Union Health Minister releases COVID-19 management protocol based on Ayurveda, yoga; Details
New Delhi: Union Health Minister, Harsh Vardhan, recently released The 'National Clinical Management Protocol based on Ayurveda and Yoga for Management of Covid-19'.
The protocol lists dietary measures, yoga, and Ayurvedic herbs and formulations such as Ashwagandha and AYUSH-64 for the prevention of coronavirus infection and treatment of mild and asymptomatic cases. The details of the protocol reads;
Preamble
The COVID-19 pandemic has created a global health crisis posing an unprecedented public health emergency. The number of deaths and people being infected is increasing daily throughout the globe. This situation is much more severe due to possible devastating situations because of several social and economic factors. Effective management to address this infection is still evolving and attempts are being made to integrate traditional interventions along with the standard of care.
Ayurveda and Yoga can certainly play a pivotal role to augment preventive measures provided in the guidelines by the Ministry of Health and Family Welfare (MoHFW). The current understanding of COVID-19 indicates that good immune status is vital to prevention and to safeguard from disease progression.
The following three aspects are considered while preparing this protocol:
1. Knowledge from Ayurveda classics and experience from clinical practices
2. Empirical evidence and Biological plausibility
3. Emerging trends of ongoing clinical studies
This consensus document is developed by expert committees from All India Institute of Ayurveda (AIIA), Delhi, Institute of Post Graduate Training and Research in Ayurved (IPGTRA), Jamnagar, and National Institute of Ayurveda (NIA), Jaipur, Central Council for Research in Ayurveda (CCRAS), Central Council for Research in Yoga and Naturopathy (CCRYN), other national research organizations. This protocol is for the management of mild COVID-19. Moderate to Severe COVID-19 individuals may have an informed choice of treatment options. All severe cases will be referred to.
This protocol and its annexure are approved by the Chairman, Interdisciplinary Committee for the inclusion of Ayurveda and Yoga in the management of mild COVID-19, and approved by the empowered committee of the Interdisciplinary AYUSH Research and Development Taskforce on COVID-19, both constituted by the Ministry of AYUSH.
General and Physical measures
1. Follow physical distancing, respiratory and hand hygiene, wear a mask
2. Gargle with warm water added with a pinch of turmeric and salt. Water boiled with Triphala (dried fruits of Emblica Officinalis, Terminalia chebula, Terminalia bellerica) or Yashtimadhu (Glycyrrhiza glabra) also can be used for gargling.
3. Nasal installation/application of medicated oil (Anu taila or Shadbindu Taila) or plain oil (Sesame or Coconut) or nasal application of cow's ghee (Goghrita) once or twice in a day, especially before going out and after coming back to home.
4. Steam inhalation with Ajwain (Trachyspermum ammi) or Pudina (Mentha spicata) or Eucalyptus oil once a day
5. Adequate sleep of 6 to 8 hrs.
6. Moderate physical exercises
7. Follow Yoga Protocol for Primary Prevention of COVID-19 (ANNEXURE-1) and Protocol for Post COVID-19 care (including care for COVID-19 patients) (ANNEXURE-2) - as applicable
Dietary measures
1. Use warm water or boiled with herbs like ginger (Zingiber officinale) or coriander (Coriandrum sativum) or basil (Ocimum sanctum / Ocimum basilicum), or cumin (Cuminum cyminum) seeds etc., for drinking purpose.
2. Fresh, warm, balanced diet
3. Drink Golden Milk (Half teaspoon Haldi (Curcuma longa) powder in 150 ml hot milk) once at night. Avoid in case of indigestion.
