Role of Yoga in the Management of Covid 19 Patients
There is ample evidence and expanding coverage on the Covid 19 pandemic today. The increasing burden of cases has not only overwhelmed our fragile public healthcare system but also stressed our economy due to lockdowns. The last one year of the pandemic has seen tough testing times for our healthcare systems, social support systems and resilience of our citizens to anti-pandemic measures. Evidence-based treatment guidelines have been formulated, revised and advocated by both Ministry of Health and Family Welfare and Ministry of Ayush in the last one year for healthcare practitioners to treat Covid 19 patients. There has been a clamour for improving one's “Immunity” and being healthy and fit to reduce the impact of Covid 19. The present article highlights the benefits of yoga in management of Covid and Covid like acute respiratory illnesses.
Covid 19 pandemic is an Acute respiratory illness caused by SARS-COV-2 virus. There is a variability in its clinical presentation from no symptoms at all to mild symptoms that form a large proportion of those affected to those with moderate and severe symptoms requiring oxygen, ventilator or ICU support. Covid 19 patients have to contend with distress due to fear of worsening of symptoms, respiratory distress, hypoxia, fatigue and insomnia and other symptoms during covid 19 infection that is amplified due to isolation anxiety. The anxiety and uncertainty about the trajectory and course of illness among the Covid 19 positive patients and those suspected and being in quarantine can lead to psychologic distress that can down regulate their immune defenses and increase the chance and severity of infection similar to earlier studies. Studies have shown psychologic stress to enhance the rates of infection in communities during a flu season. Even among the healthcare workers impending anxiety and stress can down regulate immune responses and defenses that can lead them to contract this infection and increase its severity.
The accompanying psychologic distress and sequel in covid 19 patients are often ignored and not managed. There have been reports of anxiety and acute depression leading to suicides during home isolation and in covid care hospitals. Social isolation has led to anxiety and led to severe mental health issues in those with preexisting anxiety or depressive disorders.
Providing psychological treatment and support may reduce the burden of comorbid mental health conditions and ensure the wellbeing of those affected. There is some evidence that enhancing general physical and mental health may reduce burden of acute respiratory illness. CCRYN has been in the forefront in the war against covid by deploying doctors and yoga therapists in Covid care hospitals. Simple yoga practices that involve improving respiratory effort and lung capacity have been shown to improve Oxygen saturation in those with respiratory distress. Bhujangasana breathing, Sulabha Matsyasana breathing, shashankasana breathing and yogic breathing have been found useful in this situation. Inducing relaxation response using pranayama such as Nadishodana and Bhramari and yogic relaxation techniques have shown to reduce psychologic distress, anxiety, depression and stress in these hospitalized patients. These techniques have also shown to reduce severity of symptoms on Wisconsin Upper respiratory tract symptom survey in adults with mild to moderate covid symptoms. Stress reduction effects have been observed using stress questionnaire and cardiac autonomic function, i.e. heart rate variability. Yoga is also known to improve duration and quality of sleep with lesser waking episodes and more deep sleep as assessed using a novel sensor technology. Several practices like Yogic breathing, chair breathing and shashankasana breathing are also known to improve oxygen saturation levels independently.
Yoga and meditative practices can play an important role as an adjunct in reducing psychosocial distress in the community. CCRYN (Central Council for Research in Yoga and Naturopathy) an autonomous body under Ministry of Ayush has developed a psychosocial rehabilitation program for Covid 19 patients in consultation with NIMHANS (National Institute of Mental health and Neuro Sciences), Bengaluru and SVYASA University where in Ayush doctors will be trained in screening for psychosocial distress, counselling and management of psychosocial distress in covid 19 patients using yoga and naturopathy approaches. It is important that through socio-culture structuring the masses are motivated to engage in regular physical activity, yoga and meditative practices. WHO has taken these initiative at world over as GAPPA (Global action plan on physical activity) program. Fit India Movement program of Govt. of India is also following in the same direction. This apart, Covid 19 patients also need to be educated on Lifestyle, diet and self-care approaches for managing symptoms during home isolation involving Naturopathy methods such as steam inhalation, nasal irrigation with saline water, Cold sponging for fever, hot chest pack, arm and foot bath for chest congestion, along with home remedies for mild symptoms. It’s imperative that we adopt an integrated evidence based approach of all healthcare systems to manage this pandemic effectively.