Clinical practice and safety of acupuncture in the COVID‐19 pandemic: Lessons for the next pandemic — have there been any changes in the empirical knowledge of acupuncturists and physicians practicing traditional medicine since the outbreak of COVID‐19? “1st International Symposium on Kampo Medicine”

To the Editor

In 1918, during World War I, the Spanish flu swept the entire world. Slightly more than 100 years later, in March 2020, the WHO declared a pandemic for a new coronavirus infection. While this outbreak is not over, Russia's military invasion of Ukraine broke out in February 2022, which added more difficulties to the existing pandemic. Wars have been repeated throughout the long history of the world and the SARS‐CoV‐2 mutation is still occurring, with no end to either. We still share these catastrophic incidents at this moment.

In the last 100 years, the development of vaccines and antiviral agents has seen remarkable progress. Even before that, traditional herbal medicine, acupuncture and moxibustion have been used to manage infectious diseases. In conventional medicine, there is no specific treatment method for infectious diseases such as COVID‐19. However, traditional herbal medicine, acupuncture and moxibustion may treat COVID‐19 symptoms effectively. Traditional medicine, which originated in East Asia, has now spread throughout the world as complementary and alternative medicine (CAM). Since the pandemic outbreak, clinical trials of traditional herbal medicine against SARS‐CoV‐2 have been actively conducted by researchers around the world, and the Japan Society for Oriental Medicine is no exception [1]. Although there is no specific acupuncture treatment for COVID‐19 itself, there are treatments for post‐COVID‐19 psychiatric symptoms and other symptoms caused by COVID‐19 infection [2, 3]. Practitioners are still committed to their daily clinical work for COVID‐19 patients and its related chronic conditions under these circumstances.

In this session, internationally active doctors and acupuncturists who overcame the unprecedented ordeal of the COVID‐19 pandemic hope to give us the wisdom to be ready for future pandemics based on their clinical experiences.

The first presentation is “Acupuncture Practice During the COVID‐19 Pandemic — My Experience in London.”

The pandemic has impacted all aspects of our lives with the first wave leaving people feeling anxious and with a fear of the unknown. This situation was new for everyone and affected healthcare professionals without exception, in particular those in close‐contact services, including acupuncturists. In this presentation, I will share my personal clinical experience and reflection through the pandemic, such as how it required changing the way I run my acupuncture and Kampo clinic; how it affected my patients and myself; what kinds of clinical complaints I have seen more of; and whether I treat Long COVID patients. In addition, I will discuss how I re‐learned the importance of practice management with an example of a case in which a potential new patient did not agree to wear a face mask. Although medically exempt from wearing one, I could not treat her without compromising the safety of my other patients. Everything done was with the number one priority of providing a safe environment for both patients and practitioner. If we have to face similar challenges again in the future, we have some key points to learn that will help us in the next ones.

The second presentation is “Different Faces of Long COVID in View of Five Elements — Perspective as a Heilpraktiker in Germany.”

If I remember right, it is now three years since I first heard about the “corona” virus.

From the time of the outbreak until now, the delta, omicron and omicron‐BA2 mutant strains of COVID‐19 have emerged one after another. During treatment and from observations in my clinic I have noticed that, depending on the mutations of each virus strain, symptoms at the time of infection are different.

The post‐infection symptoms, like Long COVID, seem to change little by little.

The number of patients with Long COVID and post‐vaccination symptoms that are coming to me for treatment is increasing rapidly. I observed those symptoms from the point of view of the five elements.

The third presentation is “Impact of COVID‐19 on California Acupuncturists and Future Perspective.”

California entered the state of Shelter in Place on March 16, 2020. People stayed at home, and the highways became empty. Many businesses, including acupuncture clinics, were forced to close for a while. Acupuncture & Integrative Medicine College, Berkeley (AIMC)'s didactic courses quickly shifted to online, and all clinical visits shifted to telehealth. Since we started seeing patients in person again, we have significantly improved safety precautions within the facility to prevent the possibility of cross‐infection. Patients have gradually returned to the acupuncture treatments.

Acupuncturists here in California are eager to treat the variety of symptoms experienced by post‐COVID patients with acupuncture and Kampo/Chinese herbal formulas. Additionally, our hope is that in the future, acupuncturists will be able to treat patients with active COVID‐19. More importantly, we aim to strengthen people's immunity by providing regular acupuncture treatments to the public and playing a part in preventing future pandemics.

The fourth presentation is “An Experience of Post‐Acute COVID‐19 Syndrome Treatment with Acupuncture and Herbal Medicine.”

We report a case of a 52‐year‐old man who was diagnosed with COVID‐19 on September 6, 2021. One week prior to diagnosis, he presented with fever after his first COVID‐19 vaccination. However, he was only diagnosed with COVID‐19 and admitted to the hospital when pneumonia was evident on computed tomography. Two weeks after admission, headache, sweating, fatigue, and insomnia persisted. He first visited our clinic on October 8, 2021. He was diagnosed with post‐acute COVID‐19 syndrome and received five sessions of acupuncture treatment and herbal medicine until December 3, 2021. The selected acupoints were EX‐HN5, CV17, EX‐HN3, ST8, GV20, LI4, ST36, LR3, BL2, TE23, GB17, and ST1. The purpose of acupuncture treatment was to manage headache and fatigue. A decoction of the herbal medicine Sasam‐maekmundong‐tang (Sasam‐bakumondo‐to) and a granular powder extract of Siho‐ga‐yonggol‐moryo‐tang (Saiko‐ka‐ryukotsu‐borei‐to) were administered to control fatigue and insomnia, respectively. The Fatigue Severity Scale score of the patient decreased from 48 (first visit) to 18 (last visit). Headache, insomnia, and sweating disappeared completely after treatment. This case demonstrates the possibility of post‐acute COVID‐19 treatment with traditional Asian medicine. Further prospective clinical trials are needed to assess treatment efficacy.

CONFLICT OF INTEREST

The authors declare no conflicts of interest in this work.

APPROVAL OF THE RESEARCH PROTOCOL BY AN INSTITUTIONAL REVIEWER BOARD AND THE APPROVAL NUMBER

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INFORMED CONSENT

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REGISTRY AND THE REGISTRATION NO. OF THE STUDY/TRIAL

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ANIMAL STUDIES

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