders. You feel the anxiety dissipate, and with the release of the emotional contraction you are able to connect with your kids, read them a story (further calming you and them), and arrange with your partner some time without the kids so you can look into financial assistance without being asked inane questions every 47 seconds.
Hopefully the above illustration gives you an idea of the dynamics between the Quadrants and empowers you to see how many ways you can create change in any given situation.
Supporting Your Emotional and Mental Health
Within the UL, whatever you may be experiencing in regards to COVID-19, the important first step is to cultivate self-awareness. Developing your capacity for self-observation (your “witness”) creates a little space between yourself and your experience. You are not your anxiety you have anxiety. This space creates a little relief, which through practices such as breathing, meditation, HeartMath in the UL, or UR interventions such as anxiolytic (calming) herbs, exercise, etc can be expanded. Don’t attempt to take action to fix the problem upon which the anxiety has fixated (which isn’t always the “root” problem) until you’ve shifted your state of anxiety. A clear mind, relaxed body and a state of psychophysiological coherence enable problem solving whereas anxiety and its companions, physical tension, interpersonal drama etc create a state of “cortical inhibition” essentially shut down your higher brain functions including, logic, problem solving, language skills, interpersonal skills, communications, impulse control, etc.
For me HeartMath is the perfect tool for such situations, along with exercise and movement, especially outdoors, and helps reduce my stress and increase my resilience.
HeartMath is giving away their program, “The HeartMath Experience, for cultivating emotional balance, mental clarity and resilience”. Or you can contact EarthMind for individual coaching sessions.
iAwake, creators of the Profound Meditation program, are giving away one of their brain-wave entrainment programs, Schummann Holophonic. I’ve extensively used and helped test their many of their products and find them extremely effective in reducing anxiety, stress, and depression, and helping with sleep as well as as for catalysing personal growth and supporting meditation practice. If you’ve never tried binaural brain-wave entrainment I highly recommend binaurals for those new to meditation as well as for more experienced meditators as it can transform meditation from chore to a pleasure. This is one of my favourite tracks. You can download it for free:
Sometimes a shift of state is sufficient, however if this issue is chronic and on-going, or overwhelming than further measures can be taken. Reach out to friends, family, or others for support. This may be an opportunity to engage in some stress-management to learn new approaches for transforming stress into resilience, psychotherapy or herbal medicine.
Growth-orientation and Resilience
One of the most important aspects of the UL is also my process of making meaning of a situation. I addressed this partially in the LL as individual meaning-making and world views are embedded in the collective world views (though not necessarily in agreement). The important part to elaborate here is the concept of growth-orientation. A growth-oriented individual sees challenges/obstacles as opportunities for growth, learning, and transformation. How can you as an individual, couple, family and us as a nation and species take this situation on-board and create change for the better? This perspective is already unfolding, even when we are still amidst the crisis management which is part of the acute situation. Such an orientation helps us maintain and cultivate resilience within challenging situations.
One way to describe resilience is as the capacity to protect yourself from and handle challenging situations (both in day to day life and in specific larger situations). The individual in a state of resilience bounces back quickly after being knocked down . The approach difficulties with an attitude of “what can I learn from this situation, what can I make of it, how I can grow, how can I create a better world for myself and others?” Resilience has facets in all four quadrants: UL: mental, emotional, spiritual: UR: physical fitness and physiology, neurological, immune system, LR: social, political, economic, and social – such as our health care infrastructure (the NHS) and LL: cultural resilience in our belief systems (worldviews, religions, myths), family, relationships, communities. Different individuals tend to have more resilience in different realms (an athlete may have plenty of physical resilience and very little resilience in the face of interpersonal conflict). In the case of COVID-19 we are experiencing individual and collective challenges to our resilience. Taking a growth-oriented perspective creates an opportunity for individual and collective learning and transformation. Resilience is fundamental to our capacity to make it through the pandemic and we are witnessing a dramatic challenge to our resilience in all four quadrants – our strengths and our weakness are being individually and collectively thrown onto center stage for all to see. This is true for individual mental and physical health, for our social and economic systems, our businesses and corporations, our public infrastructure (the health care system in particular), and our environment.
So how do you cultivate resilience? In the UL practice meditation, breathing techniques, and particularly HeartMath. heartMath cultivates psychophysiological resilience in all Quadrants: emotional, physiological (immune!), interpersonal and social. For those in roles as carers HeartMath can be vital in avoiding a state of burn-out and “over-care.” We need our health care and other key workers to maintain their resilience under trial. Showing gratitude, as the nation did when applauding the NHS workers, is a key way of supporting resilience and cultivating a state of collective coherence. In the UR lifestyle changes, supplements, and herbal medicine can all support your resilience as we shall see in the following section.
I’ve seen some good recommendations on stress-management during lock-down and one of the keys is to not feast on the fear-fest that the media is engaging in. Fear sells better than sex and the media is taking full advantage of this with their sensationalist reporting. It’s easy to be lured into obsessive information seeking (information is empowering after all), however a overdose of media information is detrimental to one’s own mental and emotional state and increased anxiety. If you are feeling anxious and would describe yourself as a worrier I’d highly recommend restricting your time with the news to 5-10 minutes a day, which is plenty to get the gist of daily events. Otherwise you may find yourself sucked into a state of anxiety, worry, and incoherence that is highly draining to your resilience and will impact your immune system.
HeartMath’s Quick Coherence
HeartMath’s Quick Coherence is a technique for shifting from a state of incoherence to one of psychophysiological coherence. It reduces the impact of stress and cultivated mental, emotional and physical resilience. It is comprised of three steps.
1. Heart-focus: focus on the area of your heart.
2. Heart-breathing: breath into your heart to a count of five, out to a count of five. The count can be more or less but keep the same length in-breath and out-breath.
3. Heart-feeling: bring to mind a situation, activity, person, or memory for which you feel a sense of appreciation and gratitude. Once a sense of gratitude has arisen breath that gratitude into your heart.
Quick Coherence shifts you physically, emotionally, and mentally, stopping the physiological impact of stress and optimising the function of your nervous system, endocrine system, and immune system in ways that are measurable (in the UR) and well-documented by numerous studies.
I few more helpful ideas came from a blog on Deepak Chopra’s website.
“If You’re Panicking About the Coronavirus, Stop Yourself by Trying These 7 Methods”
One means of transforming your anxiety, especially if fuelled by feeling powerless is by taking positive action to support yourself and others such as volunteering.
Upper Right – Exterior-Individual
Here we come to the realm of biology and how COVID-19 interacts with individual living organisms. I’m going to skip over basic descriptions of the Coronavirus and its symptoms and instead plunge into what we can do for potential prevention and treatment.
Applying the practice of “meaning-making” take a moment for self-reflection regarding one’s basic health. As we shall see below, the basic conditions which make an individual high-risk if infected by Coronavirus are, for the most part, health conditions which are generally considered “diseases of Western Civilisation. Most of these conditions and their physiological foundations, are largely caused by lifestyle, stress and dietary factors, and are very responsive to health focused changes in lifestyle and diet. So I want to empower you to make health positive changes because 1 – these will benefit everybody regardless of COVID-19 and 2 – the pre-disposing factors implicated in individuals being high risk are often readily (and sometimes rapidly) improved by simple measures in all 4 Quadrants.
