Speakers:

Yu Yanhong, a member of the Central Guidance Team in Hubei province, a member of the Leading Party Members' Group of the National Health Commission, and secretary of the Leading Party Members' Group of the National Administration of Traditional Chinese Medicine;

Zhang Boli, academician of the Chinese Academy of Engineering and president of Tianjin University of Traditional Chinese Medicine;

Huang Luqi, academician of the Chinese Academy of Engineering and president of China Academy of Chinese Medical Sciences;

Liu Qingquan, president of Beijing Hospital of Traditional Chinese Medicine;

Qiu Haibo, vice president of Zhongda Hospital of Southeast University.

Chairperson:

Xi Yanchun, spokesperson of the State Council Information Office of China

Date:

March 23, 2020

Xi Yanchun:

Good afternoon, friends from the media. Welcome to the ninth press conference held by the State Council Information Office in Wuhan, Hubei province. We will brief you on the important role of Traditional Chinese Medicine (TCM) in prevention and control of COVID-19. First, a short video will help us get to know today's speakers.

(video clip)

Let me introduce the speakers: Yu Yanhong, a member of the Central Guidance Team in Hubei province, a member of the Leading Party Members' Group of the National Health Commission, and secretary of the Leading Party Members' Group of the National Administration of Traditional Chinese Medicine; Zhang Boli, academician of the Chinese Academy of Engineering and president of Tianjin University of Traditional Chinese Medicine; Huang Luqi, academician of the Chinese Academy of Engineering and president of China Academy of Chinese Medical Sciences; Liu Qingquan, president of Beijing Hospital of Traditional Chinese Medicine; and Qiu Haibo, vice president of Zhongda Hospital of Southeast University.

Now, I will give the floor to Ms. Yu.

Yu Yanhong:

Friends from the media, good afternoon! This is my third time to join you in a press conference held by the State Council Information Office in Hubei. On the previous two occasions, I introduced the role and effect of TCM. I would like to take this opportunity to thank journalists for their coverage. Your recognition spurs us to continue with relevant work.

As COVID-19 moves from epidemic to global pandemic status, the question arises as to what China can offer to the world in terms of its experience in the use of TCM? Many of you have shown keen interested in how TCM can exert its influence.

Friends from the media, under the situation when COVID-19 poses a global threat, several experts and I have gathered here today hoping to conduct more discussion and exchanges, to share with you our thinking on the role of TCM in the prevention and control of COVID-19, as well as its effect in patient treatment.

General Secretary Xi Jinping has attached great importance to the prevention and control of COVID-19. He has personally led, commanded and deployed all available forces in the battle against the outbreak, emphasizing many times the usefulness of combining TCM and Western medicine. Under the leadership of the CPC Central Committee with Comrade Xi Jinping at its core, with the deployment of the central leading group on epidemic response, as well as Premier Li Keqiang and Comrade Wang Huning, the Central Guidance Team in Hubei led by Vice Premier Sun Chunlan has promoted the involvement of TCM in treating COVID-19 patients. I will brief you on the role TCM has played in epidemic prevention and control in the following aspects:

First, we have mobilized a great many TCM experts. More than 4,900 TCM medical staff across China have been organized to support Hubei, including three academicians and hundreds of experts, accounting for about 13% of the total medical staff assisting Hubei. The size and professional level of the TCM assisting team is unprecedented.

Second, we have been carrying out classified treatment. For mild cases as well as patients in the recovery stage, we applied TCM early on. For severe and critical patients, we combined treatment with TCM and Western medicine. Corresponding treatment plans and norms have been formulated. In the early stage of the outbreak in Wuhan, many suspected cases were waiting for the diagnosis results at the quarantine areas, we offered them TCM decoctions or ready-made TCM formulae to effectively relieve their symptoms and ease the burden on medical services.

Third, we have screened traditional Chinese medicine (TCM) prescriptions and medications in treatment and selected those that are effective against the COVID-19 disease. We promoted breakthroughs in medical science and technology, and synchronously observed the clinical effectiveness of Chinese patent medicines and herbal compounds for inclusion in the fifth, sixth, and seventh editions of the national diagnosis and treatment plan for the COVID-19. Up to now, "three medicines and three formulas" have been proven effective in treating the disease, namely: Jinhua Qinggan Granule, Lianhua Qingwen Capsule, Xuebijing Injection, Lung Cleansing and Detoxifying Decoction, Huashi Baidu Formula, and Xuanfei Baidu Formula.

People in all the sectors agree that TCM has played an important role and become a highlight in the epidemic prevention and control work. Here is a set of data. A total of 74,187 COVID-19 patients, or 91.5% of the total confirmed cases nationwide, have been treated with TCM. Among them, 61,449 were from Hubei, accounting for 90.6% of confirmed cases in the epicenter province. Clinical observation showed that the total effective rate of TCM treatment reached over 90%. TCM has proven effective in relieving symptoms, preventing mild and common cases from developing into severe cases, improving the recovery rate and reducing fatality rate, and boosting the recovery of patients during their rehabilitation process.

During the epidemic prevention and control, TCM professionals were among the first to arrive at the scene. With proficient medical skills and strong medical ethics, they boosted their motivation to move forward, demonstrated the uniqueness and strengths of TCM treatment, and made great contributions in the fight against COVID-19.

