Tibetan Medicine and Covid-19

Updated: Mar 15

What does Tibetan Medicine have to say about Covid-19, the novel coronavirus that has infected over 120,000 people and claimed 4,300 lives? Cases in China were largely treated with a combination of allopathic and traditional therapies, which has led to quicker control and lower mortality rates than in outbreaks outside of China, so it's worth asking what traditional medicine has to offer our understand and approach to infectious diseases.


There have been a number of people commenting on Sowa Rigpa's take on these events, including my teacher Dr. Nida Chenagtsang. As explained by Dr. Nida, novel pandemics such as Covid-19 fall under the category of duruka (དུ་རུ་ཀ་) diseases, explained by Yuthok Yönten Gönpo the Younger as future epidemic infections that have the capacity to kill many people. There are various kinds of duruka, including those related to weapons, poison/toxicity, and disease.


More generally speaking, infectious diseases like Covid-19 are classified as a kind of rim-né, or infectious disease, traditionally understood to be caused by unseen beings known as dön. In a medical context, these "unseen" beings include microorganisms such as bacteria and viruses.


Covid-19 has been referred to as a kind of influenza, including by the US president, which is scientifically false. Covid-19 is caused by SARS-CoV-2, a novel coronavirus related to SARS and MERS, not a strain of the influenza virus. Its symptoms, while similar to the flu for many patients, are distinct, and the disease is expected to be at least 23x more deadly than the flu.


Coronavirus primarily attacks the respiratory system, though in severe cases there can also be damage to the heart and other organs. These complications cause death in about 2% of cases, though recent reports out of Italy place the mortality rate closer to 6% for regions outside of China. Among the causes of death are heart, liver, and kidney failure, while autopsies have also revealed serious lung damage caused by excess phlegm spilling out of the alveoli, indicating an inflammatory immune response to the virus. In many patients, permanent pulmonary fibrosis is a complication of the disease. Because Covid-19 attacks both the lungs and the immune system, some doctors in China have described it as a combination of SARS and AIDS. That shouldn't be blown out of proportion, but it provides some key information about treatment methods. Even Harvard has acknowledged that HIV medications are being explored as a potential treatment for this coronavirus.


Both SARS and MERS coronaviruses impact the intestines through the cells of the gut lining, ultimately causing severe gastrointestinal symptoms in addition to respiratory infection. While it's unclear whether Covid-19 follows these same pathways, numerous patients have experienced intestinal symptoms like diarrhea as a result of coronavirus infection. While researchers don't quite understand why a respiratory infection would bother with the gut, Tibetan Medicine has long identified a strong connection between the lungs and the intestines, so it isn't terribly surprising.


Without dwelling on data that is best taken from scientific researchers, I would like to offer a breakdown of the Tibetan Medical perspective on diseases like Covid-19. Integrating traditional knowledge with modern research, Tibetan doctors in Asia have been seeking to support their communities and contribute to the fight against Covid-19. In China, over 85% of patients have received traditional herbal treatments alongside biomedical antiviral therapies. Tibetan doctors in Asia and abroad have been seeking to support their communities through this outbreak, as well as Ayurvedic practitioners and western herbalists, and their insights are valuable contributions to the global conversation.


When asked about Sowa Rigpa's approach to the virus on Facebook, Dr. Nida offered the following classification for the disease:

Many people have been asking me for advice on what to do about the new Corona or COVID-19 virus. In Tibetan medicine, we refer to viruses like COVID-19 as ‘duruka’. Duruka problems are mentioned in the prophecies of Yuthok Yonten Gonpo the Younger, the father of Sowa Rigpa or Tibetan traditional medicine. In Sanskrit, duruka means ‘that which brings suffering’. In the Tibetan tradition, we talk about the duruka of weapons, the duruka of poison, and the duruka of disease. According to Yuthok’s prophecies, COVID-19 would fall under the category of the duruka of disease. Duruka diseases refer especially to epidemic, contagious diseases which have the power to kill very many people.

As explained by Dr. Nida, novel pandemics such as Covid-19 fall under the category of duruka (དུ་རུ་ཀ་) diseases, explained by the 12th century master Yuthok Yönten Gönpo (as well as other masters) as epidemic infections that would arise in the future and kill large numbers of people. More generally speaking, Covid-19 would be classified as a kind of rim-né, or infectious disease caused by unseen beings (in this case a virus) known as dön.


