COVID-19

One Herbalist’s Thoughts On The Coronapocalypse

This page is a work in progress. It’s regularly updated with resources as I find them. The treatment section will change as I see more people with and presentations of Covid-19.

There is a virus called SARS-CoV-2. That’s a mouthful, so once someone has the virus, the infection is called by the acronym COronaVIrus Disease 2019 = COVID-19.

Coronavirus name derived from the Latin corona, meaning crown, because under an electron microscope the viral envelope appears crown-like. COVID-19 is a gnarly mutation from one of the family of viruses that cause the common cold. Conspiracy theories abound, but I’ve seen no evidence this virus was engineered. It looks like it crossed from an animal to humans. There’s a 96% similarity between a virus from a horseshoe bat sample collected in Yunnan, and 90% similarity to a virus carried by pangolins. Transmission from animal to human isn’t uncommon. In Bangladesh the Nipah virus is spread from bats to humans when people eat raw date palm sap contaminated with bat urine.

How Bad Is This Going To Be ?

The first known person was reported to have contracted the virus on Dec. 1 in China. Today, it’s spread to at least 118 countries. It’s here in the U.S., and there’s no stopping it. We are beyond containment (stopping the disease spread), and well into mitigation. The main goal now is to prevent a huge spike in cases that will overwhelm our healthcare system – we must flatten the curve!

Unlike the common cold, 15%-20% of people with COVID-19 develop a severe infection and require hospitalization. Based on CDC scenarios between 2.4 million to 21 million people in the United States could require hospitalization. Most people will recover, with adequate medical treatment. The problem is there are only about 925,000 staffed hospital beds, and less than 100,000 ICU beds, about half of which are already being used. The U.S. has 2.8 hospital beds per 1,000 people. That’s fewer than in Italy (3.2), China (4.3) and South Korea (12.3), all of which have had problems keeping up with the surge in hospitalizations. 

But Isn’t The Mortality Rate Overinflated?

It’s really hard to know the case mortality rate with much certainty because of the many factors involved – access to healthcare, testing (which has been abysmal in the U.S.), the long period between the onset of the illness and fatality, and frequency of mutation. I’ve reviewed tons of research and projections, and I agree with many experts that think a plausible covid-19 fatality rate could be as low as 0.5-1% If we can spread the burden out on our healthcare system by flattening the curve. Even in the best-case scenario COVID-19 is probably 5-10 times more deadly than the seasonal flu. If we don’t flatten the curve and our healthcare system is overwhelmed things could be much worse.

Flattening the curve means spreading the frequency of infection out, slowing the inevitable spread to allow our healthcare system to adapt. Every person with COVID-19 infects approximately two people. The infection rate doubles every six days.  If 50,000 people have the virus today, then in 6 days, 100,000 people will have it. In another 12 days it’s 400,000 and less than two weeks later it’s over a million people.  We have 330 million people in the US. The experts expect that 40-70% of people will be infected. Our actions over the next week will determine how quickly the infection spreads.

I’m Healthy, Young, And At Low Risk.

If our healthcare system breaks we all suffer. If the hospital filled with COVID-19 patients, people with appendicitis, and heart attacks, will not be able to be treated. Everyone is at risk if there is a systemic failure of our health care system, not just those with COVID-19. This will happen here, in as little as two weeks if we don’t take decisive action now.
About 5% of infected people will need a ventilator in an ICU, and we have only a limited number of ventilators available in the country. The last survey on ventilators in 2013 (so the number are probably a little higher now) found we had 52,118 full feature mechanical ventilators, and another estimated 10,000 in federal emergency reserves. Ventilators are a short-term bridge that allow many critically ill people to recover. By slowing the spread we allow those affected the worst to have access to the lifesaving equipment they need.

  • Support your schools’ decisions to close: Proactive school closings save more lives than reactive school closings. Your schools should close now … before infections are present. Closed schools do not mean playdates for children – this counteracts the social distancing the school closures are meant to create in the first place.
  • 6 feet: The COVID-19 virus spreads through droplets. They can move 6 feet before gravity brings them to earth.  Stay 6 feet away from people if you need to go outside.
  • Meticulous hand washing: Wash thoroughly and wash often. Alcohol-based hand sanitizer works well if your hands are otherwise clean.
  • Do not touch your face. This is hard. This is a learned skill: Practice often.
  • Clean doorknobs, toilets, cellphones, countertops, refrigerator handles, and so on many times each day.  The virus could live on certain surfaces for 4-72 hours.
  • If you can work from home, work from home.
  • No tournaments, no sports events, no soccer, baseball, dance, volleyball, softball, gymnastics, concerts, martial arts, etc.  We don’t care how much they claim they will clean the equipment.
  • Cancel vacation travel. We know you planned this for a long time.  You will be saving many lives by doing so … perhaps someone you know.
  • Cancel weddings/ bar/bat mitzvahs, birthday parties, and so on. Help other people live so they can celebrate future events too.
  • If you are over 60 years old, you should stay home. You should only go out if there is a critical need.
  • If you have parents/grandparents in a nursing home, you should consider moving them home for now.
  • Do not congregate in a restaurant, bar, etc.  Again, you will save the lives of people you will never meet.
  • If you feel sick, stay home. It doesn’t matter if you don’t feel too sick. Going to work will put countless other people at risk of suffering or dying.
  • Cancel all business travel.  Your life and the lives of others are more important.
  • Expect supply chain issues: Work with your doctor to try to get a three month supply of medication.
  • Many grocery stores have order ahead options with either pick up or delivery. There are online grocery delivery services available in many areas. Wash your hands thoroughly after unpacking groceries.