Friends from the media, TCM is a treasure of ancient Chinese science, and a form of holistic medicine that covers prevention, treatment and rehabilitation of illnesses. It enjoys a history dating back to antiquity and extensive popularity among Chinese households. Whenever a serious epidemic has broken out, we have always found suitable solutions using TCM treatment. Various ancient medical classics, including Qian Jin Fang (Essential Formulas for Emergencies [Worth] a Thousand Pieces of Gold) by Sun Simiao, Shang Han Za Bing Lun (Treatise on Cold Damage Disorders) by Zhang Zhongjing, Wen Yi Lun (A Treatise on Epidemic) by Wu Youke, and Wen Bing Tiao Bian (Analysis of Pestilential Febrile Diseases) by Wu Jutong, offer a systematic summation of basic TCM theories, clinical practices, prescriptions, medications and medical techniques for the prevention and treatment of infectious diseases. Such books embody the wisdom of ancient Chinese people who have constantly explored, considered and summarized the rules of epidemic prevention and treatment. Inspired by the ancient TCM classic Zhou Hou Bei Ji Fang (Manual of Clinical Practice and Emergency Remedies) written by TCM master Ge Hong, Tu Youyou, a researcher at the China Academy of Chinese Medical Sciences, discovered artemisinin, which saved millions of lives across the world. The discovery won her the 2015 Nobel Prize in Physiology or Medicine.

TCM has also proven effective in treating infectious diseases caused by viruses. In recent years, with frequent outbreaks and the spread of viral respiratory diseases, the TCM treatment of SARS and influenza virus A subtype H1N1 have yielded significant results. Meanwhile, we have accumulated rich experience in responding to emerging infectious disease epidemics. Research confirmed that TCM can enhance the body's immunity by holistic adjustment and can also inhibit the viral infections and even kill viruses.

Despite the lack of any effective drugs or vaccines in the early stage of the COVID-19 outbreak, medical staff carefully examined TCM procedures and drew on the lessons from the past experience of using TCM in treating viral infections. We have also studied the classic TCM prescriptions devised in ancient times in the light of our clinical practices, putting forward a plan for COVID-19 diagnosis and treatment involving TCM alone and a combination of TCM and Western medicine. This is an important feature and also the advantage of the Chinese plan. We have selected a series of effective TCM treatments featuring three types of medicines and three kinds of prescriptions. This once again demonstrated that TCM, as an everlasting and valuable asset inherited by many generations through the ages, is something to be cherished. It is not only still useful and effective, but also economical and easy to access.

Diseases know no borders, and a virus is the enemy of all humanity. We are willing to share with the rest of the world our valuable experience and effective treatment on COVID-19. WHO Director-General Tedros Adhanom Ghebreyesus has also underlined the effectiveness of the measures taken by China to deal with the virus, urging other countries to learn from China's experience.

I would like to take this opportunity to say that TCM community in China would like to strengthen cooperation with the rest of the world, share experiences concerning epidemic prevention and control as well as medical treatment procedures, and provide any part of the world in need with effective Chinese patent medicine, advice, and assistance as much as we could. Thank you.

Xi Yanchun:

Thank you, Ms. Yu Yanhong. Next, we will move on to questions. Please ask questions via the video link, first identifying your news outlet. The floor is now open for questions.

CGTN:

TCM has been widely and effectively applied in the treatment of COVID-19 in Wuhan. My question is for Mr. Zhang Boli. What are the lessons you've learnt in the course of the medical treatment in Wuhan and are willing to share with the rest of the world?

Zhang Boli:

Thank you for your question. I arrived in Wuhan on Jan. 27. That is almost two months ago. When I first came here, the epidemic situation was fairly severe. Hospitals were filled to capacity. Hundreds of people were waiting in line at fever clinics, and they couldn't get medical treatment for hours. Patients and accompanying visitors were mixed together, which was very worrying. Two months later, what is the situation in Wuhan today? The number of hospitalized patients has been reduced from over 60,000 to around 5,000, and that of patients in critical condition has fallen from 12,000 to about 1,800. In particular, until yesterday, no new confirmed cases of COVID-19 were reported in Wuhan, marking the fifth day in a row we have seen zero increase, including zero new confirmed case, zero new suspected case, and zero existing suspected case. Therefore, the situation in Wuhan is turning for the better, just like Dante Alighieri wrote in Divine Comedy that "E quindi uscimmo a riveder le stele ["And so we went out to study the steles."]

However, when I read about the current situation in Europe and the U.S., I'm also very worried and sympathize with them. Therefore, we are very willing to share our experience with all our peers around the world. In the light of our experiences with a disordered situation in Wuhan at the very beginning of the outbreak of the epidemic, the Central Guidance Team made a decisive decision, seeking to conduct classified management and centralized isolation of all suspected infection cases. People with fever symptoms, people who need a 14-day quarantine for medical observation, suspected infection cases, and people who had close contact with COVID-19 infected cases were totally separated. Thanks to the great efforts made by local community workers and residents in Wuhan, it only took a few days to separate the different types of cases for appropriate treatment. However, without medicine, isolation is only half of the battle. Since there is no effective medicine or vaccine, we began to give TCM decoctions and proprietary Chinese medicines to our patients. At the beginning, it didn't go well; we only delivered medicines to some 3,000 to patients from 13 districts of the city on the first day. The curative effect of TCM appeared after two or three days, however. With the fever gone and cough reduced, patients began to try TCM on their own initiative, and more than 10,000 bags of TCM decoction were delivered at that time. So far, we have delivered TCM products to more than 600,000 patients. What's the effect? It has contained the spread of the epidemic. Let me give you some data. In early February, over 80% of the four types of people I mentioned previously became confirmed COVID-19 infected cases. By the middle of February, it dropped to 30%, and then down to under 10% at the end of February. Centralized isolation of all suspected infection cases, and enabling our patients to take TCM have contained the spread of the epidemic, which is the foundation of our fight against COVID-19.

