Introduction

Adopting an unhealthy way of life, especially lack of physical workout along with increased psychological stress giving rise to extreme intensification in the frequency and dominance of non-communicable complaints. From the previous data recorded, non-communicable disorders killed approximately 41 Million individuals per year which are likely to be equivalent to 71% of mortality ratio happens globally which is the major reason for the health care system to concern about communicable disorders and non-communicable disorders. The changes occurring in surrounding and in a universal system, unauthorized practice of antibiotics or continuous usage of immune suppressant treatments or raise in the frequency of drug-resistant microscopic organism, increasing populace, malnutrition, poverty is the reason of occurrence of novel disease-causing toxicities or re‑appearance of disease-causing infections that indicates the hazard of attacking incipient infections. The contaminations which are recently appearing in inhabitants or be real beforehand but which are rapidly aggregate in commonness or a topographical array can be known as Emerging infections.

As per Ayurveda, the philosophy, epidemic comes under the word of Janapada-udhwamsa , which cause due to either of unbalanced Vayu (air), Jala (water), Desha (habitat) and Kala (seasons), assured ailments rise, kills the majority of populaces. According to Ayurveda, there are mainly three routes of Cause of all Diseases.

1. Pragyaparadha: Mistake of Intellect.

2. Asatmedriyartha Samyoga: Indecorous Dealings of senses with their objects.

3. Parinaam or Kala: The peripheral environs can initiate infection by distorting the body through atypical & life-threatening discrepancies in malaise, Rainfall or breeze which in turn leads to the causation of epidemics.

Also, under the title of Adidaivika Bala Pravritta Vyadhi (that causes which is unable to control by human brainpower), terms as Sansargaja and Upsargaja are cited which defines sicknesses which can be passed on directly from infested human being too healthy human being. As per the tip-offs obtainable in Ayurveda literature, the supervision of transmissible syndromes can be done one or the other precautionary or else therapeutically.

Materials and Methods

Data was gathered from authentic Ayurvedic texts like Ashtanga Hridaya, Bhaishajya Ratnavali Rasa tarangini Rasaratna samucchaya Sidha bheshaja manimala Rasendrasara sangraha, Charak Samhita, Sahastrayoga and guidelines of WHO for COVID-19 along with various published articles.

Ayurveda and Novel Corona Virus

Recently the occurrence of an epidemic Novel coronavirus infection shocked the global health system. Coronaviruses (CoV) are infection fluctuating from the generalised cold to more severe sicknesses such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV) is a new strain which previously mysterious in humans. Coronaviruses are zoonotic, which means they easily spread among animals and people. Thus, it requires mass awareness, co-operation and association between different health care organizations and medical systems. Incidence of occurring infectious diseases more often also the transmitting rate more rapid than ever in several poles apart provinces of the world. Crucial scheduling, arrangement also its arrangements for epidemic prevention and its control are necessary for managing of newly‑occurring ailments. On-going circumstances are demanding the extra added research to identify accurate modes of transmission and its medical countermeasures with influencing factors along with its effective management, especially its preventive aspect for viral disorders. In Sanskrit, the Virus is known as "Vaayu + Rasa”. The infection which transmitting through the air including Novel coronavirus called as airborne viruses. As the infecting viruses like Novel corona majorly transmitting through the air, thus it require a healthy change in the surrounding atmosphere which can prevent such kind of infections.

SARS-CoV-2 was first reported in Wuhan (China). It was declared as an epidemic by WHO on 11^th of March 2020 and confirmed its presence in all zones except Antarctica. For the evolution and treatment of the Novel coronavirus, or COVID 19 constant researches are being carried out globally, as till the date no reliable treatment is present. Many of the people across the world are in the state of panic owing to its fast-communicating nature, as per experts, no need to get panic as the infected individuals are under isolation. To avoid the possibilities of additional occurrences, should take precautions.

