By: Shelley Ochs and Thomas Avery Garran ~ Published by Brill in Asian Medicine – Journal of the International Association for the Study of Traditional Asian Medicine
The mobilization of Chinese medicine resources in the 2020 COVID-19 epidemic in Hubei, China, was part of the larger mobilization of society and multiple tiers of the healthcare system. In this article we describe how Chinese medicine teams organized treatment and prevention, how they conceptualized this treatment and evaluated the results, and what this may contribute to our understanding of how traditional medical traditions can be safely and effectively integrated into modern epidemic treatment and control.Keywords: Chinese herbal medicine; COVID-19; Wuhan; integrated medicine; Chinese- Western medicine
One of the new terms coined by the press during the COVID-19 public health crisis in China was “people going against the flow” or “people putting themselves in harm’s way to serve others” (nixingzhe 逆行者). This expression succinctly conveyed that while many others were traveling to their hometowns to celebrate the Lunar New Year holiday, medical personnel were going in the opposite direction toward a poorly understood, rapidly spreading viral epidemic. This was a small army of “angels in white coats” (baiyi tianshi 白衣天使), another popular epithet: 42,600 medical personnel from all over the country were sent to aid Hubei Province.
Since large-scale mobilizations of people and resources in a public health emergency can only be orchestrated by local and national government authorities, the campaign to fight the epidemic (kangyi 抗疫) was primarily top-down. The Chinese government spent an average of 23,000 RMB(approximately 3,550 USD) per person for medical treatment, with an average expenditure of 150,000 RMB (approximately 23,000 USD) for severe and critical cases. This included 3,000 people over the age of 80, and seven persons over 100 years of age. By May 31, 2020, a total of 1.3 billion RMB (approximately 200 million USD) had been spent on treatment and prevention by various government agencies.1 Although we cannot take the exact set of measures that were implemented in China and apply them to other societies and healthcare systems without significant modifications, nevertheless how China has (and is) controlling the epidemic is worthy of study, and, frequently, praise.
However, evaluating the successes and failures requires that we also look at the bottom-up contributions of ordinary people. For example, Dr. Zhang Boli, the leader of the Chinese medicine teams sent to Hubei, described his surprise when he discovered that the volunteer who took him from his hotel to the hospital on his first day in Wuhan was from Heilongjiang, a province far to the north.2 The man drove his own car the 2,300 kilometers (approx. 1,430 miles) to Wuhan, paying for his own gas, to help transport medical personnel around the city as all public transport was halted due to the lockdown. Tens of thousands of people in cities across the country volunteered at fever checkpoints, delivered meals and medicine to the elderly, performed throat swab tests, and supervised social distancing for the millions who were tested. In Wuhan, citizens would anonymously order meals and simply have them delivered to the hospitals in the city so that doctors and nurses would have food despite the strain on their kitchen canteen staff.3
The mobilization of Chinese medicine resources was part of this larger mobilization of society and multiple tiers of the healthcare system. Below we describe how Chinese medicine teams organized treatment and prevention, how they conceptualized this treatment and evaluated the results, and what this may contribute to our understanding of how traditional medical traditions can be safely and effectively integrated into modern epidemic treatment and control.
As it became clear that the epidemic in Wuhan was going to be both severe and drawn out, discussions of the role of Traditional Chinese Medicine (TCM) in historical responses to epidemics in China began to appear on both scholarly and popular media platforms in China. For example, a five-part documentary news series on the role of Chinese medicine in fighting the epidemic in Hubei devoted a good deal of the first episode to reviewing how classical herbal formulas were developed and used in epidemic outbreaks throughout Chinese history. The National Administration of Traditional Chinese Medicine (NATCM)4 published a colorful scroll of cartoon drawings on its official social media site to bring this history to the public.5 The scroll begins in the Han dynasty and takes us up to the present day, reviewing the use of Chinese herbal medicine to treat smallpox, cholera, typhoid, Japanese encephalitis, bubonic plague, influenza, and severe acute respiratory syndrome (SARS). Before the influx of Western medicine in the nineteenth century, sophisticated theories and methods from within the tradition of medicine and medical literature in China were used to address these conditions.