The second experience is classified management and scientific treatment. The central government asked to leave no coronavirus patient unattended, and treat every single one regardless of cost; however there weren't enough hospital beds at that time. The Central Guidance Team then decided to treat severe cases in specially hospitals designated, while keeping the mild cases in Fangcang shelter hospitals, and introducing management standard of treatment for mild and ordinary cases. However, Fangcang shelter hospitals are quite different from ordinary hospitals. With thousands of people living in a super large hall, how to manage them in an orderly way is a big problem. Under such circumstances, Professor Liu Qingquan and I jointly advised the headquarters to adopt TCM to treat the patients in Fangcang shelter hospitals. At the same time, the first temporary TCM hospital was built in Jiangxia district of Wuhan. In this temporary hospital, we put service ahead of treatment. How did we provide our service? Because of the large space, the temperature inside Fangcang shelter hospital was relatively low. We provided every patient with a warm bed, hot water, hot meals, as well as our hospitable service. At the same time as treatment, we also tried our best to show our care for the patients. For example, we communicated with our patients a lot, celebrated birthdays with them, and lead them to do exercise together. Because of our enthusiasm, the doctor-patient relationship became very harmonious. After staying a few days at Fangcang shelter hospital, patients felt it was more like a big community or extended family instead of hospital, which was also helpful to the treatment of all patients.

Patients treated in Fangcang shelter hospitals were all mild and ordinary cases. According to the WHO, severe cases account for 13% of the total COVID-19 infected cases, while critical cases account for around 7%. So, our goal when treating patients in the Fangcang facilities was protecting them from developing a severe or critical condition. We adopted a comprehensive treatment which combined TCM with Western medicine. In addition to TCM decoction and oral proprietary Chinese medicine, we also provided massage, guasha (or scraping therapy), and medicine for external application. What's the effect? Let me take Jiangxia temporary hospital as an example. There were a total of 564 patients treated, and none developed severe symptoms. We then shared our experience with other Fangcang temporary hospitals, and treated more than 10,000 patients with TCM. As a result, around 2% to 5% of patients treated in Fangcang hospitals developed a severe condition. Therefore, we could say that TCM treatment has significantly reduced the possibility of mild cases turning into severe and critical cases, which is the key for our fight against COVID-19.

Another point is that treatment of severe cases is the most important of all. So for severe patients, we still prioritize the use of Western medicine, while traditional Chinese medicine (TCM) is used as a supplement –in other words, we use the combination of TCM and Western medicine. The use of TCM can often have a significant effect despite being supplementary. It has been used in the treatment of severe cases in Jinyintan Hospital, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, and Leishenshan Hospital, and have achieved very good results. So our conclusion is that TCM injections should be used boldly and early. For example, Shengmai Injection and Shenmai Injection can stabilize the saturation of blood oxygen and improve the oxygenation level of patients; Tanreqing Injection and Reduning Injection can work along with antibiotics; while Xuebijing Injection has some effect on inhibiting inflammation and controlling disease progression. Thus, the treatment of severe cases and the combination of TCM and Western medicine have helped reduce mortality rates and contributed to our victory.

Lastly, when patients turned negative for the virus, they will be discharged from hospital and moved to isolation centers for rehabilitation. During the rehabilitation stage, patients may sometimes experience fatigue or cough, or are not in very good spirit. Their lung inflammation have not been fully squashed, and the immune function has not been completely repaired. In this case, we combine TCM and Western medicine to help them do some breathing exercises, in addition to TCM acupuncture, massage and other comprehensive therapies. This can improve their symptoms, promote lung inflammation reduction, protect the damaged organ, and repair immune function. Therefore, we can say that TCM and Western medicine play their respective roles and their combination is conducive to the rehabilitation period, thus securing the final victory.

The early intervention of TCM and its participation in the whole process of treatment of the COVID-19 plays an important role. The course of COVID-19 is like a parabola, and TCM is effective at both ends of the curve. And although there is so far no specific cure for the disease, TCM has provided effective treatment plans. The combination of TCM and Western medicine is the highlight of the Chinese approach to the disease. Currently the epidemic is rampant across the world and the disease knows no border, and TCM is always ready to help. We are very willing to share the above experience with our colleagues. Thank you.

Reuters:

Du Bin, a member of the High-level Expert Panel of the National Health Commissio, said during a press briefing last week that he hoped that TCM will use the evaluation methods of Western medicine to prove its effectiveness in treating the novel coronavirus. What are the TCM treatment methods that are endorsed by the Chinese government? What evidence is there to prove their effectiveness? Thank you.