4. Drink Ayush Kadha or Kwath (hot infusion or decoction) once a day.
Specific Measures I Symptom Management
Clinical | Medicines* | Doses & Timing |
Prophylactic | Ashwagandha (Aqueous extract of Withania somnifera IP) or its powder | 500 mg extract or 1-3 g |
Guduchi Ghana vati [Samshamani vati or Giloy Ghana vati having Aqueous extract of Tinospora cordifolia IP] or the powder of Tinospora cordifolia | 500 mg extract or 1-3 g | |
Chyawanaprasha | 10 g with warm water / |
Clinical | Clinical | Medicines* | Doses & Timing |
Asymptomatic — COVID- ic 19 Positive | For prevention to symptomatic and severe form and to improve | Guduchi Ghana vati [Samshamani vati or Giloy vati having Aqueous extract of Tinospora cordifolia IP] or the powder of Tinospora cordifolia | 500 mg extract or 1-3 g |
Guduchi + Pippali (Aqueous extracts Tinospora cordifolia IP and Piper longum IP) | 375 mg twice daily with | ||
AYUSH 64 | 500 mg twice daily with |
In addition to these medicines; general and dietary measures are to be followed
Clinical | Clinical | Clinical | Medicines* | Doses & Timing |
Mild COVID-19 | Symptomatic | Without | Guduchi + Hippaii (Aqueous extracts Tinospora cordifolia IP and Piper longum IP) | :31b mg twice daily with warm |
AYUSH 64 | 500 mg twice daily with warm water for 15 days or as directed by Ayurveda physician |
In addition to these medicines; general and dietary measures are to be followed. Refer
ANNEXURE-3 for additional medicines. Physicians have to decide useful formulations from the above or from ANNEXURE-3 or substitutable classical medicines based upon their clinical judgment, suitability, availability and regional preferences. The dose may be adjusted based upon the patient's age, weight, and condition of the disease
** Guidelines for Ayurveda Practitioners for COVID-19 notified by the Ministry of AYUSH may also be referred.
In addition to these medicines; general and dietary measures are to be followed.
According to the physician's discretion. Physicians have to decide useful formulations from the above or substitutable classical medicines based upon their clinical judgment, suitability, availability, and regional preferences. The dose may be adjusted based upon the patient's age, weight and condition of the disease.
** Guidelines for Ayurveda Practitioners for COVID-19 notified by the Ministry of AYUSH may also be referred.
References:
1. Guidelines for Ayurveda practitioners for COVID-19; available at. https://www.ayush.qov.in/docs/ayurved-quidlines.pdf
2. Guidelines on Clinical Management of COVID-19; Government of India, Ministry of Health & Family Welfare; available at https://www.mohfw.gov.in/pdf/GuidelinesonClinicalManagementofCOVID1912020. pdf
3. Advisory from Ministry of AYUSH for meeting the challenge arising out of the spread of coronavirus (COVID-19) in India; available at https://www.ayush.gov.in/docs/125.pdf
4. Ayurveda's immunity-boosting measures for self-care during the COVID-19 crisis; available at https://www.ayush. pov. in/does/123.pdf
5. Post COVID management protocol of Ministry of Health & Family Welfare; available at https://www. mohfw.gov. in/pdf/PostCOVI D 13092020. pdf
6. Revised SOP on preventive measures to be followed while conducting examinations to contain the spread of COVID-19; available at https://www.mohfw.govin/pdf/RevisedS0Ponpreventivemeasurestobefollowedwhileconductin gexaminationstocontainspreadofCOVID19.pdf
Yoga Protocol for Primary Prevention of COVID- 19
Objectives:
• To improve respiratory and cardiac efficiency
• To reduce stress and anxiety
• To enhance immunity
S. No. | Practices | Name of the Practice | Duration |
1 | Prayer | 1 | |
2 | Loosening Practices | Neck Bending | 2 |
Shoulder's movement | 2 | ||
Trunk Movement | 1 | ||
Knee Movement | 1 | ||
3 | Standing Asana | Tadasana | 1 |
Pada-hastasana | 1 | ||
Ardha Chakraasana | 1 | ||
Trikonasana | 2 | ||
Sitting Asana | Ardha Ushtraasana | 1 | |
Sasakasana | 1 | ||
Utthana Mandukasana | 1 | ||
Simhasana | 1 | ||
Marjariasana | 1 | ||
Vakrasana | 2 | ||
Prone Lying Asana | Makarasana | 1 | |
Bhujangasana | 1 | ||
Supine Lying Asana | Setubandhasana | 1 | |
Utthanapadasana | 1 | ||
Pawana Muktasana | 1 | ||
Markatasana | 1 | ||
Shavasana | 2 | ||
4 | Kriya | Vata Neti 2 rounds (30 secs each with 30 sec relax) | 2 |
Kaphalabhati (2 rounds, 30 strokes each ) | 2 | ||
5 | Pranayama | (i) Nadi Shodhana (5 rounds ) | 2 |
(ii) Surya Bhedhana Pranayama (5 rounds ) | 2 | ||
(ii) Ujjayee Pranayama (5 rounds ) | 2 | ||
(iii) Bhramari Pranayama (5 rounds) | 2 | ||
6 | Dhyana | 5 | |
7 | Shanti Patha | 1 | |
Total Duration for Each | 45 | ||
• Advised Jalaneti kriya weekly thrice.
• Advised steam inhalation every day or alternative day.
