While the world still navigates through the Covid-19 pandemic two years on, we are starting to understand the long term impact on our mental and physical health. We now need to pivot from survival and damage control to recovery.
Almost 6 million people have died as of February 2022 of Covid-19, and the economic and emotional impact has impacted many businesses and families. The actual toll of this pandemic can never be known. Fear, change, and uncertainty has divided communities and families. It is time to look at how we work together to navigate this next stage of this pandemic.
Long Covid Prevalence
Early on, Covid predominantly impacted the respiratory system. However, we are now seeing Covid as a multi-organ infection. Post an infection with Covid, some people experience Long Covid, with a wide range of symptoms.
Research is being gathered on prevalence with the new Omicron variant. An earlier study suggested 36% of people with Covid still have symptoms 3-6 months following the acute phase. The prevalence is a moving target as the research considers vaccination rates and the new variants of Covid19, such as Omicron.
Symptoms of Long Covid
A sliding scale of symptoms can occur due to long Covid. One research study found over 60 physical and psychological symptoms from Long Covid. Another study found the “10 most prevalent reported symptoms were fatigue, shortness of breath, muscle pain, joint pain, headache, cough, chest pain, altered smell, altered taste and diarrhoea. Other common symptoms were cognitive impairment, memory loss, anxiety and sleep disorders.”
Post viral symptoms are similar to other post-viral infections such as influenza, which I have been treating for years as a physiotherapist and breathing coach. Shortness of breath, fatigue, gut issues, and malaise can cause altered breathing patterns post-infection and often misdiagnose.
Recovery from Long Covid
If you do experience long covid, you may feel like this is something that you have to live with. However, Long Covid could also result from breathing patterns being altered during the infection phase with high temperatures, and your body is stressed. And let’s be honest, there has been a lot of fear and hype around getting covid and when you do have it, how you will recover, will you get unwell, will you need to go to the hospital.
Understandably, our body reacts as if it is in danger.
Hyperventilation syndrome, which we treat with breathing retraining, is a consequence of being stuck in an altered breathing pattern for an extended period and breathing beyond the body’s needs. Its symptoms can mirror many of Long Covid as they both impact the autonomic nervous system that regulates our heart, lungs, gut, immunity, blood flow, and so much more.
While we want to rule out serious causes for shortness of breath, such as changes to the heart and lungs post virus, we need to make sure that we are treating the whole person as part of recovery. We need to look at the nervous system, the bridge between the mind and the body, and controls our immune response. The vagal nerve that connects our autonomic nervous system has been proposed to be impacted as part of Long Covid.
Treatments for the symptoms of Long Covid need to look at ways for the immune and autonomic nervous system to recover. Breathing, unlike most physiological functions in the body, is both voluntary and involuntary. For that reason, we can use breathing exercises and techniques to help restore function to the autonomic nervous system when it is viable.
Breathing retraining for Long Covid
Stockley et al. looked at lung function and breathing patterns in hospitalisation for Long Covid. They observed 18.8% abnormal breathing patterns, but it wasn’t clear on consistent patterns. While you are breathing all the time, the issue post a virus is the rhythm and rate that you breathe with and the muscles you use. The diaphragm is our primary breathing muscle that can become deconditioned with prolonged bed rest and require extra training to get it functioning at a higher level for day-to-day activities.
When our breathing gets hijacked, and we move into autopilot mode, our nervous system, mind, emotions, and body become impacted. Our chimp brain can take over, and we get stuck feeling anxious, worried, depressed and unable to break the cycle.
What breathing exercises to use to help recover from Covid-19?
When starting to change your breathing, it is best to do it in a supportive group with trained health professionals as changing your breathing, and some techniques can trigger symptoms. It isn’t a one size fits all model for recovery and breathing.
Clinically we see a large group post virus with a hyperinflation pattern of the rib cage that need to learn to deflate. It is a simple thing, but if you are already over-expanded in the rib cage, you can’t get more air in, and this can create a vicious cycle of air hunger and shortness of breath. It can take several weeks to retrain your breathing and start to regulate your nervous system, but like anything you do, the more consistent you are with it, the better the results.
The stress of Long Covid
Research showed that 86% of people experience a relapse of long Covid symptoms triggered by exercise, physical or mental activity, or stress. Like any stressful life event or illness, our body can react and remain stuck in this altered breathing pattern. You may have had to breathe more shallowly, faster or feel like you are not getting enough air in. This pattern may have been a coping mechanism when you felt unwell or had a temperature, making you shift your breathing.
It may be essential to talk to someone about your experience to help you process the impact and changes it has had on your life. This helps our chimp brain feel supported and nurtured, allowing us to release the emotions and tensions that have been created post the illness.
Returning to work and life post-Covid
37% of patients with Covid-19 reported a reduced quality of life https://gh.bmj.com/content/6/9/e005427.abstract with symptoms impacting work and life. Like any illness, it is important to remember to pace yourself, build up slowly and take breaks as your body learns to readjust.
The truth is there is still so much unknown about how to recover from Covid-19 and Long Covid. Research has a long way to come to catch up with what we are doing clinically and to help us understand Covid-19. Remember as you recover to look at all aspects of your health, not just your physical. Your mental and emotional recovery is also important.
Finally, learn to listen to your body instead of pushing through. Our body is like a Tesla battery, and when you have had a virus-like Covid-19, your battery can be stuck running on empty. Practice tools and techniques that allow you to charge up over time.
To learn more about breathing tools to help with Long Covid, go here.