I study historical European fencing and the first basic principle of defence is avoidance, which essentially means to get out of the way of the sword. This remains the first recourse, and the best defence in case of COVID-19 and is covered by the government strategy of social distancing and self-isolation. Another strategy is blocking and this is exemplified by maintaining a barrier between yourself and the virus: protective clothing, masks, goggles, gloves and is particularly vital for our health-care workers who are in close contact with individuals infected with Coronavirus and can not practice evasion. A third strategy is to redirect, which might well describe hand-washing – contact is made with the virus but it is neutralised before it can penetrate your defensive boundaries. These are the primary measures, all external behavioural measures, that can be taken. We will now focus on internal measures for supporting your physiological resilience and immune function.
The table below provides a valuable illustration.
(COVID-19: self care for the vulnerable. College of Medicine, Simon Mills).
Most of the population will either remain uninfected or asymptomatic. The table above describes three further categories: mild infection, severe infection, critical infection. The goal of the recommendations will be to prevent infection all together, or in the case of infection to prevent you from sliding from mild to severe infection or severe to critical.
Evidenced-based Medicine and COVID-19
Now, it may be true that there is little in the way of “clinical trials” for the treatment of COVID-19 by natural means. This is the criticism carelessly bandied about “against” all the worlds diverse modalities for health except that of our standard biomedical model. However, clinical trials are only one branch of evidence, and provide poor guidance for individual health care decisions. The phrase, “evidenced-based” so often bandied around by various parties is often assumed to refer mostly to evidence from clinical trials. This is a very flagrant limitation of the term restricting its utility largely to public health policy. Far more relevant to practitioners and clients is a clinical understanding of EBM. Clinical decisions are informed by three equal strands of evidence: 1 – Fundamental Research and Clinical Trials, 2 – Practitioner Experience (which could also include traditional and folk medicine practices) , and 3 – Patient Experience and preferences. Together these three stands create a stable three-legged stool that a practitioner can sit upon while making decisions in collaboration with their patient/client. Remove one and the process becomes prone to catastrophe or becomes blind to the wealth of potential solutions or mayhem of potential problems. The statistical information from clinical trials is not a good source of clinical guidance for a health practitioner working with a specific individual. So in the case of COVID-19, we have three realms to guide us.
1) There is current research and clinical trials on COVID-19 and extrapolation from in-vitro and animals studies on COVID-19, and other coronaviruses and viral infections. In addition to direct application to COVID-19 we can also look at risk factors and how to reduce them. This last is a subject for which there is extensive research supporting for lifestyle, dietary, and herbal recommendations.
2)There is also a wealth of knowledge and experience of practitioners from the current as well as previous epidemics both recent and historical. These provide us with invaluable insights that can guide our recommendations in the dynamic management of an infection. We should learn from our past failures and successes.
3) There are the actual experiences of illness and its treatment and recovery from actual patients. I will be taking all three of the strands of Evidence-Based Medicine into account in my recommendations.
Supporting Health and Resilience vs Treating Illness
My primary focus for this section remains one of supporting overall resilience. The epidemiological data and the published studies to date show a clear pattern of which individuals are at highest risk of falling within the severe or critical infection category. What measures can “high risk” individuals take in order to reduce the probability of a severe reaction? Such general health measures, as well as interventions in the other Quadrants, can have a dramatic impact on reducing the risk factors implicated in a severe response to infection. A pro-active approach to addressing risk factors, could not only save individual lives, but collectively reduce the overall burden on our health care systems and the need to use heroic measures that are in short supply to save critical patients.
The first thing to remember is that each state of illness, from mild to severe to critical ,is determined by the extent and nature of the immune system’s response The symptoms one experiences with a flu or cold are defensive measures taken by your immune system. The healthy immune response therefore needs to be optimised while alleviating the discomfort of the symptoms. If the initial immune response is ineffective, the immune system my overact to the virus resulting in a more severe response with more destructive (less precisely targeted) inflammatory measures. Essentially collateral damage may begin at this point. Symptoms such as dry cough and shortness of breath are signs of inflammation entering the lungs. There are a host of herbs for reducing inflammation in the lungs, supporting healthy respiratory function, and therefore reducing the chance of developing a secondary bacterial infection. There are also specific herbs for treating bacterial infections in the lungs and upper respiratory tract. The shift into Critical Infection which most likely occurs in high risk individuals involves the immune system entering into a state of chaos, sometimes called a “cytokine storm.” There are many herbs that may be useful mostly for prevention of a cytokine storm but this remains a situation that will likely require medical care and hospitalization. Our focus is on preventing a downwards spiral from mild to severe to critical. What is needed (from the first category onwards) is a coherent immune response versus a chaotic one and herbs can help increase immune system resilience, the coherence of its response, and strengthen its response while down-regulating excess inflammation and reactivity.
Who’s at risk?
Currently 70% of fatalities are men, of a median age of 80.5. Most have pre-existing chronic pathologies. Those with more than one pathology have higher risk. In this regard COVID-10 differs from seasonal flu, where the risk individuals are usually immune-comprised, including young children and pregnant women. If you are pregnant and want specific reassurance and support you can look at Aviva Jill Romm’s resources. She is a mother, herbalist, midwife, and doctor of functional medicine .
https://avivaromm.com/category/covid-19/
The health conditions that most increase risk are:
(COVID-19: self care for the vulnerable. An open access review from the College of Medicine. 31st March, 2020, Simon Mills, ed.)
Some of you may tick one or more of these boxes, and feel rightfully alarmed. However, this is a perfect opportunity to practice HeartMath (which reduces blood pressure, improves blood sugar regulation, decreases inflammation, and improves immune function). There are lifestyle, nutritional, and herbal recommendations that can have a rapid impact on many of the factors behind these conditions. These very same factors are implicated in increasing your risk of having a severe response to Coronavirus.
Obesity, and its associated poor blood sugar regulation and systemic inflammation, also places individuals at increased risk. In particular a Body Mass Index great than 40.
Reviews of Chinese patients indicates increased gastro-intestinal symptoms. This may be due either to infection of the intestinal mucosa or as a side-effect of antiviral and anti-infective drugs. The researchers called for the use of probiotics to help maintain wider immune function. Our microflora on our skin, in our respiratory system, urinary system, and especially our digestive system play an integral role in defending us from pathogenic organisms and viruses, and regulating systemic immunity (including preventing hyper-reactive immune responses – ie allergies, and inflammation). Maintaining healthy gut flora also improves the absorption of nutrients. Microflora can also effect blood sugar regulation, obesity, and mental health. So taking probiotic foods or supplements is one important way of potentially keeping yourself in the “Mild infection” category. There is also some evidence that taking a probiotic may decrease the severity and duration of colds/flus though this is non-specific to the coronavirus. As is often the case the benefit of probiotic will be most apparent in individuals with dysbiosis (ie an unhealthy microflora) and less visible from the perspetive of a clinical trial especially in those with a healthy microflora. See the College of Medicine’s summary on the research below:
“Coronavirus (COVID-19) – Protecting the vulnerable”
Also note that certain medication, such as prescriptions for cancer, and diabetes, as well as alcohol and recreational drugs may increase your cardiovascular vulnerability by disturbing mitochondrial function in the heart cells.
