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Naturopaths, chiropractors, TCM practitioners, and charlatans selling various nostrums are serving up a seemingly limitless supply of blog fodder in their efforts to exploit the COVID-19 pandemic. Today we take yet another look at this phenomenon, focusing (again) on naturopathy.

Naturopathic “doctors” and “physicians” display an allegiance to pseudoscience and quackery combined with an inflated sense of their competency that does not bode well for their role in combating the coronavirus pandemic, a role they insist on playing to the detriment of their patients and to the real health care providers on the frontlines of treating victims of COVID-19.

The pandemic puts naturopaths and their organizations in an awkward position. To the authorities, they must at least appear to toe the scientific line by urging compliance with advice given by the CDC and other reputable sources, including the fact that there are no proven preventatives or treatments for COVID-19. Otherwise, they could risk the consequences. On the other hand, they’re not about to give up their livelihood – indeed, their raison d’être — which depends on bogus diagnoses, worthless treatments, and a rejection of evidence-based medicine, including their traditional opposition to immunization.

This tension has resulted some hypocritical advice from the American Association of Naturopathic Physicians (AANP), which is asking its members to

Please communicate only evidence-based, accurate information. . . Refrain from posting medically inaccurate or unsubstantiated claims regarding any potential therapies with relation to COVID-19.

The AANP correctly states that

there are no known preventive measures, treatment protocols, or cures specifically for COVID-19 [and] claims that you or naturopathic medicine can prevent, treat, or cure COVID-19 are considered false and misleading. Such claims could impede public health efforts, harm the profession by drawing negative attention, and could put your license in jeopardy.

Given the naturopathic view that evidence-based medicine is optional, one could rationally conclude that “harm the profession by drawing negative attention” is the driving force behind this effort.

Yet, even as they try their hardest to project an air of scientific authority, the AANP cannot resist promoting unproven therapies.

A recent AANP press release urges physicians and hospitals to utilize IV Vitamin C as “an effective and affordable intervention” for “high risk and hospitalized patients”, pretentiously offering themselves as “a resource to physicians and organizations looking for clinical guidance in the proper use of this intervention”. Why? Because Paul Anderson, ND, described as an expert on IV Vitamin C and a member of the AANP’s COVID-19 Task Force, has “been using IVC safely and effectively . . . for over 20 years” and his review of the evidence “shows that the use of IVC in hospitalized COVID-19 patients has a high probability of reducing hospital stay, duration and improving outcomes.”

Should the medical profession count on the AANP’s and Anderson’s assessment of the evidence? Well, the FDA and its experts were decidedly unimpressed by Anderson’s supposed expertise when he served as the AANP’s point man in trying to get approval for the use of unproven substances in compounded drugs. Anderson

testified before the PCAC [Pharmacy Compounding Advisory Committee, a panel of experts advising the FDA] in support of sodium dichloroacetate, stating that his group had administered over 10,000 doses orally and IV as an adjunct treatment for cancer. Anderson testified at the same committee meeting in favor of cesium chloride. Both substances were voted down unanimously by the PCAC and cesium chloride was ultimately banned by the FDA.

Later, the agency also concluded that sodium dichloroacetate is not appropriate for use in compounded drugs.

Before its ban, cesium chloride, which can have deadly side effects, was used by naturopaths and other fringe practitioners in the treatment of cancer based on a crackpot “theory” that it neutralizes the toxic material produced by tumor cells and prevents them from dividing.

In fact, the FDA has rejected, due to lack of evidence of safety and efficacy, at least a dozen of the AANP’s nominations for substances naturopaths, in their devotion to “evidence-based, accurate information”, have heretofore freely employed in treating their patients.

The California Naturopathic Doctors Association and the state’s Naturopathic Medicine Committee (NMC) are all-in on promoting IV Vitamin C as well:

NMC is also aware of the new research that is available regarding IV Vitamin C and shortened duration of hospital stays for COVID-19 patients, and are prepared to help get NDs into hospitals to assist with administering this therapy to patients should it be recognized as a treatment option.

Not that the medical profession, even without this background information, would ever consider a press release from the AANP as guidance in the treatment of COVID-19, it is worth noting that the Australian Government Department of Health recently issued a safety alert, stating it

is aware of a report that intravenous high-dose vitamin C may be beneficial in the management of a COVID-19 infection. We have investigated this report and found there is no robust scientific evidence to support the usage of this vitamin in the management of COVID-19.

Other experts agree that the evidence for IV Vitamin C in the treatment of COVID-19 is lacking and recommend against it.

In another display of mixed messaging, the AANP advises naturopaths not to claim

This product will boost your immunity to COVID-19 and is a must-have during this pandemic! Purchase now through our site.

Yet, the AANP also says

The global impact of the pandemic and extremely high demand for some products is definitely interrupting the supply of certain ingredients, especially for immune support products. In the face of supply challenges across the entire supplement industry, AANP’s corporate partner Fullscript encourages providers to use their similar products tool to find brands or products that you may not have tried before in case your trusted product may be unavailable.

