Journal of Indian System of Medicine

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 9  |  Issue : 4  |  Page : 242--246

A cross-sectional survey on awareness and practice of Ayurveda in COVID prevention and management among selected populations across Kerala


Dinesh Karayil Subramanyan, Geethu Balakrishnan, Anju Sathian 
 Department of Kaumarabhritya, Vaidyaratnam P.S. Varier Ayurveda College, Kottakkal, Kerala, India

Correspondence Address:
Dr. Dinesh Karayil Subramanyan
Department of Kaumarabhritya, Vaidyaratnam P.S. Varier Ayurveda College, Thusharagiri House, Changaramkulam, Alankode P.O., Kottakkal 679585, Kerala.
India

Abstract

Background: Despite the known richness of traditional medicine in India, it has not been implemented successfully on a widespread scale in managing COVID-19.4 In this context, it was reported that the state of Kerala reduced the mortality rate and rapid spread of the infection in the first year of managing patients with COVID-19. This cross-sectional survey was conducted at the present juncture for analyzing the impact of Ayurveda amid a selected populate of Kerala for its facets of health practices, home remedies, lifestyle guidelines, and medicines. Aims: To study the extent of awareness among a selected population across the state of Kerala pertaining to the usage of Ayurveda medicine and lifestyle guidelines. Settings and Design: A structured questionnaire was developed on a web-based platform of the survey monkey application and was made available to 2688 people via social media groups. Results: Among the studied respondents across Kerala, a majority were aware about the existence of preventive medicine (75%) and Ayurveda treatment (67.5%) for COVID-19. Against this background, about 77.5% of people had undergone either Ayurveda treatment or home remedies and also 82.5% of people had changed their lifestyle with Ayurveda for the same. Conclusion: The population of India, in particular that of Kerala, are inextricably connected with Ayurveda through the multiple facets of their culture, food, and lifestyle guidelines. The people of Kerala are immensely acclimatized to adopt Ayurveda as an alternative system of medicine as it has been deep-rooted in their daily subsistence over ages and was well reflected here in this study.



How to cite this article:
Subramanyan DK, Balakrishnan G, Sathian A. A cross-sectional survey on awareness and practice of Ayurveda in COVID prevention and management among selected populations across Kerala.J Indian Sys Medicine 2021;9:242-246


How to cite this URL:
Subramanyan DK, Balakrishnan G, Sathian A. A cross-sectional survey on awareness and practice of Ayurveda in COVID prevention and management among selected populations across Kerala. J Indian Sys Medicine [serial online] 2021 [cited 2022 Jan 24 ];9:242-246
Available from: https://www.joinsysmed.com/text.asp?2021/9/4/242/334262


Full Text



 Introduction



The dark menace related to a pandemic outbreak such as COVID-19 emerged in China in the late 2019 and continues to spread rapidly among the global population.[1] The whole world has still not revived of the shock created by the prevailing series of events that occurred as a result of the very first case of pneumonia of an unknown cause detected in Wuhan, China on 31 December 2019 to the declaration of the novel coronavirus outbreak as a Public Health Emergency of International concern on 30 January 2020.[2] Even so in this scenario where the whole health-care guild and researchers are knocking every vestibule of the health-care system for a redress to restrain the phage flareup, other side reports are emerging on how China has contained it in a beautiful way to a death rate of less than 5000 with the help of its own Traditional Chinese Medicines (TCM) and is still maintaining the rate.[3] The Chinese medical community accumulated with valuable TCM experience have availed themselves of the same at different levels of COVID management and thus could largely dwindle the casualties.[4]

 Background/Rationale



Across the globe, there exists an ambiguity among the populace stumbling in the lack of light of consistent facts on the safety and efficacy of COVID management, including the usage of vaccines.[5] The public has been barraged with apprehensions on health and prevention conflicted by pooled-up COVID messages on hiked mortality rate on the one hand and claims from the different traditional medicinal systems such as Homeopathy, Ayurveda, and Acupuncture in successfully managing COVID cases on the other hand.[6] Such a cauldron of dilemma is escalated among the people of Kerala, with the highest literacy rate of the country being 90.9%[7] and increased Internet access. The increasing affinity of the Kerala population toward the traditional systems could be accorded to the same, being part of their culture over years.

Despite the known richness of traditional medicine in India, it has not been implemented successfully on a widespread scale in managing COVID-19.[8] In this context, it was reported that the state of Kerala reduced the mortality rate and rapid spread of the infection in the first year of 2020 by managing patients with COVID-19.[9] For several decades, the populace of Kerala (about 36.4%) have been relying on Naturopathy, Homeopathy, and Ayurveda of the AYUSH (Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy) system[10] and the systems of AYUSH are evenly distributed within the state, with every panchayat having an AYUSH hospital.[11] Being a fourth tier, the people of Kerala have been using the AYUSH system, especially the principles of Ayurveda, as an integral part of their tradition and culture in a multitude of aspects, including lifestyle, medicine, food etc.[12] Recently, the Kerala government has also started availing the AYUSH system for overcoming the undulations created by managing mild COVID-19 cases. Ahead of this survey, 768 dispensaries and 119 hospitals under the Indian System of Medicine (ISM) have so far started prescribing Ayurveda medicines intensively for coping with primary contacts, mild invalids, and post-COVID convalescence by wielding their lattice. This cross-sectional survey was conducted at the present juncture for analyzing the impact of Ayurveda amid the selected populate of Kerala for its facets of health practices, home remedies, lifestyle guidelines and medicines. Driven by the need-based demand, faster growth in the Ayurveda industry has been observed in the state of Kerala,[13] getting utilized for satisfying the primary health-care needs. In this regard, this survey was planned to evaluate whether such a response still stands true in the COVID-19 scenario as modern medicine is still taking the lead in its management.

