India’s indigenous idea of herd immunity: the solution for COVID-19?

Ram Shepherd Bheenaveni

India’s indigenous idea of herd immunity: the solution for COVID-19?

Ram Shepherd Bheenaveni1*

1Department of Sociology, Osmania University, Hyderabad 500007, (T.S.), India.

Note: Shepherds in rural India are performing the herd immunity for their livestock with the help of herbal produces in order to prevent the virus-causing epidemics. They attenuate the virulence of virus with help of leaf juice extracted fromplant before inoculation or viriolation. This photograph was taken at Urumadla-Ramchandrapur village of Siddipet district in Telangana State, India in May, 2020. Bheenaveni Rajaiah (left) and his son Bheenaveni Laxman (right) are conducting the viriolation to the uninfected sheep to achieve herd immunity.

Background

The coronavirus disease 2019 [1], also known as COVID-19, was first reported in humans in Wuhan, Hubei province, China, in late December, 2019 and emerged as a rapidly spreading pandemic with its unprecedented outbreak [2–3]. Within its first 100 days, it has attacked 1,431,973 people, and 82,096 of them lost their precious lives [4]. Its unimaginable outbreak has reached 202 nations, and every person in the world is at risk of being infected by the virus in one way or the other. Thus far, no suitable medicine or vaccine is invented against COVID-19. The World Health Organization declared it as the “Public Enemy No. 1” and was considered as one of most dangerous health catastrophes ever occurred in human history [5].

The data forecasted by London-based scientists report the fatality rate of COVID-19 which is about 10 to 20 times deadlier than the seasonal influenza [6]. Many epidemiologists believe that the coronavirus outbreak could be similar, on a general scale, to the 1957 influenza, but it is not assumed that it would be as catastrophic as the 1918 influenza pandemic [7]. However, the outbreak of virus is accelerating more than how it is foreseen by the experts as it has only taken 67 days from the very first reported case to reach 100,000 cases–11 days for another 100,000 cases [8], 4 days for the third 100,000 cases, and just 2 days for fourth 100,000 cases [9]. Currently, it has infected more than 5 million people [10].

The reason why the entire world is put on lockdown and “social distancing” and “self-quarantine” are being strictly imposed and practiced is to curb the exponential curve of such contagious disease. It is also a given fact that the world cannot survive with the lockdown for a longer period. Even if we put an end to the lockdown after one or two months, there is still a high possibility for a second wave of the coronavirus across the globe as we cannot simply identify the infected individuals owing to its 15-day window period [11]. Therefore, this is the time to dwell deeper into different preventive ways and healing methods and tackle the current COVID-19 pandemic.

In this regard, this comment aims to offer insights of probable solution for the coronavirus pandemic from experiences of Indian shepherds who have been widely exposed to indigenous herbal knowledge systems from the ancient times and evolved in a unique set of practice called(herd immunity) to address the epidemics or pandemics that affect their people, livestock, and herds or flocks.

Indigenous idea of herd immunity

Based on folklore and traditional wisdom, when a shepherd purchases a few new sheep from an unknown seller or from a distant place, he keeps them away from his old flock of sheep for a period of 15 days. This, in other words, is a unique practice of herd quarantine. The new flock is permitted to mingle with the old flock only after the completion of the prescribed quarantine period. In case someone tries to violate the principle of herd quarantine, the herd council will impose a rigorous punishment.

Whenever traits of virus-causing diseases, like cowpox, sheeppox, and goatpox, appear in cattle herds, shepherds anticipate its inescapability of viral infection and its inevitable outbreak and visualize that herd quarantine may not be a practical solution in the long run. Although shepherds are not exposed to the term “virus,” they have a solid understanding of the very existence of a foreign specie that damages the health of their herds. To mitigate and militate the repulsive repercussions of the virus, they purposively evolve a typical method of treatment named,,known as herd immunity. This can be observed in all remote Indian villages until today.

In the modern framework, the idea of herd immunity was first adopted in 1923 to denote the premunity or immunity of a given total population, examining the rate of disease fatality among populace at various degrees of immunity in an experimental research. The study recognized herd immunity as a naturally occurring phenomenon [12]. During the mid-1930s, A.W. Hedrich’s epidemiological study of measles in Baltimore noticed a substantial decline in new infections after several children had been conscientiously exposed and immune to measles [13]. In light of this, mass vaccination is performed to develop premunity among the masses; this process is called herd immunity in our modern medical sciences, as everybody of us naturally develops immunity after a due course of time.

