UK Doc’s Breathing Technique for COVID-19 Patients: Does it Work?

UK Doc’s Breathing Technique for COVID-19 Patients: Does it Work?

As countries around the world struggle to contain the COVID-19 pandemic, the search for probable treatments and courses of relief for infected patients continues.

In a video by Dr Sarfaraz Munshi of Queen’s Hospital in London, he explains a breathing technique advised by Sue Elliott, Director of Nursing, from her experience in the ITU.

The video soon made its way across social media after author JK Rowling claimed that it helped her ‘fully recover’ from the symptoms she had been experiencing. She tweeted, “For the last two weeks, I’ve had all symptoms of C19 (though I haven’t been tested) and did this on doctor husband’s advise. I am fully recovered and this technique helped a lot”

However, it is crucial to critically assess any proposed solution to the disease as it is still being studied by medical practitioners and scientists. FIT speaks to doctors to understand what they think of the technique and whether they would recommend it.

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The Technique

People infected with the novel coronavirus are advised to do the following::

1. Take five deep breaths and hold each for five seconds.

2. Take a sixth deep breath and exhale with a big cough while covering your mouth.

3. Repeat this twice.

4. Then lay flat on your stomach bed with a pillow, not on your back.

5. Stay like this for 10 minutes, taking slightly deeper breaths.

“Once you have an active infection, you need to be getting a good amount of air into the base of the lung. I want you guys to start doing this if you have the infection, right from the beginning. If you want to do it before you even pick up the infection, that’s a good idea too,” Dr Munshi says in the video.

In order to evaluate whether the technique does really have benefits, the two basic suggestions in it need to be discussed: deep-breathing and lying on the stomach after.

Breathing in, Coughing Out

Dr Nevin Kishore, Head of Bronchology & Senior Consultant - Respiratory Medicine at Max Hospital, tells FIT that there is no scientific evidence for this working against COVID-19.

But while doctors are not too sure about the extent to which breathing exercises such as this can help in ‘treating’ COVID-19 patients, they do believe that there could be some merit to them.

Dr Nimish Shah, Consultant Respiratory Medicine at Jaslok Hospital and Research Centre, explains, “We advocate breathing techniques for all our respiratory patients. Even all our Yoga techniques are useful for maintaining lung health. Now the way this virus seems to be affecting the lungs, it may not be a bad idea for patients to try it to optimise their lung functions to the best.”

Dr Nimish Shah“But this is all based on anecdotal data. We don’t have specific scientific studies about the impact of such exercises on patients with COVID-19. So it’s important to not look at this as a safety mechanism. Rather, it’s just generally good for the lungs.”

FIT spoke with Dr Satya Ranjan Sahu, Pulmonologist, PSRI Hospital, who explained that the technique will not be helpful for people who are in the serious stages of the disease. “Due to a virus such as the one we have now encountered, certain patients reach the stage of acute respiratory distress syndrome (ARDS). The alveolus (air sacs in the lungs) fill up with fluid and are unable to take in air, because of which the pumping action of the lung fails. Most of the deaths are happening due to this additional component.”

Dr Satya Ranjan Sahu“Such breathing techniques are actually recruitment manoeuvres and can help open up air spaces. But they can only be done by those who are relatively healthy and can actually hold the breath, and even they would need monitoring. For patients who have reached the ARDS stage, it is difficult to hold on to their breaths and this won’t be of much help.”

He again adds that it is not proven whether these exercises will help patients or not, but it can be presumed that they could keep healthy those parts of the lungs which can later be impacted the most by the disease. It is possible that this contributes to preventing the infection from progressing to the last stage and decreases the chance of compilations among those who are infected.

Lying on Your Tummy: Does It Help the Lungs?

Dr Sumit Ray, critical care specialist in Delhi, explains that lying face down, or ‘proning’ as it is called in the field of medicine, has actually been a part of treating people on ventilators who have severe ARDS.

ARDS, in fact, is the condition which necessitates patients of COVID-19 to be put on ventilators, he explains. “Patients on ventilators are sometimes kept in that position for 18-20 hours a day. Of course, they are deeply sedated.”

Studies have found that this positioning helps with oxygenation, improves respiratory mechanics, facilitates drainage of secretions, increases lung volume and reduces the chance of ventilator-associated lung injury.

Dr Sumit Ray“So for milder patients who are able to turn by themselves, it could be of benefit. Similarly, breathing exercises can help open up lung areas that have started to close because of the disease. But of course, nobody knows the exact number of times one should breathe in and out like this, or the extent to which this can help.”

“We can just expect positive results, but we aren’t sure about the specifics”, he says.

Experts Advise Caution

Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. He brings up an important point to keep in mind while doing the routine.

Dr Ashwini Setya“Since we are talking about infected people, precautions must be followed. It is necessary that such breathing exercises are only being carried out in closed isolated spaces. The virus can pass on through aersolizaation, and therefore coughing inside the shirt, or wearing a mask is advisable.”

Talking about the efficiency, he reiterates that there is no authentic evidence of this particular technique. However, our common logic from Yoga and the different pranayamas which we have been practising historically, tells us that they can be effective for lung health.

Dr Ashwini Setya“Any harm from such exercises is unlikely if the patient is isolated and does not have pneumonia or any other serious complication.”

Dr Sahu also advises patients with co-morbidities to be careful. “For instance, people with heart problems or any other chronic illness may not be able to hold their breath for long. This can lead to complications. So a normal person without co-morbidities may opt for it, but others must be exercise caution.”

Dr Shah adds that these exercises can be quite strenuous because we are blowing out carbon dioxide with a lot of pressure. Even the doctor in the video said he felt dizzy after the first round. “If you feel dizzy, don’t do too many repetitions and ensure you are sitting and doing the exercise.”

It is important to understand that these are not precautions and do not ensure immunity from the disease. While doctors agree such exercises could offer benefit for the lungs of people with a mild infection, they maintain that this isn’t an assured ‘treatment’ of the disease. Studies into their exact benefits still need to be conducted to make any robust claims. Isolation, supervision and medical help is advised.

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