Although the disease was almost controlled (Salzberger, Glück, & Ehrenstein, 2020), whether it has still Pervasive in Europe and US (Grasseli, 2020; Rate, Onder, Rezza, & Brusaferro, 2020). There are various meditational therapy, yet the evidence of the role played by Traditional Chinese Medicine (TCM) cannot be ignored (Cui et al., 2020; Ren, Zhang, & Wang, 2020). It was with authority convoluted in Chinese Guideline on diagnosis and Treatment protocol of COVID-19, which was extraordinarily essential. Total numbers of positive cases cured by TCM, which was reported precisely 60,107 (Ren et al., 2020).

In rationality with the accomplishment of TCM in supervision a transmittable endemic, it was reasonable and needed to find how Ayurveda can help in COVID-19 pandemic challenge (Patwardhan et al., 2020; Rastogi, 2020). Definitely, this moment is crucial for AYUSH systems to convert Indian healthcare (Patwardhan & Tillu, 2018) and determine the impending of AYUSH for re-establishment of health (Tillu, 2018). About 80% of COVID-19 positive cases are present with having mild signs necessitating merely primary therapeutic care. Rest of 20% cases, 15% require urgent medicinal attention in secondary health care services. Residual 5% of cases needs intensive care which transferred to tertiary health care units equipped with ICU (Zhou et al., 2020). Hypertension, DM, CHD and cerebrovascular disease are risk factor with a high risk of mortality (Wang et al., 2020). ARDS tracked by un-curable hypotensive shock, a multi-organ failure which may lead to death (Wu & McGoogan, 2020). Reduced peripheral capillary oxygen saturation (SpO2) below 90% is a risk pointer in superficially mild cases (WHO, 2020).

OBSERVATION

Ayurveda is having a unique method of approach towards newly identified diseases. Ayurveda embraces a holistic method rather than focusing on the microbiological etiology for particularising the details of the disease at hand. For the elaboration of an unknown disease, Ayurveda having three points for an approach which are Vikaara prakrti, adhishtanam and samuthaana visesham.

In the middle of situation those developed with pneumonia, 98% were suffering from fever (Jwara), 72% were complaining of fatigue (tandra), 57% of symptom were of dry cough (vataj kasa), 41% of people were having anorexia (aruchi), 36% symptom was of myalgia (anga marda), 33% of people were suffering from difficulty in breathing (shwasa) and 24% were complaining of cough with sputum production (kaphaja kasa) (Huang et al., 2020).

In another report, the main clinical features seen were fever (jwara), cough (kasa), shortening of breath (shwasa). If the situation is worse, there will be labour breathing (shramaj shwasa), stubborn pain or pressure in the chest (urah vedana), mental misperception (moha), incompetence to arouse (samaja Nasha), cyanosis (aasya shyavata) (Alqahtani, 2017). Diarrhoea (atisara) and nausea (chardi) were very slight while the primary presentation.

The controlling of Aagantuja vikaara, a treatment protocol of nija vikaara should follow (R Rathi and B Rathi, 2020). Therefore, appropriate identification of pathological model along with its associated features is important. Referring to the details existing from the places where the Covid-19 has maximally exaggerated, and especially from China, almost 41% of the cases were very mild with no features of viral pneumonia, other 39% of the cases had moderate features with mild pneumonia, 15% had severe features and 5% were critical, at appearance. Many patients informed about fever, dry cough and slight respiratory distress. Later on the fever subsided, but respiratory distress turned out to severe and many of individual died.

After referring above factors, Novel coronavirus can be considered as Kapha-vaata samsargaja jwara (Rathi, Rathi, & Khobragade, 2020) with pitta association. As per the clinical features cited in classics, the initial stage was considering and comparing, but it acquires the stage of sannipataj jwara in a certain group of the patient population as the condition of infection exaggerates.

Consequently, the patients belonging to a geriatric age group and those with existing co-morbidities are more prone to be in the group that gets worse once the disease exaggerates. Therefore, in that group, the clinical course can be charted as follows- mild symptomatic illness at the appearance, leading to moderate illness terminating in fatal illness (WHO, 2020). The jwara may end up into the fatal forms of sannipata jwara, Because of the syandana and Shoshana property of prevailing pitta. That is the reason, the entire clinical course of covid-19 can be hypothesised as having these stages. (Aniket, Pallavi, Aziz, Avinash, & Vikas, 2017; Deshmukh, Rathi, & Rathi, 2020; Rastogi, Lakhotia, & Singh, 2019),(Table 1).