COVID-19 and ME/Fibro/CFS
Are individuals with ME/Fibromylagia/Chronic Fatigue Syndrome at high risk? If you or someone you loves suffers from ME please be assured that there is no evidence of increased risk of a severe reaction. ME is one of my specialities and most individuals with ME simply don’t fit the same physiological patterns associated with a high risk. If you are worried because you tend to catch every cold and flu, a combination of adaptogens and adrenal support will generally improve your immune response. Jacob Teteilbaum, an integrative doctor, specialising in ME has some helpful resources along these lines.
A Health Positive Perspective: Focusing on Self-care, personal empowerment, lifestyle change.
This is where a little “meaning-making” can be of benefit. If you have any of the conditions that are considered risk factors you have an invitation to address them both for your overall well-being and in order to decreases your chance of developing a severe or critical response to COVID-19. It’s worth noting that the vast majority of them are highly preventable and largely treatable by dietary and lifestyle measures. Though genetics play an important role in an individuals vulnerability to developing specific conditions it requires a particular environment for most diseases to be triggered and develop. Diseases that are strictly genetically determined (ie would develop under any circumstances) are far more rare. Regarding COVID-19 risk factors most of them are “diseases of Western civilisation” which result from the lifestyle, diet and environment we have been developing since the agrarian revolution and which the industrial revolution has amplified. The vast majority of health conditions resulting in morbidity (disease) and mortality (death) in the developed nations (cardiovascular disease, metabolic syndrome, diabetes, obesity, cancer, auto-immune diseases,etc) turn out to be the very risk factors contributing to a severe response to infection by COVID-19.
If we were to address these conditions on a collective level we would require a socio-economic (LR) and cultural (LL) change of vast proportions. It is the socio-economic context of agrarian and industrial society within which individuals are born, live, and die that create the conditions (the “terrain”) in individuals making them vulnerable to the development of these diseases. I would hope this would lead public health policies to focus much more on the prevention aspect of health (prevention is many times cheaper than “treatment”). A health care system focused on healthy lifestyle would have far fewer individuals with the conditions above creating a lower burden on everyday medical resources, and vastly reducing the number of individuals at risk from COVID-19. I think this is a perspective worth learning from as the demand upon our health-care and economic system is put to the test. For the individual there is a possibility of being empowered, COVID-19 could motivate you to better self-care and lifestyle changes that will increase your resilience, improve your quality of life, and potentially treat pre-existing conditions while reducing your vulnerability to COVID-19. So where to start?
How about with some chocolate?
“Video – Our Guide to Improving the Immune System Against Coronavirus”
“Coronavirus (COVID-19) – Protecting the vulnerable”
Lifestyle Recommendations.
Moderate exercise is a first port of call, reducing stress, improving cardiovascular parameters (blood pressure) and blood sugar regulation (comprised in metabolic syndrome and diabetes), and improving immune function. Especially with the social distancing restrictions finding a way of letting loose and releasing pent of energy and tension is vital (especially if you have children enclosed in a small space). Note that strenuous exertion (such as marathons) tends to depress immune function (possible due to the huge amount of inflammation and to suing up one’s physical reserves therefore decreasing resilience.
SLEEP. Good sleep has a huge impact on immune function. Those with insomnia, night shifts, or disturbed sleep will attest to the tendency to have an increased number of annual colds/flus. Good sleep helps maintain resilience. More time on your hands? Go to bed early or take a nap. Don’t feel guilty about it as it contributes to the national effort! If anxiety is impacting your sleep there are numerous strategies. I’d start with practicing Quick Coherence, meditation, or grounding yoga postures. There are also some very calming herbal remedies and for more chronic sleep issues a combination of herbs, supplements and “Sleep hygiene” can be very helpful. Sleep hygiene comprises practices you can take on to promote good rest and include:
1. Avoiding excess stimulus in the evening. Screen time, particularly the activity of being on-line pursuing information or compulsively doing social media tends to stimulate a physiological stress response.Furthermore the blue light frequency of screens suppresses melatonin which is vital not only for sleep but also for immune function. No screens after dinner is my general recommendation.
2. Do calming activities. This is the time for nurturing oneself and others: baths with essential oils, foot baths and massages, yoga class, meditation or HeartMath, etc.
3. If worrying excessively try a worry journal. Give yourself 10-15 minutes to write all your worries down as fast as you can in a journal. Then shut the journal and set it aside.
4. Meditation/HeartMath. I mention them again as they both dramatically alter physiological parameters (for more information see the section on the UL). HRV Coherence in particular has been shown to improve immune function and reduce immune hyper-reactivity (allergies). If you do get infected, what you want is an appropriate, coherent, immune response and not a hyper-reactive response (as typified by a severe infection) or a chaotic response (as typified by the critical infection). Increased HRV coherence is correlated with improvements in most health parameters, increases an individual’s well-being, and is good for relationships. If you want more specific data on the subject you can ask me or look at the Institute of HeartMath website.
Nutrition
There are two facets to my nutritional recommendations. One is supporting your basic health and immune system and the other is addressing specific risk factors.
While nutrition should vary by individual constitution and health conditions, there are some basic principles. For me the primary guideline to nutrition is to avoid any food that requires the industrial revolution. This basic guideline makes for a diet that is colourful, largely seasonal, diverse, and avoids processed substances such as flour, sugar, fined and oils. The “mediterranean-style” diet (lots of fish, fruit, veg, and olive oil) to be a prime example or a modified “paleo” diet.
You can easily improve blood sugar regulation, thereby decreasing inflammation by increasing the uptake of fibre from fruits, green leafy vegetables (kale), and root vegetables (other than potatoes). These are also good pre-biotics that will feed the healthy microflora.
Along this note, I’m a firm believer in the benefits of fermented foods such as kimchi, saurkraut, miso, kefir, etc. These can easily be made at home. (See the book Nourishing Traditions or go to www.fermentista.com).
You can also decrease inflammation and improve cardiovascular health by eating more omega-3 fatty acids from fish and grass fed meat, and consuming other healthy fats such as olive oil, sesame oil, hemp, flax and coconut oil.
Inflammation will also be reduced by the consumption of anti-oxidant, polyphenol-rich foods such as berries, nuts, chocolate (must be 70% or greater) and green and black tea. These also support general immune function and response to viral infection. They also improved cardiovascular health and blood sugar regulation and potentially reduce blood sugar. Positive changes have been measured with the consumption of Cacao in days! So why not try berries with yogurt, cacao powder, and a teaspoon of cinnamon (Cinnamon regulates blood sugar). Or making avocado chocolate pudding? Or my favourite raw food cheesecake with berries, nuts and chocolate?
Spices and Herbs
Spices such as ginger, turmeric, and cinnamon, have an impact on endothelial function and inflammation. This is important as endothelial dysfunction (the endothelium are the cells lining your blood vessels) is a key factor in the development of heart disease,
Spices can create a positive change after even a single meal and have been shown to reduce inflammation, improve blood sugar regulation, and circulation. Many culinary herbs are also very helpful for respiratory function, especially thyme and oregano. Both these herbs have anti-microbial properties that are specific to the lungs (the essential oils are secreted via the lungs) and can be used for the prevention and treatment of secondary bacterial infections in the respiratory system. Thyme in particular is also useful for coughs. Oregano oil also has viral inhibitory properties that may apply to COVID-19. High Risk individuals might consider keeping a bottle in their toolkit in case of viral or bacterial infections of the respiratory system. This can be taken according to the manufacturer’s recommendations, usually 1-3 capsules per day.
