Beijing pushes traditional Chinese medicine as coronavirus treatment despite questions over benefits

Jun Mai

Traditional Chinese medicine is being promoted as a treatment for Covid-19 with more than 90 per cent of patients receiving traditional treatments, according to official figures.

While many scientists are sceptical about its benefits, traditional medicine has official support and has been endorsed by President Xi Jinping.

It has been credited with curing tens of thousands of patients during the outbreak and is also being promoted beyond China’s borders, as an alternative medical solution and a source of national pride.

One of the treatments being used is ephedra, which has been used to treat respiratory complaints since the 13th century, and a special soup in which it is mixed with poria, blackberry lily, apricot kernel and gypsum can help alleviate symptoms, according to official guidelines from the Chinese National Health Commission.

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The use of Chinese medicine has been supported by the national medical authorities during most recent pandemics, including the H1N1 flu outbreak in 2009 and H7N9 in 2013.

Traditional Chinese medicine has proved effective in shortening the recovery time of patients with mild symptoms, and a mixture of tai chi, acupuncture and massage can help with their mental health, according to Zhang Boli, a Chinese medicine expert with the Chinese Academy of Engineering.

He added that Chinese medicine mostly worked on the human immune system and could not replace invasive forms of treatment such as life support.

“It’s pointless to argue if it’s better than Western medicines and such debates are driven either by ignorance or people with vested interests,” he told state broadcaster CCTV last month.

But Du Bin, director of the intensive care unit of the Peking Union Medical College Hospital, said it was difficult to establish the efficacy of Chinese medicine with standard experiments.

Asked on Monday about the use of traditional treatments for Covid-19, Du said that standard drug tests required parallel tests with fixed doses for fixed duration was different with Chinese medicine.

“Even for patients who may look entirely the same in appearance – at least as far as I can tell – they may require different medications and different dosages every day, and that has rendered a fair comparison impossible or meaningless,” he said.

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Chinese health authorities have published a series of figures trying to prove the efficacy of Chinese medicine.

Official figures showed that more than 50,000 recovered Covid-19 patients have been prescribed Chinese medicine in their treatment.

According to Hubei’s provincial health commission, Chinese medicine has been used on 91.91 per cent of the patients as of mid-March.

In the makeshift hospitals built temporarily to treat patients with mild symptoms, between 94 and 99 per cent of people were given Chinese medicine.

Lao Lixing, former director of the school of Chinese medicine at the University of Hong Kong, acknowledged that these figures could not be taken at face value.

“We do not have statistics as evidence to show which of those should be credited to Chinese medicine,” said Lao, now president of the Virginia University of Integrative Medicine in the US.

But he added that there was no evidence that there was a downside to using it.

“Given the lack of statistics of such, at the very least, we have not heard of cases that have got worse after being treated with Chinese medicine, or evidence showing its conflicting with Western medical treatment. So why stop using it especially at a time when any kind of effective treatment is much needed?” Lao said.

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Scientists are racing to develop a vaccine for Covid-19 and work out the most effective treatments, and some attempts to promote traditional medicine have backfired.

Late in January, state media reported that two laboratories in Shanghai and Wuhan discovered that Shuanghuanglian liquid – a popular herbal remedy used for fever and coughs that contains Japanese honeysuckle, Chinese skullcap and the shrub forsythia suspensa – had the apparent effect of restraining the coronavirus that causes Covid-19.

But some leading Chinese medicine experts urged caution and reminded the public that the drug had not yet been proved effective, and could carry mild side effects.

A push by the government in Lancang county in Yunnan province earlier this month to force students and teachers to take a traditional remedy known as big pot soup prompted a public backlash.

They were told they could not return to school unless they took the remedy, which includes‎indigowoad root and loquat leaves, but the ensuing public outcry forced the authorities to drop the plan and apologise.

Earlier this month the World Health Organisation removed a warning not to use herbal remedies from a “what not to do” list on its website earlier this month – a move critics highlighted as an example of the organisation bowing to pressure from the Chinese government.

In a statement explaining the decision, it admitted that it had removed the advice from the Chinese-language version before doing the same in other languages.

But it said it had removed the advice against taking traditional medicine after it realised that “many people turn to traditional medicines to alleviate some of the milder symptoms of Covid-19”.

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But some scientists have called for caution in using Chinese medicine.

“Care should be taken to not give patients drugs of unknown efficacy, which might be detrimental to critically ill patients with Covid-19,” Xiao Yonghong, an epidemiologist with Zhejiang University’s medical school, wrote in a commentary published in The Lancet early this month. “Clinical trials are urgently required in this context.”

He listed Chinese medicine along with oseltamivir, lopinavir/ritonavir, prednisone and antibiotics as treatments that have not been proved to be effective in treating the disease.

Traditional Chinese medicine supplies on sale in Guangzhou. Photo: EPA-EFE

But the official support for Chinese medicine goes beyond science, with Xi last year describing it as a “treasure” of Chinese civilisation that will help in the “rejuvenation of the great Chinese nation”.

Last month the president called for Covid-19 patients to be given both Chinese and Western medicine and has previously said “lots of people like to have Chinese medicine because it has little side effects, it’s effective and relatively cheap”.

He also said “I myself like Chinese medicine a lot”, but it is not known what treatments he uses.

Vice-Premier Sun Chunlan echoed these comments last year, saying it was part of China’s “cultural self confidence”, a phase used by Beijing to promote national pride and the superiority of the country’s system.

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Beijing has also been keen to present Chinese traditional medicine as an effective treatment as Covid-19 spreads around the world.

Yu Yanhong, Communist Party secretary of the National Administration of Traditional Chinese Medicine, said on Monday that practitioners had been sharing their experience with other countries, including Japan, South Korea, Italy, the US, Iran and Singapore.

She also said Beijing had donated traditional Chinese medicines and acupuncture equipment to a dozen countries and regions including Italy and France.

“We are very happy to share the Chinese experience with the international community, and are willing to let Chinese medicine play a more important role in the pandemic for people of other countries,” said Li Yu, an official with the same body, said last week.

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But Gu Su, political scientist at Nanjing University, warned that “promoting the medicine on ideological grounds could backfire, and such trends have grown more obvious in the past few years”. He added: “Science alone should be left to decide what treatments are better for the patients.”

A doctor in Zhejiang province, who was trained in Chinese medicine before specialising in Western medicine, said he was sceptical about the effectiveness of traditional treatments in treating coronavirus patients as there was little evidence to show they had more than a placebo effect.

“Giving every coronavirus-infected patient Chinese medicine was a national policy passed down to hospitals. The top level has made it clear that as long as the patient can orally ingest the medicine, we have to give them TCM prescriptions,” the doctor, who asked for anonymity because of the sensitivity of the subject, said.

“Even if Western medicine doctors do not agree with some judgments that the Chinese medicine doctors make, no one will speak out against the Chinese medicine doctors’ treatment plans and will only discuss it privately. Who would dare to oppose national policy?”

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