Keywords
COVID-19, alternative medicine, pandemic, search activity
This article is included in the Emerging Diseases and Outbreaks gateway.
This article is included in the Coronavirus (COVID-19) collection.
COVID-19, alternative medicine, pandemic, search activity
The COVID-19 pandemic is a massive health crisis worldwide. Within seven months, it has affected 216 countries, and more than 11 million population have been infected by the SARS-COV-2 virus, which causes COVID-191. In Indonesia, COVID-19 transmission has been reported in all provinces, with 68,226 confirmed cases recorded by July 8th 20202. The World Health Organization (WHO) noted that Indonesia is the third country with largest number of cases in South East Asia3. Therefore, appropriate action is urgently needed to halt COVID-19 transmission among the public.
Effenberger et al.4 noted that the high virulence of SARS-COV-2 contributes to the super-spread of COVID-19. In addition, the large number of asymptomatic cases catalyze the intensity of the transmission among population. Currently, no vaccine has been developed for COVID-19. The pandemic has triggered a large-scale behavior change among the global population to protect their health5. This may include an increase of public interest concerning alternative medicine.
Alternative medicine in Indonesia is called Jamu and is well-known. It is commonly composed by herbal medicines, such as ginger and curcumin, which are extracted and added to water to be drinkable. Both ingredients and other methods of Jamu are accessible and available to the general population of Indonesia. Jamu is commonly used to preserve immunity. Therefore, this study aimed to examine public interest concerning alternative medicines in Indonesia during the COVID-19 pandemic. Time lag scenarios were also investigated.
This was a quantitative study using secondary data from Indonesia. The data was obtained from Google Trends using Google Relative Search Volume (RSV) and COVID-19 case data. Google RSV presents information on how many terms have been searched at a particular time using the Google search engine, i.e. the data provides information about public interest towards a particular term6. A high RSV (maximum 100 points) indicates high public interest; while the lowest (0 points) shows an absence of public interest7. In this study, COVID-19 cases were defined as laboratory-confirmed cases positive for SARS-COV-2 virus as reported by the Indonesian Government. The data were retrieved from January 1st 2019 to June 6th 2020 weekly (total of 74 weeks; 2019: weeks 1–52, 2020: weeks 53–74).
Data for confirmed cases of COVID-19 nationwide were collected from the Indonesian Ministry of Health (MoH), where COVID-19 cases are reported daily (https://www.kemkes.go.id/article/view/20031900002/Dashboard-Data-KasusCOVID-19-di-Indonesia.html).
Google RSV data for Indonesia were collected from Google Trends (www.trends.google.com) with web search as default option8. Search terms were divided into three categories with subterms in each of the categories as follows: 1) alternative medicine (‘Jamu’ [alternative medicine]; 2) herbal medicine (‘tanaman obat’ [herbal medicine], ‘jahe’ [ginger], ‘kunyit’ [curcumin]); and 3) alternative medicine activities (‘cara membuat jamu’ [how to make jamu], ‘membuat jamu’ [make jamu], ‘menanam tanaman obat’ [planting herbal medicines], ‘menanam jahe’ [planting ginger], ‘menanam kunyit’ [planting curcumin]).
The first category ‘Jamu’ was employed to recognize public interest toward alternative medicine during the pandemic in Indonesia; as stated before ‘Jamu’ is traditional alternative medicine in Indonesia used for maintaining and improving immunity. The second category (herbal medicine) was used to understand public interest on the types of medical plants being used. According to Salim and Munadi9, the production of ginger and curcumin in Indonesia was the highest compared to other medicinal plants, where the consumption trend during 2011–2015 increased by 21.95% and 5.92%, respectively. Moreover, the Statistics Office of Indonesia recorded that the total harvest of ginger and curcumin on 2018 is the largest in Indonesia10. Therefore, search terms of ‘jahe’ [ginger] and ‘kunyit’ [curcumin] was selected in the second category. The third category (alternative medicine activities) collected information about public interest toward performing Jamu and planting herbal medicines.
This study followed the methodology of previous studies7,11. After checking and cleaning the data, there was no missing data noted. The data was stored in Microsoft Excel 2010, and then transferred to STATA v13 (College Station, TX, USA) for analysis. Google RSV data was available weekly, and therefore COVID-19 case data was also analyzed weekly.
The data was not normally distributed, so Spearman rank test was used to examine the correlation between Google RSV and COVID-19 cases. Time lag correlation between Google RSV and COVID-19 was also analyzed, where the procedure referred to Husnayain et al.11 and Torres-Reyne12. The significance level was set at 0.05.
The pattern of COVID-19 case and Google RSV in Indonesia is visualized in Figure 1. Since the first confirmed COVID-19 case was reported in Indonesia on March 2nd 2020 (week 61 of this study), COVID-19 cases have been increasing in Indonesia. According to the MoH, 30,514 confirmed cases of COVID-19 were reported during 14 weeks (March 2nd–June 6th 2020); mean weekly cases were recorded as ~315 cases.