While there are many different kinds of rim-né, they are believed to arise from similar fundamental causes. As Dr. Nida explains:


In general, Tibetan medicine recognizes four main causes of disease: disease caused by imbalanced diet; disease caused by an imbalanced or unhealthy lifestyle; disease caused by seasonal influences; and disease caused by so-called ‘provocations’ or invisible, harmful influences (dön in Tibetan). Dön generally refers to disease triggered by the provoking of spirits, but it can also include illnesses linked with invisible microbes. In the Tibetan worldview, rimné or infectious diseases are seen as mostly coming from dön. Spirits who are the true owners of natural forests, mountains, oceans etc. and the wild animals and ecosystems found there are said to send out contagious bacteria and viruses in retaliation when human beings disrespect nature and wild animals and engage in destructive and unsustainable activities (extracting resources through mining, cutting down forests, releasing poisons into the air and water, polluting ecosystems and so on). This is why Tibetans sometime do ritual practices to propitiate and pacify these owners of disease and the natural environment they govern when contagious diseases strike.

Central to the Tibetan medical worldview is tendrel, or interdependence. We do not exist within an environment - we are part of the environment. In the Tibetan cosmological system, our world is populated by countless manifestations of conscious life. Many forms of life are quite unlike humans and other animals - for instance, they may take the form of powerful unseen beings which have the power to invade the body and cause physical and mental disease (including, for instance, viruses and bacteria). Some wholly conscious life forms may not even be carbon-based, and we may engage with them in ways that we don't fully comprehend. Scientists are constantly looking to other planets for hints of alien non-carbon life forms, but we fail to look in our own backyards.


According to many traditional cultures, the natural world is home to more than flora and fauna - it is also home to a vast network of elemental spirits. These spirits are affected by our interactions with the environment - meaning that pollution, deforestation, and the depletion of resources have an impact on them. It's believed that illness develops among these classes of spirits due to environmental imbalance, which is then passed along to humans (and sometimes other animals), who then have the ability to infect one another.


The underlying concept here is that infectious pathogens arise from an unhealthy relationship with the natural world. These "unseen beings" invade the body and cause various kinds of infections. Whether or not you choose to project sentience onto this process, it does seem clear that our health is dependent on the health of the environment.


All that said, I'd like to break this pandemic down into aetiological causes and conditions, symptoms, prevention, and therapies.



Root Causes


According to Tibetan Medicine, infectious diseases arise from environmental abuse. In the case of Covid-19, we can trace the current outbreak to the wild animal market in Wuhan, a poorly-regulated and illegal market where people trade a wide variety of wild animals, many of which are known to carry disease. SARS, Covid-19's pathogenic cousin, also arose in China from a kind of Rhinolophis sinicus bat.


While we aren't sure if Covid-19 arose from bats, in keeping with the topic of Tibet it's worth noting that eating bats was forbidden as early as the 8th century, being identified as a source of disease and toxicity during the time of Trisong Detsen:



"Bats (pa-wang)...sometimes called birds with teeth, are similar to rats with

grey skin and fur, and cannot go out during the daytime.

Their flesh is toxic..."

(Source: Tulku Yeshi Rinpoche)


While wild animal trade is highly risky from a human health standpoint, animal agriculture as a whole has been responsible for a massive number of recent epidemic diseases. If we are going to actually sever the root of these illnesses, we need to address the behaviours that allow them to arise in the first place. We must address animal agriculture, environmental destruction, and access to clean food and water.


As explained, contagious infections are linked to dön, or afflictive external influences. According to the Tibetan Medical tradition, disturbance and provocation of these influences include activities that negatively impact our natural and energetic ecology. As explained by Namkha'i Norbu Rinpoche, epidemics like these are usually connected with mamos, a traditional class of elemental spirits in Tibetan and Indian culture. In particular, the following activities are considered to be the major causes of disturbance:


-Digging the earth, especially at a nyen-sa (vulnerable place), and taking what was underneath and bringing it to the surface.

-Cultivating wild grasslands for agriculture.

-Disturbing and polluting natural water environments.

-Converting wild land into a garden or yard.

-Felling trees.

-Cutting/mining stone.

-Releasing toxins into the air.

-Killing animals.

-Gossiping, spreading rumors, or participating in negative actions.

-Spiritual practitioners not keeping up with practice commitments and seeking only to gain power and defeat one another.

-Any disturbance of nyen-sa, especially with the above actions.


