SCIO briefing on TCM's important role and a list of effective drugs in COVID-19 prevention and control
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E-mail China.org.cn, March 25, 2020
CGTN:
TCM has been widely and effectively applied in the treatment of COVID-19 in Wuhan. My question is for Mr. Zhang Boli. What are the lessons you've learnt in the course of the medical treatment in Wuhan and are willing to share with the rest of the world?
Zhang Boli:
Thank you for your question. I arrived in Wuhan on Jan. 27. That is almost two months ago. When I first came here, the epidemic situation was fairly severe. Hospitals were filled to capacity. Hundreds of people were waiting in line at fever clinics, and they couldn't get medical treatment for hours. Patients and accompanying visitors were mixed together, which was very worrying. Two months later, what is the situation in Wuhan today? The number of hospitalized patients has been reduced from over 60,000 to around 5,000, and that of patients in critical condition has fallen from 12,000 to about 1,800. In particular, until yesterday, no new confirmed cases of COVID-19 were reported in Wuhan, marking the fifth day in a row we have seen zero increase, including zero new confirmed case, zero new suspected case, and zero existing suspected case. Therefore, the situation in Wuhan is turning for the better, just like Dante Alighieri wrote in Divine Comedy that "E quindi uscimmo a riveder le stele ["And so we went out to study the steles."]
However, when I read about the current situation in Europe and the U.S., I'm also very worried and sympathize with them. Therefore, we are very willing to share our experience with all our peers around the world. In the light of our experiences with a disordered situation in Wuhan at the very beginning of the outbreak of the epidemic, the Central Guidance Team made a decisive decision, seeking to conduct classified management and centralized isolation of all suspected infection cases. People with fever symptoms, people who need a 14-day quarantine for medical observation, suspected infection cases, and people who had close contact with COVID-19 infected cases were totally separated. Thanks to the great efforts made by local community workers and residents in Wuhan, it only took a few days to separate the different types of cases for appropriate treatment. However, without medicine, isolation is only half of the battle. Since there is no effective medicine or vaccine, we began to give TCM decoctions and proprietary Chinese medicines to our patients. At the beginning, it didn't go well; we only delivered medicines to some 3,000 to patients from 13 districts of the city on the first day. The curative effect of TCM appeared after two or three days, however. With the fever gone and cough reduced, patients began to try TCM on their own initiative, and more than 10,000 bags of TCM decoction were delivered at that time. So far, we have delivered TCM products to more than 600,000 patients. What's the effect? It has contained the spread of the epidemic. Let me give you some data. In early February, over 80% of the four types of people I mentioned previously became confirmed COVID-19 infected cases. By the middle of February, it dropped to 30%, and then down to under 10% at the end of February. Centralized isolation of all suspected infection cases, and enabling our patients to take TCM have contained the spread of the epidemic, which is the foundation of our fight against COVID-19.
The second experience is classified management and scientific treatment. The central government asked to leave no coronavirus patient unattended, and treat every single one regardless of cost; however there weren't enough hospital beds at that time. The Central Guidance Team then decided to treat severe cases in specially hospitals designated, while keeping the mild cases in Fangcang shelter hospitals, and introducing management standard of treatment for mild and ordinary cases. However, Fangcang shelter hospitals are quite different from ordinary hospitals. With thousands of people living in a super large hall, how to manage them in an orderly way is a big problem. Under such circumstances, Professor Liu Qingquan and I jointly advised the headquarters to adopt TCM to treat the patients in Fangcang shelter hospitals. At the same time, the first temporary TCM hospital was built in Jiangxia district of Wuhan. In this temporary hospital, we put service ahead of treatment. How did we provide our service? Because of the large space, the temperature inside Fangcang shelter hospital was relatively low. We provided every patient with a warm bed, hot water, hot meals, as well as our hospitable service. At the same time as treatment, we also tried our best to show our care for the patients. For example, we communicated with our patients a lot, celebrated birthdays with them, and lead them to do exercise together. Because of our enthusiasm, the doctor-patient relationship became very harmonious. After staying a few days at Fangcang shelter hospital, patients felt it was more like a big community or extended family instead of hospital, which was also helpful to the treatment of all patients.
Patients treated in Fangcang shelter hospitals were all mild and ordinary cases. According to the WHO, severe cases account for 13% of the total COVID-19 infected cases, while critical cases account for around 7%. So, our goal when treating patients in the Fangcang facilities was protecting them from developing a severe or critical condition. We adopted a comprehensive treatment which combined TCM with Western medicine. In addition to TCM decoction and oral proprietary Chinese medicine, we also provided massage, guasha (or scraping therapy), and medicine for external application. What's the effect? Let me take Jiangxia temporary hospital as an example. There were a total of 564 patients treated, and none developed severe symptoms. We then shared our experience with other Fangcang temporary hospitals, and treated more than 10,000 patients with TCM. As a result, around 2% to 5% of patients treated in Fangcang hospitals developed a severe condition. Therefore, we could say that TCM treatment has significantly reduced the possibility of mild cases turning into severe and critical cases, which is the key for our fight against COVID-19.
Another point is that treatment of severe cases is the most important of all. So for severe patients, we still prioritize the use of Western medicine, while traditional Chinese medicine (TCM) is used as a supplement –in other words, we use the combination of TCM and Western medicine. The use of TCM can often have a significant effect despite being supplementary. It has been used in the treatment of severe cases in Jinyintan Hospital, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, and Leishenshan Hospital, and have achieved very good results. So our conclusion is that TCM injections should be used boldly and early. For example, Shengmai Injection and Shenmai Injection can stabilize the saturation of blood oxygen and improve the oxygenation level of patients; Tanreqing Injection and Reduning Injection can work along with antibiotics; while Xuebijing Injection has some effect on inhibiting inflammation and controlling disease progression. Thus, the treatment of severe cases and the combination of TCM and Western medicine have helped reduce mortality rates and contributed to our victory.
Lastly, when patients turned negative for the virus, they will be discharged from hospital and moved to isolation centers for rehabilitation. During the rehabilitation stage, patients may sometimes experience fatigue or cough, or are not in very good spirit. Their lung inflammation have not been fully squashed, and the immune function has not been completely repaired. In this case, we combine TCM and Western medicine to help them do some breathing exercises, in addition to TCM acupuncture, massage and other comprehensive therapies. This can improve their symptoms, promote lung inflammation reduction, protect the damaged organ, and repair immune function. Therefore, we can say that TCM and Western medicine play their respective roles and their combination is conducive to the rehabilitation period, thus securing the final victory.
The early intervention of TCM and its participation in the whole process of treatment of the COVID-19 plays an important role. The course of COVID-19 is like a parabola, and TCM is effective at both ends of the curve. And although there is so far no specific cure for the disease, TCM has provided effective treatment plans. The combination of TCM and Western medicine is the highlight of the Chinese approach to the disease. Currently the epidemic is rampant across the world and the disease knows no border, and TCM is always ready to help. We are very willing to share the above experience with our colleagues. Thank you.
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