Liver function and detoxification can be supported through increased consumption of fibers, bitter greens (kale, dandelion, wild greens, etc) and sour tasting foods(a whole lemon squeezed into a cup of warm water is a great way to start the day). In Chinese medicine spring is “liver time” and the process of detoxification is vital to healthy immune function. You can learn more about this from Michael Tierra who integrates Western and Eastern Herbalism. (Coronavirus: Common-Sense Prevention Tactics: https://planetherbs.com/blogs/lesleys-blog/coronavirus-herbal-prevention-and-treatment/)
Avoid sugar
Sugar is highly inflammatory and depresses immune function. I addition to sugar refined (white) flour as well as whole wheat flour, rice, potatoes etc contain carbs which are very swiftly converted into simple sugars resulting in a rapid spike in blood sugar. Sugar consumption, and its impact on your physiology (inflammation, dysbiosis, immune suppression, and development of metabolic syndrome and diabetes) are more important contributors to heart disease than the saturated fats and cholesterol that have received so much attention by the medical system. You can therefore have a huge impact on your health by simply cutting out sugars. So what’s the alternative for your sweat tooth?
1. Pause and Shift. Sugar craving is a symptom of a stress-response and is often driven by anxiety, bordom, fear, grief, loneliness. If you the issue driving the craving it often evaporates. HeartMath, meditation, exercise, be present with your emotions, connect with others.
2. Sweet cravings are often misdirected protein cravings. Try protein first.
3. Try something bitter. This will sometimes halt a sugar craving.
4. A teaspoon or two of coconut oil will often halt a sweet craving as well.
5. Try alternative sweeteners. Artificial sweeteners are as bad for ypu (maybe worse) than plain sugar. Xylitol, Stevia, Licorice, Cinnamon are all all healthy sugar alternatives.
6. Eat sweets only after a meal or along with protein and fibre.
Cuppa tea anyone?
Yes, Great Britain’s standard solution to all situations proves itself once more appropriate. Besides the benefits of stopping and slowing down for a few moments tea, as mentioned before is rich in polyphenols (a class of phytochemicals with important health benefits). However you’ll want to cut the sugar. Replace with xylitol or Stevia. Green tea may have a number of benefits in addition to the polyphenols. It has a tradition in Buddhism of being used by monks to support meditation. Why? Compounds within tea help expand the bronchial thereby deepening respiration. Green tea also promotes relaxed alertness. This may be due to mild stimulating effects of green tea along with the effect of a compound called L-Theanine which induces alpha-brain waves (UR) and a state of calm (UL). Inhaling the essential oils in the steam may also support the respiratory system. Supplementation with L-Theanine can be beneficial for anxiety, sleep, as a meditation support, and studies show it can shorten duration of colds/flus.
This is an opportunity to explore some new cooking styles and recipes and reinvent your diet in a way that will benefit you and your family for the rest of your lives. You can also get your kids involved in the cooking. I like to recruit the kids for pounding the cabbage when I make saurkraut.
For Information on Flavonoids, polyphenols and pro/prebiotics.
“Coronavirus (COVID-19) – Protecting the vulnerable.”
For loads of information and recipes on a “paleo” diet go to”
https://chriskresser.com/category/paleo-recipes/
My favourite site for healthy deserts (including raw-food cheesecakes).
www.rawmazing.com
Bo’s oatmeal recipe:
Oatmeal
Berries (raspberry, blackberry, blueberry, cherries, strawberries, currants)
Walnuts
Banana
Dark chocolate (85%)
Ground Flax seed
For further health benefits add warming spices which promote circulation, lift the mood, and support blood sugar regulation. A teaspoon of cinnamon, ginger, nutmeg, cloves, cardamon…
I like to add coconut or coconut oil. Tasty and healthy.
Specific nutrients and Supplements
You might consider the following nutritional supplements. Quality varies greatly by brands so I highly recommend you source them from me or get brands that I recommend. I have practitioner discounts for some companies and it is often cheaper for me to place orders for you. If it’s not to your advantage I won’t do it.
I’ve already mentioned probiotics. These will be most beneficial for you if you have signs and symptoms of dysbiosis such as GI discomfort, IBS, candida, a generally poor diet, blood sugar regulation issues, obesity, and relatively recent anti-biotic usage (last few years).
Zinc. Zinc is one a vital nutrient for immune systemic immune function and according to research contact with zinc disables the coronavirus. Zinc lozenges are apparently sold out. If you can get them give them to someone on the front-line. Your local nurse or GP. An alternative is to chew on some pieces of licorice root which has antiviral properties and helps protect your respiratory passages. You can take zinc as a supplement to support the innate and adaptive immune function. It has also been shown highly effective in supporting recovery from severe respiratory infections.
For more information see Jacob Teitelbaum “Coronavirus and CFS/Fibromyalgia (Part 2)”
and Donnie Yance’s “Zinc: The Most Important Nutrient for Immunity”
Vit C, Vit A, E. All these vitamins are implicated in healthy immune system. Vitamin C in particular has some evidence of improving responses to colds/flus (though admittedly some of the evidence is ambiguous). Vitamin C supports immune cell function and the warding off of pathogens while supporting the health of the respiratory system. Take 500 to 2000 mg/day preferably with bioflavonoids (such as with rose hips) in addition to if you wan to insure an adequate supply of key vitamins and minerals. I can provide you with a discount on Innate Response Formulas and Garden of Life in the UK. If in the US I’d recommend New Chapter (get it from www.vitacost.com).
Vitamin D. An essential vitamin for immune function and our capacity to fight infection. At this time of year in the UK the sun is creeping towards the 45’ angle at which we receive sufficient UV to stimulate vitamin D production. However with the lock-down it will be quite difficult to get sufficient exposure and by this time of year most people have long-ago used up their reserves of vitamin D and are in a state of deficiency. I generally recommend a supplement of at least 1000 IU (often included in a multivitamin) or 4000-5000 IU if you have any specific health conditions. I’ve personally found that it has a positive effect on my mood in the winter, avoiding the “winter blues” that so often descend upon us residing in the higher latitudes. Vitamin D has been shown to protect individuals from acute respiratory infection and has been found to be deficient in individuals who developed a potential complication of COVID-19 known as acute respiratory distress syndrome.
Probiotics/Prebiotics. The microflora on our skin, in our respiratory passages, urinary tract and digestive system play a vital role in modulating our immune function, reducing inflammation, improving the digestion and assimilation of nutrients, protecting us from pathogenic organisms, and protecting us from a host of health conditions. Dybiosis, ie imbalances in our microflora and the existing of pathogenic, instead of symbiotic, micro-organisms can be correlated with (though not necessarily causing) depression, anxiety, brain-fog, sleep issues, autism, IBS, diabetes, obesity, chronic sinusitis, allergies, asthma, food intolerance, etc. The state of our microbiome will therefore influence how your immune system responds to an infection such as COVID-19. Probiotics are very safe and though meta-analysis of clinical studies shows limited evidence specifically for prevention of flus (though benefits to children, athletes and the elderly were found) its is their systemic impact on health that is most important. I would highly recommend them. A healthy microflora is foundational to a healthy immune function and thereby contributes to our overall resilience. While they may not prevent infection, they will mediate our immune system’s response to infection, potentially decreasing our chance of having a severe response to COVID-19.
