COVID-19 and Homoeopathy: An opportunity to gain the lost ground?

The COVID-19 pandemic is far from over. After two deadly waves, we are still staring at the possibility of subsequent ones. It is difficult to fathom the aftermath each wave leaves behind.

Homoeopaths have always claimed the utility of homoeopathy as an effective treatment modality for pandemics, based on its undeniable role in managing the Spanish flu^[1] and other epidemics. Hence, when COVID-19 began, there was a lot of buzz of positioning homoeopathy to ride the crest of the wave! Unfortunately, as a profession, we faltered and the ‘known devils’ stepped in to ridicule and criticise homoeopathy in print and on social media.^[2] Little was it realised that we were in a situation where all were shooting in the dark; the loudest voices claiming victory were shouted down by the subsequent ones announcing ‘success!’^[3] The relentless march of the illness continued among the rich and the poor, the west and the east.

Global events of this nature always call for massive research and development. Vast swathes of information which has been generated, should be applied in practice, analysed, evaluated, reviewed and published. What is not effective should be discarded. This is the way any new scientific knowledge is generated. To cater to the extraordinary demands of the time, globally-academic peer-reviewed journals, scholarly publishers and scientific websites have stepped up to make new knowledge openly available and deliver new insights quickly. Many leading journals and publishers have modified their editorial procedures and policies to warrant fast dissemination of relevant information.^[4] Under these conditions, accidents are bound to occur. Yet, these gross errors are never ridiculed or condemned. It is claimed that one learns through errors; except, homoeopathy is not allowed the luxury of errors.

Policies, treatment protocols, treatment modalities, vaccines and their efficacy, drug therapies and newer investigations are being studied, reviewed, revised, modified and published in all medical specialties. Hence, if we are to demonstrate the efficacy of homoeopathy, we need to publish our results in peer-reviewed scientific journals. Reporting individual cases of COVID-19 treated with homoeopathy are welcome, but that should not lead us to sensationalism through making tall claims without a thorough clinical review. We must encourage randomised trials; preferably, in conventional hospitals or public medical institutions and follow strict, accurate protocols and standard operational procedures. Every step must be documented, the studies appropriately supervised and all effort made to publish results (positive or otherwise) in peer-reviewed journals.^[5]

Has homoeopathy somehow missed the bus in the aspect of seeking knowledge in this orderly fashion? If one does a simple search for scholarly articles on homoeopathy and COVID-19, one gets a limited number of papers in quality peer-reviewed journals. Most papers are individual case reports/ experiences of COVID-19^[6,7] or are focused on the clinical repurposing of homoeopathic drugs, based on their previous pharmacological studies.^[8-10] In some papers, the frequently appearing symptoms are recorded and studied to come up with a repertorial analysis based on symptom matching.^[11] A retrospective cohort study demonstrated the role of homoeopathy along with conventional treatment based on the government guidelines and identified the frequently used homoeopathic medicines in COVID-19 cases; however, this study also reported limitations with regard to the assessment of the definite role of homoeopathy in terms of clinical improvement and laboratory parameters.^[12]

The need of the hour is to conduct homoeopathic clinical trials (especially RCTs) in moderate and severe hospitalised cases of COVID-19. However, seeking permissions and getting clearance of the ethical committees of the superspeciality hospitals for such trials are a difficult task.^[13]

In this issue, we are pleased to publish an RCT conducted by Phansalkar et al. at a tertiary care hospital in Pune, India, that aimed to understand the efficacy of indicated homoeopathic medicine as an adjuvant to standard treatment in improving the subjective and objective parameters in patients with mild-to-moderate COVID-19.^[14] To the best of our knowledge, very few studies worldwide have attempted to study this in such a structured manner. Not only did the ethical committee of the superspeciality tertiary care hospital subject it to a thorough scrutiny but also they reviewed and monitored the entire study. The findings of this study will surely lay down a road map for more research on these lines and help the profession to plant its feet firmly on the ground where rapidly changing treatments have ruled the roost.

To enhance acceptance and publication of clinical trials in homoeopathy, confirmatory laboratory/imaging studies on patients are important.^[15] Such studies help a more effective demonstration of the efficacy of homoeopathy to the scientific community. In this issue, we have two such original papers. Lobo. B demonstrates the efficacy of homoeopathic medicine Hamamelis 30C in the management of varicose veins and its complications using revised venous clinical severity score tool and peripheral venous Doppler study.^[16] Mathur et al. demonstrated a positive correlation between patient age and the severity score of lower urinary tract symptoms in men aged 50 years and above visiting a homoeopathic hospital.^[17]

There is also a growing need to study clinical trials and/ or experimental studies on the pharmacological effects of homoeopathic medicines. These studies open newer dimensions to study homoeopathic Materia Medica. Rehman. T presents a scholarly review of clinical trials and/ or experimental studies on the pharmacological effects of the homoeopathic medicine, Nux vomica.^[18]

COVID-19 has irreversibly changed the world and peoples’ lives; it has also changed the way medicine is practiced. Change has become not just a thought, but the burning need of the hour.

This is the time to recall the lines of the song ‘Who Knows Where The Time Goes’ written by English Singer – songwriter Sandy Denny:

‘Before the winter fire,

I will still be dreaming,

I have no thought of time.

For who knows,

where the time goes?

Who knows,

where the time goes?’^[19]

Time flies, it never waits. Homoeopathy must not rest on its past laurels and claim to have found a cure for COVID-19. We will need to prove this; not by just talking, but by demonstrating the efficacy and subjecting the results to the scrutiny of the scientific world in a time-bound manner.