In contrast to modern science, the original idea of herd immunity is not a natural process since inoculation or variolation is a must. This happens when the virulence of the virus is considerably condensed with the help of natural substances, like herbs and plants, and then the attenuated virus will be inoculated into the body of a healthier animal, where the spurious virus enters through the medical intervention of shepherds which will eventually infect the flock one after the other. By this means, the infection becomes mild, unlike the natural attack. The inherent antigens in animals will quickly respond to face the attack of the mild virus by producing awe-inspiring antibodies in order to develop immunity within a stipulated period.

Procedure and protocol of herd immunity

As part of traditional roles, the head of herds and shepherds, who is usually widely exposed to indigenous medical lore and equipped with sociopolitical powers to make decisions, conducts a survey among the herds dwelling in different villages attacked by viral infections and locates the severely infected flock of sheep. Next, he identifies a critically infected animal in that flock, undoubtedly a survivor, to use as the host and infuse the virus to healthier animals staying in different herds. On request or by paying price, he brings the infected sheep near an uninfected herd, while he extracts leaf juice of a specific tree named,(Figure 1). The collected leaf juice is poured in a cup made of thick leaves. He also collects serum/plasma from the blood of the infected animal to amalgamate with the extracted leaf juice. With the help of a diamond cutter-like metal instrument and a bunch of surgical instruments, he pinches or draws a small cut on the healthier sheep’s ear edge to infuse the virus through biosynthesis prepared out of the extracted leaf juice and the serum/plasma collected from the infected animal. Likewise, all animals in the flock, one animal after the other, will be infected in a day. Thereafter, the entire herd will go for strict quarantine for a period 15 to 21 days.

During quarantine, the shepherd meticulously observes the health condition of each and every sheep to assess the degree of severity of infection. Those with mild infection among the sheep can be allowed to stay in the herd, while those in critical condition are offered special fodder in a separate setting. However, it is true that all the sheep only get mild infection due to the application of leaf juice extracted from theplant. If the virus attacks naturally, the entire flock will be severely affected. However, if the same virus enters into the healthy sheep through the shepherd’s intervention of health care, the flock is prone to mild infection only. In the combat of the virus and sheep immunity, the sheep’s natural immunity suppresses the mild infection and facilitates recovery of its own as well as the herd within a due course of time. Of course, the mild infection never gets the chance to harm the health of an animal in the long run, so eventually, the flock comes out of the threat of the epidemic or pandemic.

There are numerous examples of shepherds’ indigenous healthcare systems that can be seen in India even in the present times. Their knowledge over crossbreeding is also an interesting one, although they are not aware of modern genetics. They usually pick up a ram from a flock away from a considerable distance to their herd’s place. In fact, this is one of the primary norms in selecting and breeding a ram among the shepherd community. It latently implies that as the biological or genetic relationship is far distant, the health status of upcoming lambs will be much stronger and more immune. Our modern doctors are also propagating a similar kind of awareness among the populace following the development of Genetics as a discipline. But even before the emergence of Genetics, the shepherds had already discovered the same sort of idea.

Figure 1a:plant; b: Leaves and seeds ofplant situated at Urumadla-Ramchandrapur village of Siddipet district in Telangana State, India.

Herd immunity for humankind

The similar kind of herd immunity strategy used to be implemented to preserve the public health when humans are prone to measles, chickenpox, or smallpox. The leaf juice extracted from theplant will be mixed with serum/plasma collected from the survivor of the viral disease. With the help of traditional sewing needle, the amalgamated serum/plasma and leaf juice will be injected into the muscle of healthier individuals to get immune. As a rule, new or sterilized needles must be peculiarly used for each case to infuse the virus in order to avoid transmission of other infections. It causes a peanut-shaped blister which is considered as an indicator of the proper execution of treatment. In cases where a person does not get a blister, he will be ordered for re-variolation. If, by mistake, the injection spots on a nerve that seriously wound the entire nerve, it will be cured by other medicinal herbs. Therefore, enormous concentration has to be paid by the indigenous healers while injecting the spurious virus. This deliberate infusion through variolation to each and every individual in the community gradually develops herd immunity.