COVID-19 cases compared with (A) ‘Jamu’ [alternative medicine] search term; (B) herbal medicine search terms (‘tanaman obat’ [herbal medicine], ‘jahe’ [ginger], ‘kunyit’ [curcumin]); (C) alternative medicine activities search terms (‘cara membuat jamu’ [how to make jamu], ‘membuat jamu’ [make jamu], ‘menanam tanaman obat’ [planting herbal medicines], ‘menanam jahe’ [planting ginger], and ‘menanam kunyit’ [planting curcumin]). Letters: A, January 30th 2020: COVID-19 declared as Public Health Emergency of International Concern; B, March 2nd 2020: first imported case was reported in Indonesia; C, March 16th 2020: social distancing declared by Indonesian Government.
RSV of ‘Jamu’ [alternative medicine] from week 1 until week 60 was 40–60 points, with search activity increasing from week 61 (March 1st-7th 2020). The highest RSV score for this search term was in week 63 with 100 points (Figure 1A). The RSV of ‘tanaman obat’ [herbal medicine], ‘jahe’ [ginger], and ‘kunyit’ [curcumin] before the pandemic (week 1–60) was 19–49 points, with the RSV dramatically increasing from week 61 (42–79 points). The peak for all herbal medicine search terms was found in week 64 (100 points) (Figure 1B).
A similar trend is shown for alternative medicine activities search terms (Figure 1C). Before the pandemic (week 1–60) these terms had an RSV of 0–36 points. In week 61, the RSV increases ~2 fold higher. The term ‘cara membuat jamu’ [how to create jamu] and ‘membuat jamu’ [create jamu] reached their peak on week 63 (100 points) and 64 (100 points), respectively. Meanwhile, the peak for ‘menanam jahe’ [planting ginger] and ‘menanam kunyit’ [planting curcumin] was recorded on week 65 and week 63, respectively, with 100 points. The peak for ‘menanam tanaman obat’ [planting herbal medicines] reached its peak on week 63 (similar to ‘cara membuat jamu’ [how to create jamu]) with the highest score of 48 points.
Table 1 displays the correlation between COVID-19 cases and Google RSV in Indonesia. All search term categories (alternative medicine, herbal medicine, and alternative medicine activities) are positively correlated with COVID-19 cases (p<0.05). The terms ‘jahe’ [ginger] (r=0.6376), ‘kunyit’ [curcumin] (r=0.6550) and ‘menanam jahe’ [planting ginger] (r=0.6713) have the strongest correlation towards COVID-19 new cases in Indonesia. Based on a time lag scenario, the correlation between COVID-19 cases and Google RSV showed good performance with weekly data, where all search terms are significant (p<0.05). In the time lag scenario, a strong correlation is also found for the terms ‘jahe’ [ginger], ‘kunyit’ [curcumin], and ‘menanam jahe’ [planting ginger] (r>0.6; p<0.05).
Search term | Weeks | ||||||
---|---|---|---|---|---|---|---|
lag -3 | lag -2 | lag -1 | lag 0 | lag 1 | lag 2 | lag 3 | |
Alternative medicine | |||||||
‘Jamu’ [alternative medicine] | 0.4351** | 0.3858** | 0.3917** | 0.4028** | 0.3165** | 0.3113** | 0.3032* |
Herbal medicine | |||||||
‘tanaman obat’ [herbal medicine] | 0.5231** | 0.5474** | 0.5648** | 0.5643** | 0.5839** | 0.5408** | 0.5330** |
‘jahe’ [ginger] | 0.6362** | 0.6306** | 0.6289** | 0.6376** | 0.5806** | 0.5668** | 0.5422** |
‘kunyit’ [curcumin] | 0.6096** | 0.6115** | 0.6238** | 0.6550** | 0.5974** | 0.5839** | 0.5623** |
Alternative medicine activities | |||||||
‘cara membuat jamu’ [how to make jamu] | 0.5324** | 0.4589** | 0.5101** | 0.5127** | 0.4573** | 0.4410** | 0.4360** |
‘membuat jamu’ [make jamu] | 0.5531** | 0.5082** | 0.5592** | 0.4874** | 0.4525** | 0.4236** | 0.4132** |
‘menanam tanaman obat’ [planting herbal medicine] | 0.5212** | 0.5312** | 0.5609** | 0.5690** | 0.5778** | 0.5583** | 0.5394** |
‘menanam jahe’ [planting ginger] | 0.5699** | 0.5802** | 0.6117** | 0.6713** | 0.6253** | 0.6174** | 0.6052** |
‘menanam kunyit’ [planting curcumin] | 0.2830* | 0.3019* | 0.3146** | 0.4187** | 0.4076** | 0.5019** | 0.4790** |
Since the first COVID-19 confirmed case was reported on March 2nd 2020 (week 61), there have been a dramatic increases in cases in Indonesia. The mean weekly cases of COVID-19 is ~315 case (Figure 1), and we noted the highest case load reported on week 74 (4741 cases). We also show in our data that COVID-19 cases in Indonesia have increased by ~305% within 14 weeks (30,514 cases; Figure 1). This indicates a super-spread of COVID-19 in Indonesia. The high population and population mobility may take an essential role in intense COVID-19 transmission13,14.