As more and more natural ecosystems are decimated by human activities like agriculture, deforestation, and poaching, it’s hard to imagine that any beings connected with wilderness would fare very well. Deforestation in the Amazon alone has reached a rate of 150 acres per minute, mostly cleared for animal agriculture, and across the world dozens of wild animal species are wiped out every day. In the United States, over 40% of all land is devoted to animal agriculture alone, between feeding and grazing domestic animals raised for human consumption. Our effects on the diversity and welfare of animals alone should be reason for deep concern, without even considering an imagined community of unseen beings affected by the trauma. But if there are indeed elemental spirits living within our midst, they are almost certainly negatively affected by our destructive habits. Whether or not they exist, the observed effect of detrimental influence on human health is apparent.


Even famous examples of this dynamic in the Tibetan tradition, such as Dzé (a severe lymphatic disorder usually equated with leprosy), have clear scientific correlations. Leprosy was believed to be fundamentally caused by unseen beings living underground, who invade humans and produce an ultimately contagious disease. Interestingly, leprosy is now known to be caused by Mycobacterium leprae, a bacteria that lives in the soil and is mysteriously transmitted between humans via pathways that are still not understood.


While we might scoff at these seemingly superstitious explanations for scientific phenomena, it's important to remember how Homo sapiens process and integrate information. We are storytellers by nature, and we’re best able to comprehend complex systems through narrative and inter-relational dynamics. Human civilizations grew because of our ability to talk about each other, not because we learned to talk about animals or the physical features of the natural world. It’s our complex social structures that make us who we are, and if we expand those social structures to include natural forces (or animals), our relationship with these phenomena will naturally change.


So we can effectively say that, from the perspective of Sowa Rigpa, the provocation of infectious diseases is connected to maltreatment of the natural environment and our diverse manifestations of life. It's from this ultimate "cause" that epidemics like Covid-19 arise.



Conditioning Factors


The secondary conditions which actually give rise to viral infection in an individual come down to pathogenic exposure.


In addition to exposure to the virus, a number of individual circumstances make active infection more likely, largely centred around our immune function and preexisting conditions. Stress has a drastic impact on immune health, which unfortunately precipitates a vicious cycle in the case of a global pandemic. Weakness in key organ systems also portend a more severe infection and, in some cases, a higher risk of death.


According to available research on Covid-19, patients with the following pre-existing conditions should take extra precautions to ensure that they do not contract the virus:

-Cardiovascular disease

-Hypertension

-Cancer

-Diabetes

-Pulmonary disease or predisposition to pneumonia

-HIV and other immune-compromising disorders

-Kidney disease


In addition to these pre-existing health conditions, the virus also follows certain trends relating to age and sex. Men have constituted 62% of cases in Italy, and the majority of cases (and deaths) have been in individuals over the age of 60. The virus does not seem to favour children, with only .5% of Italian cases in individuals between 0-9 years old.


According to Tibetan Medicine, here are some of the primary conditioning factors that make us more susceptible to viral infection:


Imbalance due to seasonal influence - Our immune function is weaker during the cold winter months, as well as in the early spring while pekén is being activated. While we may have more success in stopping the virus during the summer, this depends on the individual behaviour of this virus and its mutations, and how pervasive it becomes by then.


Physical, mental, and emotional stress - Whether physical or mental in nature, stress depletes our immune function and makes us more susceptible to infection. It's vital that people get plenty of rest and actively work to counteract stressful influences in their lives. This will not be possible for everybody, especially since widespread quarantines will create great financial strain on many people. But avoiding undue stress as much as possible will help to support your natural immune function. Strong afflictive mental states like anger and fear are also traditionally believed to negatively impact the body. In particular, anger and aversion give rise to heat-natured tripa in the body, which stokes inflammation, and fear gives rise to excess rlung in the body, which depletes our immune function and causes infections to spread.


Exposure to pollutants - Those in regions with high amounts of environmental toxicity and air pollution (i.e. China) will likely experience more complications than those living in clean environments. In addition, behavioural factors like smoking tobacco products are correlated with more serious pulmonary and cardiac complications in covid-19. It is important to try as hard as possible to quit smoking in order to avert this unnecessary strain on the lungs.


Compromising dietary influences - Even though covid-19 arises from external pathogens, the state of our digestion is vital for a proper immune response. In particular, sugar puts a massive amount of stress on the body and depletes our capacity to fight infection. It is best to cut out sugars that are not eaten as a part of whole fruits. At the same time, eating food that is high in essential vitamins, minerals, fibre, healthy fats, and protein is essential for maintaining a healthy body, and observing a humourally-oriented diet is most advisable. Eat lots of fruits and vegetables, and make sure that your food is cooked and served warm in order to ensure maximum digestibility.