Aims and Objectives

To study the extent of awareness among a selected population across the state of Kerala pertaining to the usage of Ayurveda medicine and lifestyle guidelines.

 Subjects and Methods



This was a cross-sectional general public-based survey conducted among the selected masses all over the state of Kerala who were not professionally related with Ayurveda. However, only those participants were recruited for the study who were linked with any of the nine faculties working in the department of Kaumarabhritya, Vaidyaratnam P.S.Varrier Ayurveda College where the study was carried out or related with any of the Ayurveda practitioners who are active members in WhatsApp groups related to Ayurveda. Data collection was done by a web-based survey proforma questionnaire, and the period of data fetching comprised one week starting from 3 June 2021 to 10 June 2021. With the quick turning around and sharing of news on the social media, there is no delay for today’s story becoming tomorrow’s forgotten story and hence such a short period of one week was opted for. A decline in the traditional means giving way to the recent social media platform has drastically remodeled the effective shelf life of the news cycles.[14] Based on focal group discussions (FGDs) including subject experts, epidemiologists, and statisticians, a structured questionnaire was developed on a web-based platform of survey monkey application (www.surveymonkey.com). The questionnaire was designed on five multiple domains comprising a total of five questions covering the awareness on preventive health care, home remedies, the preferred system of medicine etc. Initial questions were based on the public awareness on preventive medicine availability in Ayurveda for COVID-19, awareness on Ayurveda treatment available for COVID-19, the population that was treated with Ayurveda medicines or home remedies for COVID-19, etc. The fourth and fifth questions were based on information sources regarding Ayurveda medicines for COVID-19 and on the percentage of people who had changed their lifestyle in the background of COVID-19 as per the norms of Ayurveda. A message with research background and the link to the survey questionnaire was made available to 2688 people via social media by WhatsApp groups. The questionnaire was developed based on anonymized data, and the nondisclosure of identity pertaining to each participant was previously assured. A total of 376 participants had responded within the period of one week, and it was compulsory for each of the participants to make one response only.

Exclusion criteria

In order to avoid any kind of bias, all the social media groups comprising Ayurveda doctors, technical and nontechnical staff earlier or currently working in any of the government or private Ayurveda sectors, and those who had enrolled to any of the Ayurveda courses were excluded. Also, all the respondents who had enrolled after 10 June 2021 were excluded from the survey.

 Results



The questionnaire was developed in a dichotomous manner, except for a question on Ayurveda medicines pertaining to its source of information. The very first question was regarding the awareness on Ayurveda preventive medications for COVID-19.

1. Graph 1

Regarding the awareness about Ayurveda preventive medicines for COVID-19, 75% of the respondents were aware; regarding the availability of Ayurveda treatment for COVID-19, 67.5% of the surveyed population were aware. Also, 77.5% of the people had utilized Ayurveda medicine or any of the home remedies for COVID-19.

The percentage distribution of public awareness on preventive medicine and treatment availability in Ayurveda for COVID-19 and the percentage distribution of people who underwent any of the Ayurveda medicines or home remedies for the same are depicted [Graph 1].{Figure 1}

Graph 2

On information regarding the source of Ayurveda medicines or lifestyle guidelines or home remedies, 48.5% of respondents were aware about the same from health workers, 31.4% were from friends, 25.4% were from social media, and the remaining 8.5% were informed about the same from other sources [Graph 2].{Figure 2}

Graph 3

Overall, 82.5% of the surveyed population responded that they had changed any of their lifestyle in accordance with Ayurveda guidelines in the background of COVID-19 [Graph 3].{Figure 3}

 Discussion



There are several Ayurveda formulations, home remedies and preventive health care measures for Covid-19 common among the Kerala population [Table 1].{Table 1}

A major finding that emanated from our survey study was that among the studied respondents across the population of Kerala, a majority were aware about the availability of Ayurveda medicine (75%) and Ayurveda treatment (67.5%) as a preventive measure for COVID-19.

