A COVID-19 remedy? Really?

A friend has a family member who tested positive for COVID-19 recently. Even though the family member was not an elderly or unvaccinated person at risk of severe diseases, the family was concerned. They found a locally developed herbal pill that many claimed to have good results on COVID-19. My friend sent me the product website, a scientific paper on the product, and some testimonials that claimed the product’s efficacy against COVID-19 and wanted me to comment on it. I wrote the friend a reply, which I share here without naming the product. My intention is to provide an example of how we can analyse the information on many COVID-19 cures or remedies that we may read on social media these days.

Dear XXX

Thank you for forwarding the information to me. I read it with interest, especially the scientific article. You asked for my thoughts previously on its treatment for COVID-19. With these materials, I can comment from the perspectives of a naturopath and a researcher.

Many herbs can help to reduce inflammation and improve symptoms of flu, but it is hard to justify that they can cure a virus infection.

The product is a proprietary formula consists of common Chinese herbs including Lithospermum erythrorhizon (紫草), Siraitia grosvenorii (罗汉果), Chrysanthemum Indicum (菊花), Artemisia annua (青蒿), Prunella vulgaris (夏枯草), and Lophatherum gracile (淡竹葉). These herbs are commonly used in traditional Chinese medicine for flu, fever, inflammation, and detox. Singapore Health Science Authority approved the product as Chinese proprietary medicine for “Cold & Flu Aid.” Hence, the herbal properties are appropriate for COVID-19 symptoms affecting the upper respiratory tract. Furthermore, according to the treatment regimen,  for COVID-19 positive patients, the product is combined with a simple diet that promotes convalescence and the traditional Gua Sha therapy for fever release. The overall effect can indeed make the patients feel better in recovery. From a naturopath’s perspective, the treatment protocol makes sense, and it definitely fills a gap for most COVID-19 patients with mild to moderate symptoms under home recovery. It can ease the fear and worry of those told to recover at home by their doctors as they need no special treatment from the conventional healthcare system.

Fever, cough, and sore throat are some common symptoms of COVID-19 similar to cold and flu. However, 98.7% of the COVID-19 patients had no or mild symptoms.

However, from a scientist’s point of view, the supporting evidence that the product alone effectively treats COVID-19 is very weak. The scientific paper is an unpublished manuscript yet to be peer-reviewed. Peer review is a scientific process whereby a study is reviewed by researchers in the same field to assess whether the research is conducted appropriately using scientifically sound methodology. The process is essential to establish the validity of any study before the manuscript can be accepted for publication in a scientific journal.

In any case, the study is an in vitro study. That is, it is only tested on infected cells outside the body. Furthermore, the study is not conducted on coronavirus that causes COVID-19 but on human rhinoviruses for cold and flu. The study demonstrated that the product has antiviral and anti-inflammatory effects, which is not surprising since they are the known properties of the ingredients. Although there is a mention of clinical trials being conducted in India, I cannot find any available publication or trial registration. So, this is definitely ongoing research. Without direct human study on the effect of the product on COVID-19, there is no way we can confirm that the product indeed can reduce the viral load of COVID-19 and improve the rate of recovery.

You may want to ask why the claim by the company that “they have treated more than 300+ cases of Covid-19 in SG, and all survived. 100% efficacy” is not considered evidence? From the scientific point of view, there are too many confounding factors that influence the recovery of these patients. Firstly, we know that 98.7% of the COVID-19 patients had no or mild symptoms. Given that there were 87,150 infected people in Singapore over the last 28 days on 26 Oct 2021, a total of 86,003 people are asymptomatic or with only mild symptoms. We have no details of these 300+ cases regarding their age group, medical history, and vaccination status. However, they most likely belong to the group with asymptomatic or with only mild symptoms. Let’s say 300 of them belong to the larger group of 86,003 people, and the product does help them. They are just 0.34% of the group. The rest (99.66%) also survived (with no or mild symptoms) without the treatment. So, the “100% efficacy” claim is misleading, especially with 84% of the Singapore population already vaccinated.

An illustration of a randomised clinical trial.

We can only tell whether the product can help reduce viral load and improve the time to recovery is comparing it with a group of similar control patients with similar age groups, vaccination status, and medical histories. The control group will also follow a similar protocol with the diet and Gua Sha, except that the control group will take placebo capsules (or padanol) instead of the product. The two groups will then be tested daily for their viral load and symptoms until recovery or hospitalised. Only through the results of such placebo control trials can we be sure that the product’s effect is above and beyond the rest of the confounding factors. Of course, such clinical trials are expensive and take a long time to complete, and not all company is willing to invest in such research.

To conclude, as a naturopath, I say the product can play a role in improving people’s health and well-being when facing COVID-19 uncertainty. The ingredients are commonly used herbs that are safe to consume and can ease the fear of many who tested positive for COVID-19 infection. However, the product’s efficacy against the COVID-19 virus is mainly unknown scientifically.

With regards,

Soo Liang

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