ABSTRACT
Prolonged cough in coronavirus disease 2019 (COVID-19) is not only uncomfortable for patients, but also prolongs the length of stay in an isolation facility. This results in delays in patients' return to their daily life. Therefore, the prompt treatment of cough is important. In this report, we used Japanese traditional (Kampo) medicine, chikujountanto for the treatment of cases with residual cough, airway secretions, slight fever, anxiety, and insomnia, several days after the onset of coronavirus. From October 2020 to September 2021, we prescribed chikujountanto for thirty-three COVID-19 patients with prolonged cough in an isolation facility. Seven patients (6 women and 1 man with ages ranging 37-70 years) were treated with no other medication. Comorbid symptoms included slight fever, sputum, sore throat, nasal discharge, headache, anxiety/insomnia, and taste/olfactory disorders. The start date of treatment ranged from 9 to 21 days after the onset of COVID-19, and the time until cough and comorbid symptoms improved to values less than NRS 2 or less, was 2 to 6 days after treatment. Three patients had persistent cough and needed to switch to other medication. In COVID-19, chikujountanto may be useful for coughing during the period when the peak of the viral proliferative phase has passed but airway inflammation is still present.
ABSTRACT
This paper studies the social acceptability and feasibility of "herd immunity" strategies against coronavirus disease 2019 (COVID-19). To this end, we propose a control scheme that aims to develop herd immunity while satisfying the following two basic requirements for a viable policy option. The first requirement is social acceptability: the overall deaths should be minimized for social acceptance. The second is feasibility: the healthcare system should not be overwhelmed to avoid diverse adverse effects. Exploiting the fact that the severity of the disease increases considerably with age, the proposed control scheme protects high-risk individuals that mainly consist of the elderly. The protection of high-risk individuals reduces the average severity of the disease in the unprotected population, thereby substantially reducing mortality and avoiding the collapse of the healthcare system. Social acceptability (in terms of the resulting mortality) and feasibility (in terms of the healthcare system capacity) of the proposed herd immunity strategy are summarized into two respective, easily computable conditions by building on a simple susceptible-infected-recovered (SIR) model. For its parsimony, the proposed framework can provide a rule of thumb that applies to various populations for studying the viability of herd immunity strategies against COVID-19. For Japan, herd immunity may be developed by the considered control scheme if [Formula] and the severity rates of the disease are 1/10 times smaller than the previously reported value, although as high mortality as seasonal influenza is expected.