Highlight on Washing Our Hands

 

Wash hands with soap and water for 20 seconds. If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains at least 60% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water.

You can help yourself and your loved ones stay healthy by washing your hands often, especially during these key times when you are likely to get and spread germs:

Before, during, and after preparing food

Before eating food

Before and after caring for someone at home who is sick with vomiting or diarrhea

Before and after treating a cut or wound

After using the toilet

After changing diapers or cleaning up a child who has used the toilet

After changing diapers or cleaning up a child who has used the toilet

After touching an animal, animal feed, or animal waste

After handling pet food or pet treats

After touching garbage

Five Steps To Wash Your Hands The Right Way

Washing your hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community—from your home and workplace to childcare facilities and hospitals.

Follow these five steps every time.

Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.

Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.

Rinse your hands well under clean, running water.

Dry your hands using a clean towel or air dry them.

Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. You can tell if the sanitizer contains at least 60% alcohol by looking at the product label.

Sanitizers can quickly reduce the number of germs on hands in many situations. 

⦁ Sanitizers do not get rid of all types of germs.

⦁ Hand sanitizers may not be as effective when hands are visibly dirty or greasy.

⦁ Hand sanitizers might not remove harmful chemicals from hands like pesticides and heavy metals.

How to use hand sanitizer

⦁ Apply the gel product to the palm of one hand (read the label to learn the correct amount).

⦁ Rub your hands together.

⦁ Rub the gel over all the surfaces of your hands and fingers until your hands are dry. This should take around 20 seconds.

 

Beyond Conventional Advice 

Your first layer of defense against infectious organisms is your skin and mucosal membranes, the tissues exposed to the outside world. Covid-19 infections occur when viral laden droplets from an infected person enter into your musosa.

Via the CDC
“The virus is thought to spread mainly from person-to-person.
Your first layer of defense against infectious organisms is your skin and mucosal membranes, the tissues exposed to the outside world. Covid-19 infections occur when viral laden droplets from an infected person enter into your musosa.

⦁ Between people who are in close contact with one another (within about 6 feet).

⦁ Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Spread from contact with contaminated surfaces or objects

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads”

 
 

The Superpower Of Snot

Mucus is over 90% water, but also contains proteins, salts, immune cells, and mucins. It’s such an important part of our immune response the average person produces more than a liter of mucus a day. Mucins are proteins covered in chains of sugar that stick out like bristles on a brush, allowing them to attach to each other to form gels and create a strong barrier against microbes. Microbes get stuck in the mucin gel, allowing enzymes and immune cells to kill or isolate the pathogens. When pathogens make is past the first layer of defense (snot) and infect mucosal tissue the body ramps up mucus production to try to expel the invaders. 

 

Mucus Contains:

–       Lysozyme to break down the cell walls of microbes

–       Antibody called secretory IgA that prevents microbes from attaching to mucosal cells and traps them in the mucous.

–       Lactoferrin to bind iron and keep it from being used by microbes

–       Lactoperoxidase to generate toxic superoxide radicals that kill microbes

 

Why Do We Get Sick In The Winter?

Winter time sees an increase in respiratory infections, at least partially because the outside air is more dry, and people spend more time indoors with heaters and lower air humidity. Lower air humidity dries out mucosa, and allows virus laden droplets to travel farther. Robust research points towards 50-60% air humidity as ideal to decrease respiratory infections. An instrument called a hygrometer, available for about $10, will measure air humidity.  

A steam humidifier is a convenient way to add moisture to the air, but a pot of water on your stove set on low, or even a crockpot on low works just as well. If you use a crockpot or stovetop you can add a pinch of your favorite kitchen spice to freshen the air – I’m partial to rosemary or thyme. 

 

Hydration is also essential to keeping your mucosa lubricated with mucus. Try to drink enough fluids to make sure you’re urinating 6-8 times a day, and your urine is pretty clear; after your first morning urination – that one is supposed to be more concentrated. The amount of fluids you should drink varies person to person, but 6-12 cups a day works for most. Please don’t drastically increase your fluid intake if you have kidney issues. Water, herbal teas (that aren’t diuretic), broths, low sugar fruit juices, and vegetable juices are ideal fluids. Sugar rich drinks, including sodas and the HFCS water with a splash of fruit flavor being passed off as fruit juice should be avoided. 

Some people that drink adequate fluids, and keep air humidity in the ideal range will still have dried out mucosa. 

Some People Are Prone To Dryness

Some medications, like antihistamines and diuretics make people dry, while others are just inherently prone to dryness (constitutionally dry). 

Your tongue is a good indicator of your respiratory mucosa’s moisture level. 

 
Healthy
Dry
Very Dry

If you’re on the dry side while hydrated and in adequately humid air don’t fret! In just two easy steps you can moisten those membranes. 

Step 1: Avoid, Limit, Or Compensate For Drying Herbs (with step 2)

Many of the most popular herbs for respiratory illnesses tend to promote dryness.

Garlic, Ginger, Osha, Elecampagne, Turmeric, Sage, Lomatium, Red root, Rhodiola, and Nettles can all be drying to the mucosa. If you’re really dry, consider avoiding them. If you’re only a little dry and want to use a warming/drying remedy, be sure to offset the drying nature with demulcents!

Step 2: Demulcents To The Rescue! 