Alternative medicine is one option for individuals to maintain and increase their immunity during the COVID-19 pandemic. In our study, we found that the search activity of alternative medicine-related terms, including herbal medicine and activities surrounding alternative medicine, was low and steady before the pandemic (weeks 1–60). This was even though a Public Health Emergency of International Concern had been declared by the WHO on January 30th 2020 (week 56). Interestingly, only after the first COVID-19 confirmed case in Indonesia was announced on week 61 did the search activity dramatically increased. Most of the search terms looked at in this study reached their peak on week 63–64, after which social distancing issue has been established in Indonesia (on March 16th 2020)15. The alternative medicine issue also appeared among the public around March 13th – 16th (week 63) during the pandemic. In this period, the President of Indonesia claimed that herbs can fight COVID-19, which may have increased public interest toward alternative medicine16.
In this study, all search terms were associated positively with COVID-19 cases in Indonesia (p<0.05). This indicated that increasing COVID-19 cases elevated the public interest concerning alternative medicine. A similar result was also shown with the time lag scenario, where all search terms were positively associated with COVID-19 cases (p<0.05). This finding shows that there was an increase in search activities 1–3 weeks after and before the increase of COVID-19 cases in Indonesia. However, a strong correlation is detected at the present time (lag 0), particularly for the herbal medicine category. This study found that correlation analysis using weekly data of Google RSV compared to COVID-19 new cases in Indonesia showed good performance, which is collaborated by previous studies7,17–19.
The trend of Google RSV for all search terms was higher during the pandemic. This indicates increasing public interest toward alternative medicine during the pandemic in Indonesia. Wise et al.20 noted that awareness of the public related to the COVID-19 pandemic is elevated due to the risk posed by the virus, and the large number of available information sources serves to reinforce their protective behavior. Galankis21 also reported that the public tend to search for information related to health either short- or long-term during the pandemic.
The Indonesian Government plays an important role in the high public interest toward alternative medicine during the pandemic. Actions concerning monitoring and providing valid information regarding alternative medicine to the public are urgently needed. These actions should prevent misuse of medical herbal among the public. In addition, information could be used to empower communities to provide self-remedial source at a household level, such as planting herbal medicines.
Public interest on alternative medicine related-terms has dramatically increased during the COVID-19 pandemic in Indonesia. Search terms relating to alternative medicine, herbal medicines and activities surrounding alternative medicines correlate positively with an increase of COVID-19 cases in Indonesia. This study recommends that the Indonesian Government take an active role in informing the public about alternative medicines, and monitoring and providing valid information. This may empower households to produce medical herbs independently.
COVID-19 case data available from: https://www.kemkes.go.id/article/view/20031900002/Dashboard-Data-KasusCOVID-19-di-Indonesia.html
Google Trend data available from: https://trends.google.com/. Search terms and other parameters are provided in the text.
Mendeley: Public interest on alternative medicine during pandemic in Indonesia, http://dx.doi.org/10.17632/fv7tprb24j.122.
Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).
Views | Downloads | |
---|---|---|
F1000Research | - | - |
PubMed Central
Data from PMC are received and updated monthly.
|
- | - |
Is the work clearly and accurately presented and does it cite the current literature?
Yes
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
Yes
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Yes
References
1. Kardeş S: Public interest in spa therapy during the COVID-19 pandemic: analysis of Google Trends data among Turkey.Int J Biometeorol. 2021. PubMed Abstract | Publisher Full TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: Balneotherapy; Rheumatic and Musculoskeletal Diseases; Google Trends
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
Yes
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Medical Informatics, eHealth, mHealth, IoT, smartphone apps, data mining, CDSS
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Partly
If applicable, is the statistical analysis and its interpretation appropriate?
Partly
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Yes
References
1. Yuan X, Xu J, Hussain S, Wang H, et al.: Trends and Prediction in Daily New Cases and Deaths of COVID-19 in the United States: An Internet Search-Interest Based Model.Explor Res Hypothesis Med. 2020; 5 (2): 1-6 PubMed Abstract | Publisher Full TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: clinical epidemiology, statistical methodology
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | |||
---|---|---|---|
1 | 2 | 3 | |
Version 2 (revision) 25 Feb 21 |
read | read | |
Version 1 06 Oct 20 |
read | read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Already registered? Sign in
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)