Symptoms


Symptoms of Covid-19 are primarily identified as a fever, dry cough, and breathing difficulty. Sometimes additional symptoms like a sore throat, runny nose, or gastrointestinal upset also occur, but these seem to be rare and inconsistent. For some, especially young immunocompetent individuals, the principal symptom may just be a fever. In many cases, the symptoms manifest similarly to the flu. To be abundantly safe, it is best to treat any fever or flu-like symptoms as a possible indication of infection and self-isolate (then seek medical advice).


In the Tibetan tradition, symptoms of viral infections are distinguished from bacterial infections by a greater degree of psychological symptoms. Some viral infections can even trigger full-blown psychiatric disorders. Many people notice this when they come down with the flu. Strange dreams and a general feeling of being intoxicated or disoriented are common. Of course, this is common with any fever, but it can be observed more frequently in viral infections according to Sowa Rigpa. That said, don't become paranoid if you have strange dreams during this outbreak, since most of us are being exposed to disturbing information that can easily cause bad dreams.


In most cases, coronavirus symptoms are mild in nature, but this is actually one of its most dangerous qualities. Especially in a capitalist society with limited safeguards for these kinds of incidents, the likelihood of folks staying home from work and school because of mild flu-like symptoms are far below what is necessary to curb its spread. Furthermore, the tendency to underplay covid-19's seriousness is a grave danger.


In the most severe cases, covid-19 can result in severe pulmonary fibrosis and organ failure (especially heart failure). It also causes the immune system to attack itself, which is itself a major cause of serious complications. Some patients have been treated with HIV medications, itself indicating that the impact on the immune system is quite significant.



Prevention and Treatment


By far the most effective protocol against Covid-19 is prevention. In order to be truly holistic, we should look at preventative nutrition and herbal therapies in addition to hygiene, personal and social behaviour, and spiritual conduct.


In regards to preventative measures, Dr. Nida advises the following:


For most of us right now, prevention is the most important thing when it comes to the Corona virus. Proper hand sanitation and the wearing of protective face masks are very important interventions but the most important thing is that people get enough rest and sleep and work on their immune systems. Improving and maintaining one’s immune system will be the best approach for dealing with this virus. It is important that we have a good and varied diet and maintain a balanced lifestyle. This means getting enough good exercise, getting enough sleep and engaging in relaxing and healing activities like doing yoga, reciting mantras, and so on. Relaxation and peace of mind are very important: too much panic and worry can weaken the immune system, making us more susceptible to contagious disease and decreasing our ability to respond to infections.

Dr. Nida follows a traditional preventative therapy scheme primarily centred around diet and lifestyle. In Tibetan Medicine, these are the primary modalities used for prevention of imbalance, while medicine and external therapies are primarily indicated for the treatment of imbalance. He adds to the list spiritual methods including yoga and mantra recitation, which are traditionally used both as prevention and treatment. Herbal support can be an excellent preventative resource as well, however, and should be considered in this case along with adequate nutritional supplementation.



Preventative Nutrition

In addition to a balanced diet that is mostly composed of plants and is humourally-sensible, it is advantageous to eat immune-boosting foods high in essential vitamins and minerals and to ensure that your metabolic function is strong. Foods that are rich in Vitamins C, B6, D, and E, zinc, magnesium, selenium, and antioxidants will all help the body stave off infection, and a reduction in immune-compromising substances like sugar is also beneficial.


In the case of contagious diseases like cold and flu (rim-cham), it's incredibly important that those who are ill avoid drinking alcohol during the early (and any) stages of the disease. This can give rise to a condition known as champa kyur-shor, which increases the odds of mortality according to Sowa Rigpa.


Metabolic function is key in maintaining a healthy immune system, so extra care should be taken to ensure that the digestive fire is supported through this time. If your metabolism is healthy, your immune system will follow suit. Drinking ginger tea in the morning is a good way to give our digestion a quick boost, and its advised that all food be eaten warm and cooked.


Herbal Therapies and Nutritional Supplements for Prevention

In at least 85% of Covid-19 cases in China, patients have received a combination of antiviral therapy and traditional herbal medicine. While it's not advisable to take anything the Chinese government says at face value, this could be one reason why China has seemingly been able to curb the growth of their outbreak.