Qiu Haibo:

Professor Du Bin is a colleague of mine, and we are treating severe and critical patients together. We often discuss COVID-19 diagnosis and treatment as well as the combination of TCM and Western medicine in the treatment.

I myself practice Western medicine and I am an ICU doctor. As to how to evaluate the effectiveness of TCM, we can see that it is increasingly evaluated by internationally recognized evidence-based medicine methods. Also, we can see that more and more TCM, proprietary Chinese medicines and TCM injections are using internationally recognized randomized controlled trials to evaluate their efficacy. As we all know, the randomized controlled studies led by Academicians Wang Chen and Gao Runlin evaluated the treatment of influenza H1N1 and chronic heart failure by Chinese patent medicine Jinhua Qinggan Granule and Qiliqiangxin Capsule respectively. The sample sizes were 410 to 526 cases respectively. It was observed that, as compared to standard treatment solely, the additional use of Jinhua Qinggan Granule can significantly shorten the fever time of influenza patients, while Qiliqiangxin Capsule can significantly improve the cardiac function of chronic heart failure. These studies have been published internationally.

In addition, Xuebijing, a Chinese medicine injection, has been highlighted during COVID-19 treatment. The academicians and professors here today have been adopting the internationally recognized method of evidence-based medicine to make clinical research on this. Indeed, we know that TCM treatment is usually based on syndrome differentiation, and that prescriptions vary among individuals. However, we are increasingly using internationally recognized methods of evidence-based medicine to evaluate the efficacy of TCM.

TCM was used early on coronavirus treatment, especially for the treatment of severely and critically ill patients. According to our clinical observations, the treatment is mainly useful in the following circumstances: First, preventing patients with mild and moderate symptoms from becoming severely ill; second, preventing severely ill patients from developing into critically ill cases; third, treating severely and critically ill patients; fourth, helping severely and critically ill patients recover. TCM has played a very important role in the above four aspects. To reiterate, it works well in preventing moderate and severe symptoms from becoming worse, plays a certain role in the treatment of severely ill patients, and proves to be a very effective method for the rehabilitation from COVID-19.

Actually, TCM and Western medicine adopt quite different treatment models. In Western medicine, most chemical drugs are designed to hit a single target, while TCM drugs mostly act on multiple targets. That is to say, TCM works more like as a team. But, as far as the disease is concerned, there are many targets to hit. In the case of COVID-19, the virus can cause inflammation and immune disorder, leading to impaired organ function including that of the lungs and heart. In other words, the virus, inflammation and the organ damages caused by immune disorder are all targets. Western medicine relies on chemical drugs that attack a certain target for treatment, while TCM could hit multiple targets, that is, it might have an effect on curbing virus replication, the regulation on inflammation and immunity, later organ damages and coagulation, among others.

Here, I would like to take Xuebijing Injection as an example. Xuebijing has been well studied in recent years, and has been proven to be effective with at least six chemical constituents by the Shanghai Institute of Materia Medica of the Chinese Academy of Sciences. Moreover, in vitro experiments have shown that the Xuebijing Injection can inhibit the replication of novel coronavirus. In related animal experiments, we have also found that Xuebijing Injectionn can suppress inflammatory responses and restore coagulation disturbances. Based on these preclinical studies that show Xuebijing is effective in treating severe pneumonia, we decided to use it to treat severely and critically ill patients.

We know that there is no specific drug for the treatment of COVID-19. As such, would a TCM injection have therapeutic effects on it? First of all, the efficacy of Xuebijing has been widely demonstrated during the treatment of severe pneumonia and sepsis. For example, one study tested Xuebijing Injection on critically ill patients with severe community-acquired pneumonia (SCAP) in 33 Chinese hospitals. This study was led by Professor Bai Chunxue from Fudan University. Outcomes included an 8.8% lower 28-day mortality rate, and a significantly shorter duration of mechanical ventilation and ICU stay. This research, as well as research for treating patients with sepsis, revealed that Xuebijing Injection was effective in reducing mortality rates.

We have seen the therapeutic effects of Xuebijing in previous studies of SCAP and sepsis, so now we are observing whether it is effective for the treatment of severely and critically ill patients infected with the novel coronavirus. We have learnt that a study on 156 severely and critically ill patients in 32 hospitals has found promising results for Xuebijing Injection combined with basic treatment among some cases. However, final conclusions can't be made until the research is finished. At least given the current situation, Xuebijing Injection might be a very important therapy for the treatment of COVID-19, especially for the treatment of severely and critically ill patients.

Of course, there is also a lot of concern about the safety. However, the post-marketing safety research of Xuebijing Injection showed that its clinical adverse reaction rate was no higher than 1%, which is basically safe. As a multi-target therapy of the COVID-19 treatment, I believe that traditional Chinese medicine, combined with current traditional therapies, will certainly save more lives of severe and critical patients. Thank you.

Xinhua News Agency:

According to current research, which traditional Chinese medicines are most effective for treating COVID-19 and how did you evaluate their efficacy? Thank you.

