DR SANDHYA RAMANATHAN IS AN AUCKLAND-BASED GP WHO PUBLISHED AN 18-MINUTE YOUTUBE VIDEO GUIDE TO MANAGING MILD CASES OF COVID-19 – HER ADVICE:
The first – priming – is straightforward and relevant to both people with and without Covid-19. To build up our immunity, she encourages people to eat healthy whole foods and keep hydrated. She highlights the importance of sleep and the need to stay calm and keep a positive mindset. She also says people should take daily immune supplements including zinc, vitamin C and vitamin D. All of these can help boost immunity, and a number of studies have suggested vitamin D can reduce the effects of Covid-19.
The second section focuses on reducing the amount of virus in the nose – or the “viral load” for those who have Covid-19. For this she advises people to use saline gargles, with a couple of drops of an antiseptic solution twice daily, combined with saline nasal sprays. She offers a recipe for a home-made nasal rinse: 250ml cooled boiled water, half a teaspoon of bicarbonate of soda, half a teaspoon of salt and a few drops of antiseptic liquid.
Ramanathan recommends steam inhalation with Vicks, especially for people who have lost their sense of smell, and use of a nasal decongestant such as Otrivine nasal spray, and antihistamine tablets.
The third section of Ramanathan’s guide outlines steps people with the disease can take to protect their lungs. People with respiratory illnesses including Covid-19 are at risk of “hypoxia” or low levels of oxygen saturation in the blood. It became clear in the early stages of the crisis that many people were unaware their oxygen levels were dipping until it was almost too late.
She encourages people to invest in an pulse oximeter, an easy-to-use and relatively cheap device that measures oxygen levels in the blood. It is important such devices are bought from reliable sources and meet all EU safety standards and are for medical use.
Ramanathan says oxygen saturation levels should be managed daily for the first 14 days of the illness. A normal range is 95-100 per cent. Medical intervention is needed if it drops below 93 per cent, she says, or if people develop shortness of breath.
Ramanathan puts a huge emphasis on breathing techniques to keep airways open and outlines a range of breathing exercises. She suggests that the simple act of blowing up a balloon while seated creates positive end-expiratory pressure similar to that created in mechanical ventilation, while blowing bubbles through a straw into a glass can also be helpful. This technique is not a substitute for a ventilator – a crucial treatment for serious cases.
A practice known as proning, or sleeping on the stomach, can help avoid the collapse of air spaces at the base of the lungs. Ramanathan says the trick with proning is to position pillows along the torso and up to the head rather than just under the head.
She recommends box breathing, which sees people breathe out for three seconds, then hold for three seconds followed by a second three-second inhale and a second hold for three seconds. Ramanathan says the key is to focus on complete exhalation to empty the lungs. This will produce a deep inhalation reflex, optimising oxygen intake.
“I am a GP but I never appreciated the important of exhalation,” she says. “When you focus on breathing out, the inhalation is a reflex.”
She stresses that her advice is evidence-based and won’t cause harm. She repeats that her management system is neither a cure nor a treatment for Covid-19 but a way to give people an edge in the fight against the disease.
“What frustrates me is no one is telling anyone anything. If you look on the WHO site on the Centre for Disease Control site, where are the instructions for home management of Covid? Why aren’t people being told to buy a pulse oximeter or take vitamin D?
“Around 80 per cent of the cases are managed in the home, and all we are being told is take paracetamol and maybe eat soft foods. It is the same in every country and it makes me furious.”
There is, as she says, science behind her plan.
A study at Connolly hospital in Blanchardstown has pointed to lower vitamin D levels in Covid-19 patients admitted to its intensive care unit, while another from Germany found that hospitalised Covid-19 patients had lower vitamin D levels than less sick Covid-19 outpatients and in-patients with a vitamin D deficiency were up to 15 times more likely to need to be admitted to ICU. A small Spanish study saw 50 patients with Covid-19 getting a high dose of vitamin D and another 26 not given it. Half of the second group ended up in ICU while only one patient given the vitamin was admitted.
Obviously, I can only add that you should always contact your GP or Health Service if you suspect you have the virus and should self-isolate immediately. The same old rules of hand-washing, social distancing, travelling a max of 5k and keeping social contacts to a minimum still apply and still work.
https://www.irishtimes.com/life-and-style/health-family/covid-19-how-to-look-after-yourself-if-you-catch-the-virus-1.4465085
