Impact of the COVID-19 Pandemic on Ayurveda Practice and Research

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Impact is the remarkable influences on the existing system by

forced invade of a new think as like-pandemic disease. This impact

can be interpreted as positive, negative or neutral based on the sensible

variables. It is an essential exercise to assess impact of serious illness

in pandemic form for its negative and positive influence on the

economy, society, public policy, preventive, promotive and curative

health, quality of life, environment and to allocate research project

for maximum benefit with minimum waste of funds and manpower

[1]. Health Impact Assessment (HIA) is a combination of procedures,

methods, and tools used to evaluate the potential health effects of a

policy, programmer or project. Using qualitative, quantitative and

participatory techniques, HIA aims to produce recommendations

that will help decision-makers and other stakeholders make choices

about alternatives and improvements to prevent disease/injury and

to actively promote health [2]. Covid-19 pandemic has a significant

remark in many areas which are reflected in Wikipedia. But its impact

on Ayurveda practice and research is not found either in Wikipedia or

another search engine in internet platform. Therefore, an attempt was

taken to assess the impact of Covid-19 pandemic in Ayurveda practice

& Research.

Ayurveda is a live traditional system of health care with an

unbreakable practice for 3000 years. Ayurveda gained importance

in its own country where it was originated after the establishment of

Department of AYUSH in 2003. Then National Rural Health Mission

(NRHM) includes Ayurveda (one of the components of AYUSH)

as alternative therapy option to integrate with western medicine to

serve the people of India in better way in 2005. Ayurveda health care

is more focussed after the establishment of AYUSH ministry in 2014

[3]. Central council of Research in Ayurveda Sciences (CCRAS) has

also intensified the specific research-based programme and project

and renamed its institute as specific system based to create more

data on practice of Ayurveda & initiate research in 2016. Herbal

medicine is used by 75%-80% of the world population, mainly in

developing countries for primary health care [2]. But only 6.9% of

Indian population favoured AYUSH system of medicine as evident

in NSSO survey in 2014 [4]. Many committees recommended that

more awareness and research are required to popularize the system.

Many patients prefer Ayurveda after dissatisfied or frustration with

contemporary medicine, low cost of Ayurveda medicine in comparison

to allopath, easy excess to Ayurveda physician, last option and less side

effect [5]. More over some patient choose Ayurveda primarily based

on their personal experience and strong recommendation of other

people [6,7]. The Ayurveda diagnostic process is subjective and patient

oriented, some of diagnostic tools such as Prakruti (Constitution)

assessment and Nadi Parikshya (Pulse diagnosis) are also patient

centric. The treatment always personalized and classified as Sodhana

(Purificatory) and Samana (Palliative). The Sodhana therapy is also

called as Panchakarma therapy or detox therapy where snehana

(oleation) and swedana (Sweating) are preparatory therapy which

need personal contact of panchakarma technician and Ayurveda

physician. Ksharasutra, leech therapy and uttara vasti are para surgical

procedures mostly practice in Ayurveda hospitals. The researches in

Ayurveda are academic research in post graduate centers and special

research in Research centers. Some of the academia and Institutes

have been conducting clinical trial, animal experiments and other

researches like Clinical epidemiology, Pharmaco epidemiology etc.,

[8,9].

If health care sector is considered, then various clinical guidelines

are issued for management of COVID-19 patients as well as normal

patients. Research Councils under the Ministry of AYUSH, Government

of India have also issued advisory based on the Indian traditional

medicine practices i.e., Ayurveda, Homeopathy and Unani before the

outbreak in India. A consensus statement in Ayurveda management and

prevention was developed for COVID-19.

 Impact on Ayurveda Practice: In the first and 2nd phase of lock

down, many Ayurveda hospital discharged their IPD patients. The

Panchakarma hospitals and message centers completely closed down

which was depend on tourism. All para-surgical procedures and invasive

panchakarma procedure are stopped due to outbreak of COVID-19. In

this stage more asymptomatic cases and carriers are found, which would

amplify the chances of infection, therefore Ayurveda doctors managed

the research and general cases by wearing surgical musk, hand wash by

sanitizers. After that PPE kit was provided to some doctors those are

doing COVID duty. Ayurveda doctors postponed the wellness therapy

and non-urgent cases. IPD services of most of Ayurveda hospital is

closed down. In the Unlock process, some of the Ayurveda hospital and

Medical colleges converted to COVID hospital by its State government.

Some of AYUSH doctors sacrificed their life also.

The impact on Ayurveda Research is also noted in many centers, the

trial subject cannot continue the clinical trials. There is a mass drop out/

partial drop out of subjects from ongoing clinical trials and new patients’

recruitment is not possible for close down of clinical laboratories.

In the midst of the Pandemic, MoHW, in collaboration with Niti

Aayog, released Telemedicine Practice Guidelines enabling Registered

Medical Practitioners to provide healthcare in remote settings using

telemedicine. These guidelines recognized by some of the Ayurveda

hospitals. The patient’s attendance dropped upto 80% of most of Ayurveda

hospitals. The clinical trials cases dropped out the trial due to lock

down process. Whereas new trials on COVID-19 was encouraged and

more positive impacts were generated when Prime Minister Narendra

Modi endorsed traditional ways to boost the immune system, directing

people to follow the guidelines issued by the Ayush ministry to avoid

contracting Covid-19. The prime minister also asked those practicing

traditional medicines to utilise the platform of tele-medicine and reach

out to the people to generate awareness in the fight against the Covid-19

pandemic. Phyto therapeutic agents containing higher concentration

of sesquiterpene, polyphenols and flavonoids have inhibited the

production of inflammatory cytokines and prostaglandin which are

more produced in COVID-19. Yastimadhu, Gilay and Aswagandha have

equal effect on cough as codeine. The Anu taila nasya has special power

to prevent COVID-19. More than 70% of Indian population has been

using Ayurveda Kadha (Decoction), Haldi milk and practice Yogasana

and pranayama for prevention of Covid-19.

Clinical research studies on Ayurveda interventions as prophylaxis

and as an add-on to standard care to Covid-19. A Collaborative clinical

study was proposed as a joint initiative of Ministry of AYUSH, Ministry

of Health and Family Welfare (MoHFW) and the Ministry of Science &

Technology through Council of Scientific & Industrial Research (CSIR)

with technical support of ICMR. The Interdisciplinary Ayush R&D

Task Force has formulated and designed clinical research protocols for

prophylactic studies and add-on interventions in COVID-19 positive

cases through a thorough review and consultative process of experts

of high repute from different organisations across the country for

studying four different interventions viz. Ashwagandha, Yashtimadhu,

Guduchi+Pippali and a polyherbal formulation (AYUSH-64) developed

by CCRAS.

 Ayush Sanjivani application-based study for impact assessment of

acceptance and usage of AYUSH advisories in its role in the prevention

of Covid-19 is initiated in all Ayurveda Institutes and hospitals. The

Ministry of AYUSH has developed Ayush sanjeevani mobile app, for

generating data of large population with a target of 5 million people.

The Researchers are worked hard to reach to expected outcomes include

to generate data on acceptance and usage of AYUSH advocacies and

measures among the population and its impact on the prevention of

COVID-19.

Although negative impacts are more noted in terms of lock down

of Ayurveda hospitals and Ksharasutra and panchakarma centers.

There is a significant drop of OPD strength due to lock down and

shut down process. But positive impact is more as it creates awareness

to opt Ayurveda kwatha, nasya, pranayama and yagasana to prevent

COVID-19. It also reached every house of India.

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