Zhang Boli:

Thank you for your question. Don't panic if you have good medicine in your hand. Every time after a major epidemic, good medicines will emerge. There's a saying that goes, "good medicine comes from a terrible plague." There is no specific drug or vaccine to treat COVID-19, so just like our fellow practitioners of Western medicine, we have focused on finding effective existing drugs. Meanwhile, we have developed several new drugs and prescriptions, which Ms. Yu just mentioned: "three drugs and three prescriptions." Since Professor Qiu has made a very good introduction of Xuebijing Injection, I would like to mainly introduce the Jinhua Qinggan Granule and the Lianhua Qingwen Capsule.

The Jinhua Qinggan Granule was developed during the 2009 H1N1 influenza pandemic, and was already available on the market. The drug itself is the combination of two drugs: one is Maxing Shigan Decoction from Shanghan Lun (the Treatise on Cold Pathogenic Diseases), and the other is Yinqiao Powder from Wenbing Tiaobian (the Detailed Analysis of Epidemic Warm Diseases). By now, Maxing Shigan Decoction has been used for 1800 years, while Wenbing Tiaobian has a history of 300 years. Therefore, both are effective prescriptions which stand the test of time. The drug's main effects are dispelling wind, ventilating the lungs, clearing heat and removing toxicity. During the course of its development, Wang Chen, an academician of the Chinese Academy of Engineering, performed a RCT (randomized control trial) study, and published a paper in the American journal Annals of Internal Medicine to demonstrate that the drug is as effective as Tamiflu in treating H1N1 influenza, but has less adverse reactions and a lower price.

We have also done a 102-case clinical RCT study at the frontline in Wuhan. The results showed that in treating mild and moderate patients of COVID-19, patients who took the Jinhua Qinggan Granule, compared to the control group, reduced their rate of turning more severe by two thirds, and decreased their fever 1.5 days faster. At the same time, white blood cell, neutrophil and lymphocyte counts reflecting immune function were significantly improved. The results proved that the Jinhua Qinggan Granule dose have an effect, especially in reducing the rate of patients turning severe and improving immunological indicators.

Beijing You An Hospital has conducted clinical observations on this medicine given to over 80 patients, and found it shortened the time taken to obtain a negative nucleic acid test result by 2.5 days. The absorption of pneumonia exudate started to show improvement two or three days earlier than those in the control group, with leukocytes and lymphocytes increasing significantly. Therefore, we consider this an effective medicine to treat the COVID-19, and is widely used in the clinic.

Prescribed by academician Wu Yiling during the fight against SARS, Lianhua Qingwen medicine can detoxify the lungs and clear dampness and heat. It has shown curative effects on mild and common COVID-19 patients. China has donated 100,000 boxes of Lianhua Qingwen to Italy, and I also heard that Italy would like another 100,000 boxes.

A total of 284 COVID-19 patients from 23 hospitals in nine provinces and municipalities were involved in a random controlled trial (RCT) guided by academician Zhong Nanshan, academician Li Lanjuan and myself. Research showed that, compared with the control group, the symptom disappearance rate of the treatment group was higher and the duration of symptoms was shorter. About 83.8 percent of the patients in the treatment group saw an improvement in their lung scan images, and 78.9 percent recovered, while the figures for the control group were respectively 64.1 percent and 66.2 percent. As for the rate of mildly-ill patients entering a more severe infection was 50 percent lower for the treatment group than the control group.

In-vitro studies also showed that Lianhua Qingwen has an inhibitory impact on the novel coronavirus outside the body. So, how to distinguish it from Jinhua Qinggan in the clinic? Well, those with low-grade fever and a severe headache could take Jinhua Qinggan, while those with high-grade fever and dry stool could be given Lianhua Qingwen. Thank you.

US network NBC:

It was reported that China has flown medical materials to Italy and dispatched a medical team consisting of TCM experts. Many people don't believe TCM is scientific. Are you worried that Western patients may be not ready to receive TCM treatment? Thank you.

Huang Luqi:

Thanks for your question. I am not worried at all. I don't worry because I am confident in TCM and the practice confirms this. Belonging to totally different medical systems, TCM and Western medicine study diseases and health from different perspectives based on clinical efficacy. Just now, Ms. Yu Yanhong mentioned Chinese scientist Tu Youyou, who received the 2015 Nobel Prize for Physiology or Medicine for her work in helping to discover artemisinin, which is widely used to treat malaria. Based on clinical efficacy, TCM has now been spread to 183 countries and regions. Statistics from the World Health Organization (WHO) show Chinese acupuncture has been recognized by 103 WHO member countries. The 72nd World Health Assembly passed the Eleventh Revision of the International Classification of Diseases that, for the first time, adopted chapters on traditional medicine originated from TCM.

Based on clinical efficacy, Ms. Yu introduced you to the "three medicines and three formulas", and Mr. Qiu and Mr. Zhang briefed on other three prescriptions. Now, I will also elaborate on the "three formulas" in accordance with their clinical efficacy.

The first formula is the Lung Cleansing and Detoxifying Decoction which is derived from several classic recipes including Ephedra, Apricot, Kernel, Gypsum, and Licorice Decoction, Belamcanda chinesis and Ephedra Decoction, Minor Bupleurum Decoction, and Poria Five Powder. It can be used as a general recipe for treating mild, moderate, severe and critically-ill patients.