It is a pertinent time to rethink and utilize the indigenous knowledge of Indian shepherds and folk healers in order to discover a healing system for the coronavirus pandemic. Historically, India is known for deities who actually invented healing systems for different diseases and epidemics. Public health professional Pochamma, in Telangana State, is the classic example for the development of treatment of different poxes. Balamma is known for midwifery, prenatal, and postnatal healthcare. Their succession has been continuing in the form of indigenous medical care, and their knowledge remained as age-old traditions, oral histories, folklore, and unique set of practices around their shrines.

Herbal treatment for COVID-19

To wipe out the virus residing inside the human body, different antiviral drugs need to be fiddled out of our genes. Recently, the mainstream opinion among biologists across the globe is that herbal plants have no such capability has seriously been debated. However, there is an overwhelming amount of data supporting the innate and ingrained herbal potentiality and effectiveness in antiviral treatment for COVID-19 in China [14]. This also implies that herbs are capable enough to dilute the virulence of the virus and suppress its infections from utmost severity to a mild level. Herd immunity will be made possible through the inoculation or variolation of virus after its attenuation by herbal substances, and the infusion of mild virus as part of medical intervention is critical to the host to achieve herd immunity.

Lin, L.T., Hsu, W.C., and Lin, C.C., (2014) recapitulated antiviral behaviors during the use of different herbal medicines and natural products against several notable viral pathogens like coronavirus, dengue virus, coxsackievirus, and so on [15]. In China, scientists evaluate the latest national and provincial clinical guidelines, retrospective cohort studies of COVID-19, and propose traditional Chinese medicine (TCM) for treatment as an option for substantial utilization [16]. Treatment patterns of COVID-19 confirm that early intervention of TCM plays a pivotal role in amplifying the rate of cure, shortening the span of disease, condensing disease progression, and reducing mortality rate [17]. Huan-Tian Cui (2020) envisioned that the classical prescription of Chinese medicine, Da Yuan Yin, which is recorded in the ancient book of Chinese medicine(1642 C.E.) and contains Binlang (), Houpo (), Caoguo (), Zhimu (), Shaoyao (), etc., was considered as means of prevention against smallpox and stated that the utilization of TCM has been resulting in remarkable improvement and alleviation of symptoms in COVID-19 patients [18]. Ni, L., Zhou, L., Zhou, M., et al. (2020) explained the usage of Western medicine via,5 mg, and75 mg with a combination of a Chinese patent drug, Shuanghuanglian oral liquid with the approval number SFDA of China (Z10910017), which is comprised of three herbs: Huangqin (), Jinyinhua () and Lianqiao () in a ratio of 1:1:2 to treat the first case of the novel coronavirus patient in Wuhan [19].

Many COVID-19 patients were prescribed with the empirical formula of Chinese medicine, Qing Fei Pai Du decoction, prepared from 21?herbs including Mahuang (), Gancao (), Kuxingren (), Shengshigao (), Guizhi (), etc., in Shanxi, Heilongjiang, and Hebei provinces, and its overall effectiveness was ≥ 90% until February 5, 2020 [20]. The retrospection of Luo, H., Tang, Q., Shang, Y. et al. (2020) into ancient Chinese healthcare practices was mentioned in the ancient book of Chinese medicine(, unknown publication time) and reconciled the usage of herbs, including Huangqi (), Gancao (), Fangfeng (), Baizhu (), Jinyinhua (), and Lianqiao (). Moreover, they also pointed out that the herbal formulas of Chinese traditional medicine could be an alternative approach for the prevention of COVID-19 by highlighting their potential preventive outcomes [21]. The clinical efficacy retrospectively was analyzed by Yao et al. (2020) for the effectiveness of Chinese patent drug Lian Hua Qing Wen capsule with the approval number by SFDA of China (Z20040063). Linghua Qingwen capsule is composed of 11 herbs, including Lianqiao (), Jinyinhua (), Mahuang (), Kuxingren (), Banlangen (), etc., in treating COVID-19 patients and found that the traditional herbal medicine could possibly decrease major disease symptoms, such as cough, cold, and flu, due to their potentiality in promoting recovery [22].

