Answers to Common Questions About COVID-19 Infection
Lately everyone has been asking all kinds of questions about COVID-19 infection. It is hard to answer each one individually, so today I write a unified reply, hoping it helps.Q: Is there a specific drug for COVID-19 now? Is there a specific TCM drug for COVID-19?A: There is no specific drug for COVID-19 yet. Although Pfizer and Merck have each developed drugs for it, there is currently no evidence that they are specific cures. As Reuters in London reported, the complete results of a large UK clinical trial recently showed that Merck oral molnupiravir speeds recovery in COVID patients but does not reduce hospitalization or mortality in high-risk groups. In fact Pfizer oral Paxlovid has only similar effects. China domestic Azvudine tablets are the same; its clinical data have never been published, so we cannot know its clinical efficacy.But all the above drugs have been shown to have certain liver and kidney toxicity, so clinical use should still be very cautious; there is no need to rush into hoarding or taking them. If they only shorten the course without lowering hospitalization or fatality, then compared with many TCM formulas they have no clear advantage and cost far more.Chinese medicine also has no specific cure for COVID-19. All current TCM formulas—including those published by the National Health Commission and the empirical formulas I and other TCM practitioners share—only relieve symptoms and cannot be called specific cures. After the main symptoms ease, such drugs should not be taken further. So when I prescribe, I basically give only 1–3 doses and tell patients to stop once symptoms ease and let the body recover on its own.Some TCM formulas have side effects, so be careful. For example formulas containing Xixin (Asarum) can damage the liver and kidneys; Asarum has a liver-cancer-inducing side effect, and abusing it may later cause hepatic cancer. In the last century many people abused Longdan Xiegan Wan, which eventually caused kidney damage and triggered urothelial cancer in a batch of people. Asarum and the Guanmutong in Longdan Xiegan Wan are both Aristolochiaceae plants with hepatorenal toxicity and carcinogenicity. So use medicine carefully.People often message me claiming they have a specific COVID cure; some ask me to promote their formula, others ask to partner and sell drugs to patients. I disregard all of it. In the three years since the outbreak, Chinese health regulations allowed only designated hospitals to take COVID patients; other medical institutions and individuals were forbidden to do so. So early on no one had much clinical experience, and only after the policy was lifted—just over the past month—have all medical institutions and doctors been allowed to take COVID patients.In this short month, no one could possibly develop a specific cure for COVID-19 and accumulate large clinical data proving its efficacy. So do not believe any "miracle drug" touted to cure COVID. As for the various circulating TCM specific formulas for COVID, I have tried them all and seen no miraculous root-cure effect. The formulas I recommend can only relieve some symptoms; they cannot root out COVID.Q: How is the cough after COVID-19 infection treated?A: Many people cough after infection, but the causes differ. Only about 4.5% of infected people show pneumonia, and the great majority are very mild and basically self-recover within 2–3 weeks.Right now over 80% of my own family members have coughed through to self-recovery; a few with underlying disease (including myself) do not recover quickly. So if you had no prior respiratory disease and no especially distressing symptoms now, simply wait for self-recovery; there is no rush to take any medicine.COVID can trigger acute flares of chronic respiratory disease; such patients need different treatment after infection. Chronic-disease patients should seek help from the attending doctor who has long managed them, since those doctors know the underlying disease well.Many coughs are also caused by various bacterial infections: those coughing yellow phlegm mostly do not have viral pneumonia but a bacterial cough. Right now winter influenza and RSV are also spreading widely. So the causes of cough are very complex, with no single regimen.Any drug or formula claiming to solve every cough circulating at this stage is not to be trusted. If cough lasts long, does not ease, and is worsening, or if breathing is difficult, seek a doctor for targeted individualized treatment; do not abuse drugs.Q: Are there sequelae after COVID-19? Can they be prevented or treated?A: Yes, there are sequelae, even after Omicron. The main long-COVID symptoms are fatigue, dyspnea, and difficulty concentrating.The Guardian recently reported that, according to the UK Office for National Statistics, as of this November over 2.1 million Britons still had COVID symptoms four weeks after their first confirmed or suspected infection—about 3.3% of the UK population. The UK was the first to pursue herd immunity and has been through many infection waves; that so many still have sequelae shows the disease impact should not be underestimated. But UK experts also note that medicine currently has no clear understanding of the pathology of long COVID and no effective treatment.Personally I think measures should start one week after infection to prevent sequelae; preventing sequelae matters more than treating them. Though the cause is unknown, COVID damages blood vessels and the nervous system; cardiomyocytes are slowly but progressively injured after infection, so heart, lung and neural tissue are all affected.I myself have chosen dietary therapy plus Chinese medicine for prevention. From the literature, I feel TCM Shengmai San and hawthorn are relatively suitable foods/drugs with very few side effects. My whole family is using them; my heart does feel more comfortable and my energy is higher.I take one vial of Shengmai Yin oral liquid daily and eat 3–4 whole hawthorns a day. I cannot yet verify the actual effect—the time is short and data insufficient—so