According to one set of treatment guidelines, this is an example of a prophylactic therapy protocol being used in China:

Prescription of Chinese herbs for prophylaxis: Astragalus mongholicus 12 g, roasted rhizoma atractylodis macrocephalae 10 g, saposhnikovia divaricata 10 g, Cyrtomium fortunei 10 g, honeysuckle 10 g, dried tangerine or orange peel 6 g, eupatorium 10 g, and licorice 10 g. Taking the medicine above yielded decoction once a day for adults, and for 5 days as a treatment course. If for children, cutting the dose to half.

Below I've listed some more readily-accessible supplements and herbal therapies that can be incorporated into a dynamic prevention protocol. There is, of course, no guarantee that any of these can prevent or cure Covid-19 infections, and this should not be treated as medical advice. The FDA has been threatening companies who make unsubstantiated health claims about their products in regard to Covid-19, so I want to be abundantly cautious. Don't use any of these products without consulting with a doctor, and please don't replace medical treatment or guidance with any advice you read online. Strictly for "educational purposes," these are just a few substances which have been used to support immune function and counteract viruses:


Elderberry - This incredible berry, most commonly taken in a syrup preparation, is incredibly rich in vitamins and antioxidants, and has been shown to lessen the severity of cold and flu symptoms. It's generally recommended to take around 2 tsp. of syrup three times a day in order to provide adequate protection during cold & flu season. As many folks have noted, elderberry increases cytokine response, which can exacerbate the autoimmune component of Covid-19, so this should be seen as a preventative measure and not a treatment once you are ill. Also note that pregnant and breastfeeding mothers should not use elderberry.

Astragalus - This powerful root has been used widely against coronavirus in China, as seen above, and has potent immune balancing properties, helping to support a healthy expression of proteins involved in dynamic immune function. Note that this is also a preventative herb and not to be used during the illness itself.

Vitamin C & D - These are two essential supplements for immune health. Vitamin C helps to prevent infection and can speed healing time for those who are already ill, and therapeutic levels of Vitamin D3 (i.e. at least 5,000 IU/day for most people) are also highly immunoprotective. Especially in darker climates like Great Britain, Vitamin D3 (with K2) supplements are a phenomenal resource for those who want a more robust immune system. However, if you are in a region with abundant springtime sun, safe sun exposure is the best way to naturally increase Vitamin D levels.

Garlic - Raw garlic contains potent antiviral and antibiotic compounds (namely allicin), which can help protect the body from these pathogens. Note that cooked garlic does not display the same potency, so supplementation with capsules are the best option for most of us.


Echinacea - This powerful healing herb has a long pedigree in the western herbal tradition. However, as Tibetan and western herbal practitioner Lucy Jones mentions, it is best reserved for when you actually come into contact with the virus and need more advanced support. While it's best known for its immune-boosting effects, the main mechanism by which it achieves this is through cleansing the blood, and therefore it is a more appropriate acute therapy as opposed to a long-term immune tonic.

Tibetan Formulas


In the Tibetan tradition, a few standard formulas are being used to prevent and treat coronavirus. Once you are actually ill, it's important to follow more individualised treatment. In the Tibetan tradition, strong antiviral herbs are used in order to tackle the pathogenic aspect of the disease (which should only be used under close supervision), while other formulas focus more on supporting the respiratory system, ripening and pacifying fever, and enhancing immune function. I'll avoid posting specific formulations and will steer clear of discussing strong Tibetan antivirals, as both should be acquired from a Tibetan doctor. But some of the principal ingredients and combinations are as follows:


Drebu Sum (Triphala) - This combination of three kinds of myrobalan (chebulic, beleric, and emblica officinalis) help to purify the blood and reduce inflammation. In the case of infectious disease, it is often used to help cleanse the system of pathogens and purify the blood. It can also boost immune function.


Manupatra (Elecampane) - "Manu" root is used widely in pills, powders, and decoctions to ease inflammation and expel excess heat from mixed wind/blood disorders, including infectious diseases. It acts as an expectorant, and also supports metabolic function.


Shing-ngar (Liquorice Root) - Both eastern and western varieties of liquorice are incredible medicines for the respiratory tract, and are famed for their antiviral properties. In Tibetan Medicine, it is treated as a principal ingredient in lung formulas, especially when the disease is dry in nature. Countless studies have demonstrated liquorice's power against past strains of coronavirus (like SARS), and research into glycyrrhizin (one of the active compounds in liquorice) has been conducted as an adjunct therapy for those with coronavirus infections. Chinese hospitals have been widely using this, along with astragalus and a number of other herbs, to help prevent the spread of the virus.


Gundrum (Raisin) - A classic simple remedy for mild respiratory distress is raisin tea, made by simply infusing a small handful of raisins in hot water and drinking it throughout the day. This is also good to maintain proper lung health during the prevention phase, especially since it is hydrating and helps to counteract any dryness in the respiratory tract. In my experience in the west, golden raisins are best.