If you have chronic sinusitis or rhinitis (chronic stuff or drippy nose) your respiratory system may also have dysbiosis (an imbalance in your microflora) which may result in increased vulnerability to upper respiratory infections. This is usually readily treated with a combination of dietary measures, a nasal spray formula, and probiotics. Your immune system will literally transport the right species of bacteria from your gut to other lymphatic tissue in the respiratory system (how cool is that!).
You should also consider a course of probiotics if you have taken antibiotics in the last few years, have chronic digestive, urinary or respiratory issues, allergies, or any of the risk factors implicated in COVID-19. This must be combined with dietary changes – you need to stop feeding the unhealthy bacteria (who thrive on sugar and refined carbs) and start feeding the healthy bacteria (who thrive on fiber from fruits and veg). You can also take specific prebiotics (bacterial foods) such as fermented foods (also probiotic) and inulin (such as chicory coffee). A high fiber diet, which is rich in prebiotics, will support a healthy microflora with all the accompanying benefits. I usually recommend soil-based micro-organisms as a short course of these along with dietary measures usually re-establishes a healthy microflora and you can then discontinue supplementation. Dairy-based probiotics tend to have benefit during consumption but don’t always recolonize the digestive system.
Conclusion:
Eat a colorful diet, very low in sugar and carbs, to reduce systemic inflammation, support healthy immune system, regulate blood sugar, improve cardiovascular health, and support a healthy microbiome. Take a multivitamin if you feel you could use some extra nutrients and other supplements if warranted.
Herbal Medicine for COVID-19
Well, here we are, finally arrived at herbs. There is little in the way of specific research regarding the prevention and treatment of COVID-19 with herbs (there’s no money in such research). I go into the reasoning behind my recommendations in some depth below, if you are interested. Skip the next section if you want to jump into the recommendations themselves. Use of herbs for infections and fevers is an enormous topic so I have just touched upon the essential and provided links to more in-depth resources if you need them.
So first of all let’s recall our general principles of Evidence-based Medicine.
1 – Research and Clinical Trials. There is some research regarding the use of herbs and phytochemicals (plant chemicals) for various viruses, including flus, colds, and some of the previous coronaviruses. The lack of COVID-19 specific research is a limitation but one we can work around because most of the herbs are not directly “killing” the virus (viruses aren’t actually considered living organisms) but supporting and recruiting our body’s own resources for dealing with infection. The research behind treatments for COVID-19 is for the most part indirect (this is also true for the treatments currently being used in the hospitals). Instead I am adopting a functional medicine perspective.
Functional medicine focuses on supporting and re-establishing health functioning of the bodies different systems (metabolic, digestive, endocrine, immune, nervous system, etc.). This is combined with a fundamental understanding of immune function and how herbal medicine interacts with the immune system. This allows herbalists and functional medicine practitioners to recommend relevant herbal interventions for prevention and management of infection. Those interested in details in both Coronavirus specific and more general research can follow the provided links.
Secondly, we are looking at supporting overall health and resilience with a specific focus on the conditions (and their associated physiological parameters) present in high risk individuals that are implicated in COVID-19 developing from mild to severe or critical- unnecessarily complex and lengthy.
Living system, plants, fungi, and humans have been in co-evolution for millennia and are capable of mutually supporting each other in a rapid and elegant adaptations to pathogenic challenges by bacteria and viruses. Our innate capacity for self-healing, though it sometimes requires external support, is a far greater intelligence than the plethora of scientists that have devoted themselves to this puzzle (as is well demonstrated by the likely millions of individuals who have adapted to COVID-19 without even noticing they were “infected.” A single individual’s immune system is capable of developing immunity to COVID-19 within a few weeks. In contrast the combined academic institutions and pharmaceutical corporations of the world will require a concerted effort over months and years to develop and test treatments that will likely be only partially effective and very expensive. Supporting our overall health and addressing risk factors specific to COVID-19 will therefore be a more immediate, effective, and cheaper (it will actually decrease overall health care costs). Furthermore, it will have side-benefits instead of side-effects, resulting in an general increase in well-being whereas pharmaceutical solutions and vaccines generally have a relatively high rate of adverse side-effects of varying severity.
2 – Practitioner experience. I’ve been avidly reading the recommendations of many integrative, conventional, and herbal health practitioners. This information is a fusion of professional experience and the study of medical traditions from around the world. We have been learning how to treat infections and fevers and pandemics since humans first began to use plants for medicinal purposes. Many animals are known to self-medicate with plants and there is archeological evidence of human usage of plant medicine still used by herbalists today in Neanderthal graves from 60,000 B.C.E. There are also systems of medicine that have evolved with written records for thousands of years amounting to diverse approches to human health and disease and a vast repertoire of interventions. The experience of the Eclectic doctors of the 19th and early 20th century US remains a vital resource as they combined a scientific understanding of physiology and chemistry along with extensive use of plants either taken over from European tradition or gleaned from observation of Native American medicine. Strategies for treating infections and for managing fevers are therefore part of the repertoire of herbal knowledge from traditions around the world and remain highly relevant under the current circumstances.
3 – Patient experience. This may include the experience of those who have been infected by COVID-19 (if you have been diagnosed with COVID and our willing to share your experience please contact me as this would be very helpful). However, in this case we be focusing more on your own experience with the aim of suggesting methods for personally supporting your own health. When in your life have you been most resilient? What supports that resilience? What activities support a state of coherence and well-being? What situations trigger and feed a state of incoherence and stress? What activities help you reduce stress and maintain health? If you have risk factors what can you do to address them? Empowering yourself and taking action to reduce stress and cultivate mental, emotional and physical resilience and address underlying health issues will provide tangible benefits regardless of COVID-19.
In the exploration of the following herbs we will have two sections. One taking a “terrain” perspective: you are the terrain or environment within which the infection exists. What can be done to make your internal environment inhospitable to viruses and resilient to infection thereby avoiding a severe response? Second, a “germ theory” perspective – what herbs can be used directly to prevent and manage/treat infection and its symptoms.
Herbs for General Health and Addressing Risk Factors
If any of you have been through periods of low resistance to infection due to stress, lack of sleep, mental health issues (anxiety, depression, trauma), digestive system disorders, or any of the health conditions found to be associated with high risk in COVID-19, this is your opportunity to address them. Taking such lifestyle, dietary and herbal measures will benefit your overall health for the rest of your life.
Below is a list of different categories of herbs for supporting overall resilience and immune function.
1) Adaptogens. Adaptogens are herbs that buffer us from life’s challenges and support our mental, emotional and physical resilience. They modulate our stress -response in its various facets- endocrine system, nervous system and immune system. For example they modulate the Hypothalamus-Pituitary Adrenal axis so that we have an appropriate response to stress/challenge AND are able to return to balance when acute situations are past. Adaptogens also help re-establish a healthy balance if we are stuck in a state of chronic stress or protect us if we must traverse a period of increased stress (for example during an pandemic). They strengthen an appropriate immune system response while calming hyper-reactivity. Withania, Tulsi, Reishi, Cordyceps, Licorice and others may all be of benefit in these circumstances. I love adaptogens and most of my clients are given formula’s with at least one adaptogen.