So, don’t claim a product will “boost” a patient’s immune system but we’ll help you find products that allegedly provide immune “support” to stock your online pharmacy. I’m sure there’s a difference in there somewhere. (Unlike medical ethics, which regards in-office dietary supplement sales as a financial conflict of interest, this is not considered an inherent conflict in naturopathic practice.) By the way, instead of the hard sell, the AANP suggests a subtler approach to promoting dietary supplements in this recommended script for naturopaths advising their patients on COVID-19:

The CDC has recommended that patients secure a three month supply of medications. Our practice has products in stock if you are running low & need refills.

Note the conflation of “medications” with “products in stock”.

To further one’s suspicion that the AANP’s supposed dedication to evidence-based treatment of COVID-19 is less than robust, the AANP is urging participation in a global collection of treatment anecdotes, one purpose of which is to “report contributions by naturopaths to COVID-19 management and risk reduction”. Called the “Naturopathy and Complementary Medicine COVID-19 Support Registry”, it collects case reports not only from naturopaths, but also chiropractors, acupuncturists, herbalists, and practitioners of reiki, healing touch, Ayurvedic, and TCM, as well as MDs, DOs, and nurses, and their patients. The Registry asks practitioners and patients to check off, from a long list of unproven treatments, any therapy they’ve employed, including turmeric/curcumin, colostrum, hydrotherapy, mushrooms, homeopathy, echinacea, olive leaf, garlic, yarrow, and (of course) IV Vitamin C, and state their therapeutic goal (prevention, treatment, recovery, etc.). Practitioners and patients are then asked to provide the “case outcome”, all the way from “did not become infected with COVID” and “full recovery-remained outpatient” to “hospitalization-ICU” and “death”.

In other words, having admonished naturopaths not to use unproven treatments, the AANP is urging naturopaths to report the results of those unproven treatments which, of course, they cannot do without using them.

Color me suspicious that this survey will actually produce any information truly useful in treating COVID-19. Rather, I wager it will be a repository of unconfirmed, cherry-picked cases to be deployed as PR and “evidence” of the success of naturopathic and other CAM treatments. We’ll see what happens.

Paging Drs. Fauci and Birx!

In another bit of pretentious self-promotion, the AANP issued a press release encouraging “all government officials coordinating the national response” to COVID-19 to use naturopathic doctors “in changing the trajectory of this public health crisis”. (In a similar bid to exploit the crisis, the California Naturopathic Doctors Association is lobbying for an emergency scope of practice expansion.) In language that blows one’s irony meter wide open, considering naturopathic opposition to vaccination and its association with lowered vaccination rates and higher rates of vaccine-preventable diseases, the AANP claims that

Many current public health practices . . . are foundational principles of naturopathic medicine and inform our approach to support public health efforts through this current pandemic. We stand in solidarity with our colleagues at the . . . CDC, . . . WHO and State and Local governments in promoting essential public health measures to reduce the burden on U.S. and global healthcare systems.

Right, just not the “public health practice” of immunization to reduce epidemic diseases, which their “colleagues” at the CDC named one of the 10 greatest public health achievements of the 20th century.

In its pitch, the AANP also makes the demonstrably false claim that “NDs are trained comparably to conventional doctors to diagnose and triage according to presenting symptoms . . .” The American Academy of Family Physicians begs to differ, noting, among other deficiencies, the low standards for admission to naturopathic “medical” school and their lack of a residency requirement (and therefore meaningful clinical experience), and some 15,000 hours’ difference between the education and training of naturopaths and family practice doctors. Ex-naturopath Britt Hermes has done an excellent exposé (also here) of naturopathic education and training as well, including its emphasis on quackery like homeopathy and bogus diagnoses like “adrenal fatigue”.

The press release ends with a plug encouraging

those individuals who test positive to the SARS-C0V-2 virus but are instructed by healthcare authorities to self-quarantine at home to receive personalized care from naturopathic doctors via telemedicine.

That’s a bad idea. The California NMC has, unsurprisingly, “already received numerous complaints” about naturopaths claiming their nostrums will prevent or treat COVID-19.

In some states, naturopaths are authorized to evaluate and test patients, including children, for COVID-19, a troubling development in light of their lack of education in infectious diseases and their ability to go straight into practice without adequate clinical training. They are also continuing to see patients in the office for no good reason: these naturopathic practices, for example, still offer bogus IV treatments. Another practice offers in-office acupuncture. In each of these and countless other visits to naturopathic offices, patients are increasing their exposure to the virus and naturopaths and their staff members are needlessly consuming scarce personal protection equipment. PPE is a zero-sum game, and for every mask, gown, or pair of gloves used by a naturopath administering some useless nostrum, there is a physician, nurse, or other healthcare provider out there on the front lines without proper PPE risking his or her life.

Some states have created this debacle by foolishly licensing naturopaths as health care providers and others by tolerating their practices under so-called “Health Freedom” laws. During the pandemic, states should not deem naturopaths “essential workers” (which allows them to continue working) and order them to donate their PPE to health care practitioners who actually need it.