Solo (Rhodiola) - Two main forms of "rhodiola" are used in Tibetan Medicine - solo karpo (Pagaeophyton scapiflorum) and solo marpo (Rhodiola spp.). In the west, the latter is more commonly found. Both help to increase oxygen saturation and treat hypoxia, so this is a valuable medicine for those who are struggling to breathe due to the virus.


Common formulas which include some of these ingredients include Norbu 7 Decoction, Manu 4 Decoction, Thang Chen, Trulo Kunsel, Lishi 6, and more. With some of these formulas, after a period of ripening it's necessary to use strong antipyretics to "cut the root" of the disease.


In particular for treatment of Covid-19, Tibetan doctors in Asia are relying heavily upon a couple of special formulas used for treating epidemic infections caused by provocation. While both are centered around powerful ingredients, they are also directly associated with the tantric Buddhist spiritual tradition. One of these formulas, known as Logyönma, is associated with Ritrö Loma Gyönma, the 20th Tara manifestation who is propitiated in order to pacify epidemic diseases (more on her at the end of this article). The other main formula being used is connected with Hayagriva, a wrathful manifestation of Chenrezig associated with healing (especially when rooted in external provocation). All such medicines are produced and administered both on the basis of their pharmaceutical efficacy and on their value as sacred substances. From a Sowa Rigpa perspective, their efficacy is in fact partially due to their spiritual potency, and in this way the process of healing becomes a sacred process.


As Tibetan prescriptions are usually given in sets of three (or more) in order to balance the three humours, support for the digestive system and formulas meant to pacify rLung would also be given in many cases. In addition, therapies which address the autoimmune component of the disease are beneficial. These are generally available from Tibetan doctors following a consultation, though some may also provide them under these extenuating circumstances.


Rinchen Rilbu


Tibetan Medicine contains a living alchemical lineage connected to the production of rinchen rilbu, or precious pills. These sacred pills contain up to 100+ ingredients, including microdoses of detoxified metals and gemstones. While they cannot be legally administered in the west for internal use, traditional formulas like Mangjor Chenmo and Drangjor Chenmo are frequently used in cases of severe illness, including as a prophylactic.


Nagpo Gujor


One of the most famous Tibetan Medical formulas for the prevention of infectious disease is Nagpo Gujor, or the "black 9-ingredient formula." This is a blend made from nine ingredients which is strictly used as an aromatherapy, and cannot be taken internally. People wear the formula around the neck in a satchel or as a wrapped pill, and intermittently sniff it in order to activate its protective power. Some doctors advise against using disease outbreaks as an entrepreneurial opportunity to sell Nagpo Gujor satchels, but many have attested to its efficacy in preventing illness.



Personal & Social Behaviour


Personal behaviour is perhaps the single most important preventative measure for avoiding covid-19 infection. Personal hygiene, as well as adequate social distancing, are essential in order not to become ill or expose vulnerable members of society to the virus.


Wash your hands frequently for a full 20 seconds with soap and water, and apply alcohol-based hand sanitizer between washes. Avoid contact with public surfaces as much as possible, and be sure not to touch your face, eyes, nose, and mouth unless you are adequately disinfected. The virus can survive on hard surfaces for over a week. It primarily passes through droplets of saliva, though it has shown a remarkable ability to spread long distances through the air, even after the infected individual has already left the vicinity.


Social distancing includes keeping a distance of at least six feet between you and anybody who may be infected. In Italy, this is being enacted country-wide as many small grocery stores will only allow five customers in at a time, with long queues outside including 1-2 metre space between individuals. Early social distancing is a vital key to stopping the spread of the virus before it gets too far out of hand. Avoiding public gatherings, enclosed spaces, and close contact with those who may have come into contact with a carrier of the disease is essential.


Many young and immunocompetent individuals feel emboldened to test their odds out of an abundance of confidence that they will not become seriously ill, but this is a dangerous and selfish approach. Many members of society are in a vulnerable age range, have preexisting conditions that predispose them to complications, and are immunocompromised for any number of reasons. Even for the healthy young people among us, there is no guarantee that you will not require hospitalization. The Chinese whistleblower who first reported on the outbreak in Wuhan died at only 34 years old, despite having access to sophisticated treatment.