Out of the 1,263 patients at 66 designated medical institutions in 10 provinces (excluding Hubei), 1,214 or 96.12% have been discharged from hospital after recovery. According to clinical observation, among the 57 patients with severe symptoms who received TCM treatment combined with Western medicine and took the Qingfeipaidu Formula, 42 or 73.7% have been discharged from hospital after recovering and none developed into critical cases. A comparison of CT images showed that lesions in the lungs of 53 patients (or 93%) had more or less shrank in size after they took the Qingfeipaidu Formula for two courses of treatment (six days).

Data from clinical studies suggest that the Qingfeipaidu Formula has played a positive role in preventing mild and common cases from worsening into severe and critical ones. By avoiding a deterioration in the patients' conditions, the medicine has greatly reduced the mortality rate and blunted the harm of the epidemic.

The second formula is the Xuanfeibaidu Formula, which was derived from several classic formulas, including Maxingshigan Decoction, Maxingyigan Decoction, Tinglidazao Xuanfei Decoction, and Qianjinweijing Decoction. A case-control study was conducted at Wuhan Hospital of Traditional Chinese Medicine and Hubei Provincial Hospital of Integrated Chinese & Western Medicine to compare the outcomes of 70 patients who took the formula with a control group of 50. The study proved the significant efficacy of the formula in controlling inflammation and increasing lymphocytes. Compared with the control group, the lymphocyte recovery of the patients treated with the formula was 17% higher, and the clinical recovery rate was 22% higher.

The First Affiliated Hospital of Henan University of TCM treated 40 mild and common patients with the formula. After taking the formula for an average of 9.66 days, the patients saw the nucleic acid test turn negative. None developed into severe or critical cases, and the improvement rate by CT diagnosis was 85%.

Wuhan Hospital of Traditional Chinese Medicine, Hubei Provincial Hospital of Integrated Chinese & Western Medicine and the makeshift hospital in Wuhan's Jiangxia district conducted a cohort study among 500 patients treated with the formula. The study showed that the symptoms of mild and common patients, including fever, cough and fatigue, were significantly alleviated, as shown by CT scans, and none turned into severe cases.

The third formula is the Huashibaidu Formula, developed by the national TCM team from the China Academy of Chinese Medical Sciences. It is based on the recommendations of the early national diagnosis and treatment plan as well as experiences from clinical practice.

Clinical observations were conducted at Wuhan Jinyintan Hospital, the makeshift hospital in Wuhan's Dongxihu district and the health center of Wuhan's Jiangjunlu street on the curative effect of the formula for severe, common and mild patients respectively. CT images of the 75 severe patients at Wuhan Jinyintan Hospital showed significant improvements in lung conditions and clinical symptoms. The time it took to turn the nucleic acid negative and the length of hospital stay was shortened by an average of three days. The efficacy was further confirmed by a study on 124 common patients at the health center of Wuhan's Jiangjunlu street, as well as randomized controlled observations of 894 mild and common patients (452 were treated with TCM) at the makeshift hospital in Wuhan's Dongxihu district. No adverse reactions related with the medicine were identified after monitoring the hepatic and renal functions of the patients who took the Huashibaidu Granule. In addition, an experiment on guinea pigs with the coronavirus found the formula can reduce lung viral load by 30%.

The National Medical Products Administration approved clinical trials of the Huashibaidu Granule on March 18. The research and development process of TCM is different from that of chemical or biological medicines. The Huashibaidu Formula is derived from clinical practice. The approval document has provided material evidence for the theories and clinical efficacy of TCM, and an opportunity to effectively translate the research data of TCM into high-level clinical evidence.

After receiving the approval, a great number of foreign friends asked us for the medicine. They nicknamed the formula "Q-14." The letter Q stands for "cure," while "14" refers to the fact that the medicine is composed of 14 herbal components. As the saying goes: "One for all, and all for one." We are ready to stand together with the people of other countries to fight the coronavirus, and share our experiences and achievements in TCM. Thank you.

The Kyunghyang Shinmun:

TCM was known to have been included in the treatment of diseases such as SARS and MERS. Are there any differences in TCM treatment for COVID-19 and SARS? If so, why did you make such changes? Thank you.

Liu Qingquan:

Thank you. Just now, Ms. Yu Yanhong, Mr. Zhang Boli, and Mr. Huang Luqi answered your question to some extent. TCM has been used to treat infectious diseases for thousands of years and we have developed a relatively mature scientific law during the process. The treatment of infectious diseases mainly focuses on three methods, namely clearing heat, eliminating dampness, and detoxing. Each method will be prioritized according to the causes of different infectious diseases. Several famous classic prescriptions have been developed over thousands of years. Earlier, Mr. Zhang Boli and Mr. Huang Luqi introduced that some TCM prescriptions have proved to be effective in treatment, such as the Maxing Shigan Decoction and Daqinglong Decoction of Zhang Zhongjing, a renowned Chinese physician in Eastern Han Dynasty (25-220); Reed Decoction recorded in "Qianjin Yaofang" (Essential Prescriptions Worth a Thousand Pieces of Gold) by Chinese pharmaceutical expert Sun Simiao of the Tang Dynasty (618-907); Membrane Source Opening Beverage by Wu Youke, a renowned physician of the Ming Dynasty (1368-1644) specialized in infectious diseases; and Yinqiao San (Lonicerae and Forsythiae Powder) and Zhengqi San (Qi-Righting Powder) by Wu Jutong of the Qing Dynasty (1644-1911). These prescriptions can be used in the early stages of the disease to eliminate pathogen and strengthen vital qi. TCM can quickly mobilize the human body's defense system to evict invading enemies and prevent viruses from causing significant damage to the body. For example, the method of eliminating dampness boosts immunity, like boosting the morale of military forces. In Chinese, "mianyi" (immunity) is a word with TCM characteristics, meaning preventing epidemic disease. The method of detoxing is equivalent to giving the enemy (virus) a head-on blow. The method of clearing heat can change the internal environment of the human body so that the virus cannot escape or hide. Therefore, these treatment methods can be used together to defeat the virus.

