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Why the national ayurveda protocol on COVID management appears wanting

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Summary

The protocol thus is faithful neither to the Ayurvedic classics nor to conventional diagnostic criteria. A document endorsed by the country’s Prime Minister would be expected to be clear, error-free and trustworthy. The document in question sadly has these attributes only faintly.

Full Article

The Union Health Minister recently released the National Protocol based on Ayurveda and Yoga for the management of COVID-19.This initiative is certainly welcome, but the protocol lacks the clarity and rigour expected of a scientific document.

 

The protocol, despite being a consensus document of national ayurvedic institutes, appears wanting in two major respects. One, it has a glaring internal discrepancy that muddles diagnostic criteria. Two, it does not value the classical ayurvedic insights justifiably adaptable in the management of infections like COVID-19. These issues may be examined, one by one.

 

The document rightly defines mild cases of COVID-19 as those with symptoms of fever, dry cough, sore throat and runny nose, but without signs of breathlessness and hypoxia. If breathlessness and hypoxia are present, the disease severity would be deemed moderate. What muddles these diagnostic criteria is the Annexure 3 of the same document which confusingly includes these two signs under mild disease. It even goes on to suggest Kanakasava and Vasavaleha as remedies usable in managing these signs. This discrepancy, with obvious practical implications, is too glaring to be ignored.

 

The other problem with the document is somewhat more serious. The premise behind devising an ayurveda-based protocol is to glean insights from the rich repertoire of medical experience that the ayurvedic classics meticulously document. Bypassing these insights, especially when there are compelling reasons not to do so, would be a defeat of the premise itself. If ayurvedic insights don’t matter, why have a separate protocol in its name at all?

 

The classical ayurvedic approach in the management of common fevers emphasises upon the triad of ‘langhanam, swedanam, kaalah’, roughly meaning, ‘caloric restriction, warmth (the use of warm water for hydration) and rest’ (1). The details of this approach, which is mostly non-pharmocologic, have been elaborated elsewhere. Suffice it to note that caloric restriction for a couple of days until the fever remits is central to the ayurvedic approach in the management of common febrile illnesses. This ayurvedic view appears to be gaining support from current advances in research on fasting-induced autophagy.

 

The protocol document, however, makes not even a passing reference to the importance of caloric restriction. It even violates this classical idea by recommending the use of calorie-laden,  ghee-rich jams like Chyavanaprasha and Vasavaleha in the management of fatigue and hypoxia associated with COVID-19.

 

The protocol thus is faithful neither to the Ayurvedic classics nor to conventional diagnostic criteria. A document endorsed by the country’s Prime Minister would be expected to be clear, error-free and trustworthy. The document in question sadly has these attributes only faintly.

 

References

  1. Charaka Samhita, Chikitsa Sthana, chapter 3, verses 139-142.

 

G L Krishna is an Ayurvedic doctor practising in Bengaluru. He may be contacted at gl.krishna@yahoo.com.

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