2) Immune system modulators. These herbs overlap with adaptogens but focus on the immune system and will enhance immune response while generally preventing excess immune reactivity. They can be used to prevent infection or as a way of supporting an appropriate immune response (vs the excess and chaotic response resulting in severe and critical infections). Below are the some of important immunomodulators for COVID-19.
Astragalus in particular has a strong immune enhancing effect, and is often helpful for example in preventing the development of bronchitis from a cold.
Garlic. Has specific anti-bacterial properties so may be helpful in preventing or treating secondary bacterial complications. Also supports general immune health and is very useful in treating catarrh and coughs. It’s also useful in supporting cardiovascular health.
Echinacea is also a vital immunomodulator. This can be taken to support your immune system if you feel deficient, or during infection. It’s especially effective if taken in large doses at the first signs of infection. It modulates the immune response both supporting a healthy strong response and calming excess response and may therefore prevent development of a more severe infection. I find that the sense of malaise that accompanies illness is greatly alleviated by echinacea (due to its ability to modulate the immune system and effectively support and calm it).
Sambucus. Is another excellent herb for supporting the immune system during Upper Respiratory Infections. The berries of the elder have well researched anti-viral and immune-enhancing properties during acute viral infections. The links will provide you with an in-depth explanation. All the evidence points to sambucus’s potential to help modulate immune function during an acute infection and preventing a chaotic immune response such as a cytokine storm.
“The Truth about Elderberry (Sambucus nigra)”
Licorice: As Dr. Teitelbaum points out, individuals who tend to get more than their fair share of colds/flus often find that a course of licorice addressed this issue which is often caused by under-functioning adrenals, a common condition in ME/Fibro/CFS. Licorice also has anti-viral properties, is anti-inflammatory, regulates blood sugar and helps moisten and protect the mucosal membranes (so they are less vulnerable to infection). Licorice root can be chewed or used as lozenges as it has direct anti-viral properties, or taken as tea or tincture. Those with elevated blood pressure need to be cautious and should not exceed a dosage of 3 g/day for an extended period of time.
Mushrooms: mostly used prior to infection and not during infection. If you are in the at risk group or have poor immune function, medicinal mushroom’s have the capacity to modulate a proper immune response could be essential. Reishi and Cordyceps are the ones I use most often and I have organic extracts in stock. They are also adaptogenic, supporting one’s general response to stress, building resilience, and increasing energy levels. I especially recommend Reishi for individuals with difficulty sleeping.
Andrographis: A very useful herb for its antiviral, antibacterial and immune stimulating properties and respiratory system health. I recommend the tincture and find it also has a decongestant effect.
Oregano essential oil: has antiviral, antibacterial, anti-parasitic and anti-fungal properties. Helpful for colds, flus, fever, sore throat, cough, sinusitis, bronchitis, asthma , and allergies. In-vitro (test tube) studies show that oregano oil inhibits a broad range of viruses’ including coronovirus’ by disrupting the viral capside. No research has been specifically done on COVID-19. In addition it may be helpful in preventing or treating secondary bacterial infections in the lungs. Take 2-3 capsules per day.
http://www.oreganopro.com/OreganoAntivirus.htm
Lomatium: I don’t use it myself but it was one of the primary herbs used during the 1918 flu pandemic and has strong antiviral and anti-septic action. Tincture: 1 mL 3/day
Eupatorium perfoliatum: Boneset could play a vital role in preventing the development of infections from mild to severe. Boneset was used by the eclectic doctors and by many Native American tribes for fevers, supporting a healthy fever while releiving discomfort, including the bone aching pain of severe fevers. Boneset is antiviral, modulates fever, and is used for colds and flus, sore throats, sweating and thirst, bronchitis, acute bronchial pneumonia, dyspnea (shortness of breath). During the 1918 Spanish flu pandemic the Eclectic doctors in the USA have records of its usage and credit boneset for preventing the death of their patients (they lost very few of their patients). The descriptions of the spanish flu, and the most frequent cause of death being respiratory failure, are consistent with the cytokine storm and respiratory associated with previous SARS viruses and COVID-19. During the 1918 Spanish flu eclectic doctors found that boneset was capable of both preventing and treating the severe reaction which resulted in mortality. It has a very distinct bitterness and is best taken as a tea (available in the US) or second best as tincture in hot water. If you have a fever you’ll find the taste delightful.
“Rediscovering Boneset for Influenza” by Michael Tierra
“Boneset (Eupatorium perfoliatum) Monograph” by Donnie Yance.
Symptom Management
It’s very important to remember, , that the symptoms experienced during a mild infection are part of your bodies appropriate, if unpleasant, response to combatting it. These symptoms include:
Sore throats
Ear infections
Stuffy and Runny Noses
Coughs, dry or productive
Swollen lymph glands
Digestive issues: diarrhea, nausea, discomfort
Fever
Emotional reactions…
All are signs of our bodies intelligence responding to infection. In herbal medicine the aim is to maximise the efficacy of these responses while alleviating the discomfort and preventing the development of complications (such as secondary bacterial infections or cytokine storms).
The herbs chosen will depend in part upon your own constitution. Constitution is a complex subject that can be explored in a multitude of ways. The important point is that herbal recommendations are tailored to the individuals constitution and the presentation of their illness (the symptom pattern). It is not one size fits all. In Ayurvedic terms: Vata, Pitta, Kapha or in Chinese Medicine hot/cold, damp/dry), the specific symptoms and the stage of your condition. The primary focus of my recommendations is managing a mild infection and preventing the development of a severe or critical infection. Nearly all symptoms of a mild infection can be addressed with a herbal strategy and its is likely that severe infections (and critical) would benefit from a strategy integrating herbal with “conventional” medicine.
, Below are some resources on the subject and you can always contact me for more details.
“Symptom-Specific Herbal Protection from Viruses”
Lesley Tierra
“Herbal Remedies for Acute Viral Infections”
Donnie Yance
“Herbal Medicine and COVID-19”
Todd Caldecott
“COVID-19 Herbs – suggestions for your family”
Demetria Clark.
Fever
Fever is one of youe bodies primary responses to infection and one of the most prevalent symptoms of COVID-19. Unfortunately our culture has developed an number of myth concerning fever, accompanied by excessive fear of its consequences. Fever Phobia is a wide-spread term (but not wide-spread enough) referring to an exaggerated fear and lack of understanding of fever by parents, patients and health practitioners. As mentioned above fever is a symptom which tells us that the Immune System is responding to infection. It is helpful to look at the function of fever from an evolutionary perspective: a physiological mechanism such as fever, which is highly complex and energy hungry, would not be kept by a species if it did not increase fitness, i.e. survival of individual organisms and species. It is a mechanism evolved over hundreds of millions of years and present even in some groups of lizards where it has been demonstrated to increase survival to bacterial infections.
