Statement Regarding the COVID-19 Crisis – May 2020

Full Statement

We are an alliance of naturopathic physicians brought together by the SARS-CoV-2 and COVID-19 crisis with a shared desire to disseminate quality information amongst the public and our profession. Given the importance of the current crisis and with a shared sense of responsibility as caregivers, even if many of us are not on the front lines of treating this disease, we felt it necessary to address some common concerns.

Our greatest concern is presenting information that is vital to our patients and their communities, within the bounds of what is currently known and understood about the virus. With the rise of social media, we have concerns about the quality of information so readily available to a largely non-medical audience.

Like all licensed healthcare providers, naturopathic physicians have a responsibility to both treat patients and promote effective health measures among the general public. Especially at this moment of crisis, when people are hypervigilant and distressed, we must carefully consider the accuracy of information we convey as well as the downstream effects of our communications. We therefore present some key pieces of information that are important to address:

To say that this virus is akin to influenza (the flu) is flatly incorrect. Compared to influenza, there are several factors making COVID-19 a more difficult virus to contend with:

• A longer incubation period when individuals may be asymptomatic means it is more difficult to track the novel coronavirus than the flu.
• The wide variety of organs affected and severity of damage to these tissues is causing a much higher mortality rate than deaths from the flu.

Transmission, physical distancing, wearing of masks:

• The incubation period is between 2-14 days. It is currently not known exactly how long an individual can be contagious, but early data suggests a 36-42 day window. The majority of transmissions are occurring through droplet and aerosol spread when an individual breathes, coughs or sneezes. Touching contaminated surfaces is another common method of spreading the virus.

• We fully support the recommendations of public health experts and physicians to
  • “Social distance” or physical distance by at least 6-12 feet (when no breeze).
  • Reduce the size of gatherings
  • Wash hands frequently with soap and water for at least 20 seconds–or use at least 60% alcohol-based hand sanitizer.
  • Avoid touching your face
• We agree with the recommendation to wear masks that reduce the risk of spreading or contracting the virus.
  • Given the lack of testing and threat of asymptomatic spread, we do not know who is currently spreading the virus, which is why wearing masks on a community level protects everyone.
  • More robustly-filtering masks such as N95 are in short supply and currently should continue to be prioritized for healthcare providers, but even a well-designed cloth mask with filters will help stop the spread of the virus.
• We acknowledge the staggering negative effects of distancing on the economy during this time. To ignore the financial implication to the individual, business owners, and the community as a whole would be myopic. Knowing that families are struggling emotionally and financially is a very challenging component of the topic of reopening. Weighing the health safety of those in our community with financial hardships and emotional wellbeing is a difficult task for any society.
• Little is known about the long-term complications of infection, although diminished lung function from pneumonia and resulting permanent pulmonary fibrosis has been noted. Damage to the liver, kidney, and heart, as well as blood clots and strokes all occur in COVID and may have lasting effects.
• Although the mortality is higher among all groups except the very young, the people most at risk are over 50 and/or people with pre-existing conditions such as cardiovascular disease, diabetes, chronic respiratory disease, cancer and BMI greater than 40. Together, these comprise an estimated >50% of Americans.

Social justice:

• Current statistics show the most vulnerable in society before the spread of SARS-CoV-2 are the most vulnerable to infection and severity of disease. This includes Black and Latinx communities, Indigenous communities, undocumented immigrants and the 2.3 million incarcerated individuals in the U.S.
• Pre-existing conditions which predispose to morbidity and mortality from SARS-CoV-2 include cardiovascular disease, diabetes and chronic respiratory disease – these same conditions occur disproportionately in people who lack access to preventive care and chronic disease treatment, financial resources and communities of color.
• Likewise, “essential workers” with close personal contact and lack of PPE are overrepresented by Black, Latinx and poor communities.
• Indigenous communities are already resource-depleted, experiencing lack of running water, poor access to food, scarce PPE, under-resourced clinics, few hospitals, and even fewer ventilators.
• Racial bias in healthcare has decreased quality of care and trust in healthcare providers and the medical system. Deeply flawed critiques of social determinants to health and the origins of the virus have emboldened racist behaviors and perpetuated problematic and false narratives about people disproportionately affected by COVID-19.

Malign influence:

• There are so many unknowns about this new coronavirus and we believe that is one reason there has been so much speculation and frankly, grasping at straws to make sense of this pandemic.
• The concept of being “woke” or knowing the “truth” may be tactics to gain fringe popularity. We discourage any regulated healthcare professional from using these tactics when engaging with their patients or the public as members of a health care profession.
• Western intelligence agencies and organizations that monitor malicious internet activity have studied patterns of spread through social media and have determined that there are bots designed to inflame fears about various topics by promoting and amplifying false claims through social media. Facebook & Twitter amplify the most extreme voices and can foster conspiracy theories and misinformation.
• The intent of these hostile governments is to weaken our trust in our institutions and one another. This makes critical thinking and the careful evaluation of evidence ever more important. Together we all have a role to play in reducing the spread of malicious information that undermines the functioning of our society and communities.

Conclusion

Although there is so much more we need to learn about the virus, we know that the healthier a person is, the better chance one has of avoiding severe complications from infection with SARS-CoV-2. Our training and job as naturopathic physicians is to help improve the body’s innate strengths–that is our profession’s common area of expertise and around which our primary role in the current crisis revolves.

We the undersigned are committed to provide and encourage sensible, accurate public health messaging and be a resource for vetted research while engaging in health promotion to improve patients’ resilience to infection. The expectation of professional accountability is of the utmost importance as our collective knowledge about the situation is evolving on a daily basis. Our solutions aim to work for everyone, in as equitable a way as we can find. We hope that we all do our best to stay open, curious, work hard and recognize we are connected in facing this calamity.