While Omicron, the latest Covid-19 variant to emerge is less likely to cause serious illness than its delta predecessor, it’s also a lot more infectious. Given this, and the New Zealand government’s policy change to ‘learning to live with’ this virus rather than wanting to return to lockdowns, the country is probably on the verge of a rapidly spreading outbreak.
We should be thankful that New Zealand avoided the extensive outbreaks of the more virulent delta variant experienced in most other countries, and omicron may even be the ‘beginning of the end’ phase of the global disruption caused by the SARS-CoV-2 virus over the past two and a half years. Most will experience a relatively mild infection, and around 20% of those infected with omicron are likely to be asymptomatic(1, 2).
Omicron can, however, still produce serious illness particularly in those with underlying health conditions or who are unvaccinated, and due to the likely rapid spread and extent of the outbreak, there are worries it may overwhelm hospitals and other health care services as has occurred overseas. These concerns are heightened due to staff and resource shortages within New Zealand’s mainstream health care system(3).
After two years of very low rates of influenza due to social distancing and lockdowns, New Zealand is now also overdue for a flu epidemic, and to my mind the risks of a double whammy of both influenza and omicron hitting us this winter, are relatively high. Together with the highly debilitating nature and protracted recovery time of so-called Long Covid, which can continue or develop long after the initial infection is over(4), the omicron form of Covid-19 is therefore a virus to try and avoid.
For New Zealanders, avoiding infection with omicron in the coming months, will probably be difficult. This is likely to be the case both for those who are vaccinated and unvaccinated. While vaccination and in particular having had the 3rd booster Pfizer vaccine is associated with milder symptoms(5, 6), the level of protection against omicron appears to be less than that against the delta variant(7, 8, 9). The duration of the protective action of the current Pfizer booster vaccine, is also as yet unknown.
Researchers in the U.S. who tracked the evolutionary trajectories of vaccine-resistant mutations over time in more than 2.2 million SARS-CoV-2 genomes, have found the occurrence and frequency of vaccine-resistant mutations to correlate strongly with vaccination rates in Europe and America(10). Their data suggests that vaccine-resistant mutations will gradually become one of the main evolutionary tendencies of new variants, particularly in populations with high rates of vaccination.
Despite the good intentions of the Covid-19 Vaccines Global Access (COVAX) scheme for providing vaccines to low-income countries, global vaccine inequities have also worsened with the recent focus on booster vaccines, and huge disparities continue to exist between vaccine access in high versus low income countries(11, 12, 13). This has ethical and many other implications.
While the development of new generation and multivariant vaccines may have broader spectrums of action and avoid the need for frequent booster immunisations, these factors are cumulatively reasons to reconsider the relative contribution that vaccines will make to the world’s future Covid-19 management strategy(14, 15).
Herbal approaches to dealing with omicron
Given most of us will need to manage an omicron infection at home, it’s a good time to consider other medicines that may be useful. Official government Covid-19 communications are now encouraging us to stock up on medicines such as paracetamol, ibuprofen and nasal decongestants in preparation for the omicron outbreak.
I’ve previously discussed herbal interventions that may help with either a prophylactic or treatment approach to Covid-19(16, 17, 18, 19, 20). Since this coronavirus first emerged more than two years ago, there’s also been a huge amount of research into potentially useful herbal medicines, and a lot of encouraging findings published in the scientific literature(21, 22, 23, 24, 25).
For many years I’ve promoted the benefits of herbs such as Echinacea in helping to both enhance immunity and reduce inflammation in a wide range of infectious conditions (18), provided the appropriate type and dose is used.
There’s a lot we’ve learnt about omicron from other countries in recent weeks. It has several differences to earlier variants of Covid-19, and understanding these and its particular symptomatology and pathology is helpful. A runny nose, headache and fatigue are the most common symptoms, with body ache, muscle ache, cough and fever also being frequently experienced(1).
While omicron has a greater ability than delta to infect us through our upper nasal cavity and mouths, it seems more likely to be confined to the upper nasal passages, throat and sinuses, and somewhat less able to produce a serious infection of the lower respiratory tract or lungs(1, 26).
As such, the rationale of optimising our body’s own inbuilt defence system at the top end of our respiratory tract, would seem to make particular sense. Providing a local physical barrier to the entry of airborne viruses is how masks work, and inhalations or sprays through the oral or nasal cavities are also often the route of administration of drugs used to treat lung conditions such as asthma or nasal congestion.