“Fever is a good thing helping lizards to survive.”
http://www.djur.cob.lu.se/Djurartiklar/Feber.html
Regarding fever we need to remember two main points.
1 – Within normal parameters fever is a healthy response and one of our immune systems primary means of combatting infection. The herbal perspective is that fever should therefore be modulated and not suppressed. We can optimize the benefits of the fever while maintaining comfort without suppressing the fever – herbs do this brilliantly.
2 – A normal fever may (or may not be) uncomfortable however it is NOT dangerous. Though the benefits of a fever likely “max out” at a certain temperature (100-102 Fahrenheit or 37.8-38.9 Centigrade) temperatures above this are not necessarily dangerous in and of themselves.
The common myths about the danger of fever held by patients and often doctors are debunked by even a casual search of the literature. Under certain circumstances, such as the shift from mild to severe or critical infection the fever may be part of chaotic and excessive immune response (cytokine storm). In this case bringing down the fever may become an important strategy.
You can read about Fever Phobia from the perspective of very standard medical practices and concerns regarding the inappropriate usage of anti-pyretic drugs, especially in children, in many peer-reviewed journals. Concerns include the suppression of the healthy immune response, and the inappropriate usage of fever lowering treatments.
“Fever Myths Versus Facts” provides a concise summary from a paediatric perspective:
https://www.seattlechildrens.org/conditions/a-z/fever-myths-versus-facts/
For details on the the immune function of fevers and its management from the Herbalists point of view see Donnie Yance’s excellent blog “Don’t Fear a Fever.”
In addition to the immunological role a fever plays in fighting infection which can be repressed with the over-use of antipyretics, there is also a concern regarding their inappropriate usage. One issue is the potential for overdose resulting in liver failure (paracetamol) or ibuprofen (kidneys). Adverse reactions to Aspirin were observed during the 1918 flu pandemic and up through the 1980, resulting in pulmonary edema, especially in children and young adults, resulting in lung failure. A warning label on Aspirin in the 1980‘s ended ended this condition. There is also evidence regarding the aggressive (treatment even for low fevers) use of paracetamol and ibuprofen and techniques such as cooling blanket. One clinical trial comparing aggressive fever treatment to a more fever permissive treatment was terminated due to deaths in the aggressive treatment group ! Please follow the link above for an in-depth discussion. Here it is the suppression of the fever as opposed to a direct adverse reaction to the drug itself, that may be implicated.
The take home point is that in medical systems throughout history, both Eastern and Western, practitioners have largely focused on modulating fevers. From the herbalists perspective, fever supporting and modulating strategies are likely to be highly effective in the case of mild infection, supporting a healthy immune response, thereby preventing development of a severe infection. The focus in this case may often be in warming strategies (such as the use of ginger and cinnamon tea) especially if the individual is “cold” ie. does not have a strong fever. I might recommend hot foot soaks, or baths (with essential oils or for example), or saunas (not generally available with the lock-down), while drinking herbal teas followed by wrapping up in warm blankets. These warming strategies are combined with herbs such as elder berry and flower, chamomile, linden, boneset, peppermint, yarrow, etc. These diaphoretic herbs support a healthy fever response and promote sweating (cooling) when the body reaches an optimal maximum temperature. The goal is to have a strong immune response that copes effectively with an infection while maintaining relative comfort. In my experience this often leads to the fever breaking, followed by a state of restfulness. In the case of a flu you may go through this cycle several times, however sometimes if taken early on with a cold or flu these strategies can sometimes prevent it from developing further.
In the case of a severe response we may continue to use these herbs, which help to modulate the immune system and maintain an adaptive response. Eupatorium, Achillea, high doses of Matricaria, Tilia, Sambucus, Echinacea have a significant capacity to calm the immune system (they help regulate cytokines which are the communications molecules of the immune system) and reduce discomfort. There may be more focus on cooling remedies which may prevent the immune system from spiraling into a cytokine storm and development of a critical infection. There are a number of herbs for this purpose that are “low-dose” herbs traditionally used to stop an out-of control fever that is no longer benefiting the patient. This is where the use of pharmaceutical anti-pyretics may also be appropriate. Appropriate integrative treatment in these first two categories of infection may be capable of preventing many cases from developing into a critical response.
Respiratory Support
With Upper Respiratory Infections one of the complications is when the infection descends into the lungs resulting in a local immune reaction which includes edema (fluid accumulation resulting in swelling) and inflammation – bronchitis, pneumonia, pleurisy are all examples of this. This is particularly problematic if it results in secondary bacterial infection. Herbal medicine can support the respiratory system during the different stages of infection and potentially prevent development of complications altogether or treat them if they occur. Treatment needs to be adapted to the infection, the individual’s constitution (in Ayurvedic or Chinese Medical terms), and their specific symptoms and is therefore a very dynamic process. It must also be adapted to your local climate. I have found that for myself and my family I’ve significantly altered the herbs I use after moving from Maryland, which has a cold/dry winter (and very drying forced air heat) to Scotland where the winter is cold/damp (and heat from radiators or wood-stoves). I’ve switched from using more moistening and soothing remedies (cold or warm) to more drying and heating remedies.
I use a number of remedies to support coughs, adapting to whether coughs are dry or wet. Coughs should generally not be suppressed, especially if they are “productive” (with copious phlegm) except at night so you can sleep. Herbs such as garlic, ginger, cayenne, Inula, Populus candicans, licorice, etc. during the day are often in order. While to reduce cough at night, or for unproductive spastic coughs, herbs such as Prunus serontina (wild cherry bark has long been used for coughs (it’s why cough syrup still comes in cherry flavor). Lactuca, or other calming herbs can also be used.
If you have a history of colds descending into the lungs you may want to take some preventative measures early in your cold/flu. Drinking tea such as thyme and oregano to help maintain strong defences in the lower respiratory system. The essential oils in both are secreted via the lungs and have strong anti-microbial properties thereby potentially preventing bacterial infection. You may also want to manage inflammation (many of the diaphoretic herbs will help with this) along with fresh ginger and garlic. Garlic in particular is highly anti-microbial and immune system supporting, its active compounds are secreted via the lungs (hence garlic breath), and stimulates the muco-ciliary escalator that your lungs use to keep themselves free of debris and bacteria. Once again we are facilitating the body’s natural response, enhancing its benefits and calming it if excessive, with the aim of increasing effectiveness while reducing discomfort.
One of my favourite recipes is using freshly grated ginger, about 1-2 inches of grated root, along with a whole squeezed lemon and a few cloves of raw grated garlic in a litre of hot water. Add cayenne if you have a painfully sore throat with difficulty swallowing. Add some honey if desired as honey has been shown to be as effective as cough syrup in clinical trials. Cough syrup is no longer recommended for children due to paracetamol overdoses and lack of effectiveness, give them honey instead). Make sure it steeps for about 20 minutes while wrapped in tea towel. The same recipe can be made as a concentrate. Just blend all the ingredients (including the lemon peel) together in some water and store in the fridge. Just pour some in a mug and add hot water and honey throughout the day.
Steam inhalation with essential oils can be a vital tool at any stage. Thyme, peppermint, oregano, lavender, tea tree, pine, etc. All have anti-bacterial properties and stimulate the defenses of the respiratory system. They not only alleviate congestion in the sinuses but also support a healthy response in the lungs and ease the discomfort of coughs, shortness of breath, etc.