My friend, jim mcdonald, talks about demulcents as the secret superpower herbalists have, that modern medicine doesn’t! Typical demulcents contain mucilage, a type of plant slime made from long carbohydrate chains, that seems to almost magically moisten mucous membranes. The degree to which mucilage containing plants moisten mucosa seems to be dependent on how slimy they are, with marshmallow and okra at the very moistening side, fenugreek and violet towards the middle and plantain on the slightly moistening side. 

Slimy demulcents work best as a water preparation. My preferred method for preparation is to throw a handful of any demulcent (or blend) into a quart jar, add boiling water, and put in the fridge. The longer they soak the slimier they become. Once you have a jar full of slime you can warm up a cup at a time, and add a little honey (if you’d like). 1-3 cups a day should have your mucosa moistened up in no time! 

Some people get bloating and mild digestive upset when they take slimy demulcents – never fear, the atypical demulcents are here!

Atypical demulcents tend to be bland to sweet in taste, and often have both a moistening and tonifying action upon the mucosa. Unlike typical demulcents the atypicals can be used in tincture form, making them a convenient way to offset the drying nature of other herbs in the tincture formula. 

Solomon’s seal (Polygonatum biflorum or odoratum) or Licorice (Glycyrrhiza glabra) as around 10% of a tincture blend works well to offset drying herbs – use at a higher percentage of the formula if the person is already dry. An underutilized atypical demulcent I’m partial to is pleurisy root (Asclepias tuberosa). Pleurisy root is diuretic in large doses, but in 5-10 drop doses (dried root 1:5) twice a day it’s an effective systemic moistening remedy with an affinity for the lungs. 

My friend and instructor here at the Eclectic School, Forrest Chalmers talks about two additional underutilized types of demulcents, salty and seeds. According to Forrest, salty demulcents such as seaweeds, Irish moss, and Iceland moss contain both slimy mucilage and as well as a high mineral quality that moves moisture. Traditionally salty demulcents were indicated for softening hardness. When mucus becomes dehydrated it can undergo a process of “stickyifiification” (a highly scientific term) in which it becomes more tar or glue-like – this is when mineral-rich “salty” remedies can help to soften this stickiness.

The final category of demulcents comes in the form of moistening grains and seeds, such as chia, flax, hemp, and oats.  Grain and seed demulcents contain a moistening mix of oils and mucilaginous soluble fiber. Theses remedies primarily assert their moistening action on the intestines, where they increase moisture and feed beneficial gut flora. Demulcent grains assist with healthy bowel movements by acting as both moistening and bulking agents, – their bulking nature makes them helpful in cases of loose stool and diarrhea. While these plants are most frequently consumed in their whole food form, they can actually be effective as decoctions. Hemp seeds (Hou Ma Ren) and sesame seeds (Hei Ma Ren) are both traditionally used in decoction to nourish Yin and moisten the large intestine. Hemp seeds (and hemp seed tea) have an added benefit in that they are very rich in potassium, 1 teaspoon of hemp seeds contain about 120mg of potassium.

Apricot kernels and seeds (Xing Ren) have the additional traditional indication of relieving coughing and wheezing and are one of the herbs included in TCM formulas currently being used for COVID-19 in China.  Apricot seeds were traditionally used to stop coughing and wheezing caused by both hot and cold tissue states. Its energetic action is described as a descending action on the lungs and large intestines that disperses dampness and phlegm and restores the rhythmic downward motion of respiration and peristalsis. While not traditionally indicated in TCM for respiratory complaints, hemp seeds (Huo Ma Ren) and peach kernels (Tao Ren) also possess the energetic descending action on the large intestine which is thought to help the descending action of the lungs in TCM.

Apricot kernels do contain cyanogenic glycosides watch are toxic in higher dosages.  Consumption of 10-20 kernels in children and 40-50 kernels in adults have been shown to have toxic effects (this amount is well above the traditional 3-9-gram dosage). Furthermore, the traditional preparation of apricot kernel is via decoction which drastically reduces the amount of potentially harmful cyanogenic glycosides. While we do not recommend the consumption of uncooked apricot seeds, short term use of apricot seed decoction at the traditionally recommended dosage has not been shown to have any toxic effect.

Almonds (Tian Xing Ren) are considered a viable substitute for apricot kernel in TCM. Almond decoction is traditionally considered to be weaker in its effects on relieving coughing and wheezing than apricot kernels, however they are considered more moistening and therefore more indicated for dry cough. They can be used at 6-12 gram dosage in decoction.

Demulcent Oatmeal

  • 1 cup rolled oats
  • 1 cup oat milk, coconut milk, or other non-dairy milk of your choice
  • 1 cup water
  • 1/2 teaspoon vanilla extract
  • 1/2 teaspoon ground cinnamon

Combine the oats, milk, water, maple syrup, vanilla, cinnamon, and nutmeg in a small pot. Bring to a boil over medium-high heat, then reduce to a gentle simmer. Cook, stirring occasionally, for a few minutes, until the porridge is soft and a little thinner than you’d like it. It will thicken quickly as it cools. Add honey liberally (it’s demulcent also). 

Immune Regulating Nutrients

Nutrient deficiencies are common and can suppress immune function. However taking nutrients above and beyond the dosage necessary to become replete (supraphysiologic doses) don’t boost immune function. If you eat a balanced diet including daily fruit and vegetables, and take a multi with extra vitamin D, you probably don’t need additional supplementation.
Nutrient deficiencies can not only suppress the immune system, they can make it more likely you’ll experience inflammation and delayed recovery if you get ill.
Adequate Calories, Protein, and Vitamins A, C, D, B2, B6 and B12, folate, iron, selenium, and zinc are all essential to healthy immune function.
If you’re a health nut, skim this section, you’re probably good.
Diet is by far the best way to get your nutrients (except vitamin d). Supplements are supplementary to a healthy diet. Supplements do provide a convenient way to quickly boost your nutrient reserves.
If you’re coming from the Standard American Diet and trying the equivalent of cramming the night before the test – this part is for you.

