Surviving the deadly COVID-19 virus is only half the battle. Once a patient is classified as virus-free and ready to be sent home, the often-long road to recovery including rebuilding lung capacity and overall respiratory health begins.

In about 80% of cases, COVID-19 has only mild symptoms and individuals recover without requiring significant medical interventions. 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 system or reducing the ability of the virus to spread across the pulmonary tissue may be helpful. The numbers in this paragraph may have changed as the statistics were in an article published on March 16, 2020 at the New England Complex Systems Institute by Blake Elias, Chen Shen and Yaneer Bar-Yam.

Two Cedars-Sinai respiratory therapists explain what roadblocks hospital-admitted patients face when it comes to lung health and offer tips for non-patients looking to improve their overall respiratory health.

“Patients with COVID-19 tend to be sicker for much longer than other patients with respiratory-related illnesses and, on average, stay on a ventilator for a longer duration,” said Dagoberto Naranjo, RRT, a respiratory therapist in the Department of Respiratory Therapy at Cedars-Sinai.

“When patients are intubated for long periods, it’s usually because they have accompanying or underlying medical conditions,” said Naranjo. “Patients who are healthy usually are intubated only to get them over the hump of requiring high levels of oxygen. this virus has proved to be unique, requiring different techniques and treatments than traditional standards of care.”

Because of the high levels of oxygen these patients require, coupled with the length of time they rely on ventilation, and road to a full recovery after leaving the hospital can be long for some patients.

Recovery is a long process. Returning to physical activity can take even longer. Researchers don’t know yet if anyone who has had COVID-19 can become reinfected with COVID-19 again!

For healthy people without COVID-19 Naranjo says it’s never a bad idea to increase overall lung capacity and improve overall respiratory health.

“Don’t underestimate the practice of simple deep breathing,” said Christina Rogers, RRT, also a respiratory therapist in the Department of Respiratory Therapy.” These symptoms include difficulty breathing, fatiguing easily and experiencing weakness due to their limited ability to participate in regular physical activity.”

“Most people only use a small part of their lung capacity. by increasing the length of your inhalations and exhalations, you can increase your lung capacity and strengthen your breathing, which improves the exchange of oxygen and carbon dioxide, ultimately improving lung capacity.”

Cardio workouts are also recommended to improve respiratory health. Always consult your primary care physican or alternative medical specialist to make sure you can increase your activity level.

Essentially, breathing is a continual tidal rhythm activity, drawing oxygen into the body with the inhalation and releasing carbon dioxide out on the exhalation. This happens on a large scale through the lungs, but also via each and every one of the cells throughout the entire body in cellular respiration.

The exhalation is the diaphragm releasing in an elastic recoil and drawing back up into the chest to push carbon dioxide back out. The internal intercostals only get involved and contract when the exhalation is forced, such as during exertion, panic or in specific breathing practices. In a relaxed-state-out-breath, there is no action required; a full exhalation is the result of allowing a complete inhalation to come to its full conclusion.

It’s the respiratory system that provides the means for vital oxygen to enter your body via your primary breathing organ, the lungs, into the bloodstream and ultimately through your whole body.

Healthy lungs working optimally take in about half a liter of air roughly 12-15 times each minute. They then deliver oxygen to the cardiovascular system, with all the blood in the body passed through the lungs every minute.

Deep breathing and exhalation bring fresh air in and can improve lung capacity. We typically breathe in and out only a fraction of our lung’s capacity. Expelling viral particles from the more stagnant areas of the lung may further decrease self-exposure to viral particles. Deep breathing is often recommended for health and well-being and can be done multiple times a day on a regular schedule.

There is a breathing technique that is helping people with COVID-19 symptoms. If comes from an urgent care doctor at Queen’s Hospital in London, named Dr. Sarfaraz Munshi. He says to begin practicing the breathing technique right at the start of coronavirus symptoms or even before any symptoms begin.

Dr. Munshi has recorded his method and you can see it on YouTube. The technique involves taking in five deep breathes, holding your breath each time for five seconds. On the sixth deep breath, he instructs you to cough. he then asks you to repeat that cycle once. Then, lay flat on your front and breathe slightly deeper for 10 minutes.

I suggest that you watch Dr. Munshi’s video for complete instructions on doing this method. While there is no scientific evidence to suggest this technique helps coronavirus patients, but it is recommended by the director of nursing at the hospital.

Breathing feeds oxygen to every cell in the body. Without sufficient oxygen, people are more prone to health problems, including respiratory illnesses, chronic obstructive pulmonary disease and even heart disease.

But ordinary, everyday breathing isn’t enough to keep the oxygen flowing through the body at peak levels, experts are Rush University Medical Center say, “Lungs at rest and during most daily activities are only at 50 percent of their capacity,” says Jennifer M. Ryan, PT, MS, DPT, CCS, a certified specialist in cardiovascular and pulmonary physical therapy. “Like the rest of the body, lungs thrive on movement and activity.”

I highly recommend checking out the eight tips on the Rush University Medical Center’s site. The eight tips for healthy lungs include:

Diaphragmatic Breathing

Simple Deep Breathing

Counting Your Breaths

Watching Your Posture

Staying Hydrated

Laughing

Staying Active

Joining a Breathing Club

See your primary care doctor if you have any symptoms such as shortness of breath, pain when breathing, dizziness with a change in activity, a persistent cough, wheezing with exercise, cough associated with exercising, pain in the airway (the path air follows to get into and out of the lungs).