In the case of COVID-19 treating the infection effectively from the start has the potential to prevent the body from spinning off into a less coherent response. The infected individual is more likely to have their infection (cold, flu, COVID-19) and just “get through it” with little complications. Supporting an effective initial immune response may also prevent a state of on-going or recurring infection both of which are of potential concern in individuals who have experienced COVID-19. Ever had an infection which even months later you hadn’t quite recovered from? Sometimes these sub-clinical low-grade infections may become chronic developing into Post-viral Fatigue Syndrome, a condition overlapping with ME/Fibromyalgia/Chronic Fatigue Syndrome. (Though most doctors are at a loss when it comes to treating individuals with PVFS or ME/CFS herbal medicine is very effective. Those suffering from these conditions are largely suffering needlessly.)
For a practical overview of herbs for supporting you and your family take a look at “COVID-19 Herbs – suggestions for your family” written by herbalist Demetria Clark. This has a fairly comprehensive presentation of herbs with some more details useful for both general support and specific symptoms including some good recipes.
Another resource for respiratory support is by Donnie Yance.
https://www.donnieyance.com/seasonal-respiratory-support/
Energy Medicine
Modalities that support the health of your energy body can play an important role in reducing stress and building emotional, psychological and physical resilience. This includes energy healing modalities that work with the chakras and energy fields of the body. Acupuncture is also a valuable mode for supporting immune function and if you do not have access to an acupuncturist you can still find acupressure recommendations for self-care on-line. Tai Chi, Chi Gong, and Yoga are all highly effective practices for this purpose.
Eric Thompson, creator of the iAwake Profound Meditation program, which is the best binaural brain-wave entrainment technology I’ve ever used, is giving away free copies of his Quantum Immunity mandala. He is currently working with the newly emergent science of biofields creating audio and visual technologies which will support your subtle energy body. I won’t pretend to understand it, but it’s well worth exploring.
If you are looking to explore brain-wave entrainment as an aid to meditation or for reducing stress, anxiety and depression,c iAwake is giving away one of my favorite tracks: Schumann Holophonic:
Resources and Information
Upper Right: Biology, Integrative and Herbal Medicine, Lifestyle, Nutrition.
“On-going Coronavirus Updates”
Integrative Practitioner.
This is exactly as described, on-going monitoring and updates of the situation and the current research.
“Video – Our Guide to Improving the Immune System Against Coronavirus”
College of Medicine
This is succinct summary of basic lifestyle and dietary measures for immune support.
“ Coronavirus (COVID-19) – Protecting the vulnerable”
This provides us with a summary of the evidence for lifestyle measures (exercise and stress-management), nutrition (berries and chocolate), and supplements (probiotics, medicinal mushrooms) for immune support.
“COVID-19: self care for the vulnerable”
Simon Mills.
This is probably the most helpful overview of COVID-19 that I have read to date in terms of looking at the different levels of infection and associated risk factors and measures we can take for self-care. Simon Mills is one of the worlds leading authorities on herbal medicine.
The New England Journal of Medicine
For those looking for peer-reviewed medical literature the NEJM has made its COVID-19 articles free to all.
https://www.nejm.org/coronavirus?query=RP
“RHR: Everything You Need to Know about Coronavirus, with Dr. Ramzi Asfour”
Chris Kresser
Chris Kresser is a functional nutritionist writing on-going blogs about the situation. Below is a link to a good overview of Coronavirus and external and internal measures for prevention. Does a good job keeping the pandemic in context, making the numbers meaningful, and making relevant lifestyle, dietary and herbal recommendations. He also has bountiful resources on paleo nutrition.
“Paleo Recipes”
https://chriskresser.com/category/paleo-recipes/
“Coronavirus and CFS/Fibromyalgia (Part 2)”
Jacob Teitelbaum
Jacob is an integrative doctor specialising in ME/Fibromyalgia and Chronic Fatigue Syndrome. He provides a good overview of common sense measures for prevention with a focus on key herbs and supplements.
“Part 1: Immune System Series | Innate and Acquired Immune Responses”
A helpful introduction to the immune system for those want it.
“Herbal Medicine and COVID-19”
Todd Caldecott
Herbalist Todd Caldecott integrates western and Ayurvedic medicine and provides us with strong scientific treatment of the situation and explores relevant herbal recommendations.
“COVID-19 Herbs – suggestions for your family”
Demetria Clark.
A fairly comprehensive guide to the use of herbs for the treatment of symptoms of COVID-19, or other infections. A practical resource with lots of recipes.
“COVID-19: An Integrative MD’s Commonsense Approach”
Aviva Romm
Aviva Romm is a herbalist, midwife and functional medicine doctor providing an integrative medicine approach on the subject. Very reassuring if you’re pregnant.
https://avivaromm.com/category/covid-19/
“The Treatment of Influenza with Chinese Medicine”
Giovanni Maciocia
For those interested in the Chinese Medicine approach to treating influenza Maciocia’s article is very in-depth.
https://giovanni-maciocia.com/the-treatment-of-influenza-with-chinese/
East West School of Planetary Herbology:
Michael and Lesley Tierra have written extensively on the use of herbal medicine for Coronavirus. They have played in important role in the integration of Chinese and Western Herbal Medicine and have a lifetime of clinical experience.
“Coronavirus: Common-Sense Prevention Tactics”
https://planetherbs.com/blogs/lesleys-blog/coronavirus-herbal-prevention-and-treatment/
“Symptom-Specific Herbal Protection from Viruses”
“Rediscovering Boneset for Influenza”
Donnie Yance
Donnie Yance is a herbalist specializing in cancer and chronic disease. I find him one of the most comprehensive resources integrating the modern science with traditional medical systems and clinical experience. The blogs below are in-depth treatments with plentiful citations, there’s much more available on his website.
“Herbal Remedies for Acute Viral Infections”
“Boneset (Eupatorium perfoliatum) Monograph”
“Don’t Fear a Fever – the important of working with not against the immune system in warding off infection”
“Seasonal Respiratory Support”
“The Truth about Elderberry (Sambucus nigra)”
“Zinc: the most important nutrient for immunity.”
“Quantum Immunity”
Eric Thompson – Subtle Energy Science
Upper Left: Mental and Emotional Health.
“iAwake – Profound Meditation”
If you are looking to explore brain-wave entrainment as an aid to meditation or for reducing stress, anxiety and depression iAwake is giving away one of my favorite tracks: Schumann Holophonic:
“The HeartMath Experience”
A free program for learning HeartMath tools for supporting resilience.
https://store.heartmath.com/heartmath-experience/?utm_campaign=
Lower Left: Interpersonal, Cultural, Meaning-Making.
HeartMath.
Is an excellent resource for learning communication and interpersonal skills, see above.
Michael Meade
My favorite mythologist and storyteller and one approach to finding meaning during difficult times.
https://www.mosaicvoices.org/podcast
Rick Hanson
Interpersonal Neuroscientist Rick Hanson has great resources for addressing individual and relational stress. I find his weekly newsletter very inspiring.
Lower Right: Socio-economic, Institutional Resources.
These are very much dependent on your local institutions and communities and information in this regard is being disseminated officially so I shall leave this up to you.
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