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Lifestyle

From vitamin C to breathing exercises: doctors on what you should really do for your health right now


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, here’s what you can do to put yourself in the best position to help your recovery.

Protect your lungs

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 don’t 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”.

Boost your immune system

There is no magic supplement. The advice is as it’s 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 don’t have enough sunlight in the UK, and we are coming out of winter. Vitamin D levels will be depleted, so there’s no harm in taking a vitamin D tablet.”

Rest as soon as you start to notice symptoms

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, you’ll 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 shouldn’t be doing any more than that and, where possible, you should be on the sofa or in bed.”

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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 shouldn’t wait until you feel tired [to rest], because by then you’ve expended too much energy already.”

Keep drinking fluids

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 Mary’s hospital in London, “you can become dehydrated, so you need to make sure that even if you don’t feel like it, you’re drinking as much as possible. If you feel you’re not peeing very much, that’s another sign you’re very dehydrated and should seek medical advice.”

How to manage a fever

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 then discuss that with your medical practitioner,” says Wingfield.

Definitely don’t rely on supplements or ‘miracle’ cures

Khan has seen advice online about taking vitamin C to treat coronavirus – but that doesn’t mean you should be trying this at home. “It has been used intravenously in very, very high doses in hospitals in China. That’s 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 “won’t stop you getting an infection and it won’t help treat the infection”, says Khan. And certainly don’t try to take very high doses.

Don’t pin your hopes on “superfoods” or the social media posts about “alkaline” foods (a virus doesn’t have a pH level, and you can’t change the body’s pH level through diet). What about garlic? “It may help reduce the length of things like a cold, but won’t prevent it,” says Khan. And there’s no evidence it has any effect on coronavirus.

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Can breathing exercises help?

It’s far from clear. On Monday, the author JK Rowling shared a video of Sarfaraz Munshi, the head of urgent care at Queen’s 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 you’re 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 don’t need to be in hospital. If there’s 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 Munshi’s 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.

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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 it’s 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 – “it’s 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.”

But try lying on your front

One of the big things in intensive care that we’re 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 you’re lying on your front. It’s not in any recommended guidance for patients who are not in intensive care, but if you’re able to lie on your front for a while that can help breathing.” There’s no harm in trying it, she says, but only if you’re 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 – you’re 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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