Yoga has been shown to strengthen the mind and body, while also promoting healing. Research has found that daily practice of yoga, including pranayama, asana, and meditation, decreases stress and inflammation, improves immunity, increases oxygen levels in the blood and increases the elasticity of the lungs through promoting comfortable and relaxed breathing (Patange and Sawarkar, 2020). In addition, a study done by Santaella et al. that pranayama or breathing practices improved respiratory functions in older adults (2011). Current solutions to the COVID-19 pandemic from a yogic perspective have included asana practice to promote physical activity, meditation to calm the mind, and pranayama practices to improve lung function. Practicing yoga has been found to reduce anxiety and enhance coping strategies related to COVID-19, thus reducing stress and improving immunity (Nagarathna et al., 2021). However, studies lack the detail around the methods and dosage of nature/yoga treatment.
A study by Dr. Pradeep M. K. Nair thoroughly details the recommended practices and argues that there is a need for interventions based on traditional practices, such as yoga and naturopathy, that focus on improving immunity and strengthening mental health (2020). The author mentions that such holistic treatments put more emphasis on prevention than treatment and, similar to this program, include sun-bathing and yoga therapy. The study purports the philosophical underpinnings of yoga and Ayurveda that emphasize the body’s own healing capacity and focuses on the promotion of good health and overall well-being (Nair, 2020). In particular, the author argues that yoga emphasizes the health and wellness of the physical body, as well as the mental, emotional and spiritual body.
Ayurveda, the sister science of yoga, is closely linked and connected to the natural environment and seasons. Everything is made up of the elements, vayu (air), aakash (ether/space), jala (water), teja (fire) and prithvi (earth). A combination of the elements combine to form the doshas, an ayurvedic mecial system of classification based on vata, kapha and pitta. As are humans, the seasons are also classified according to the primary dosha of that time. For example, autumn is vata with the cool, dry windy weather while winter is kapha – dark and damp. Late spring brings more warmth, light and pitta qualities, as does summer. There is an emphasis on returning to the natural cycles, including our circadian rhythm. Therefore, the program emphasized a return to nature and natural cycles. In addition, each woman’s primary dosha was considered and the practice was adapted based on their needs.
Yoga and ayurveda should be a preventive component when dealing with the COVID-19 pandemic. Again, yoga and ayurveda focus on salutogensis – that is on health and well-being rather than the disease itself. Strong immunity is the foundation of a healthy lifestyle and is key to preventing infections and sickness (Nair, 2020). The author includes various treatment modalities under the umbrella of yoga and naturopathy, including yoga postures, fasting, a healthy diet, sun-bathing to ensure sufficient Vitamin D, and hydrotherapy (such as sipping and gargling warm water or jal neti/nasel cleansing) (Nair, 2020). The author reviews the literature and scientific findings behind the practices he recommends, which are listed below. The practices have been shown to have an anti-viral and anti-inflammatory effect on the body. They also strengthen one’s mental state.
Fasting involves abstaining from food for a period of time, which has been shown to reset the circadian rhythm (Stokkan et al., 2001), up-regulate key proteins of DNA repair and the immune system and has an anti-inflammatory effect on the respiratory tract by reducing the airway epithelial cell cytokine production (Mindikoglu et al., 2020). The author goes on to explain that viruses are dependent on nutrients to replicate themselves and through altering one’s cellular metabolism and slowing down one’s metabolism through fasting, one can decrease the host’s susceptibility to viral infection (Nair, 2020).
Diet therapy is recommended as a preventative measure in terms of maintaining optimal nutrition for a strong immune system. Vitamins C, E and D play a major role in immune function, as well as other micronutrients. According to the author, nutrition is a key indicator of resilience to disease, which may be why so many Americans who suffer from obesity and malnourishment (not getting the right nutrients) succumbed to the disease.
Sun bathing is also recommended, similar to the program reviewed, and is a major treatment for naturopathy (Nair, 2020). Vitamin D is essential for so many bodily functions, including sleep and the regulation of circadian rhythms. It is also responsible for immune system functioning, having anti-bacterial and anti-viral effects with regard to tuberculosis and influenza (Nursyam et al., 2006; Hansdottir et al., 2008). Ten to fifteen minutes of sun exposure daily is enough to ensure a preventive effect against COVID-19.
Hydrotherapy involves sipping or gargling with warm water, which alleviates symptoms of the cold and flu – the warm water prevents the multiplication of viruses in the throat (Sanu & Eccles, 2008; Sakai et al., 2008; Satomura et al., 2005). Steam inhalation can also be helpful to clear mucus from the throat and upper respiratory tract. Jal neti is a yoga kriya that involves clearing the nostrils with warm water and is used traditionally to treat cold, couth and sinusitis; it has been used to treat asthma, pneumonia, bronchitis and tuberculosis (Pandey, 2009). It is also used to reduce anxiety and depression, and thus can be integrated as a preventative treatment related to COVID-19.