Many traditional applications of herbal medicine including Maori Medicine (Rongoā Māori), Ayurvedic, Chinese and European herbal medicine, utilised inhalation through the lungs as a popular method of administration. This pulmonary route of administration through inhalation or sprays, is also widely used to treat conditions such as asthma or sore throats, or as a way to deliver drugs to the general blood circulation and treat other systemic conditions.
When I researched herbs for the 1996 bird flu and 2009 swine flu pandemics, I formed the view that there is merit in the use of local applications to the upper airways of decongestant, anti-inflammatory and antimicrobial herbs, as part of a strategy to both prevent or treat these other highly virulent respiratory tract viruses. This lead me to subsequently formulate and develop both a throat spray and a lung care spray, each administered as fine sprays through the oral cavity.
These products contain some of our wonderful New Zealand grown herbs such as elecampane, horseradish, thyme and kawakawa, as well as New Zealand propolis. Each of these has specific benefits of relevance to optimising and enhancing our own natural and ‘first line’ upper respiratory tract defence barriers to infection(19, 20). Their anti-inflammatory, antimicrobial and expectorant actions provide a healthy and natural support for the body’s mucous membranes, immune system and cilia within our respiratory tract whose job is to try to keep unwanted bugs and other nasties out of our lungs.
Elecampane has long been traditionally used for coughs, chest infections, asthma and other lung conditions. Beneficial effects included suppression of pulmonary pathological changes, neutrophil infiltration, pulmonary permeability, and pro-inflammatory cytokine expression(27, 28). Promising affinity towards both the SARS-CoV-2 viral proteins and host receptors has also been reported for elecampane phytochemicals(29), suggesting a potential dual. action to simultaneously improve host immunity while targeting viral proteins to reduce the severity of the infection. Such multiple actions and sites of action, are a key strength of plant derived phytochemicals, particularly given the ability of the viral genome to mutate so rapidly and outpace our ability to develop and distribute effective new vaccines on an ongoing basis.
The common weed ribwort (Plantago lanceolata), can be safely taken as a tea or in herbal products, regarded as a tonic and food for mucous membranes, while having additional expectorant and anti-inflammatory properties(30). In sufficiently high doses, it can also act as a wonderful natural decongestant.
Other useful herbs for upper respiratory tract support include peppermint, elderflower and yarrow, all of which are easily grown in our country, and are available in various forms. The warming and sometimes diaphoretic (sweat inducing) properties of these particularly when drunk as dried or fresh herb infusions, and their traditional uses for infections such as colds, influenza and other viral infections, inflammation and fevers for many centuries, make them also worthy of use.
Apart from Echinacea, I’m now making sure I have plenty of these various herbs and products made from them, in my own medicine cabinet at home. Given omicron’s affinity to affect the upper rather than lower respiratory tract, I think they will be at least as useful as cough syrups for most people who contract this virus. That’s not to say that we wont also need these, as lung infections will still occur.
To summarise, as well as stocking up on drugs such as paracetamol and ibuprofen, coffee, toilet paper and disinfectant, there’s a lot we can do in terms of increasing our intake of certain dietary herbs and spices, and quite a number of different medicinal herbal products out there for which there is compelling evidence that they can help get us through the forthcoming omicron outbreak in Aotearoa.
Based upon their powerful tradition and strong scientific basis, I urge everyone to incorporate effective plant medicine in addition to other measures to help soften the impact of the forthcoming outbreak of the omicron variant of Covid-19, and other potential respiratory tract infections this autumn and winter.
- Kim MK, Lee B, Choi YY, Um J, Lee KS, Sung HK, Kim Y, Park JS, Lee M, Jang HC, Bang JH, Chung KH, Jeon J. Clinical Characteristics of 40 Patients Infected With the SARS-CoV-2 Omicron Variant in Korea. J Korean Med Sci. 2022 Jan 17;37(3):e31. doi: 10.3346/jkms.2022.37.e31. PMID: 35040299; PMCID: PMC8763884.
- Meo SA, Meo AS, Al-Jassir FF, Klonoff DC. Omicron SARS-CoV-2 new variant: global prevalence and biological and clinical characteristics. Eur Rev Med Pharmacol Sci. 2021 Dec;25(24):8012-8018. doi: 10.26355/eurrev_202112_27652. PMID: 34982465.
- Rasmussen PL, New Zealand’s Health System under Stress. www.herbblurb.com Aug 27, 2021.
- Desai AD, Lavelle M, Boursiquot BC, Wan EY. Long-term complications of COVID-19. Am J Physiol Cell Physiol. 2022 Jan 1;322(1):C1-C11. doi: 10.1152/ajpcell.00375.2021. Epub 2021 Nov 24. PMID: 34817268; PMCID: PMC8721906.
