Chinese Herbal Medicine Telehealth Outcomes for Symptoms Possibly Related to COVID-19

Introduction: Given the seriousness of Coronavirus Disease (COVID-19) and long-term sequelae, effective therapies are urgently needed. We are conducting an observational cohort study to describe Chinese herbal medicine (CHM) therapy, outcomes, and safety. Methods: In this prospective, longitudinal, descriptive cohort study, we will observe participants with symptoms related to COVID-19 who consent to participate in telehealth visits and receive individualized CHM. All participants are asked to obtain a COVID-19 test. Licensed practitioners with at least 20 years' CHM practice experience will determine the number of telehealth consultations necessary for each participant. All participants are prescribed individualized CHM dispensed either as raw herbs to be decocted at home or granules. Follow-up at 24- and 48-hours after each telehealth visit will provide clinicians with information to determine if an additional telehealth consultation is necessary. Follow-up is at 3, 6, and 12 months. Results: The study is registered ClinicalTrials.gov and currently enrolling. Fifty-six participants have enrolled to date: 35 (63%) are female and 21 (37%) male;45.83 average age (range 22-69). In total, 191 consultations were administered with an average of 3.35 per participant (range 1-9). In the acute phase of illness, the primary symptom reported was fever/chills (23%), fatigue (16%), and sore throat (13%). All but one participant with acute symptoms (n=48) did not progress to long-haul COVID. All long-haul COVID participants (n=7) recovered. No adverse events occurred related to the intervention. One patient was referred to the emergency room out of caution when symptoms did not adequately improve after the initial consult for evaluation. Conclusion: Describing individualized CHM treatment as a potential COVID-19 therapy will provide vital preliminary feasibility, acceptability, tolerability, effectiveness, and safety data. Findings from our study will inform future controlled trials of individualized CHM therapy for symptoms possibly related to COVID-19. Keywords: Adverse events, COVID-19, Chinese herbal medicine, Telehealth;Cohort study

Creating a chinese herbal medicine database to support a clinical trial for suspected COVID-19

Purpose: Chinese herbal medicine (CHM) is a common therapy and is used alongside conventional medicine in some Chinese and Taiwanese hospitals. While a few trials are published outside of the US examining CHM's impact on coronaviruses, in the United States, before a trial can begin, the Food and Drug Administration requires evidence of safety and effectiveness for each herb to be used. Methods: This project is a literature review of articles needed to pursue prospective controlled research in Chinese Herbal Medicine. We are following the template of a group of NIH-funded researchers who completed a successful botanical application to the Federal Drug Administration (Ritenbaugh et al, 2012). We first received from our expert herbal collaborators a list of the 60 most necessary single herbs needed to treat expected COVID-19 cases. Next, we developed a database to place herbs into the required categories: pharmacology, toxicology, interactions with biomedical drugs, and previous human experience. We searched HerbMed Pro, Natural Medicine, PubMed, Chinese Traditional Herb Database, and the textbook Chinese Herbal Medicine: Materia Medica and Formulas & Strategies v 4 (Bensky et al, 2013. Eastland Press). During the research, systematic reviews and meta-analysis resources were primarily considered. The primary targets included COVID-, viral infection-, and influenzarelated articles as well. Results: All categories in the database have been completed by the authors and we are currently double-checking each other's work. Conclusion: Students are learning what categories of information are necessary to conduct research in the United States, as well as deepening their understanding of evidence-based medicine and integrative medicine. This database will be used to support federal funding for a prospective controlled trial.

COVID-19 pandemic and American acupuncturists: Results of a national survey and lessons learned

Purpose: In the summer of 2020, the US professional acupuncture association, The American Society of Acupuncturists (ASA), surveyed their members concerning members' experiences of the effects of COVID-19 on themselves and their business practices. Our goal is to learn more about members' experiences and gather helpful suggestions that can be shared with other members. Methods: We used the SurveyMonkey platform to survey ASA members. Duplicate entries were removed by the ASA administrator before analysis by Dr. Conboy. With IRB oversight from Massachusetts College of Pharmacy and Health Sciences, we are analyzing responses to consider how the pandemic has influenced the profession. Simple tabulations are used for categorical responses, and grounded theory coding is being used for the free response. We plan to produce a manuscript for the profession and its members. A sociological manuscript will be designed to share experiences of how the pandemic influenced business practices. Results: We received over 5500 responses from ASA members across the United States. Qualitative analyses are finding that while many practitioners had concerns for their business, health of their patients, and their own health, approximately 30% reported hope that they would continue to practice and help patients during the pandemic. Still others saw the lockdown in a positive manner allowing time to help their colleagues, further their own education, and focus on their own self-care. Quantitative analyses suggest that practitioners apply responded to state and local practice guidelines. Conclusions: COVID-19 had unprecedented effects on the East Asian Medicine and Acupuncture Profession. Many practitioners were able to pivot to new methods of practicing, while for some it was devastating. The majority of acupuncturists demonstrated their ability to turn an uncertain period into one of opportunity and learning. Specific examples will be given.

American acupuncturists respond to the COVID-19 pandemic: Results of a national survey

Objective: In the summer of 2020, we surveyed all members of the United States professional acupuncture association, The American Society of Acupuncturists (ASA), concerning their experiences of the effects of COVID-19 on business practices. The goal is to learn more about members' experiences and perhaps gather helpful suggestions that can be shared with other members. Methods: All members of the ASA were invited to participate in the survey by their state organizations between 6/3/ 2020 until 6/19/2020. The survey was administered via the SurveyMonkey (c) platform. The 40 question survey included both close and open-ended questions concerning how the pandemic may have influenced work practices, home life, and professional plans. We used SPSS to tabulate the quantitative responses for presentation. The qualitative responses are being double coded, with analysis directed by Grounded Theory. Results: IRB oversight was attained (IRB#113020C). We received over 5000 responses. Demographics were similar to the population of America acupuncturists. Practitioners reported the ability to respond to federal and local health messages, and if practicing, the ability to find tools necessary for safety. Many used the closure time for education and family activities. Many had concerns for the future of their business even after solution of the pandemic. Conclusion: Not enough is known about the business practices of acupuncturists in the US, and certainly even less is known of how COVID-19 is currently affecting the profession. Similar documents have been produced by other allied health professional organizations, for example Ayurveda.We found that acupuncturists were able to respond to federal and local mandates, and modify business practices to meet the needs of public health during the pandemic.