Masks, when properly used, do absolutely help to prevent infection, despite what you may have heard. There have been multiple reports of infection events (i.e. the case of the man on the bus who infected nine people) where those who wore masks did not become ill, while others up to 4.5 metres away contracted the virus. There is, unfortunately, a widespread face mask shortage, which is the real reason why we would use them carefully. But saying that only those who are ill should wear facemasks stigmatizes those who wear them as likely infected. In reality, many of us are carrying the disease without knowing it, and we may very well be able to infect others even while asymptomatic. If mask-wearing is treated as a sensible safety precaution, then more people will wear them in public, and we will overall be less likely to come into contact with infected droplets. If you are immunocompromised, over the age of 60, or have pre-existing conditions like hypertension or cardiovascular disease, then it would be wise to wear an n95 mask when in public spaces. If you don't fit this description, then I would only wear a mask if you already possess one, and only if you have the proper type (i.e. n95 with replaceable filters).


Racism in the Wake of Covid-19


There have been appalling reports of racism in at least 32 countries worldwide since the beginning of the Covid-19 outbreak. Chinese and otherwise Asian individuals have experienced widespread discrimination and violence due to fears of coronavirus, and Asian-owned businesses have experienced many financial difficulties due to perceptions of cleanliness and risk. This is despicable and deeply damaging to the fabric of our societies.


As a part of our healthy behavioural conduct, we should seek to ensure that we do not fall into racist nonsense in the wake of the virus. This is not a "Chinese disease," and the most severe western outbreaks in Italy have been traced back to European individuals, not Chinese tourists or Asian immigrants. Coronavirus does not discriminate by race, and it would be absolutely foolish to think that you can estimate a person's likelihood of being a carrier by the colour of their skin. Certainly be careful around those who have recently visited heavily-impacted areas like Wuhan or northern Italy, but remember that you can not guess somebody's travel history based on race.


What's more, we need to use these opportunities to better support our societies, not to alienate those we deem to be "other." trump is pushing Covid-19 as an example of why the US needs a wall with the Mexican border. This event has the power to unite us as a species, or divide us with bitter xenophobia and racism. Choose the former.

Spiritual Conduct


Many lamas and spiritual teachers have been sharing Buddhist approaches for dealing with epidemic infections. These range from mantra recitations, to deity meditations, to the use of magical amulets for energetic protection. I've seen some teachers, however, remark that Covid-19 is a "karmic disease," indicating that it would only affect those who have the requisite bad karma. While it can be clearly said that each of us experiences the effects of our past karmic causes and conditions, meaning that all illnesses have some degree of karmic causation, I feel that it is misleading to refer to this as a "karmic disease" in a strict Tibetan Medical sense. This implies that the virus is a kind of divine retribution sent to purge the sinful from the world, akin to some Old Testiment plague. But I would argue that diseases like this are the result of collective circumstances, not strict individual karma.


In Sowa Rigpa, "karmic disease" usually refers either to disorders which are terminal and untreatable, or are otherwise genetically based (and therefore not related to humoural imbalance, pathogenic influence, or psychosomatic conditions). Covid-19, while certainly linked to our collective activities as a species, actually falls into the category of dön disorders, which are categorized independently from karmic diseases. Both are related to our behaviour in the world at large, including our impact on our ecology, but dön disorders have distinct causes and can be treated effectively in many cases. It's dangerous to imply that "only people with bad karma will get sick," because we all have bad karma (otherwise we wouldn't be suck in samsara). But this can be easily misconstrued as "only bad people will get sick," when in fact many good people have already gotten sick, and many more will continue to get sick despite their positive qualities.


Buddhist Practices for Covid-19


Chöd - This famous Tibetan Buddhist ritual, popularised in the 11th century by Machig Labdrön, has long been famed for its potency against epidemic infections. Engaged as a way to repair our relationship with unseen beings and pacify negative influences, Chöd is a powerful method of cutting to the root of the problem when performed by an experienced practitioner. Furthermore, practitioners are believed to have a kind of imperviousness to infectious diseases. In Tibet, Chödpas would be called in to manage the corpses of those who died from epidemic infections, because they would not themselves become ill. I will be offering a daylong webcast workshop on Chöd (previously scheduled to take place onsite in London) on March 27th. Our onsite program will be postponed until further notice, but registration for both events are now available. Please click here for more information.