The populate of India, in particular that of Kerala, are inextricably connected with Ayurveda through the multiple facets of their culture, food, and lifestyle guidelines.[15],[16] The people of Kerala are immensely acclimatized to adopt Ayurveda as an alternative system of medicine, as it has been deep-rooted in their daily subsistence over ages.[17] The state of Kerala has a total of 1171 Ayurveda doctors[18] in the government paraphernalia, comprising 768 dispensaries and 119 hospitals.[19] During the days of the corona outbreak followed by the rampant spreading of the disease, the Chief Minister of Kerala used to provide a brief on the COVID-19 status across the state through electronic media for a minimum of four times per week and the viewership of the same was quite promising. During such rundowns, both the Chief Minister and the Health minister have provided several reminders on the utilization of Ayurveda and Homeopathy medicines for the prevention of COVID-19.[20],[21] These have paved the way for the arousal of awareness on Ayurveda medicines among 75% of the respondents of our survey.

Mass recognition has been provided by the Government of Kerala on different treatment packages, such as Swasthyam (maintaining health) (scheme focusing on lifestyle guidelines including daily regimen, seasonal regimen, diet, exercise etc), Sukhayushyam (enhancing health) (scheme to enhance the immunity of elderly people), Punarjani (revival of health) (scheme on medicines to prevent secondary diseases for those recovered from COVID-19), Amritham (preventive medicine) (scheme on preventive medicines to those in quarantine), and Niramaya (disease prevention) (online consultations with doctors and to get medicines from the nearest centers) via social and print media; these have effectively reached the public.[22] This was well reflected in this survey; as for the question “whether Ayurveda has treatment for the covid 19?” the majority have answered with a “yes.” Moreover, the Ayurveda medicines made available for the people in quarantine, during the convalescent period and for those diagnosed with COVID-19 at their doorsteps through the local statutory government bodies could also be considered a ground for the mass awareness among the Kerala population. Hence, it could be inferred that in this exigency with no halt for the race for cure, most of the people have used or continue using one or other kind of Ayurveda medicines either to enhance immunity or to specifically prevent COVID-19.

A general opinion always does persist among the people of Kerala that lifestyle is much allied with the prevention of disease. And this is apparently visible in their innumerable health practices conducted for preventing diseases, such as consuming food only after a bath, oil application before a bath, no shower soon after food intake, rubbing Rasnadi Choornam after a head bath, etc. Such customs are not only present in Kerala but are also evident at every nook around the globe; they are related with their own ethno practices and in Kerala Ayurveda is the most extensive practice. Against this background, about 77.5% of people had undergone either Ayurveda treatment or home remedies and also 82.5% of people had changed their lifestyle with Ayurveda for the same. Hence, such a hiked percentage response was obtained from such a health conscious population for the question on change in lifestyle during such an epidemic.

Kerala, a small state in South India, has been lauded once again across the world as a success story under the legacy of “Kerala Model” in containing this unprecedented pandemic. With a record of early and effective interventions and rapid reduction in endemic deprivations, the public health-care system here in the state has reached even the base level.[17] The majority of the public were apprised of Ayurveda through their friends, health workers, and social media as of the results from the survey. Even the high literacy rate[18] and an increased use of electronic gadgets among the Kerala population had played a pivotal role in this. Moreover, the social distribution and density of the population in the state are very much interrelated to ease the spread of any information among the population. And this could possibly be the reason for getting knowledge regarding Ayurveda medicines through health workers and common friends. The results that unfolded from this survey shed light on many questions that aroused during these pandemic days, including the response of the common masses on bringing up the alternative systems of medicine in the frontline for the prevention and management of COVID-19. However, though there were responses from all the 14 districts across the state of Kerala, the response that emerged could not be considered an emblematic summation note. Rather, it may in a way help in reinforcing the assurance on the alternative systems among the people and thus give anticipation to policy makers, thus redefining the existing norms on COVID-19 management.

Still with the high rate of test positivity among all the states of the country and with the maximum number of COVID-positive cases, indexing on the state of Kerala with a low death rate and the observations from this survey need to be undergone in further research. Picturesque of the state still lacking of oxygen crisis, street deaths and queuing up of COVID patients in front of Intensive Care Units (ICUs) also demand consideration related to the observations from this survey. Even now with the so-called modern advanced health-care facilities in Kerala, such an elevated percentage of people had shown interest in utilizing the alternative system of medicine. This fact also well reflects on the judicious perspective of the state people on adoption of complementary and alternative systems of medicines up to which stages of causality management. This survey data also do inclines with such a discriminative expertise of Kerala population. Results from this survey along with the opinion of the beneficiaries of the earlier mentioned government projects may open up new avenues for a case-control study and hence an initial estimation on the efficacy of the same becomes evident. The majority of the population in Kerala has depended on alternative systems of medicine for COVID management related to both preventive and treatment aspects and wherein Ayurveda has a pivotal role.

 Conclusion



In India, the majority of the population depends on alternative systems of medicine, of which a bulk of 40% utilize Ayurveda.[23] Moreover, in Kerala, the awareness on the usage of Ayurveda for COVID management and the low mortality rate may have an invariant association. Based on this, the maximum population of the state with an elevated chemophobia may have relied on alternative systems of medicine as an initial resort. However, absolute assurance on the acquisition among the populace should be given, though much awareness on the preventive aspect of Ayurveda is present.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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