RESPIRATORY HEALTH FOR BETTER COVID-19 OUTCOMES

[Mike 03]

A theoretical essay by the New England Complex Systems Institute (Yaneer Bar-Yam's complexity institute)

Blake Elias, Chen Shen and Yaneer Bar-Yam, Respiratory health for better COVID-19 outcomes, New England Complex Systems Institute (March 16, 2020).
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Abstract
What can an individual do to reduce their risk of having a severe case of COVID-19? In the absence of a cure, improving the health of an individual, especially pulmonary health, is important. Hydration, balanced nutrition, and regular sleep may help along with appropriate exercise. Once an individual is infected, fresh air and cleaning the environment are recommended. This is important for protecting those who interact with a patient in home or healthcare settings. It is also consistent with reducing re-exposure to viral particles that the individual may cough, sneeze or breathe out.

Overview
Attention to wellness and individual care during the mild period of COVID-19 may impact the probability and degree of severity. Among the well established means of strengthening the immune response to many viruses are elevated hydration, balanced nutrition (chicken or egg drop soup!), good sleep habits, and non-interference with febrile (elevated temperature) unless it exceeds safe limits [1]. Improving respiratory health even before becoming infected, should also improve outcomes.

Good ventilation, and frequent cleaning, of the environment of individuals that are ill with COVID-19 is widely recommended by health authorities [2]–[5]. This is critical for anyone who must interact with a patient, whether family members in the home, or healthcare providers in medical settings. It may also provide benefits through reducing re- exposure of the individual to viral particles, which may affect pulmonary tissue that is not yet infected, or has been recently cleared by the immune system.

Deep breathing has been shown to improve respiratory health and patient outcomes across a number of conditions [6]–[8]. While more intensive chest physiotherapy has not been found effective in treating hospitalized pneumonia patients [9], for mild symptoms standard breathing exercises may be beneficial.

In about 80% of cases, COVID-19 has only mild symptoms and individuals recover without requiring significant medical intervention. In 20% of cases the disease becomes severe, 10% require Intensive Care to survive, including ventilators. and 2-4% of cases result in death. The outcome is also sensitive to underlying cardiovascular health and risk increases dramatically with age. In a typical case the disease begins mild, and after several weeks suddenly progresses to become severe. A competition between viral replication and elimination by the immune system underlies disease progression. A sudden onset of severity indicates that the battle reaches a transition (tipping point) to a different phase. This may be due to the extent of damage to lung tissue, overload of some capacity of the immune system, auto-immune impacts such as a Cytokine storm, or other mechanisms. The sensitivity of the transition to multiple factors, suggests that even a small change in individual conditions may shift the balance. Strengthening the immune system or reducing the ability of the virus to spread across the pulmonary tissue may be helpful.

The coronavirus spreads via droplets from coughs, sneezes and exhaled air of individuals who carry the virus (regardless of whether they show symptoms). The following recommendations to improve pulmonary health and reduce exposure / reexposure to viral particles are safe for individuals in reason- able all-around health. Anyone with specific health concerns or respiratory issues may wish to consult their physician before adopting them. Please note that these recommendations will not substitute for prevention, we only hope that they may reduce the severity in some cases.

Recommendations

Aerobic exercise. Before infection aerobic exercise is recommended to strengthen cardiovascular health. Once infected, during the period of mild symptoms, moderate daily aerobic exercise can improve lung ventilation. Such exercise may benefit immune function as well [10]. Ideally, do this exercise outdoors or with open windows or otherwise well ventilated areas. In sufficiently warm climates, longer walks or even running may improve lung capacity. Jumping jacks, jogging in place, or dancing can be done even in small spaces.

Read more: https://necsi.edu/respiratory-health-for-better-covid-19-outcomes

This institute has several dozen papers/essays exploring different aspects of the coronavirus crisis, including a critique of the Neil Ferguson paper and recommendations for supermarkets. There is much to explore here.

[Hoyt]

1. Wonder if breathing exercises like using an incentive spirometer might help avoid pneumonia?

[crimycarny]

2. Very helpful and answers a question I had

I’m a regular runner and whenever I’ve gotten sick (cold, whatever) I will continue to run as long as I don’t have a fever. Some have told me I shouldn’t exercise at all, but should “rest” since my immune system is trying to fight off whatever I have. But I’ve always felt better when I go for a run, especially if it’s something respiratory. It feels like I’ve cleaned out my lungs for lack of a better description.

I was wondering if I should do the same if, God forbid, I get COVID-19. After reading this article it looks like I should do do what I normally do which is to continue my exercise routine as long as I’m not running a fever. Obviously I would run outside in the fresh air and not close to anyone else.

Very interesting article, thanks for posting.

[enough]

3. K&R, thanks. NT