While I never attended Bastyr University, I did work an intense and heady 6-year span there from 1983-1989 as John Bastyr College of Naturopathic Medicine transitioned to Bastyr College on its way to its present stature. We fought to make it the first broad-scope education in natural health sciences to gain accreditation via a United States Department of Education approved agency. That winning campaign – an overt battle against antagonistic cultural political forces – was for me a sort of Marine Corp experience resulting in a Semper Fi! that, while its had its ups and downs, has at minimum left me paying attention to Bastyr’s work and that of its graduates. So when the Seattle Times published an article on the COVID-19 research at local conventional medical institutions, I recalled two significant action of Bastyr graduates relative to COVID-19 that merited mention. I drafted an Op-Ed that was rejected. They noted that they are seeing “an unprecedented number of Op-Ed submissions on the coronavirus” and finished with a kind (if routine) door-closing statement: “Respectfully, I am going to pass on it, but I hope you find a publication able to take it.” I decided to visit it on you.
The Seattle Times front page feature on COVID-19 research at the University of Washington and Kaiser Northwest Permanente Research Institute (“Potential treatments fast-tracked”, March 30, 2020) shared how Seattle’s initial status as a COVID-19 hotspot is fueling important research work on the virus at these exceptional research centers.
Not mentioned in the article were potentially valuable initiatives relative to our collective response to COVID-19 in which two graduates of another local medical institution, Bastyr University, are taking a national lead. The directions these Bastyr graduates are promoting are toward understanding an optimally “integrative” approach to COVID-19.
Notably, the Chinese government credits part of its success in reversing COVID-19’s path to thorough integration of traditional Chinese medicine with their well-developed biomedical infrastructure. Integrative medicine strategies were used with over 90% of Chinese patients. Shall we choose to deny this asserted value out-of-hand?
The Seattle Times writers are not alone in failing to report whether research on an integrative model might have dividends. In contradistinction to the Chinese government, the U.S. federal government has long been unfriendly to natural health practices – although this has begun to shift. The reason was another crisis: opioid abuse in chronic pain management. Thanks in part to 25 years of U.S. federal investment in integrative medicine research we’ve begun to see multiple non-pharmacologic, integrative methods included in pain guidelines.
Many consumers and integrative practitioners are not comfortable with the official U.S. government silence relative to such approaches relative to COVID-19. Opening paths for dialogue and understanding is where Bastyr’s naturopathic graduates are leading.
A key initiative is led by former Bastyr clinical medicine director and botanicals chair Lise Alschuler, ND. Alschuler is presently a Clinical Professor and Assistant Program Director of the Fellowship in Integrative Medicine at the University of Arizona Andrew Weil Center for Integrative Medicine. The Weil center is the most influential of the now 75 medical school with integrative medicine programs.
Alschuler led a team that included Weil – perhaps the best known of integrative medical doctors – to produce a paper entitled “Integrative considerations during the COVID-19 pandemic.” The article was fast-tracked into publication March 26, 2020 in the peer-reviewed journal Explore: The Journal of Science and Healing.
The authors are not claiming curative action. On the contrary, they begin and end with the critical caveat: “… no integrative measures have been validated in human trials as effective specifically for COVID-19.” They stress that their focus is on “supplemental considerations.” Yet they also underscore that “this is an opportune time to be proactive.”
The Alschuler-Weil team share research on natural immunostimulatory and anti-viral action of over a score of natural agents. These may be found in foods, teas, and supplements. Among those discussed are multiple products regularly discussed on social media and in practitioner newsletters relative to COVID-19 such as zinc, elderberry, curcumin and Vitamin C. The authors address safety issues. The short paper is backed by 56 citations.
We know that uncounted numbers of consumers and practitioners are using such agents. Yet what value, if any, are these practices providing? This question stimulated Bastyr graduate and former Kaiser research associate (when it was Group Health Research Institute) and current Associate Professor at the University of Washington School of Pharmacy Ryan Bradley, ND, MPH to lead a team that has created a global “Traditional, Complementary and Integrative Health and Medicine COVID-19 Support Registry.”
The project secured Institutional Review Board approval mid-March and is hosted on a secure server through the Helfgott Research Institute, which Bradley presently directs, at Portland’s National University of Natural Medicine. It’s taking patient experience information from practitioners as I write.
The Registry is gathering basic data (patient symptoms, COVID-19 status, comorbidities, pharmaceutical agents being used) and the therapeutic goals (“prevention, treatment, health promotion, recovery/convalescence, rehabilitation, other”). The menus include agents sometimes used for immune support (12), anti-viral activity (13), respiratory health (15), inflammation (18) and more. It concludes with outcomes. The practitioner who submits the data can re-enter the file and make changes.
The project quickly caught the attention of many integrative health organizations that are promoting it. Robust capture of cases will serve the public health in multiple ways – including providing data for the generation of hypotheses regarding both promising and potentially harmful treatments and protocols.
One lesson we are already learning through the COVID-19 pandemic is that a medical industry equipped for heroic measures for acute and chronic conditions is not necessarily a healthcare system prepared for a public health crisis. Historic underspending on public health has clearly harmed our health.
The integrative practice communities like naturopathic doctors position themselves between these two worlds. Practitioners promote self-care and clinical services that assist in prevention, in complementing biomedical treatment, in rehabilitation and in health enhancement.
The work that these naturopathic physicians educated in the Seattle metropolitan area’s other medical school is at the forefront of creating a USA version of the “integrative” strategy that China credits for its success and applied through its distinctly Chinese methods.
Might this also be an opportune time to respect rather than dismiss the model, and look to the leadership from graduates of another local medical institution, to make sure we turn over this other stone in efforts to find an optimal way through this time? Might COVID-19 be a wake-up call for investment in researching the value of the already evidence-informed integrative practices?
Post-note: I have been around long enough to know that it was likely suicide to submit without cutting close to half the 850 words. I liked what I’d written and figured I’d cut if they asked me to. I chose not to call or push after the reject and so have no idea the extent to which bias may have come to play in this. With the politicization of “alternatives” by the U.S. president, a decision to publish something like this might have been felt as unnecessary stimulation of the actual quackery that the president has espoused. Glad to have another audience on which to visit these more sober views of the potential from integrative practices!