CLINICAL STAGING OF THE DISEASE

Adhishtan - Site

The proper adhishtan of covid 19 can be doubted at Koshta itself, but the appearance takes place in uraha, which itself is a main site of Kapha. Many a time, it has been found that pitta dosha exerts a major pathological effect on Kapha. The ushna guna of pitta, in a group with the sa-sneha and drava guna which will exert a pathological effect on Kapha, thereby making it asthira (unstable) and abadha (unbounded). Here also, as specified in the description of the stages, pitta can generate this pathological falls leading to the syandana and further Shoshana. This can lead to dhatu Paka and death.

Samuthana vishesha – the etiology

The existence of a Kapha-Vata predominant sannipata jwara as a janapada-udhwamsa in vasanta ritu points to the speedy and violent vitiation of Vayu, udaka, desha and Kala due to the actions that can be set aside as prajnaaparadha.

STAGE WISE MANAGEMENT PROTOCOL FOR COVID – 19

STAGE 0 - Patient with positive travel history / contact history / home quarantine / isolation

STAGE 1: Symptoms and Treatment

STAGE 2 & 3: Symptomatic Treatment

STAGE 4: Treatment Protocol

STAGE 5: (Stage of Convalescence) Treatment Protocol

Discussion

Clinical course study can lead to the following conclusions that The group of patients, who are getting worse progressively and having a deteriorated state of Rogi Bala already because of old age or due to co-morbidities. The co-existing pitta, even if very mild, will be causing syandana and Shoshana in the chest gradually, which cannot be struggled by the body due to previously compromised rogi bala. Up till the date, there is no vaccination being found for COVID-19 infection yet, but this is what Vedas has suggested to fight with such health conditions which can give a try. Along with using General guiding principle for this protocol- (Table 2, Table 3, Table 4, Table 5, Table 6 and Table 7).

• As in any epidemics, firstly take the travel history and contact history of the patient.

• Examine the patient well.

• Order the needed laboratory or imaging panels as and when essential.

• Assess the koshtha, agni prominence of the patient.

• Definitely have an assessment of the vyaadhi-avastha in a careful manner, as some medicines may be contra-indicated in some specific avasthas.

• Assess the rogi bala using the ten-point clinical examination protocol (dasha vidha pariksha vidhi) and calculate the practical status of the patient.

• Assess the status of Oja and guess the chance for an immediate casualty.

• It is mandatory to read the Ayurvedic diagnostic and pathologic approach to Covid 19 prior to the management protocol and understand the pathologic processes happening at different stages of disease progression.

• The selection and combinations of medicines should be made by considering the bala of rogi, agni and koshtha, and the rogavastha.

• The dosage of each pharmaceutical preparation shall be fixed as per the classical strategies.

• The medicines described in each stage shall be utilized thoughtfully in the succeeding stages also.

• Diet and regimens, as in stage 0, maybe continuous during the treatment period.

• General safety measures for doctors, paramedics and health workers need to be confirmed in the facility.

• The technical support of western medicine has to be ensured when and where it is necessary (Deshmukh et al., 2020).

Conclusion

The world is facing to Epidemic diseases since from Ancient time. Literature related to Epidemic diseases their Causation, Prevention and Management is timely mentioned in Ancient Indian literature like Atharveda, Upanishada, Vedas etc. As per Ayurveda principles, all diseases are caused due to an imbalance in the tridosha (Vata, pitta and Kapha) due to various factors. So therapeutic management (Oral medication and Panchakarma) are done to break pathology which creates an imbalance of this tridosha. Also, Rasayan therapy helps in building Saptadhatu (basic elements of the body) and keeping Longevity. So we can conclude that epidemic diseases are formerly explained in details in ancient Ayurveda literature with their prevention and management. We can use this knowledge as a basic principle with up-gradation as per current scenario for better well-being.

Conflict of Interest

The authors declare that they have no conflict of interest for this study.

Funding Support

The authors declare that they have no funding support for this study.