From SAD to Immune Optimization In Two Weeks (or less) *Dosing for Adults

Vitamin A – contrary to popular belief, beta carotene isn’t vitamin A. Small studies show that about 50% of people don’t convert beta carotene to vitamin A. About half of Americans get inadequate dietary levels of vitamin A. Preformed vitamin A can be mega dosed short term to brings stores up rapidly.
The cheapest way to get a large loading dose is via liquid emulsified vitamin A. Most products are 10,000iu per drop. 10 drops (100,000iu) per day for 3 days brings levels up rapidly. Don’t take more than 10,000iu a day after this loading dose. One bottle of A-Mulsion by Seroyal provides a 300,000iu loading dose for 30 people.
Cod Liver Oil varies a lot in vitamin A content. Sonne’s, one of my favorite brands of CLO, has 4000iu per tsp – a perfect amount to add to a healthy diet while also getting in your EPA/DHA.
Vitamin A overdose can cause Nausea, Vomiting, Double vision, Headache, Dizziness. Don’t take more vitamin A if you experience these symptoms. Don’t take supplemental vitamin A if you have liver disease or abuse alcohol.

Vitamin D – Unless you supplement with vitamin D your blood levels are unlikely to be in the 50-60ng/mL sweet spot that maximizes immunity and minimizes inflammation. There’s also some research showing the low vitamin D levels might increase the risk of Acute Respiratory Distress Syndrome (ARDS). Taking more than 50,000iu of vitamin D at a time can cause a transient disruption in calcium metabolism. Vitamins A and K2 seem to minimize the hazards of excessive vitamin D.
Find a supplement that combines Vitamin D with K2. To boost reserves quickly try 25,000iu of Vitamin D, and 500-1000mcg of K2 daily, taken with your largest meal, for 1 month. After a month test blood levels and adjust dose or discontinue.

Vitamin C – Eat a few servings of fruits and veggies and you’ll get enough. If you’re worried 500mg of supplemental vitamin C is all you need to quickly boost stores.

B2, B6 and Folate (B9), Selenium and Zinc – A few servings of fruits and veggies daily should give you most of what you need. A decent quality (not the cheapest) multivitamin should have enough b-vitamins, selenium and zinc to supplement even a SAD diet up to normal levels within a couple of weeks.

Tending To Your Lymphatic System

About half of your lymphatic system resides just beneath your mucosa. It’s called your Mucosa Associated Lymphoid Tissue, or MALT for short. Your MALT is populated by T cells and B cells, as well as plasma cells and macrophages. These are some of the first responders once pathogens breach your mucus membranes.

To keep your lymphatic system (and therefore your immune system) in tip top shape, move your body! Movement is the primary pump for your lymphatic system and moving lymphatic fluid is essential to keep your immune system healthy! Take a walk, dance, stretch – if you have mobility restrictions move anything you can!

There’s a special class of herbs called Alteratives that address the lymphatic-immune-fluid-excretory system. (doesn’t that sound so much less reductionist than talking about isolated systems based on anatomy rather than function… welcome to system biology)

Rather than give you a definition, I’m going to let an Eclectic physician long dead opine about alteratives. 

Ode to Alteratives

“The term alterative is, we admit, an extremely elastic one. Neither is the action denominated alterative any too well understood…Yet there are those of us who are partial to the word alterative, as expressive of something which experience has taught us, even if we cannot account scientifically for its significance. Many other names have been given it but none fit quite so well as the older term when used in the sense in which the older Eclectics employed it, and even took refuge in it. As they viewed the matter they applied the term alterative to medicines which act in a quiet and sometimes unexplainable manner, so as to modify the processes of nutrition. Today, perhaps, some would say “to correct faulty metabolism.” Most of the alteratives they believed, were eliminants, acting almost silently removing so-called “morbific-material.” Whatever and however their action we know that by their exhibition in small and frequent doses, administered over a prolonged period, the appetite is increased, digestion promoted, the processes of waste favored and accelerated, and the blood improved in quality. A marked improvement in defective nerve centers takes place, especially as to nutrition, and better and healthier circulatory and respiratory action are observed.

How do they act? We do not always know. But their effects are apparent. There are those who tell us we ought not to use drugs unless we know exactly how they act. If that rule were followed but few drugs now in use would be entitled to consideration. But we believe we are justified in using drugs that have yielded results, whether or not we can scientifically account for those results. Unquestionably some of the alteratives directly attack germ life or germ products; some destroy protozoa; some act by the so-called catalytic process, for want of better understanding and a better name; some correct toxemia; some destroy the malarial parasites, some the spirochete and all more or less increase retrograde meta-morphosis, as those who love high-sounding terms are wont to say. We would like to know how they act. We would be more scientific, perhaps, if we knew. But what we are most concerned in is that they do act. And therein rests our assurance of their great worth.” – Harvey Wickes Felter, M.D. 1922

Cleavers, Violet, Red Clover and Chickweed are all pleasant tasting in tea, common, sustainable, and gentle but powerful alteratives. If you can’t move as much as you’d like, or have a history of frequently swollen lymph nodes, try a cup or two a day of any/all of those as a standard infusion (1oz to the quart, steeped for 30+min).