Across ten Chinese provinces, 701 COVID-19 patients were treated with Qing Fei Pai Du decoction. Among them, 130 patients (18.5%) were completely recovered, and 51 patients (7.27%) were also cured from having the symptoms, such as fever and cough. In addition, symptom improvements were seen among 268 patients (38.2%), and stabilization occurred in 212 patients (30.2%) [23]. Suxin Wan et al. (2020) reported that most of the coronavirus disease patients were treated with a combination of both allopathic and TCM, and the application of TCM in viral pneumonia has promptly facilitated rich experience [24]. Deng-hai Zhang et al. (2020) mentioned that 26 herbs out of 125 Chinese antiviral herbs, including Lianqiao (), Gancao (), Sangbaipi (),Juhua (), Kuandonghua (), etc. were naturally used to treat viral respiratory infection as they might contain direct anti-novel coronavirus compounds [25].

Conclusion and future course of action

Since the entire world is in search for the best preventive medicine and curable methods for COVID-19, the indigenous idea of herd immunity practiced by shepherds with the help of herbs to overcome various poxes and pandemics is shared. From the Harappan Civilization in the northwestern regions of South Asia (lasting from 3,300 B.C.E to 1,300 B.C.E. [26]), the profession of shepherding has been appearing, and a plethora of oral histories, medical technologies, and unique set of healing system were evolved around it.

In the treatment process, shepherds develop practices, like herd quarantine and herd isolation, and visualize that those practices cannot protect them from unprecedented virus attacks. Eventually, they evolve herd immunity by infusing the mild virus from an infected sheep to all the healthier animals to get immune. The head of shepherd, as part of his traditionally role, possesses and transforms the entire procedure and protocol of herd immunity from one generation to another. Extracting leaf juice fromplant and collecting serum/plasma from a survivor to mix-up in a cup made out of thick leaves and amalgamating biochemical synthetic would be infused with the help of a diamond-cutter like instruments and a bunch of surgical instruments. This similar sort of herd immunity strategy was adopted for human beings before when they got infection of smallpox, chickenpox, and other viral poxes. The leaf juice was extracted fromplant and amalgamated it with serum/plasma obtained from a human survivor, and the same will be infused with sterilized sewing needles on the muscles of healthier persons to get immune within a stipulated time.

Now, reclaiming the indigenous knowledge and healthcare systems passed through generations together among shepherds, tribes, and rural folk methodologically may offer a few new insights for the development of herd immunity scientifically to eliminate the coronavirus pandemic from the world.

1. Sophie V [Internet]. What does COVID-19 stand for? [cited 2020 April 17]. Available from: https://www.goodrx.com/blog/what-does-covid-19-mean-who-named-it/

2. Epidemiology Group of the New Coronavirus Pneumonia Emergency Response Mechanism of the Chinese Center for Disease Control and Prevention. Epidemiological characteristics of the new Coronavirus pneumonia [published online ahead of print, 2020 February 17]. Chin J Epidemiol. (Chinese)

3. Wang C, Horby PW, Hayden FG, et al. A novel Coronavirus outbreak of global health concern. The Lancet 2020, 395: 470–473.

4. World Health Organization [Internet]. Coronavirus (COVID-19) situation dashboard on [cited 2020 May 24]. Available from: https://covid19.who.int/

5. US News [Internet]. World must consider Coronavirus “Public Enemy Number One”: WHO [cited 2020 February 11]. Available from: https://www.usnews.com/news/world/articles/2020-02-11/world-must-consider-coronavirus-public-enemy-number-one-who

6. Maciej F Boni [Internet]. How big will the Coronavirus epidemic be? An epidemiologist updates his concerns. [cited 2020 March 9]. Available from: https://theconversation.com/how-big-will-the-coronavirus-epidemic-be-an-epidemiologist-updates-his-concerns-133133

7. Joel Achenbach, William Wan, Lena H Sun [Internet]. Coronavirus forecasts are grim: It’s going to get worse. [cited 2020 March 12]. Available from: https://www.washingtonpost.com/health/coronavirus-forecasts-are-grim-its-going-to-get-worse/2020/03/11/2a177e0a-63b4-11ea-acca-80c22bbee96f_story.html

8. Antonio R [Internet]. What is herd immunity and can it stop the Coronavirus? [cited 2020 March 17]. Available from: https://www.technologyreview.com/s/615375/what-is-herd-immunity-and-can-it-stop-the-coronavirus/

9. The Economic Times [Internet]. Coronavirus updates: India's total confirmed cases tally nears the dreaded 500-mark [cited 2020 March 25]. Available from: https://economictimes.indiatimes.com/news/politics-and-nation/coronavirus-cases-in-india-live-news-latest-updates-march23/liveblog/74765889.cms