- Doria-Rose NA, Shen X, Schmidt SD, O’Dell S, McDanal C, Feng W, Tong J, Eaton A, Maglinao M, Tang H, Manning KE, Edara VV, Lai L, Ellis M, Moore K, Floyd K, Foster SL, Atmar RL, Lyke KE, Zhou T, Wang L, Zhang Y, Gaudinski MR, Black WP, Gordon I, Guech M, Ledgerwood JE, Misasi JN, Widge A, Roberts PC, Beigel J, Korber B, Pajon R, Mascola JR, Suthar MS, Montefiori DC. Booster of mRNA-1273 Strengthens SARS-CoV-2 Omicron Neutralization. medRxiv [Preprint]. 2021 Dec 20:2021.12.15.21267805. doi: 10.1101/2021.12.15.21267805. PMID: 34931200; PMCID: PMC8687471.
- Lusvarghi S, Pollett SD, Neerukonda SN, Wang W, Wang R, Vassell R, Epsi NJ, Fries AC, Agan BK, Lindholm DA, Colombo CJ, Mody R, Ewers EC, Lalani T, Ganesan A, Goguet E, Hollis-Perry M, Coggins SAA, Simons MP, Katzelnick LC, Wang G, Tribble DR, Bentley L, Eakin AE, Broder CC, Erlandson KJ, Laing ED, Burgess TH, Mitre E, Weiss CD. SARS-CoV-2 Omicron neutralization by therapeutic antibodies, convalescent sera, and post-mRNA vaccine booster. bioRxiv [Preprint]. 2021 Dec 28:2021.12.22.473880. doi: 10.1101/2021.12.22.473880. PMID: 34981057; PMCID: PMC8722594.
- Cele S, Jackson L, Khoury DS, Khan K, Moyo-Gwete T, Tegally H, San JE, Cromer D, Scheepers C, Amoako DG, Karim F, Bernstein M, Lustig G, Archary D, Smith M, Ganga Y, Jule Z, Reedoy K, Hwa SH, Giandhari J, Blackburn JM, Gosnell BI, Abdool Karim SS, Hanekom W; NGS-SA; COMMIT-KZN Team, von Gottberg A, Bhiman JN, Lessells RJ, Moosa MS, Davenport MP, de Oliveira T, Moore PL, Sigal A. Omicron extensively but incompletely escapes Pfizer BNT162b2 neutralization. Nature. 2021 Dec 23. doi: 10.1038/s41586-021-04387-1. Epub ahead of print. PMID: 35016196.
- Malik JA, Ahmed S, Mir A, Shinde M, Bender O, Alshammari F, Ansari M, Anwar S. The SARS-CoV-2 mutations versus vaccine effectiveness: New opportunities to new challenges. J Infect Public Health. 2022 Jan 5;15(2):228-240. doi: 10.1016/j.jiph.2021.12.014. Epub ahead of print. PMID: 35042059; PMCID: PMC8730674.
- Ai J, Zhang H, Zhang Y, Lin K, Zhang Y, Wu J, Wan Y, Huang Y, Song J, Fu Z, Wang H, Guo J, Jiang N, Fan M, Zhou Y, Zhao Y, Zhang Q, Liu Q, Lv J, Li P, Qiu C, Zhang W. Omicron variant showed lower neutralizing sensitivity than other SARS-CoV-2 variants to immune sera elicited by vaccines after boost. Emerg Microbes Infect. 2022 Dec;11(1):337-343. doi: 10.1080/22221751.2021.2022440. PMID: 34935594; PMCID: PMC8788341.
- Wang R, Chen J, Wei GW. Mechanisms of SARS-CoV-2 Evolution Revealing Vaccine-Resistant Mutations in Europe and America. J Phys Chem Lett. 2021 Dec 16;12(49):11850-11857. doi: 10.1021/acs.jpclett.1c03380. Epub 2021 Dec 7. PMID: 34873910; PMCID: PMC8672435.
- Singhal T. The Emergence of Omicron: Challenging Times Are Here Again! Indian J Pediatr. 2022 Jan 13:1–7. doi: 10.1007/s12098-022-04077-4. Epub ahead of print. PMID: 35025038; PMCID: PMC8756165.
- Van De Pas R, Widdowson MA, Ravinetto R, N Srinivas P, Ochoa TJ, Fofana TO, Van Damme W. COVID-19 vaccine equity: a health systems and policy perspective. Expert Rev Vaccines. 2022 Jan;21(1):25-36. doi: 10.1080/14760584.2022.2004125. Epub 2021 Nov 25. PMID: 34758678; PMCID: PMC8631691.
