Graphic by Azma Mulundika
Social media platforms and news organizations in Zambia have been bustling over President Edgar C. Lungu encouraging citizens to use traditional home remedies such as steaming in the fight against COVID-19 since 13 January 2021.
Steam inhalation has been a traditional home remedy used to help treat ailments such as colds and flus across the world for many years. However, it has recently became a topic of interest in conversations about COVID-19 treatments, with many studies being conducted about it and numerous journal articles being published on it. Tanzania also recently joined Zambia in using steam therapy as a way to combat the rapid spread of the coronavirus. Having so many people advocate for this treatment has raised many questions about its effectiveness.
In a study conducted by Giancarlo la Marca and colleagues, it was briefly stated that “High temperature can cause irreversible denaturation of proteins and loss of SARS CoV and SARS CoV-2 infectivity” when heated at 56 degrees in liquid environments. Based on this information, 10 asymptomatic or pauci-symptomatic – presenting few symptoms – health care professionals, who had tested positive for the virus, were instructed to use steam inhalation at a temperature between 55 and 65 degrees for at least 20 minutes within one hour. The primary results showed that viral shedding (spreading of the virus) was reduced after four days and the treatment was “Beneficial in halting SARS-CoV-2 virus infection in the upper airway mucosae during the initial stages of infection.” However, if the virus already spread to the lower respiratory tract or internal airway, steam inhalation would be ineffective “Since steam cannot reach the bronchial tree, bronchi and lungs.” A separate article by Marc Cohen also claims that heat therapy can assist the body’s first line defense which is the innate immune system (includes the mucus lining in the respiratory tract) and second line defenses which are the respiratory defenses (the phagocytes cells that destroy foreign materials, bacteria, and dead cells by ingesting them). Steam inhalation helps do this by keeping the mucosal barrier moist and mimicking the effects of a fever which activates the body’s immune system.
There are people, however, who may not be able to use steam inhalation. According to Doctor Moses Simuyemba, a medical doctor, public health specialist, and academic, people with pre-existing conditions such as asthma are generally discouraged from using steam inhalation as it can add to breathing difficulties. Because it is also common practice to incorporate different ingredients into steaming routines, Doctor Simuyemba advises people with severe allergies to simply use plain water without the addition of other ingredients. It is very important to note, however, that steam inhalation is only being used as a treatment to provide relief for COVID-19 symptoms and not as a cure. “We are not using steaming as an actual treatment for COVID” says Elizabeth Machipisa, a medical doctor under the Ministry of Health in Zambia. COVID-19 patients are categorized according to three main levels of severity, mild, moderate, and severe. Patients with mild cases are able to benefit from steam inhalation with fewer drugs while patients with moderate cases are encouraged to use steam inhalation alongside prescribed medication.
According to Doctor Machipisa, there is no specific cure for COVID-19 and patients with more severe cases are kept in hospital on full medication, without the use of steam inhalation. The medication does not treat the virus as a whole but rather specific aspects of the virus. For instance, according to Doctor Simuyemba, patients with severe or critical cases of COVID-19 are susceptible to pneumonia because “With severe illness, you have other infections taking advantage of that situation” and the antibiotics prescribed are used to treat the pneumonia and not necessarily the virus. This is because antibiotics are mostly used to treat diseases and not viruses. Doctor Machipisa lists the anti-inflammatories colchicine and dexamethasone as the two main drugs being used in the treatment of COVID-19, as well as the antibiotic azithromycin. These drugs are accompanied with supportive drugs such as vitamin C and zinc sulfate to make up what she refers to as “The conventional treatment for COVID”.
Other recommended medications according to the Ministry of Health in Zambia guidelines are the antibiotics Amoxil and sceptrin and anti-inflammatory drugs ibuprofen and aspirin. However, some citizens prefer to take a more herbal route by adding different herbs, leaves, roots, and essential oils to their steaming routines. A study conducted by Dâmaris Silveira and colleagues, aimed at determining if herbal medication can be used as adjuvant treatment for COVID-19, provided a risks and benefits assessment for “Selected herbal medications traditionally indicated for “respiratory diseases.”” The study contrasted typically recommended medications such as paracetamol and ibuprofen with herbal medicines such as lemongrass, garlic and eucalyptus. The conclusion of the study was that while it may not be a cure, “Several herbal medicines have safety margins superior to those of reference drugs.” which means that, amongst other things, patients are less likely to suffer from the unwanted side effects of pharmaceutical drugs.
Aside from physical relief, steam inhalation also seems to provide non-physical benefits. In the article by Marc Cohen, “Heat-based treatments also offer psychological benefits and enhanced mental wellness by focusing attention on positive action.” According to Doctor Simuyemba a home-based treatment such as steam inhalation allows people to feel more in control of their situation and less stressed or anxious which helps improve their overall well-being and “When your overall well-being is improved what happens is your immunity is better. Stress, anxiety and so on ultimately reduce your immunity and make you more susceptible to infection.” Doctor Simuyemba re-emphasizes that steam inhalation is not a cure, but in order to acquire its full benefits consistency is key.