Here are a few traditional alterative formulas to give you an idea of ingredients and formulation

Alterative Compound #1

1 part Sarsaprilla

1 part Yellow Dock

1 part Red Clover

1 part Cleavers

½ part Dandelion

½ part Queen of the Meadow 

½ part Elder Flower

½ part Prickly Ash 

  • Boil with 4 quarts of water
  • Reduce down to 3 quarts
  • Add 1 cup of molasses
  • Store in fridge
  • Take 4 ounces 3 times a day   

Alterative Compound #2

1 part Burdock root

1 part Yellow Dock

1 part Sarsaprilla root

½ part Red Clover blossom 

2 parts Licorice root      

½ part Coriander seeds

  • Mix herbs well
  • Add 2 tablespoons of the herb mixture to a pint of water
  • boil water for five minutes
  • Let stand until cool

Strain and drink ½ cupful 2-3 times per day

Compound Decoction of Sarsaprilla

100 grams Sarsaprilla

20 grams Sassafras

20 grams Guaiacum wood

20 grams Glycyrrhiza

10 grams Mezereum

 33 fluid ounces of water 

  • Add the sarsaprilla and guaiacum wood to water and boil for half an hour
  • Next, add the sassafras, glycyrrhiza, and mezereum
  • Cover and macerate for two hours
  • Strain and add more cold water through the strainer (should be enough water to bring mixture up to 33 fluid ounces again)

Compound Syrup of Aralia

10 parts Spikenard

10 parts Yellow dock

10 parts Burdock

10 parts ground guaiacum wood

8 parts Sassafras root bark

8 parts Prickly Ash

8 parts Elder flowers

8 parts blue flag root 

  • powder all ingredients and mix together
  • pre moisten (with diluted alcohol) and set up as percolation
  • allow mixture to macerate for two days
  • add additional amounts of the diluted alcohol up to 2 pints of percolation
  • continue percolation until herb has been exhausted 
  • add 12 pounds of refined sugar and enough water to make 16 pints of syrup
  • gently heat the mixture to dissolve sugar 
  • mixture can be flavored with the essence of wintergreen, sassafras, or prickly ash berries

WHAT NOT TO DO

Research is now showing that both ibuprofen and acetaminophen increase the duration of illness, suppress antibody production and increase viral shedding in colds and flu’s. Don’t take ibuprofen. There’s a hypothesis that ibuprofen might increase ACE2 (angiotensin-converting enzyme 2) receptor the transmembrane enzyme receptor SARS-CoV-2 uses enter their host cells and begin replication. It could just be correlative, not causative – the more severe the infection the more likely you are to take NSAIDS for the fever and pain.

Don’t take Acetaminophen.  No one is talking about this, but Acetaminophen decreases glutathione production, your body’s most powerful antioxidant. Lowered glutathione in the lungs in common in chronic lung diseases, like COPD. 

NSAIDS and Acetaminophen seem to decrease antibody production (in petri dishes at least), putting a damper on the adaptive immune system.  

Covid19 isn’t associated with a dangerously high fever, try not to suppress it. Here a nice write up on the fear of fevers by jim mcdonald 

WHAT NOT TO WASTE YOUR MONEY ON

Colloidal Silver has zero studies on internal use, not because of a big pharma conspiracy, but because the people producing and selling it know it’s not a systemic antimicrobial and won’t fund a study destroying their sales. I used literal buckets full of the most popular colloidal silver products on the market when working with HIV orphans in Haiti. I drank a 32oz bottle every day for a week for a gut infection. It’s my opinion, based upon clinical use, and extensive research, that it doesn’t work internally. It’s a descent but expensive wound wash topically.

Taking essential oils internally is a good way to hurt yourself, with very little chance of benefit. Make an herbal tea of the plant whose essential oil you want to take. Make a personal essential oil inhaler to comfort you through these troubling times. Don’t use them internally.   

Goldenseal works best to dry up thin drippy mucus. It has some activity against some bacteria. It won’t work for Covid19, and might worsen mucosal dryness.

Grapefruit Seed Extract is chemical laden Grade A nutraceutical crap. Learn more here

 

Preventative section synopsis:

Covid 19 is here we can’t stop it. It is likely that 50-70% of the population will get it. The only way to prevent lots of deaths is social isolation to slow the burden on the medical system out into months versus weeks. Personal prevention strategies include:

  • Personal hygiene and social distancing
  • Mind your mucosa by staying hydrated and using the demulcents as needed
  • Eat a balanced diet to avoid nutrient deficiencies that might suppress the immune system and use short term high dose nutrient supplementation to rapidly replete any known deficiencies
  • Tend to your lymphatic system by moving 
  • Consider taking gentle alternatives as a preventative 
  • Try to avoid NSAIDs and acetaminophen 
  • Be cautious of cookie cutter herbal protocols that ignore individual constitutions and symptom presentations. Specifically, many of the lung remedies touted for are very drying to the mucosa. 
  • Monitor your stress levels and actively engage rest and restoration. I am a fan of nerve tonics which increase stress tolerance without causing sedation such as milky oats, skullcap, damiana, holy basil, and ashwagandha

Beyond Prevention

Theoretical protocols based largely on petri dish studies abound in both the conventional medical and herbal world.
What Follows Are My Treatment Musings Based Primarily On My Treatment Of Other Colds and Flu’s, and a few potential case of Covid19, and a few confirmed cases. The lack of test availability means most confirmed cases are from people with serious illness, often in hospitals, and most herbalists like me won’t have confirmed cases until testing is more available.   


