As the COVID-19 pandemic is escalating in India, the health care response system is being overwhelmed. In some cities like Delhi, Ayurveda hospitals have been officially designated as COVID Care Centers. In other cities such as Chennai and Mumbai, COVID 19 patients are approaching Ayurveda physicians for clinical care. Harnessing the potential of traditional systems of medicine like Ayurveda is a crucial strategy of preparedness to meet the emerging challenge of administering clinical care to an increasing number of COVID 19 patients.
In this scenario, it becomes relevant and important to initiate dialogues between Ayurveda clinicians treating COVID 19. The sharing of clinical experiences can help in better understanding the strengths and limitations of Ayurveda in caring for COVID-19 patients. The panel discussion brought together experts from institutions and general clinical practice. Following presentations by the panelists, there was a focused discussion with the participation of invited resource persons.
The meeting began with a short prayer and the opening remarks by Swami Sankaramritananda Puri (Principal and Medical Director of Amrita School of Ayurveda). He pointed out how the pandemic has impacted human life in many ways and how spirituality can help us to nurture the strength to face the challenges thrown at us by COVID 19. After the opening remarks, Vaidya P. Rammanohar (Research Director of Amrita School of Ayurveda), the moderator of the panel discussion, invited each panelist to respond to specific questions.
There were three rounds of questions. First, the clinicians engaged in clinical practice amongst the panelists (Dr. Girija and Dr. Jyoti Joshi) were invited to respond to the questions in the first round (three rounds in total), followed by the clinicians from institutions (Dr. Pooja and Dr. Prasanth). Finally, the panelist involved in clinical trials (Dr. Pawan) was invited to respond to the question. The question was common for all in the second and third rounds.
In the first round, clinicians engaged in clinical practice were asked the following questions: What type of patients comes for a consultation? Are the patients coming voluntarily to your hospital or are they also being referred by allopathic practitioners?
Dr. Girija (Chief Physician of Sanjeevani Ayurveda Foundation, Chennai) pointed out that many cases were referred to her by Allopathic physicians. She said that in her experience, Ayurveda could also help in particular stages of severe cases also and that we need not restrict to only mild and moderate cases. Dr. Jyothi Joshi (Physician, Joshi Panchakarma Clinic, Mumbai) said that patients were approaching her directly, even those who are admitted to hospitals. Though Allopathic doctors are not referring cases, they are cooperating well and permitting the administration of Ayurvedic medicines in hospitalized patients.
The following questions were asked to clinicians working in institutions: What type of patients are referred to in your institution? Are they allocated to your institution? Is there criteria for accepting the patients and a guideline for referring them for tertiary care?
In Delhi, Ayurvedic hospitals like Chaudhary Brahmaprakash Ayurveda Chikitsa Sansthan and All India Institute of Ayurveda have been set up as COVID 19 Care hospitals. Dr. Pooja Sabharwal from CBPACS and Dr. Prasanth Dharmarajan from AIIA shared their experiences in setting up the protocols and wards for care of COVID 19 patients and the type of patients being admitted. Dr. Pawan Kumar Godatwar, National Institute of Ayurveda, is participating as PI of a clinical trial to assess the efficacy of Ayurveda in COVID 19 at AIIMS, Jodhpur. He explained the criteria for inclusion and exclusion of patients in the clinical trial.
In the second round, the panelists explained the treatment protocols, diet and lifestyle followed in the management of COVID 19 patients. It was found that physicians engaged in clinical practice were able to exercise more freedom in customizing treatments according to varying clinical presentations of COVID 19.
In the third round, the panelists shared their efforts in publishing the outcomes of Ayurvedic treatments in COVID 19 both at the level of clinical practice as well as institutionalized care. Dr. Girija published the first case report of a COVID 19 patient treated with Ayurveda. The panelists pointed out that many publications are in the pipeline reporting outcomes of Ayurvedic interventions in COVID 19 patients. Dr. Tanuja Nesari (Director, All India Institute of Ayurveda, New Delhi) opened up the discussion by responding to the views expressed by the panelists and highlighting the efforts being taken at All India Institute of Ayurveda.
Dr. Geethakrishnan (Technical Officer, World Health Organisation, Geneva) shared his reflections from the viewpoint of the global response to the pandemic and pointed out that the government must bring Ayurveda into the mainstream like Chinese medicine. Dr. P. M. Unnikrishnan (United Nations University, Malaysia) gave remarks from the public health perspective and pointed out that a proper response from the Ayurvedic community to the COVID 19 pandemic can bring Ayurveda into the forefront of public health in India. Dr. James Chacko (Professor of Kayachikitsa, Amrita School of Ayurveda) spoke about challenges in developing standard treatment guidelines for the management of COVID 19 in clinical practice and emphasized the need for well classified protocols for diagnosis and treatment.
Dr. Ananthram Sharma (Professor of Panchakarma, Amrita School of Ayurveda), pointed out the need for an algorithmic approach to the development of treatment protocols and also emphasized that well documented outcomes in clinical practice is a better alternative to randomized controlled trials. Dr. Girish Tillu (Executive Editor, Journal of Ayurveda and Integrative Medicine) highlighted the scope and need for publication of treatment outcomes in indexed research journals and the key points to be kept in mind for writing papers. Dr. Rabinarayan Tripathy (Vice Principal, Amrita School of Ayurveda) summed up the discussion and extend vote of thanks.