Covid Protocol

AYUSH Ministry

National Clinical Administration Protocol on Ayurveda and Yoga

for the management of Covid-19

Introduction

The COVID-19 pandemic has created a global health crisis involving an unforeseen public health emergency. The number of deaths and infections across the globe is increasing by the day. The severity of the situation is increased due to certain social and economic factors. Effective infection management is constantly being adapted and attempts are being made to combine traditional interventions with standard treatments.

Certainly Ayurveda and Yoga can play a major role in increasing the effectiveness of preventive measures provided through the Ministry of Health and Family Welfare (MoHFW) guidelines. From the current understanding of COVID-19 it is clear that good immunity is vital for prevention and protection against the progression of this disease.

This protocol has been drawn up taking into account the following aspects:

  1. Classical knowledge of Ayurveda and experience gained from clinical practice;
  2. Empirical evidence and plausibility from the point of view of biology;
  3. Emerging trends and directions in clinical trials.

This document has been prepared through the collaboration of several expert committees belonging to the following locations and organisations: AII 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) and other national research organisations. This protocol addresses the management of mild forms of COVID-19. Individuals representing moderately severe and severe cases of COVID-19 can also inform themselves of the options that are presented. All severe cases will be referred to.

This protocol and its annexes are approved by the President, the Interdisciplinary Committee for inclusion of Ayurveda and Yoga in the management of mild COVID-19 and the empowered committee of the Interdisciplinary AYUSH Research and Development Taskforce on COVID-19, both committees being constituted by the AYUSH Ministry.

General and Physical Measures

  1. Applying physical separation, hand and airway hygiene and wearing a mask;
  2. Gargle with warm water in which you add a little salt and turmeric. Triphala (dried fruits of Emblica officinalis, Terminalia chebula, Terminalia bellerica) or Yashtimadhu (Glycyrrhiza glabra) can also be used;
  3. Intra-nasal application of medicated oil (Anu taila or Shadbindu Taila), plain oil (sesame or coconut) or cow's milk butter (Goghrita) once or twice a day, especially before leaving the house and after returning;
  4. Aerosols with Ajwain (Trachyspermum ammi), Pudina (Mentha spicata) or eucalyptus oil once a day;
  5. 6 - 8 hours sleep;
  6. Moderate intensity exercise;
  7. Application of the Yoga Protocol for basic COVID-19 prevention (ANNEX1) and the Protocol for care following COVID-19 infection (including care of COVID-19 infected patients) (ANNEX2).

Dietary measures

  1. Drinking hot or pre-boiled water together with herbs such as ginger (Zingiber officinale), coriander (Coriandrum sativum), basil (Ocimum sanctum / Ocimum basilicum) or caraway seeds (Cuminum cyminum) etc.;
  2. Practising a balanced diet, consisting of hot and fresh foods;
  3. Golden milk drink [half a tablespoon of Haldi (Curcuma longa) powder in 150 ml of warm milk] once a night. Avoid in case of indigestion;
  4. Drink Ayush Kadha or Kwath (hot infusion or decoction) once a day.

Specific measures / Symptomatic management

  • In addition to these treatments, general and nutritional measures should be followed.
  • In addition to these treatments, general and nutritional measures should be followed.

  • In addition to these treatments, general and nutritional measures should be followed. Refer to ANNEX3 for additional treatments. Physicians should decide on the recommendations made above or in ANNEX3 taking into account their clinical judgement, availability and regional preferences. Doses may be adjusted according to the patient's age, weight and condition.

** Reference may be made to the Ministry of AYUSH's COVID-19 instructions for Ayurveda practitioners.

  • In addition to these treatments, general and nutritional measures should be followed.
  • As advised by your doctor. Doctors should decide on the recommendations made above or in ANNEX3 taking into account their clinical judgement, availability and regional preferences. Dosages may be adjusted according to the patient's age, weight and condition.

** Reference may be made to the Ministry of AYUSH's COVID-19 instructions for Ayurveda practitioners.

References:

  1. Guidelines for Ayurveda practitioners for COVID-19; available at https://www.ayush.gov.in/docs/ayurved-guidlines.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
  1. Advisory from Ministry of AYUSH for meeting the challenge arising out of spread of corona virus (COVID-19) in India; available at https://www.ayush.gov.in/docs/125.pdf
  2. Ayurveda's immunity boosting measures for self-care during COVID-19 crisis; available at https://www.ayush.gov.in/docs/123.pdf
  3. Post COVID management protocol of Ministry of Health & Family Welfare; available at https://www.mohfw.gov.in/pdf/PostCOVID13092020.pdf
  4. Revised SOP on preventive measures to be followed while conducting examinations to contain spread of COVID-19; available at https://www.mohfw.gov.in/pdf/RevisedSOPonpreventivemeasurestobefollowedwhileconductingexaminationstocontainspreadofCOVID19.pdf

ANNEX 1

            Yoga protocol for the basic prevention of COVID-19

Objectives:

  • Improved efficiency of respiratory and cardiac processes
  • Reducing stress and anxiety
  • Boosting immunity

  • It is recommended to practice Jalaneti kriya three times a week.
  • Aerosols should be inhaled every day or every other day.
  • It is recommended to gargle with warm salt water regularly.

ANNEX 2

Yoga protocol for post-COVID-19 care
(including care of COVID-19 patients)

Objectives:

  • Improved lung function and lung capacity
  • Reducing stress and anxiety
  • Increased mucociliary clearance

Morning session (30 minutes):

  • The exhale period should be longer than the inhale period, a ratio of 1:2 (inhale:exhale) is preferable.

Evening session (15 minutes):

  • The exhale period should be longer than the inhale period, a ratio of 1:2 (inhale:exhale) is preferable.
  • Aerosols should be inhaled every day or every other day.
  • It is recommended to gargle with warm salt water regularly.

Notes:

  • Warm-up exercises: forward and backward stretches, torso twists.
  • Breathing exercises: sectional breathing, yogic breathing, breathing with palms facing the sky or the Earth, yogic hand stretching breathing exercises and asanas that have been shown to improve lung capacity and reduce the risk of asthma attacks and respiratory tract inflammation.
  • Breathing and pranayama: Vaataneti, Kapalabhathi kriya, Bhastrika pranayama, Nadishodana pranayama to improve lung functions.
  • Kriya: Jalaneti practice for purification and decongestion of the upper airways. Not to be used in case of dry cough.

ANNEX 3

Management of mild forms of COVID-19

  • In addition to these treatments, general and nutritional measures should be followed.
  • According to your doctor's advice. Doctors should decide on the above treatments or appropriate classical medication taking into account their clinical judgment, availability and regional preferences. Dosages may be adjusted according to the patient's age, weight and condition.
  • Reference may be made to the Ministry of AYUSH's COVID-19 instructions for Ayurveda practitioners.

These are general consultations and treatments. Participating doctors must use their clinical knowledge to select medicines according to the stage of the disease, how complex the symptoms are and what is available.

The treatments recommended in this paper are complementary approaches to standard care and prevention as well as the other Ayurvedic approaches mentioned. The information contained in this paper does not replace medical recommendations.