In the past two decades, China has developed several new prescriptions based on classic ones while dealing with the outbreak of new infectious diseases. For example, as Mr. Zhang Boli just mentioned, we introduced Lianhua Qingwen capsule/granule, a drug for virus infections, during the SARS outbreak in 2003. And several domestic academicians, including Mr. Wang Chen and Mr. Zhang Luqi, were inspired to develop Jinhua Qinggan granule to cope with the H1N1 pandemic in 2009. This proves the efficacy of TCM and its role in the fight against modern infectious diseases.

As for new diseases such as COVID-19, these conventional drugs have been put into new use. Clinical studies show that Jinhua Qinggan granule and Lianhua Qingwen capsule/granule have apparent efficacy for the clinical treatment of COVID-19 patients with mild and moderate symptoms and play a significant role, especially in the treatment for COVID-19 in Wuhan.

Xuebijing Injection has a clear phased effect in treating "inflammatory storm" and coagulopathy. Just now, Mr. Qiu Haibo gave a detailed introduction about Xuebijing Injection. I am not going to elaborate on it anymore.

In the battle against COVID-19 in Wuhan, based on the three methods, we have developed three effective prescriptions from classic ones, namely lung-clearing and detoxing decoction, dampness-eliminating and detoxing prescription, and lung-ventilating and detoxing prescription. This is a process that seeks innovative ways to treat various diseases. Thank you.

The Star:

What kind of TCM diet therapy or treatment can help people improve their immunity and enhance the cardiopulmonary function to fight against the virus? Thank you.

Huang Luqi:

Thank you for your question. I know that traditional Chinese medicine is quite popular in Malaysia. People there have a good knowledge of TCM. So, I would like to quote two sentences from the Medical Classic of the Yellow Emperor (Huang Di Nei Jing), an ancient TCM document, to answer your question:

The first sentence is "Shang Gong Zhi Wei Bing", which means that the best doctors perform preventive treatment. Preventive measures are highly valued in TCM. In the fight against the COVID-19 epidemic, preventive measures have also played an important part. In accordance with the requirements of the health commission of Hubei province, medical workers working at the Fangcang shelter hospitals were provided with preventive prescriptions taken in the form of both medicine and food, and none of them have been infected so far.

The other sentence is "Bu Xiang Ran Zhe, Zheng Qi Cun Nei, Xie Qi Ke Gan, Bi Qi Du Qi". This theory emphasizes the improvement of bodily resistance, which can be achieved through physical exercises of TCM features such as taichi and baduanjin, or by taking TCM products serving as both medicine and food. Health-building diets, taken according to TCM theories, are effective in building immunity to realize the goal of improving bodily resistance and eliminating pathogenic factors. The theory also emphasizes the importance of warding off epidemic diseases, which can be achieved by home isolation and disinfection of the living environment.

TCM theories also hold that mental health is important to improving bodily resistance. This means that, during an outbreak, we should pay more attention to balancing work and rest, harmonizing form and spirit, and keep a sound mental attitude, so we will not be susceptible to the attacks of epidemic diseases. Thank you.

China News Service:

The number of patients infected with COVID-19 has been reduced remarkably in the hospitals in Wuhan and Hubei province in general. Many of the remaining patients are severely or critically ill. For these patients, how could TCM play a bigger role in treating them? Thank you.

Liu Qingquan:

Thank you for your question. The issue you raised is very important. The treatment and cure of critically-ill patients is very important to the reduction of mortality rate at the moment. I am a doctor of intensive care medicine and an emergency physician, except that I study critical care medicine from a TCM perspective. In recent clinical treatment of COVID-19 patients over a period of more than two months, I have been talking to Director Qiu Haibo and Professor Du Bin about the relevant issues. In the two-month period, we gradually gathered experience in treating patients with a combination of TCM and Western medicine to reduce mortality. The National Health Commission and the State Administration of Traditional Chinese Medicine built a team of experts to offer guidance to conduct coordinated TCM and Western medicine treatment to treat the severe cases. TCM and Western medicine professionals worked together to treat patients with a combination of medicinal methods. Western medicine's life support technologies are very important methods to treat critically-ill patients, such as use of ventilators, hemofiltration, ECMO (extracorporeal membrane oxygenation), and maintaining water and electrolyte balance. TCM doctors have used medicines such as Da Huang (Rheum palmatum L.) to clear the hollow viscera to tackle asynchrony between patient and ventilator while lowering dosage and shortening duration in use of tranquilizer, painkiller and muscle relaxant. Medicines such as Shenmai Injection, Shengmai Injection and Pure Ginseng Decoction were used to stabilize the circulatory system and blood oxygen saturation. Xuebijing Injection was used as a therapeutic intervention for cytokine storm. TCM methods have been working well in coordinated treatments.

