COVID-19, the illness caused by the novel coronavirus, attacks the lungs. In the most severe cases, patients need ventilators to breathe, but by then it might be too late. A majority of people put on the machines are dying from the disease.

There is something you can do that might prevent this worst-case scenario.

Dr. Sarfaraz Munshi of Queen’s Hospital in London says that, if you’re starting to have COVID-19 symptoms, you should undertake breathing exercises that will help your lungs fight the illness, thus making it less likely you’ll need hospitalization and ventilation.

“Once you have an active infection, you need to get a good amount of air into the base of your lungs,” he says in a YouTube video. He says people should regularly do the exercises as soon as they begin to show COVID-19 symptoms, and that it’s not a bad idea to do them even when you’re healthy and symptom-free.

Could relatively simple breathing exercises really work? J.K. Rowling, for one, swears by them. The “Harry Potter” author said on Monday that she had coronavirus symptoms for two weeks and diligently followed Munshi’s advice. She wrote on Twitter that she’s now “fully recovered & technique helped a lot.”

Please watch this doc from Queens Hospital explain how to relieve respiratory symptoms. For last 2 weeks I've had all symptoms of C19 (tho haven't been tested) & did this on doc husband's advice. I'm fully recovered & technique helped a lot.https://t.co/xo8AansUvc via @YouTube — J.K. Rowling (@jk_rowling) April 6, 2020

Below is Dr. Munshi’s explanation of how to do the exercises. Watch the video to see him demonstrate.

“The way it will work is, you will take five deep breaths in, and each time you will hold your breath for five seconds," Dr. Munshi says. "On the sixth deep breath, you will take it in and do a big cough [to open up your lower airways], covering your mouth. You will do this twice, and then you will lay flat on your bed [on your front], with a pillow in front of you, taking slightly deeper breaths for the next 10 minutes. Because you’ve got to understand that the majority of your lung is on your back, not on your front. By lying on your back you are closing off more of your smaller airways, and this is not good during the period of your infection.”

Dr. Kathryn Dreger, a professor at Georgetown University’s medical school, explained in The New York Times recently what happens to lungs that are being attacked by COVID-19, and it helps explain why Dr. Munshi’s exercises could indeed make a difference. She wrote:

When we take a breath, we pull air through our windpipe, the trachea. This pipe then branches in two, then again into smaller and smaller pipes finally ending in tiny tubes less than a millimeter across called bronchioles. At the very end of each are clusters of microscopic sacs called alveoli.

The lining of each sac is so thin that air floats through them into the red blood cells. These millions of alveoli are so soft, so gentle, that a healthy lung has almost no substance. Touching it feels like reaching into a bowl of whipped cream.

Covid-19 changes all that.

It causes a gummy yellow fluid, called exudate, to fill the air sacs, stopping the free flow of oxygen. If only a few air sacs are filled, the rest of the lung takes over. When more and more alveoli are filled, the lung texture changes, beginning to feel more like a marshmallow than whipped cream.

When those air sacs become clogged, the lungs stiffen up. Oxygen levels in the patient dramatically fall, and the heart struggles to function properly. A ventilator can help, but only so much. Said one doctor who’s treating COVID-19 patients on ventilators:

“I feel like I’m trying to ventilate bricks instead of lungs.”

Once a patient is on a ventilator, “[d]octors are left with impossible choices,” Dr. Dreger wrote. “Too much oxygen poisons the air sacs, worsening the lung damage, but too little damages the brain and kidneys. Too much air pressure damages the lung, but too little means the oxygen can’t get in. Doctors try to optimize, to tweak.” For patients lucky enough to survive this ordeal and be removed from ventilators, some are likely looking at lifelong severe health problems.

With this context, Dr. Munshi’s breathing and coughing technique makes sense. That said, it’s certainly not a cure-all, and how much it truly helps is unknown.

If you do develop COVID-19, monitor your symptoms closely and stay in touch with your doctor. If you’re having trouble breathing, you might need to be hospitalized.

-- Douglas Perry

@douglasmperry

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