The Qualifier – Literally No Western Herbalist Has Treated COVID
(yet) (that I’m aware of).

To be clear – because of the many many variables in plants, people, and presentation of illness it would take thousands of cases for anyone (me included) to say with any certainty what works, or works best.

The Two Treatment Routes

When deciding if you’re going to use herbs to treat Covid-19 you have two seeming opposite choices:

Base your decision making on theoretical mechanisms of action derived from mostly petri dish studies, often on inaccessible plants

or

Model your approach on the traditional systems based physiology/pathophysiology  found in TCM/Unani/Ayurveda/Traditional Western Herbalism, rooted  in the experience of thousands of people over thousands of years that treated similar infections based upon presentation.

The problem with anti-things including antivirals: 

Lots of herbalists and herb enthusiasts use the terms antiviral, anti-inflammatory, and antibiotic because these are familiar terms of modern medicine, a system based on reductionism, and single chemicals interacting with our bodies at the cellular level. Herbs don’t work that way. Herbs do not have a single constituent and are poorly suited to the terminology of single-compound medicine. When an herb is referred to as antiviral, that mechanism is largely based on petri dish or animal studies. Very few herbs have been studied in large groups of people over long time periods – so the term is unhelpful in explaining who might be best suited to use the plant based upon the identified mechanism by which the action occurs. 

Plants contain a complex slurry of constituents which act many ways in the body. This is why all traditional systems of medicine were based around a systems approach to physiology and pathophysiology. When we hear TCM talk about the spleen, it isn’t referring to the spleen as an organ, but to a complex series of physiological processes associated with a general area of the body. The same is true in Ayurveda, Unani Tib, and Traditional Western Herbalism. Herbalism has a language which describes the patterns of interconnected physiological responses which allows us to match the actions from plants to pathophysiology. This language is called energetics. 

Instead of focusing on anti-viral, anti-anti-everything, I believe our primary focus in selecting herbs for imbalances should be on the energetic patterns. This is why I have indicated in my formulations the primary action focused around the traditional energetic terminology and indications. If those herbs happen to have some research pointing towards antiviral properties, all the better. But selecting plants based primarily on constituent research with no thought towards visceral action is in direct contradiction to thousands of years of empirical knowledge.

Traditional treatment of fevers.

Traditionally, fevers weren’t suppressed with anti-inflammatories. Instead,  remedies were given that move blood to the surface of the body which facilitates sweating. The sweating results in a reduced body temperature. This method works with the body’s natural processes instead of suppressing them. Herbs that facilitate this process are called diaphoretics. There are two different types of diaphoretics: stimulating and relaxing. Stimulating diaphoretics  move blood to the periphery by dilating peripheral artials and/or by non-specifically increasing circulation. If you’ve ever eaten too much cayenne pepper and broken out in a sweat, then you already understand the action of a stimulating diaphoretic. 

Stimulating diaphoretics are indicated when you feel chills but aren’t running an actual fever (yet), or are only able to mount a low grade fever. They are most specific for the pre-fever and early fever phases. Use stimulating diaphoretics cautiously as many tend to dry out mucosa. If you are already taking demulcents and your tongue is not dry, stimulating diaphoretics are indicated.  Most warm pungent herbs, when taken in hot water, act as a stimulating diaphoretic. These include ginger, cayenne, horseradish, and mustard seed, which are likely available at your local grocery store. My favorite stimulating diaphoretic, however, is yarrow. It isn’t pungent but it is very aromatic, and much less likely to dry out the mucosa than the pungent herbs are. Cardamom is my second favorite, and widely available stimulating diaphoretic that doesn’t dry out mucosa. 

Alternatively, relaxing diaphoretics promote peripheral blood flow by relaxing physical muscle and tissue tension that is inhibiting the peripheral blood flow and sweating. Relaxing diaphoretics are indicated when there is a fever but no sweating. People often feel tense and peevish. My favorite relaxing diaphoretics are elderflower, catnip, peppermint, spearmint. 

A nice formula for fevers combines yarrow as a stimulating diaphoretic with elderflower and peppermint as relaxing diaphoretics taken together as a hot infusion. Feel free to use honey liberally in your infusions as a demulcent to restrain the drying actions of the herbs.

But I hurt when I have a fever. (Symptom support ideas for fevers.)

Two herbs which can support the aches and pains that accompany a fever are boneset and black cohosh. Boneset indications include bone-deep aches and pains which may include deep muscle aches. Try 2ml of tincture with a cup of chamomile tea. For muscle pain caused by tension during a fever, take small doses of black cohosh tincture (5-10 drops). Too much black cohosh can induce a headache – should that occur, drink a strong cup of green tea to remedy the headache.

Self-care Covid19 Treatment Plan

Keep those mucus membranes moist 

Hydrate. Water, veggie or bone broths, herbal teas. Make sure you’re consuming enough to urinate 8 times a day. Often 64-100oz is needed if you don’t consume many soups or water filled fruits and veggies.

Herbal steam, 10+ minutes, 3 x day – using from a tablespoon to a handful of your favorite kitchen spice. I’m partial to thyme and rosemary.

How To Do Herbal Steams: https://www.youtube.com/watch?v=MN_02xKg134

Use Demulcents! If you don’t have any in your spice cabinet, get Throat Coat Tea by Traditional Medicinals, available at most grocery stores – 3 bags to the cup. 3 cups a day

Eat Demulcent Oatmeal as much as you’d like

Covid19 is a complicated illness, with several stages and different presentations. Medical professionals have their own staging system that isn’t very helpful for herbalists, other than knowing when to send someone to the hospital (more on that later). No one approach is likely to be successful. No one formula is likely to work for many. The lack of testing, and inaccuracy of current testing is less important to my approach because I’m not advocating herbs for Covid19, rather I’m advocating a treatment based upon symptom presentation. Here’s what I’m seeing and doing.