this is for reference only, with no promise of effect.I also noticed by chance that my lung-cancer patients, who had long been taking the cough-and-phlegm, blood-activating, right-supporting, and "fighting poison with poison" herbs I prescribed, when they caught COVID, apart from a few end-stage patients, the great majority had much milder symptoms than those around them.I am also studying whether these anti-lung-cancer herbs work against COVID. Perhaps qi-supplementing and yin-nourishing, phlegm-resolving and cough-stopping, and blood-activating stasis-resolving herbs do ease symptoms and prevent sequelae—but for now this is only my hypothesis, needing practical verification.Constitution differs and underlying diseases differ, so prevention and treatment plans differ accordingly. Do not copy and abuse my plan. My regimen suits basically healthy people without underlying disease, not those with underlying illness.Q: What about severe patients? Can Chinese medicine alone cure them?A: The severe patients I have seen are rarely caused by COVID alone; the great majority are elderly over sixty with underlying disease. They should be hospitalized, the earlier the better. I advise going to the relevant specialty ward, because specialists can address the underlying disease. Those with severe respiratory symptoms should go to respiratory medicine or critical care. Severe patients should not use Chinese medicine alone, let alone be treated at home.Hospital staff can give more comprehensive care. China medical profession has gradually worked out effective experience in rescuing severe patients and issued guidelines; these (especially the modern-medicine ones) are reliable.Severe patients can receive integrated Chinese-Western treatment, but using Chinese medicine alone is extremely dangerous, because many severe patients have triggered underlying disease and serious symptoms requiring care for both COVID and the underlying illness.Q: Are there many severe patients in hospitals now? Is it safe to go?A: There are many. According to Wuhan data released the day before yesterday, over 20,000 people died in Wuhan in December; the current number of in-hospital severe patients is 19,781, 30.37% of all inpatients, with the top five hospitals: Tongji 2,448, Central Hospital 1,821, Xiehe 1,750, Wuhan University People 1,509, Wuhan University Zhongnan 1,249. Of course this is dynamic; the next second it may differ.That is a large number, but these deaths and severe cases are not all due to COVID. How many deaths COVID actually caused can only be settled after the pandemic by counting excess mortality. Every winter many hospital departments are full; respiratory and neurology wards are always tense in winter, and oncology is full year-round.The risk of nosocomial infection (mainly various circulating viruses and resistant bacteria) is indeed higher than usual, but for severe patients, hospitalization is still the better choice and relatively safer.Q: Do injections at barefoot doctors really work better?Comparing the December mortality of my rural hometown with that of Wuhan (note this is total mortality, not COVID-only mortality—the COVID-only figure must wait for excess-death counting after the pandemic), we cannot conclude that IV drips at rural barefoot doctors work better than hospital care.Moreover, those getting IV drips at rural clinics are mostly mild-to-moderate patients; rural severe patients go to big hospitals themselves. So emotional articles exaggerating barefoot-doctor IV drips are not credible; without rigorous data comparison no sound conclusion can be drawn.As I understand it, many patients who got IV drips at small clinics earlier are now seeking hospital admission; I mentioned this in a previous article. Some with underlying disease felt temporarily better after drips, or not clearly better, but days later worsened and need hospitalization. Major hospitals admit such patients every day.COVID mixed with underlying disease triggers very complex problems; do not oversimplify. Life-threatening patients should still go to a well-equipped local hospital for more professional help.Q: Does washing hair or bathing easily cause relapse after COVID?A: So far I have not seen this among my own family. Our family of three washes hair and bathes every day with no worsening or relapse. But a few people do claim washing worsened them; I can only say such patients simply had not received correct treatment.Q: Once symptoms ease after COVID, is one completely safe?A: No. International observation shows COVID has near-term, mid-term and long-term symptoms. Some symptoms appear only after recovery; fatigue, palpitations, and breathlessness may surface gradually two weeks or two months after infection.Singaporean media recently randomly interviewed infected people on the street; many said that even three months after recovery they still could not exercise vigorously as before and gasped at slight exertion. So after infection we should keep regular hours and avoid overwork. But the virus damages heart and brain vessels, and exercise protects them; so two weeks after infection, if basically back to normal, one can and should exercise moderately. Recoverees should build up gradually, not overdo it; those not yet recovered should not rush into exercise, or they may trigger worse symptoms.Seeing World Cup players still as robust as before infection, we should believe that full recovery for most is only a matter of time. Please be patient.Q: Are reinfections worse each time?A: No. Most young people are not worse with each reinfection, though a few young patients are indeed much worse the second time; this is reported in all countries but is not common. Elderly people in poor condition are at real risk with reinfection and should avoid infection and reinfection as much as possible.Q: Can one have sex after recovering from COVID?A: Yes. Once health has returned, normal sex is fine. But early in recovery, watch your body; if the heart feels unwell during excitement or exertion and breathing is harder than before, keep resting a while longer.