Finally, the author reviews the use of yoga as a preventative treatment. The fear of death and disease is considered a klesha in yoga philosophy, with stress being a factor that lowers one’s immunity to disease. Given the psychological implications associated with COVID-19, yoga, with an emphasis on physical, mental and spiritual health, is an essential practice in preventing such effects. Unfortunately, little detail is provided as to the specific yogic practices that are helpful. The author does a thorough literature review and assessment of the suggested practices, however case studies would be helpful in providing data to support the said therapeutic measures.
An article by Kulkarni et al., looks at how yoga is being used to combat the psychological impact of COVID-19 (2022). The study reviewed eight systematic reviews of a total of 243 articles related to mental health and yoga going back to May 2020. The reviews all demonstrated a positive impact of yoga on mental health for children, youth and adults (Kulkarni et al., 2022). While the article serves as a meta-analysis for all studies related to mental health and COVID-19, unfortunately the authors found only two studies to be of high quality – one was on laughter therapy and the other is a metal analysis of yoga, meditation and mindfulness practices for tertiary students. The study by Breedvelt et al. conducted a review of 24 qualitative studies on yoga mindfulness and meditation among tertiary students, which met their inclusion criteria (2019). The results found moderate positive effects of yoga, meditation and mindfulness interventions for stresss, anxiety and depression in tertiary students (Breedvelt et al., 2019). However, it should be noted that the quality of some of the studies was low due to bias and sample size issues.
A cross-sectional study related to mental well-being and yoga/meditation during the COVID-19 pandemic by Rasania found a positive correlation between mental wellbeing and practicing yoga and meditation (2021). Of the 649 subjects surveyed online, 25% were at risk of developing psychological distress and 17% were at risk of depression (Rasanaia, 2021). A higher frequency of practice of both yoga and meditation was associated with higher states of well-being (Rasania, 2021). Daily practice showed the most positive states of well-being, and there was no correlation with years of study (Rasanaia, 2021). This shows that daily consistent practice of both yoga and meditation are an essential component of mentally healing from the pandemic. Even the WHO has recognized yoga as a valuable tool for reducing communicable disease, while also increasing physical and mental well-being.
A study done by Ransing et al., looked at the role of yoga for mental health related to COVID-19, as well as building resiliency and fortitude in the face of natural disasters (2020). Such countries as India, Fiji and Bangladesh have experienced natural disasters including cyclones concurrently while dealing with COVID-19. As Ransing et al. notes, natural disasters compound existing stressful conditions and make solutions for mental health, such as tele counseling near impossible (2020). Internet connections are often disrupted and, not to mention, the digital divide in many developing countries where some people have limited access to technology.
A study by Bushnell et al. explores the literature around meditation and yoga practices as potential adjunctive treatment of SARS-CoV-2 infection and COVID-19 (2020). It was conducted by researchers from the Massachusetts Institute of Technology (MIT), University of California-San Diego, Chopra Library for Integrative Studies, and Harvard University. The results show that “certain meditation, yoga asana (postures), and pranayama (breathing) practices may possibly be effective adjunctive means of treating and/or preventing SARS-CoV-2 infection.” However, little detail is provided in terms of what postures, breathing practices and meditations can be utilized. In the scientifically rigorous review by Bushnell et al., meditation and yoga were proposed as adjunctive treatments for infectious diseases, including malaria, HIV/AIDS, and SARS, due to the anti-inflammatory effects associated with these practices (2020). This hyperinflammatory response is similar to the cytokine storm that many have experienced with COVID, and is the primary pathway to death and disease (Bushnell et al., 2020). This hyperinflammatory response of the host is the main reason such diseases are causing such widespread damage.
There are an array of natural therapies with anti-viral and anti-inflammatory effects, which this research hopes to bring more attention to. For example, many of the practices chosen for the program have been shown to lower inflammation. They also stimulate the vagus nerve complex, which is a major component of the central and peripheral nervous system. Stimulating the vagus nerve can reverse the flight or fight response of the nervous system and rather induce a para-sympathetic state of rest and digest. Increasing vagal tone has also been found to be effective in reducing psychological stress and trauma (Boyd, 2018). Even just six weeks of a 20 minute daily meditation results in a significant reduction of proinflammatory transcription factor nuclear factor kappa B (Boyd et al., 2018). Chronic inflammation has also resulted from pollution (Abramson et al., 2020). Such long term, chronically elevated levels of inflammation can contribute to an increased risk of cardiovascular disease and neurodegenerative diseases, such as Alzheimer’s (Finch & Kulminski, 2019; Moir, Lathe & Tanzi (2018). Another study by Sawant, Zinjurke and Binorkar promoted the preventive aspects of Ayurveda and yoga towards newly emerging diseases, such as COVID-19. Unfortunately, millions of research dollars have been investing in vaccines and drug solutions that target the virus or external agent, while the focus should rather be on enhancing immunity with integrative practitioners, which has gone largely unfunded (Bushnell et al., 2020).
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