Stage 1 Symptoms: Early symptoms are most frequently fatigue, muscle aches, and transient respiratory congestion. 30-40% reporting primarily diarrhea. Around 30% of people lose their sense of smell. Loss of smell can happen with other infections and allergies, and isn’t specific to Covid19. In this early stage there might or might not be a low grade fever. This stage seems to last for 1-5 days. It might or might not progress to stage 2.

Stage 1 Treatment:

Rest. Seriously. Go to bed.

For muscle aches – mix and match, use as needed: Black cohosh 3-10 drops; Kudzu 5g in standard decoction, or 3-5ml tincture; Lemon Balm 5g in standard infusion or 3-5ml tincture. Black cumin seed tincture 2-4ml. If those don’t work, or are unavailable, try the diaphoretic therapies for fever listed above (even if you don’t have a fever).

Don’t suppress the fever with NSAIDS or Acetaminophen.

The use of demulcents is important here to prevent dryness in stage 2.

Zinc: 50-100mg a day for 1 week. Any form works. Lozenges are nice.

Use the preventative measures mentioned above.

Stage 2 Symptoms: The onset of hot, dry respiratory symptoms. The tongue is dry and red. This seems to either be the end of the infection, or a short (1-2 day) transition phase before stage 3. Low grade or intermittent fever is present. Many cases seem to stop here.

Stage 2 Treatment:

Muscle ache symptom treatment from stage 1.

Demulcents.

For heat and dryness, administer 3-5 times daily: Peach or Wild cherry bark tincture (5-10 drops) (peach or pear juice can be used if the tincture is unavailable); Linden infusions flower 5g in standard infusion (check the Mexican spice section of your grocery store to find Linden by the name Tila/Tilo); Honeysuckle leaf and/or flower 5g in standard infusion or 3-5ml tincture.   

Zinc: 50-100mg a day for 1 week. Any form works. Lozenges are nice.

Niacinamide: 250-500mg once a day

I’m not recommending extensive herbal protocols, nor acute immune stimulants for stage 1 and 2, because people in stage 3 and 4 need the limited supply of herbs.

Stage 3 Symptoms: Presents with much more intense dry feelings in the throat and upper respiratory tract, low-grade or intermittent fevers that might be worse in the evenings, chest tightness that comes and goes, and maybe occasional diarrhea. The fatigue and muscle aches continue.

Stage 3 Treatment:

Most cases presenting with low grade fevers I am hesitant to use the traditional pungent remedies (composition powder, cayenne, dried ginger) as stimulating diaphoretics because of the increased drying action on the mucosa. Instead, I am favoring aromatic diaphoretics such as yarrow, and sassafras, as well as recommending small doses of cardamom because it is the least drying of the pungent diaphoretics. Fresh ginger is less drying than dried ginger, and if available, can be used interchangeably with cardamom. Offset the drying action of pungent remedies with honey or sugar. You can increase metabolic heat (poke the fever) without drying out the mucosa by taking a brisk walk, soaking in a tub, or doing a sauna. STAY HYDRATED!

Acute Immune Stimulants: Add echinacea to the gentle alternatives used for prevention (50% of the formula). Echinacea was traditionally indicated for fluid derangement (mixed states of dampness and dryness); its secondary action is an immune stimulant. I am not concerned about over stimulating the immune response because of its prolific and efficacious use in SARS. 

Mucolytics from stage 3 onwards. Mucolytics are an important category of herbs for both the moderate and more severe stages. True mucolytics work by breaking the disulfide bonds in snot which makes it more viscous and thus easier to expel. Many herbs are said to have a mucolytic action, but most are better termed mucoactives. The two mucolytics most researched are n-acetyl-cysteine (NAC) and onions. In my experience, anise seed seems to best fit the action of mucolytic though no research has proven its mechanism. My friend John Slatterly feels that cottonwood twigs and buds have a profound mucous dissolving quality, maybe beyond what’s common of mucolytics. 

My favorite mucolytic preparation, onion syrup, is easy to prepare with supplies you likely already have: onions, a jar and sugar.  To make it, slice onions and place about a quarter inch in a jar, then cover with an ⅛ to ¼ inch of sugar. Repeat until the jar is full. Refrigerate. Take 1 tsp of the honey onion juice syrup 6-10 times a day. More is better here unless you feel like it’s drying your mucosa out. Last 1 week. Discard and make a fresh batch weekly.

Respiratory formula – 3-5ml 4 x day

4 parts elecampane

3 parts mix and match: violet, solomon’s seal, pleurisy, shatavari, omphongon

2 parts aromatic expectorant: thyme, oregano, monarda, lovage, eucalyptus

1 part respiratory antispasmodic: lobelia, khella, silk tassel, or New England aster 

1 part of a cooling bitter diaphoretic: blue vervain or boneset

1 part cooling respiratory bitter for hot phlegm: horehound or bamboo leaf

 

Continue Niacinamide: 250-500mg once a day

Stage 3 is normally from days 5-7 through day 8-12 before subsiding or moving to stage 4. If it’s not stopped by the body here is the turning point. Until now it’s been predictable in course, though not in length of stages. Until now it’s been much like a bad flu. Now it settles in and transitions from hot mucosal/surface dry or hot mucosal/surface damp to Stage 4, hot tissue damp, or skips over that and goes straight to Stage 5, cold tissue damp. 

