Is there anything to Madagascar’s herbal remedy COVID-Organics?

COVID-Organics as extracted from Artemisia Annua
Recorded fatalities per recorded case, sub-Saharan African countries as of 25 May
“Flavonoids from Artemsia Annua . . . “ (Ferreira et al)
Hits of -7.7 kcal/mol and above Source: EMSKE Phytochem
This is in the ‘tunnel’ structure of the SARS-CoV-2 protease, called Mpro.
  • Covid-Organics turns out to contain extracts primarily of two plants artemisia annua and Ravintsara (as cinnamomum camphora).
  • From the audience gained through the above post, I was able to obtain confidential shipment data of CVO to African countries during the pandemic period. (Unfortunately I can’t share that data for confidentiality reasons). Suffice to say that the above list of countries who received CVO wasn’t comprehensive and of course lacked the important nuance of how many doses were shipped to each country.
  • It was found through the shipment data that the nation of Chad was the only country to maintain sustained and significant shipment volumes of Covid-Organics relative to caseload, and was known through local media reports to have administered it with intention to its covid patients.
  • That assertion turned out to be backed up by relevant media reports from Chad (in French). In chronological order they are 12-May: A, 4-June: B, 11-June: C, and 16-June D. (I’ve made inquiries through a WHO program manager contact to Chad’s Ministry of Health; as anywhere, covid-related data is heavily politicized, so I have only learned that they haven’t produced any formal data for public consumption other than the media reports).
  • From article C, we know that 34 ‘high-risk’ covid patients were treated exclusively with Covid-Organics by 4-June. All were brought back to health again. Given Chad’s high initial fatality rate at the start of their outbreak, this is notable.
  • Article C implies that additional patients were treated with covid-organics alongside other medications. However Article D goes on to mention that covid-organics should not be used with hydroxychloroquine. (This isn’t surprising as similar flavonoid glycosides are known to competitively inhibit two liver enzymes known for processing many common chronic medications — and so the possibility of hydroxychloroquine overdoses in patients so treated exists — such unfortunate events would explain their media’s non-reporting of that patient segment)
  • One of their government ministers is quoted saying (Google translated), “We are pleased today to reiterate what our Minister of Health has already said. Covid-Organics has been a positive experience in Chad”
  • Given that there is typically a lagtime between a reported case and any fatality associated with it, the Outperformance metric described earlier is brought out in terms of zero lag, 1-week lag, 10-day lag, 2-wk lag, and 3-wk lag.
  • The outperformance data for Chad accounting for case-fatality lag, (set relative to an arbitrary 10% baseline) is:
  • What we see is the case fatality rate initially doing poorly; Then from May 12th we start to see an improvement in Chad’s case fatality ratio performance (across all lag metrics).
  • This can be compared to the raw Case vs. Fatality charts for Chad from Worldometer — note the gap of the case trace (blue) over the fatality trace (red) in days 20–40. So the above chart is essentially highlighting the gap seen in yellow below.:
Day 0 = May 3rd. Blue: Chad covid cases (left side scale), Red: Chad covid fatalities (right side scale). Yellow highlighted is anticipateded fatalities that (thankfully) never materialized.
  • Indeed, 12-May (as per Article A) is when the first Covid-Organics (aka Tambavy CVO) shipment is confirmed to have arrived in Chad. We don’t know precisely how soon after 12-May they start administering to patients, but we presume soon afterward as by 4-June they report having already administered to patients and seeing encouraging results.
  • As the right-side and left-side scales have been proportionally well-aligned to each other, then reviewing the yellow highlight, we offer that it’s possible that Chad saved up to 20–25 lives with their CVO intervention.
  • Might any lives have been lost due to the intervention? It’s actually not outside the realm of possibility. Article D seems to acknowledge the possibility when they warn about co-administration of CVO with chloroquine. This drug interaction makes sense, as flavonoids competitively inhibit liver enzymes that are relied upon to process xenobiotics such as chloroquine. (The resulting overdose causes heart arrhythmia which could prove difficult to manage in a low capability health care setting).
  • Net-net of any such complications, it looks like Chad and its patient caseload came out the better for the intervention. In the face of a pandemic outbreak with essentially nil treatment options at the time (remember this is all before dexamethasone’s efficacy was identified), it’s hard not to appreciate the unique actions that their health ministry took during their May outbreak.

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Coming from a multidisciplinary technical background in Silicon Valley, SE Asia, & East Africa, the author builds awareness of plant medicines. Tw: @EMSKEPhyto

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EMSKE Phytochem

EMSKE Phytochem

Coming from a multidisciplinary technical background in Silicon Valley, SE Asia, & East Africa, the author builds awareness of plant medicines. Tw: @EMSKEPhyto