10. Worldometer [Internet]. COVID-19 coronavirus pandemic [cited 2020 April 16]. Available from: https://www.worldometers.info/coronavirus/

11. Bruce Y Lee [Internet]. Study: 17.9% of people with COVID-19 coronavirus had no symptoms, forbes. [cited 2020 March 18]. Available from: https://www.forbes.com/sites/brucelee/2020/03/18/what-percentage-have-covid-19-coronavirus-but-do-not-know-it/#19dc54997e90

12. Topley WWC, Wilson GS. The spread of bacterial infection. The problem of herd-immunity. Epidemiol Infect 1923, 21: 243–249.

13. Sencer DJ, Dull HB, Langmuir AD. Epidemiologic basis for eradication of measles in 1967. Public Health Rep 1967, 82: 253–256.

14. Chen S [Internet]. Coronavirus: do herbal remedies work, and could they help in the stricken epicentre of Hubei? [cited 2020 February 18]. Available from: https://www.scmp.com/news/china/society/article/3051009/coronavirus-do-herbal-remedies-work-and-could-they-help-stricken

15. Lin LT, Hsu WC, Lin CC. Antiviral natural products and herbal medicines. J Tradit Complement Med 2014, 4: 24–35.

16. Chan KW, Wong VT, Tang SCW. COVID-19: an update on the epidemiological, clinical, preventive and therapeutic evidence and guidelines of integrative Chinese-Western medicine for the management of 2019 novel Coronavirus disease. Am J Chin Med 2020, 48: 737–762.

17. Ren J, Zhang AH, Wang XJ. Traditional Chinese medicine for COVID-19 treatment. Pharmacol Res 2020, 155: 104743.

18. Cui HT, Li YT, Guo LY, et al. Traditional Chinese medicine for treatment of Coronavirus disease 2019: a review. Tradit Med Res 2020, 5: 65–73.

19. Ni L, Zhou L, Zhou M, et al. Combination of Western medicine and Chinese traditional patent medicine in treating a family case of COVID-19 in Wuhan. Front Med 2020: 1–5.

20. Yang Y, Islam MS, Wang J, et al. Traditional Chinese medicine in the treatment of patients infected with 2019-new coronavirus (SARS-CoV-2): a review and perspective. Int J Biol Sci 2020, 16: 1708.

21. Luo H, Tang Q, Shang Y, et al. Can Chinese medicine be used for prevention of corona virus disease 2019 (COVID-19)? A review of historical classics, research evidence and current prevention programs. Chin J Integr Med 2020: 1–8.

22. Yao KT, Liu MY, Li X, et al. Retrospective clinical analysis on treatment of novel Coronavirus-infected pneumonia with traditional Chinese medicine Lianhua Qingwen. Chin J Exp Tradit Med Form. 2020: 1–7.

23. Healthcare Medicine Institute [Internet]. Chinese herbal medicine for COVID-19 (coronavirus) treatment [cited 2020 February 17]. Available from:https://www.healthcmi.com/Acupuncture-Continuing-Education-News/2009-chinese-herbal-medicine-for-covid-19-coronavirus-treatment

24. Wan S, Xiang Y, Fang W, et al. Clinical features and treatment of COVID-19 patients in northeast Chongqing [published online ahead of print, 2020 Mar 21]. J Med Virol.

25. Zhang DH, Wu KL, Zhang X, et al. In silico screening of Chinese herbal medicines with the potential to directly inhibit 2019 Novel Coronavirus. J Integr Med. 2020, 18: 152–158.

26. Wright, Rita P. The Ancient Indus: Urbanism, Economy, and Society. Cambridge University Press, 2009.

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TCM, traditional Chinese medicine.

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The authors declare no conflicts of interest.

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Ram Shepherd Bheenaveni. India’s indigenous idea of herd immunity: the solution for COVID-19? Traditional Medicine Research 2020, 5 (4): 182–187.

:Nuo-Xi Pi.

: 14 April 2020,

9 May 2020,

:27 May 2020.

Ram Shepherd Bheenaveni, Department of Sociology, Osmania University, Hyderabad 500007, (T.S.), India. E-mail: bheenaveni@gmail.com;bheenaveni@osmania.ac.in.

10.12032/TMR20200519181