Stage 4 – Hot/ Deep Tissue Damp

As covid19 progresses from stage 3 to 4, the mucus dampness starts to thicken over hot irritated tissues. It seems the innate immune response is decreasing, and the inflammatory response is increasing. The coating on the tongue becomes heavy and yellow, the intermittent shortness of breath becomes a constant constriction, feeling like the chest is squeezed. This is the stage that adding bitter, cooling/draining remedies seems most helpful. Many of our bitter, cooling, draining remedies have some antiviral properties (see antiviral section). While none of them have research specifically about  COVID-19, their traditional indications combined with our current understanding of viruses makes them especially indicated.

Stage 4 Treatment:

Bitter, cooling, draining formula 3-5 times a day: Andrographis 4-5ml standard tincture, 1-2ml fluid extract; Isatis 4-5ml standard tincture, 1-2ml fluid extract; Boneset 5g standard infusion; Sweet annie or wormwood 4-5ml standard tincture, 1-2ml fluid extract

Onion Syrup

Alterative formula

Respiratory formula

Continue Niacinamide: 250-500mg once a day

Formulation Ideas for Stage 4

4 parts Echinacea – Primary indication: Fluid derangement. Secondary indication: Immune stimulation. 

2 parts Andrographis – Stagnant intense heat. Secondary indication: Immune stimulation. 

2 parts Horehound or bamboo leaf – Primary indication: Hot damp phlegm. Secondary indication: Cooling draining remedy

2 parts Boneset – Primary indication: Intermittent fevers, bone deep ache. Secondary indication: Immune stimulant

4 parts Violet – Primary indication: Gentle alterative/lymphatic. Secondary indication: Demulcent to restrain excessive drying

1 part Poke root – Primary indication: Stimulating alterative/lymphatic. Secondary indication: Immune stimulation.

Optional Considerations: Chinese skullcap, apricot kernel or almond decoction

3-5ml 3 x day

 

Stage 5 Cold (from heat exhaustion)/Damp

As covid19 progresses from stage 3 directly to stage 5, or stage 4 to 5, the mucosal/surface dampness starts to thicken over exhausted, damaged tissues. Hospitalization is probably imminent. The coating on the tongue becomes white and greasy, the intermittent shortness of breath becomes a constant constriction, feeling like the chest is squeezed.

This is the stage that TCM practitioners use Ginseng, Cinnamon and Prepared Aconite (in combination with atypical demulcents) to drive vitality for one last push against the invader (dear TCM practitioners, I know I’m butchering a much more complex and nuanced process of clinical reasoning – forgive my lack of eloquence).

This is the stage that you consider adding saturating doses of strong thyme tea (1 quart a day or more). This is the time you warm the interior with angelica or composition powder. This is the stage you consider your deeply warming expectorants Osha and Lomatium. The more frail the person the more American Ginseng is called for in this stage. This is where a practitioner might think about small doses of blood root (don’t use this if you aren’t a practicing clinical herbalist that’s used this before).

Formulation Ideas for Stage 5

4 parts Echinacea – Primary indication: Fluid derangement. Secondary indication: Immune stimulation. 

2 parts Osha or Lomatium – Primary indication: Warming expectorant

1 part Angelica or Composition formula – Primary indication: Constitutional warming

2-6 parts American or Asian ginseng  – Primary indication: Fatigue, lack of vital force

1 part Poke root – Primary indication: Stimulating alterative/lymphatic. Secondary indication: Immune stimulation.

1 part Thuja – Primary indication: Warming stimulating alterative/lymphatic. Secondary indication: Immune stimulation.

Considerations: Atypical demulcent to formula like pleurisy root or Solomon’s seal to restrain over drying.

Oxygen can theoretically drop at any stage, though it seems most likely to at stage 5. Buy a pulse oximeter. If at any time resting o2 saturation drops below 90 go to the hospital. The 6 minute walk test is being used in many hospitals to triage who needs to be admitted or not. I’ll have more to say about this later. Until then, here’s a resource

A note about cinchona bark:

Cinchona bark was the original source for quinine. Researchers are currently investigating chloroquine and hydroxychloroquine, semi-synthetic quinine derivatives, as antivirals. It is reasonable to think that cinchona alkaloids have a similar mechanism of action as chloroquine/hydroxychloroquine. 

The down side: cinchona alkaloids can induce cinchonism, which starts as ringing in the ears and rapidly progresses into deadly heart arrhythmias. The variability of alkaloid concentration from species to species and growing regions means that you should not self-administer cinchona bark at all. Ever. If you’re an herbalist and you have never used cinchona bark, now is not the time to learn. Chances are if you are hospitalized with COVID-19, they will give you chloroquine and/or hydroxychloroquine which are much easier to dose. I would rather you take a proven medication with a reduced risk of side effects than hurt yourself trying to figure out cinchona. 

Below are topics that I am still working on. 

Post infection recovery herbs

Immune Stimulants – pros and cons, indications and contraindications

Is herbal immunology ready for prime time?

Are Immune “Modulators” a thing? – My experience with autoimmunity and immune “modulators”

Nutrient restraints on immunity overactivity

T-helper Cells and Cytokine Complexities

Ace2 receptors and Potassium Loss

Will elderberry cause a cytokine storm – no. Elderberry myths, shoddy research, lack of history, and contraindications. Do I use elderberry, not much. 

If you have the crud, book an appointment to see me via phone or zoom for free. All herbs are free also. We are all in this together. Hang in there!

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