• Advised gargling with lukewarm saline water regularly
ANNEXURE-2
Yoga Protocol for Post COVID- 19 care (including care for COVID-19 patients)
Objectives:
• To improve pulmonary function and lung capacity
• To reduce stress and anxiety
• To improve Muco-ciliary clearance
Morning Session (30 Minutes):
S. No | Practices | Name of Practice | Rounds | Duration (in |
1 | Preparatory | Tadasana | 6 | |
2 | Urdhva Hastottanasana | |||
3 | Uttana Mandukasana | |||
4 | Shoulder rotation | 3 rounds | ||
5 | Trunk twisting | 3 rounds | ||
6 | Ardha ustrasana | |||
7 | Sasakasana | |||
8 | Breathing | Vaataneti | 2 rounds (30 secs/round) | 2 |
9 | Kapalabhati | 3 rounds (30 secs/round) | 2 | |
10 | Deep Breathing | 10 rounds | 2 | |
11 | Pranayama Practices | Nadishodhana | 10 rounds | 6 |
12 | Ujjaayee | 10 rounds | 3 | |
13 | Bhramari | 10 rounds | 3 | |
14 | Meditation | Dhyana | Awareness of breathing or Awareness of Positive thoughts /emotions /actions | 6 |
Total Duration | 30 | |||
*Period of exhalation shall be more than the period inhalation, preferably 1:2 (Inhalation: Exhalation).
Evening Session (15 Minutes):
S. No. | Name of the practice | Rounds | Duration (in |
1 | Savasana (Corpse Pose) arms stretched | 1 | 1 minute |
2 | Abdominal Breathing | 10 rounds | 2 minutes |
3 | Thoracic Breathing | 10 rounds | 2 minutes |
4 | Clavicular Breathing | 10 rounds | 2 minutes |
5 | Deep Breathing (lying down position) | 10 rounds | 2 minutes |
6 | Relaxation in Shavasana with awareness on Abdominal breathing | 5 minutes | |
Total Duration | 15 minutes | ||
• Period of exhalation shall be more than the period inhalation, preferably 1:2 (Inhalation: Exhalation).
• Advised steam inhalation every day or alternative day.
• Advised to gargle with lukewarm saline water regularly.
Note:
• Loosening Exercises: Forward/ Backward bends, Spinal twist,
• Breathing Exercises: Sectional Breathing, Yogic Breathing, Hands in and Out Breathing, Hands Stretch Breathing Yogic Breathing exercises and asanas found to improve lung volumes and reduce asthma attacks and inflammation in respiratory tract.
• Breathing and Pranayama: Vaataneti, Kapalabhathi kriya, Bhastrika pranayama, Nadishodana pranayama for improvement in pulmonary functions.
• Kriya: Jalaneti practice to cleanse and decongest the upper airways. Not to be used in dry cough.
Management of Mild COVID-19 Cases
Clinical | Symptom | Formulation* | Dose* |
Mild COVID-19 | Fever with Body ache, Headache | Nagaradi Kashaya | 20 ml twice a day or as directed by Ayurveda physician |
Cough | Sitopaladi Churns with Honey | 2 g thrice daily with Honey or as directed by Ayurveda physician | |
Sore throat, Loss of taste | Vyoshadi vati | Chew 1-2 pills as required or as directed by Ayurveda physician | |
Fatigue | Chyawanprasha | 10 g with warm water/milk once a day | |
Hypoxia | Vasavaleha | 10 g with warm water or as directed by Ayurveda physician | |
Diarrhoea | Kutaja Ghana Vati | 500 mg - 1 g thrice daily or as directed by Ayurveda physician | |
Breathlessness | Kanakasava | 10 ml with an equal amount of water twice a day or as directed by Ayurveda physician |
* In addition to these medicines; general and dietary measures are to be followed.
* According to the physician's discretion. Physicians have to decide useful formulations from the above or substitutable classical medicines based upon their clinical judgment, suitability, availability, and regional preferences. The dose may be adjusted based upon the patient's age, weight, and condition of the disease.
* Guidelines for Ayurveda Practitioners for COVID-19 notified by the Ministry of AYUSH may also be referred.
This is a general advisory. Attending physicians need to use their discretion to select the drugs based upon the stage of the disease, symptom complex, and availability of the medicines. The recommended formulations in this attempt are in addition to standard approaches of care and prevention as well as other Ayurvedic approaches recommended for prevention earlier. Moderate to Severe COVID-19 individuals may have an informed choice of treatment options.
For more details click on the link below-
https://medicaldialogues.in/pdf_upload/pdf_upload-135453.pdf