Vajra Armor - Dorje Kotrap is practiced widely in tantric communities as well as by Tibetan doctors. As a kind of mantra healing practice, this mantra is accomplished in isolated retreats and recited daily in order to avert and heal a wide variety of diseases. Special activities associated with the practice include the creation of amulets and substances which can be worn or taken internally as a preventative or curative method. A special amulet exists specifically for preventing infectious diseases, though this must be prepared by an accomplished practitioner. Dr. Nida teaches this mantra regularly, as do some other teachers. Khandro Kunzang Dechen Chödron will be teaching it in Lama Dawa Rinpoche's style in Vermont this May.


Ritrö Loma Gyönma - This form of the female buddha Tara is specifically associated with quelling epidemic diseases. This activity can be invoked through recitation of her mantra, OM TARE TUTTARE TURE NAMO TARE MANO HARA HUNG HARA SOHA, through deity practice, or through the use of amulets. Numerous examples of Loma Gyönma's amulet have been circulated online, but ideally they should be consecrated by a lama or accomplished practitioner prior to use. Lama Tsultrim Allione and Tara Mandala are running a campaign collecting accumulations of this mantra for coronavirus.


Medicine Buddha - The practice of Medicine Buddha, along with his mantra, are considered to be supreme for all kinds of health-related issues. Anybody can recite his mantra, even without transmission, accompanied by the visualisation of the Medicine Buddha cleansing the illnesses of all beings. It's important that, with any of these practices, the intention is to eradicate suffering for all beings, not just oneself. Likewise, all of our personal and social conduct should be focused not only of avoiding illness ourselves, but also on protecting the most vulnerable among us. Medicine Buddha's mantra is TAYATA OM BEKHANDZE BEKHANDZE MAHA BEKHANDZE RADZA SAMUNGATE SOHA.


Sang - Fragrant smoke offerings such as the Riwo Sangchöd can be performed in order to cleanse the environment (and even remove physical pathogens from the air), repair negative relations with elemental spirits, and restore broken commitments.



Integrative Healing


If you or a loved one is experiencing coronavirus-like symptoms, it is essential that you self-isolate and seek medical attention. Western antiviral therapies are absolutely necessary in many cases, and further intervention may be necessary if you experience complications. If you know you've been in contact with somebody who may be infected, isolate yourself until they can get tested. If they are positive, it is advisable to self-isolate for two weeks and to get tested yourself. For around 10-20% of those affected, hospitalization will be required. Do not ignore this, and do not simply rely on herbs and tea to heal yourself. Seek medical advice from a trained professional - not only for yourself but for your community.



On Panic


This unfortunate disease has exposed where many of the gaps are in our handling of public health issues. In the United States, healthcare services are very much not a basic right, and therefore the spread will likely be far worse than in Italy. What's more, limited resources for those who are unable to work due to illness or closures will create a particular kind of strain on the average person. Many people who need to stay home to avoid infecting others will be unable to do so and will pass the virus along. This should push us to consider proposals like Medicare for All, since when it comes to epidemic infections we are only as healthy as the most vulnerable among us. Italy has a highly competent medical system, and already they are beyond capacity in many areas. Doctors are forced to make life & death decisions because there simply aren't enough resources for everybody. In many cases, divisions are drawn on the basis of age. In places like the United States, they will be drawn on the basis of money.


Countless people, including holistic health professionals, are strongly advising people not to panic. And they are right - panic will weaken our immune response and cause unconstructive behaviours like panic-buying storehouses of toilet paper. However, we should not be taking this lightly, and a healthy dose of concern shouldn't be discouraged. It is not an overreaction to avoid socialising for the next few weeks in order to prevent infection. It is not an overreaction to cancel trips abroad or avoid handshakes. We cannot afford to be blasé about this, no matter how uncool it looks to be earnestly concerned about a global pandemic. This is not a hoax or political ploy. This is a live example of an emergency that we have known was possible for a very long time.



I am sending my deepest regards and prayers to all those who have been impacted by this disease. Please take care of yourselves, and make sure that those around you are supported through this crisis. While we should follow the lead of scientific researchers in preventing and treating covid-19, it is my hope that we may take some advice from Sowa Rigpa to ensure that people have the most robust and holistic treatments available.


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© 2020 Shrīmālā Healing Arts. Tibetan Medicine is a millennia-old healing discipline formally acknowledged in Tibet, China, India, Bhutan, and Nepal. However, it is not a licensed medical discipline in the USA, UK, or EU, and therefore is not regulated by the FDA, AMA or any other regulatory body in these countries. Erik is not legally qualified to diagnose any conditions, and no herbal formulas recommended or supplied are intended to prevent, treat, or cure any disease. Therapies or treatments pursued under a Tibetan Medicine Practitioner should not be treated as a replacement for qualified care by a licensed physician.