In the process of visiting patients while integrating TCM and Western medicine therapies, our Western medicine experts focus on standardizing the treatments, such as through the use of mechanical ventilation, the use of hemofiltration, choosing the best time for tracheal intubation, and so on. TCM doctors, based on such problems mentioned above, have promoted the use of TCM for the severe and critically ill patients. The organic combination of TCM and Western medicine brings out the strengths in one while making up for the other's weaknesses, thereby reducing the mortality rate. These are indispensable Chinese experiences in treating severe and critically ill patients with COVID-19 and reducing the mortality rate. In the global response to the epidemic, these experiences can be provided to countries around the world for use, and ultimately help the mortality rate of severe and critically ill patients decline further, and further alleviate the condition. Thank you.

Bloomberg:

Which countries has China given advice to on TCM in the treatment of COVID-19? And have other countries used TCM in their treatment? What have the results been?

Yu Yanhong:

Thank you for your interest in the international cooperation regarding TCM. The public health crisis is a common challenge facing mankind, in which solidarity and cooperation are the most powerful weapons. After the COVID-19 outbreak, many countries and people gave selfless aid to China. People from different countries called out "Stay strong China, stay strong Wuhan," making us feel understanding, support and trust from beyond national borders. Now that the epidemic is breaking out at many locations in many countries, China is willing to cooperate with countries in need in the epidemic prevention and control with TCM and to provide aid within our capacity. The following works have so far been carried out:

First is sharing treatment experiences. We are actively cooperating with the WHO in a timely manner, sharing relevant information on the use of TCM in epidemic prevention and control, translating the latest Chinese versions of the COVID-19 diagnosis and treatment plan into English, putting the full text on the new media outlet of the National Administration of Traditional Chinese Medicine, and actively sharing it with other countries and regions in need. You can check these texts online at any time. These versions of the plan are the most valuable experiences obtained from the centralized management and treatment of tens of thousands of patients over a short period of time. This is indeed precious and the results are very clear. We have also provided technical solutions through remote video conferences for exchanges, and shared treatment experiences with Japan, South Korea, Italy, Iran, Singapore and other countries. For example, Professor Zhang Boli, Professor Liu Qingquan, and President Qiu Haibo, who sit with us today, have carried out several video conferences and international online exchanges. A few days ago, Mr. Zhang Boli connected and exchanged online with counterparts in the United States. Yesterday, Academician Tong Xiaolin also participated in a remote video consultation to check patients far away in Iran.

Second, we have donated TCM products. The donations of these products, such as Chinese patent medicines, prepared slices of Chinese crude drugs, and acupuncture needles, from relevant domestic organizations and institutions, have been delivered to more than ten countries and regions, including Italy, France, and China's Hong Kong and Macao special administrative regions. Since Mr. Zhang and Mr. Huang have detailed the issue, there is no need for me to repeat it.

Third, a number of TCM experts and practitioners have been selected to provide overseas medical assistance. We have noted that some experts have already headed to Italy and Cambodia to lend a hand in the fight against the virus. Based on my knowledge, some TCM experts have also kept close contact with their overseas counterparts, and the feedback has been positive.

Friends from the media, as an oriental wisdom formed in the practices of understanding, interpreting and revealing relations between life and death, TCM has offered up its approaches to prevent the outbreak and exacerbation of infectious diseases. Therefore, its legacy is worthy of being inherited, developed and utilized. During her acceptance speech, Chinese Nobel laureate Tu Youyou said that TCM is a great treasure-house and Artemisinin is a gift from TCM to the world. It is my belief that TCM has always been an essential tool in dealing with epidemics. We are willing to join hands with all countries around the world to defeat COVID-19 and usher in a new glorious era whereby the health of the human race is much improved. Thank you.

Xi Yanchun:

We are much obliged to the speakers here today. No matter whether they are government officials or TCM experts, they went to Wuhan and braved the virus outbreak there for more than two months from winter to spring. For this, we deeply admire them, especially Mr. Zhang, who is at an age above 70. Therefore, please allow me to take this opportunity to pay homage to them again.

Recently, the newly confirmed cases in Hubei province have dropped to zero for several consecutive days. Under the strong leadership of the CPC Central Committee with General Secretary Xi Jinping at its core, with full support from other parts of the country, and with the strong will and mutual help among the people in Hubei province, especially in Wuhan, we finally achieved what we had long expected. Now the cherry trees have blossomed to announce the commencement of spring. On this bright sunny day today in Wuhan, I would like to take this opportunity to wish a more promising future for Wuhan, for Hubei and for China. I would also like to again thank the guests and all of you. Today's press conference has now concluded.

Translated and edited by Wang Yiming, Wang Qian, Wang Yanfang, Li Xiao, Zhu Bochen, Zhou Jing, Lin Liyao, Li Huiru, Zhang Lulu, Wang Wei, Zheng Chengqiong, Huang Shan, Fan Junmei, Guo Xiaohong, Zhang Liying, Yang Xi, Duan Yaying, Liu Sitong, Yuan Fang, Zhang Rui, Wu Jin, Zhang Junmian, Jay Birbeck, Laura Zheng, David Ball, Geoffrey Murray. In case of any dispute over a discrepancy, the Chinese version is deemed to prevail.