- Editorial, Omicron is bad but the global response is worse. Nature 2021 Dec;600(7888):190.
- Cohen J, Omicron sparks a vaccine strategy debate. Science 2021; Dec 24)374(6575):1544-1545.
- Haque A, Pant AB. Mitigating Covid-19 in the face of emerging virus variants, breakthrough infections and vaccine hesitancy. J Autoimmun. 2022 Jan 1;127:102792. doi: 10.1016/j.jaut.2021.102792. Epub ahead of print. PMID: 34995958; PMCID: PMC8719928.
- Rasmussen PL, Optimising Immunity to protect against coronaviruses. www.herbblurb.com Feb 4, 2020.
- Rasmussen PL, Culinary herbs and spices to know about, in infectious times. www.herbblurb.com Mar 20, 2020.
- Rasmussen PL, Echinacea in the time of a pandemic. www.herbblurb.com Oct 30, 2020.
- Rasmussen PL, SARS-CoV-2 – the coronavirus that is changing the world. www.herbblurb.com July 25, 2021.
- Rasmussen PL, Propolis – amazing stuff made by bees from nature. www.herbblurb.com Apr 9, 2021.
- Adhikari B, Marasini BP, Rayamajhee B, Bhattarai BR, Lamichhane G, Khadayat K, Adhikari A, Khanal S, Parajuli N. Potential roles of medicinal plants for the treatment of viral diseases focusing on COVID-19: A review. Phytother Res. 2021 Mar;35(3):1298-1312. doi: 10.1002/ptr.6893. Epub 2020 Oct 9. PMID: 33037698; PMCID: PMC7675695.
- Aleem A, Akbar Samad AB, Slenker AK. Emerging Variants of SARS-CoV-2 And Novel Therapeutics Against Coronavirus (COVID-19). 2022 Jan 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 34033342.
- Bhattacharya R, Dev K, Sourirajan A. Antiviral activity of bioactive phytocompounds against coronavirus: An update. J Virol Methods. 2021 Apr;290:114070. doi: 10.1016/j.jviromet.2021.114070. Epub 2021 Jan 23. PMID: 33497729; PMCID: PMC7826042.
- Haridas M, Sasidhar V, Nath P, Abhithaj J, Sabu A, Rammanohar P. Compounds of Citrus medica and Zingiber officinale for COVID-19 inhibition: in silico evidence for cues from Ayurveda. Futur J Pharm Sci. 2021;7(1):13. doi: 10.1186/s43094-020-00171-6. Epub 2021 Jan 9. PMID: 33457429; PMCID: PMC7794642.
- Naik SR, Bharadwaj P, Dingelstad N, Kalyaanamoorthy S, Mandal SC, Ganesan A, Chattopadhyay D, Palit P. Structure-based virtual screening, molecular dynamics and binding affinity calculations of some potential phytocompounds against SARS-CoV-2. J Biomol Struct Dyn. 2021 Mar 8:1-18. doi: 10.1080/07391102.2021.1891969. Epub ahead of print. PMID: 33682632.
- Kozlov M. Omicron’s feeble attack on the lungs could make it less dangerous. Nature. 2022 Jan;601(7892):177. doi: 10.1038/d41586-022-00007-8. PMID: 34987210.
- Seca AM, Grigore A, Pinto DC, Silva AM. The genus Inula and their metabolites: from ethnopharmacological to medicinal uses. J Ethnopharmacol. 2014 Jun 11;154(2):286-310. doi: 10.1016/j.jep.2014.04.010. Epub 2014 Apr 19. PMID: 24754913.
- Gierlikowska B, Gierlikowski W, Bekier K, Skalicka-Woźniak K, Czerwińska ME, Kiss AK. Inula helenium and Grindelia squarrosa as a source of compounds with anti-inflammatory activity in human neutrophils and cultured human respiratory epithelium. J Ethnopharmacol. 2020 Mar 1;249:112311. doi: 10.1016/j.jep.2019.112311. Epub 2019 Oct 20. PMID: 31644941.
- Singh P, Chauhan SS, Pandit S, Sinha M, Gupta S, Gupta A, Parthasarathi R. The dual role of phytochemicals on SARS-CoV-2 inhibition by targeting host and viral proteins. J Tradit Complement Med. 2021 Sep 8. doi: 10.1016/j.jtcme.2021.09.001. Epub ahead of print. PMID: 34513611; PMCID: PMC8424525.
- Rasmussen PL, Effects of human pollutants on plants: the case of ribwort. www.herbblurb.com Apr 12, 2019.