Do breathing exercises really work? UK doctors on how to protect against coronavirus and manage symptoms – The Guardian

Posted: April 10, 2020 at 2:47 am

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Rest as soon as you notice any symptoms (posed by model). Photograph: PeopleImages/Getty Images

You will already be regularly washing your hands and social distancing, but many of us are still likely to become infected with coronavirus. Doing what you can now to improve your health and boost your immune system will help your body cope. Thankfully, the majority of cases are mild and you should recover within a week, though if your symptoms are persistent it is vital to seek medical advice from NHS 111 rather than try to continue to manage at home. With that in mind, heres what you can do to put yourself in the best position to help your recovery.

Tom Wingfield, a physician and clinical lecturer in infectious diseases at the Liverpool School of Tropical Medicine, says you should avoid anything that damages your lungs stop smoking, and dont expose others to secondhand smoke. Open fires are not great, and if you have allergies that irritate your lungs, avoid what you can. One upside of the lockdown is that air pollution has decreased. And, says Wingfield, [general aerobic] exercise will help your lungs.

There is no magic supplement. The advice is as its always been: reduce your alcohol consumption, exercise, sleep well and reduce stress. A varied, balanced diet, with lots of vegetables and fruit, is important, but there is little evidence for most vitamin and mineral supplements.

Getting out in the sun each day can also be beneficial, says the GP Amir Khan. The majority of people have low vitamin D because we dont have enough sunlight in the UK, and we are coming out of winter. Vitamin D levels will be depleted, so theres no harm in taking a vitamin D tablet.

Many people who are suspected of having had the virus report at least one day of fatigue. Now is not the time to try to tough things out. Your body is using all its energy to fight a virus that is infecting cell after cell, says Khan. Even with mild symptoms, youll have some days when you feel fine and other days when you are tired and achey. You can potter around the house and make food if you need to, but you shouldnt be doing any more than that and, where possible, you should be on the sofa or in bed.

Once you develop a fever, he says, your body is starting to use energy to raise your core body temperature to make it an unfavourable environment for the virus to reproduce. You shouldnt wait until you feel tired [to rest], because by then youve expended too much energy already.

Khan says: Everybody should be sticking to two to three litres of fluid a day as normal. When you have a fever, says Saira Ghafur, an honorary respiratory consultant at St Marys hospital in London, you can become dehydrated, so you need to make sure that even if you dont feel like it, youre drinking as much as possible. If you feel youre not peeing very much, thats another sign youre very dehydrated and should seek medical advice.

Take paracetamol, rather than ibuprofen. There has been concern that ibuprofen, an anti-inflammatory, could reduce immune function and make coronavirus symptoms worse, but there is not enough evidence to confirm this. Still, the advice is to take paracetamol for fever and muscle pain instead. If you have been prescribed ibuprofen and develop symptoms of Covid-19 then discuss that with your medical practitioner, says Wingfield.

Khan has seen advice online about taking vitamin C to treat coronavirus but that doesnt mean you should be trying this at home. It has been used intravenously in very, very high doses in hospitals in China. Thats a big difference to what you get in a tablet. The jury is still very much out in terms of using intravenous vitamin C for coronavirus.

Taking a vitamin C tablet from the chemist or supermarket wont stop you getting an infection and it wont help treat the infection, says Khan. And certainly dont try to take very high doses.

Dont pin your hopes on superfoods or the social media posts about alkaline foods (a virus doesnt have a pH level, and you cant change the bodys pH level through diet). What about garlic? It may help reduce the length of things like a cold, but wont prevent it, says Khan. And theres no evidence it has any effect on coronavirus.

Its far from clear. On Monday, the author JK Rowling shared a video of Sarfaraz Munshi, the head of urgent care at Queens hospital in Romford, London, demonstrating breathing techniques that he said could relieve symptoms and prevent someone developing a secondary pneumonia infection. People with asthma and those recovering from pneumonia are often helped by respiratory physiotherapists, says Wingfield, who can help support your breathing with exercises. The main thing you are trying to do is make patients lungs open as much as they can and try and get rid of some of the fluid and inflammatory material.

Coronavirus, says Khan, causes inflammation around the alveoli, the air sacs at the peripheries of the lungs, and it can damage them. It reduces your lung capacity. If you are safely managing your condition at home [on advice from a doctor or the NHS 111 service], then breathing exercises might help.

What youre really doing there is forcing air into the alveoli by taking big breaths in and holding the alveoli open, and that will help clear any excess mucus, pathogens, as well as stop them from becoming hardened, which can happen. This is with the caveat that you are safe to stay at home and you dont need to be in hospital. If theres any chance of pneumonia, you should be in hospital.

However, Laura Breach, a spokeswoman for the Association of Chartered Physiotherapists in Respiratory Care (ACPRC), says while the exercises should be harmless for healthy individuals, she would not advise them, adding that they could make symptoms worse in someone suffering breathlessness. Although Munshis video was well-intentioned, the ACPRC says the techniques are not correct (it is preparing its own video). If you did try the exercise, you only need to take three or four breaths so as not to hyperventilate and become dizzy, and if you have coronavirus symptoms, there is no need to make yourself cough as part of the exercise. We would always encourage nose-breathing rather than mouth-breathing, because your nose is really important in humidifying the air that you breathe in and catching any particles in the air, says Breach.

There is no evidence these exercises will help healthy people prepare for the illness, she says. There are patients with longer-term respiratory conditions and we do teach them techniques to give them a better starting point. If its something you should be doing then your healthcare professional will have already advised that. Instead, the ACPRC says: Propping yourself up with pillows, or leaning forward onto the back of a chair can be beneficial to breathlessness.

Wingfield also questions whether the exercises can aid recovery from coronavirus its a slightly evidence-free zone and says if you are having trouble breathing, you should seek medical help rather than simply try to follow breathing exercises at home. But they can keep your lungs moving, and some people might find these exercises meditative and stress-relieving, says Wingfield. Ghafur agrees: None of this is evidence-based.

One of the big things in intensive care that were seeing with a lot of patients, says Ghafur, is you have to put them on a ventilator in what we call a prone position, which basically means youre lying on your front. Its not in any recommended guidance for patients who are not in intensive care, but if youre able to lie on your front for a while that can help breathing. Theres no harm in trying it, she says, but only if youre generally fit and healthy. Do not try to lie on your front if you are older, infirm, have mobility problems or are pregnant.

Lying continuously on your back is not ideal. If you can sit and take deep breaths in and out, that will help any respiratory condition youre taking in a bigger lungful of air and that will help remove any mucus. However, she adds that there is no evidence that this will improve your recovery.

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Do breathing exercises really work? UK doctors on how to protect against coronavirus and manage symptoms - The Guardian

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April 10th, 2020 at 2:47 am

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