As COVID-19 continues to wreak havoc across the planet, hospitals have repurposed drugs like remdesivir, an antiviral, and dexamethasone, a cheap steroid, to combat the deadly disease. Meanwhile, Chinese scientists and pharmacologists have been looking to the ancient wisdom of Eastern medicine to explore approaches American biomedical researchers would never consider.
At the tail end of the worst of China’s own COVID-19 outbreak, the government there claimed that more than 92 percent of patients nationwide had been treated with traditional medicines, some of which lean on substances like honeysuckle, magnolia bark, rhubarb, sweet wormwood and, of course, forsythia—of Contagion fame.
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The last 20 years have yielded medical advances beyond imagination, from mRNA vaccines to robotic surgery. Yet those figures from China approach twice the percentage of patients treated with traditional methods—or an integration of traditional medicine and biomedicine—during the SARS outbreak of 2002-2003.
Experts on traditional Chinese medicine will tell you this is because the stuff actually works—or at least, is worthy of serious study.
Take Jinhua Qinggan, which is made from ingredients like honeysuckle, licorice, and sweet wormwood, and which was used in the H1N1 and SARS epidemics, when peer-reviewed research found its key ingredient helped get rid of fever. Now, the medication is one of several new purported treatments for coronavirus-related fever, cough, and fatigue already available on the market in China. Or Lianhua Qingwen, which contains plants including forsythia, rhubarb root, and more honeysuckle. It may help treat those same symptoms and was found in a peer-reviewed study published in June in Pharmacological Research, to inhibit SARS-CoV-2 (novel coronavirus) replication. It, too, is available in China, where the government deemed trial results so promising, they donated 100,000 boxes to Italy.
Systematic reviews and meta-analyses have indicated that Chinese medications like these may be beneficial for the treatment of COVID-19 in “improving clinical symptoms, imaging, and laboratory indicators, shortening the course of disease, and reducing the number of severe cases.” But at the end of the day, the original trials are too small and preliminary to be sure.
At a time when everyone is looking for a COVID cure—or at least safe, effective treatments—it is easy to write off anything involving, say, honeysuckle as “woo woo.” But those who don’t write it off may see it translate directly into promising biomedical advances. In a new study published this month in Cell Discovery, researchers from Nanjing University, the Wuhan Institute of Virology, and the Second Hospital of Nanjing found that a drug derived from honeysuckle, MIR2911, may be able to suppress SARS-CoV-2 infection and “directly and sufficiently inhibit” SARS-CoV-2 viral replication.
The research follows previous studies in which the Nanjing University group found indications that the plant-derived mRNA could directly target viruses like H1N1 and H5N1. The group is now preparing for a clinical trial.
Zhang, director of the Advanced Institute for Life Sciences and a professor of biochemistry at Nanjing University, told The Daily Beast via email that the compound is no different from other mRNA-based treatments being developed in U.S. and European labs—including the basis for several leading Western coronavirus vaccine candidates. “The only difference [with] the synthetic drugs is [this is] just produced by a natural product,” he said.
He added that honeysuckle, among other substances commonly used in traditional medicine, is an especially popular focus for COVID research in China right now.
To even have the idea to investigate the potential of honeysuckle mRNA, Zhang and colleagues had to be versed in—or at least open to—its centuries, if not millennia, of established use as a medical treatment.
Marta Hanson, a historian of Chinese medicine and public health and an assistant professor at Johns Hopkins University, said the media is quick to criticize the “quackery” of traditional medicine—an attitude that dates back as far as Chinese medical texts’ first translations into Latin and European languages. But even if she is speaking as a historian rather than a physician, she does believe Chinese therapies and traditional approaches may prove useful.
One recent and prominent example, Hanson said, was the breakthrough discovery of Chinese researcher Youyou Tu, who worked on Chairman Mao’s top-secret Project 523 to help find a new drug to treat malaria beginning in 1969. In 2015, she was awarded the Nobel Prize in Physiology or Medicine for the discovery of malaria drug artemisinin, derived from extracts of a plant used in traditional Chinese medicine since the fourth century.
“That’s why we should maximize our engagement with people who are working in China,” Hanson told The Daily Beast. “Otherwise, we’re losing opportunities for things that come out of the plant world.”
Hanson believes there should be more money put into finding pharmaceutically active drugs by prospecting in traditional medicine, but further, that support for continued education and training in traditional medicine is critical.
“These are not ‘cures,’ but they do help alleviate symptoms, and that is the Chinese medical position,” she said. “The approach, just like [Chinese medicine expert] Shelley Ochs eloquently says, is to alleviate the symptoms as they present themselves and look for a larger pattern. … If you don’t train people in that way of thinking, you lose the rationale for how these formulas were used for hundreds of years before.
So far, coverage of China’s research in traditional medicines to address COVID symptoms has been limited, and the position of the media has been one of deep skepticism. Breitbart jumped on the bandwagon to cover China’s “pressuring” Africa to adopt “‘traditional medicine’ coronavirus cures.” Helen Tilley, a medical historian at Northwestern University, observed in a May paper in the journal Somatosphere: “These articles pit ‘science-based medical communities,’ characterized as trading in real diagnoses and effective treatments, against China’s state-based initiatives on ‘traditional medicines,’ which are described as having scant evidence or scientific-backing to support them,” speculating that this dialogue may have more to do with geopolitics than public health.
As America’s COVID numbers continue to tick upward and as the 2020 election grows closer, this politicization has only intensified. Widespread criticism of Russia’s hastily approved vaccine rings disingenuous to some vaccine experts as the U.S. spends $1.5 billion on its own not-yet-approved vaccine, potentially putting political pressure on the regulatory bodies who need to objectively evaluate it. When hydroxychloroquine was branded by the president as curative despite a lack of sufficient data confirming its safety, it began appearing right alongside #MAGA as a campaign rallying cry.
Trump has also reportedly embraced a new unfounded cure in oleandrin, which, ironically, happens to fall into the category of traditional Chinese therapeutic herbs. Beyond the absence of even a single peer-reviewed study on the substance’s efficacy against COVID-19, medical ethnobotanists are sounding the alarm because oleandrin is a compound derived from the poisonous oleander plant, improper use of which could be “particularly dangerous.”
Dr. Morgan Prust, a fellow in neurocritical care at NewYork–Presbyterian Hospital who treated ICU patients through the peak of coronavirus in New York City, told The Daily Beast that, as with hydroxychloroquine, he can’t evaluate the potential benefits of traditional Chinese medicines without large-scale, peer-reviewed research. For the most part, he said, traditional treatments exist in the U.S. as herbal supplements that lack rigorous demonstrations of efficacy and safety, not to mention a regulatory framework for their distribution and manufacturing that is subject to the same levels of scrutiny that pharmaceutical medications are.
“Randomized control trials are incredibly expensive and usually require funding either from a government or a large and wealthy pharmaceutical company,” Prust said. “So nobody’s going to fund a large, rigorous, controlled study on something where A) there isn’t a lot of data to support that it actually might be useful and B) where there isn’t somebody that stands to make a profit on it at the end of the day.”
As long as the big money of big pharma remains the Western authority on what is curative and what is quackery, the potential of traditional Chinese medicine in a pandemic or otherwise will remain, as Prust put it, anecdotal.
“In terms of the market forces that govern drug development in this country, there is no incentive to study things like this,” he said.
