Expert Talk: Consultant Pulmonologist Dr Anshu Punjabi’s Covid-19 Guide For TB Patients

Before the fright of COVID-19 arose, there was a much more dangerous respiratory disease, Tuberculosis. And it is still present. Both diseases can be released and spread through air particles exhaled by an infected individual. This 24th March is World Tuberculosis Day and the theme is ‘The Clock Is Ticking’, sounding the alarm that while we focus on COVID-19, around 4000 people die of TB, every day. 

TC46 connected with Pulmonologist and Sleep Medicine Expert Dr Anshu Punjabi from Fortis Hospital, Mumbai to understand the possible connection between the two respiratory diseases and what someone suffering from TB should know about dealing with Covid-19.

1. COVID-19 and Tuberculosis are both respiratory diseases

Both Tuberculosis (TB) and COVID-19 19 affect the lungs primarily. 

Both the diseases are highly infectious and if not treated in a timely manner, they can cause serious complications and even death in some cases. If you have any such symptoms you should consult a doctor who can do appropriate tests and offer a timely diagnosis. 

2. TB patients are more vulnerable to COVID-19

There is insufficient data to support that TB patients are more prone to COVID-19. However, if you have Pulmonary TB, any damage to your lungs could make you more vulnerable to other infections such as COVID-19. If a person with TB is also diagnosed with the COVID-19 infection, they must consult their doctor immediately. They should continue their anti-TB medications as prescribed unless told to stop by their doctor. If you have been cured of TB and do not have any other health conditions, then your risk from COVID-19 is likely to be the same as for the general population. If you have required lung surgery or have been left with lasting damage to your lungs you are considered to be at increased risk from COVID-19.

3. TB services should be uninterrupted even during the pandemic

It is important that TB services are running uninterrupted during the pandemic. We have seen a decrease in the TB cases notification as there is a delay in accessing health services during the pandemic, as well as social stigma associated with respiratory diseases. Educational campaigns for public awareness should be run and screening of suspected cases should continue. Arrangements should be made for fewer visits for TB patients via the use of telemedicine and enhanced engagement with community health workers. 

4. Consult a doctor 

If diagnosed with either illness, consult a specialist doctor immediately and follow their advice. Avoid the use of home remedies and alternative medicines. 

5. The measures to prevent COVID-19 and Tuberculosis are similar

For both TB and COVID-19 there are lots of simple but effective measures that you can take to protect yourself.

• Always carry tissues with you and use them to catch your cough or sneeze. Then bin the tissue, and wash your hands, or use a sanitiser gel
• Always wear a mask outdoors, especially in crowded places. 
• Wash your hands more often than usual, for 20 seconds each time with soap and water or hand sanitiser, especially when – you get home or into work, blow your nose, sneeze or cough, eat or handle food
• Avoid touching your eyes, nose and mouth with unwashed hands
• Avoid close contact with people who are unwell.

Vaccination is the best prevention for COVID-19 and experts are urging people to get vaccinated soon. Don’t let the rumours stop you from getting vaccinated, learn the truth and stay safe.

TC46 Recommends 5 Yoga Poses To Boost Lung And Respiratory Health

Here are some yoga poses one can practise at home to boost lung and respiratory health. 

1. Nadi Shodhana (Alternate Breathing)

Nadi Shodhana helps in improving lung function and respiratory endurance. The body receives a larger amount of oxygen than normal breathing. 

1. Sit in a comfortable position with crossed legs. 
2. Gently close your right nostril with your thumb. Inhale through your left nostril, then close it with your ring-little fingers. 
3. Open and exhale slowly through the right nostril.
4. Keep the right nostril open, inhale, then close it, and open and exhale slowly through the left.
5.  Repeat 3 to 5 times, then release the hand mudra and go back to normal breathing.

2. Virabhadrasana (Warrior Pose) 

Virabhadrasana helps in strengthening the arms, shoulders, thighs and back muscles. Opens the chest cavity, improving the elasticity of the lungs.

1. Stand straight with your legs wide open. 
2. Turn your right foot out by 90 degrees and left foot in by about 15 degrees. 
3. Lift both arms sideways to shoulder height with your palms facing upwards. 
4. Bend your right knee while breathing out.
5. Turn your head and look to your right. 
6. As you settle down in the posture, stretch your arms. Hold the posture and keep breathing as you go down. 
7. Bring your hands down from the sides. Repeat it for the other side of your body.

3. Urdhva Mukha Svanasana (Upward-Facing Dog Pose)

Urdhva Mukha Svanasana relieves the tension in the lungs, shoulders, chest and buttocks. It is a great remedy for sciatica, depression, fatigue and asthma. 

1. With your belly towards the floor, lie flat on the ground. The arms must be placed beside the body with feet faced downwards. 
2. Gently fold your elbows. Place your palms next to your lowest rib.
3. Press your hands on the mat as you gently lift your knees, hips, and chest off the mat. Your body weight must be spread across the top of your feet and your palms.
4. Look ahead, slightly tilting your head backwards.
5. Hold the pose for 30 seconds to 1 min. While coming back to the starting position, slowly lower your knees, hips and torso back on the mat.

4. Bhramari Pranayama (Humming Bee Breath)

The first step towards self-healing is breathing, and understanding the technique affects positively our thoughts and moods. This pranayama teaches to keep our breath still so that we can stabilize and de-stress our mind.

1. Sit cross-legged or toward the front of the chair, keep the spine straight. 
2. Close your eyes and keep your lips and your teeth slightly apart.
3. Bring your thumbs to your ears and gently close them. The other fingers will rest on the crown. 
4. Breathe in slowly through your nose, and then exhale slowly with a low-pitched ‘hmmm’ sound at the back of your throat. 
5. You will be able to feel a vibration resonate through your head once you are going in deep. 
6. Repeat it at least 10 times, sit silently in that position for five to ten minutes.

5. Matsyasana (Fish Pose/ Reclining Back-Bending Pose)

It is also known as the destroyer of all kinds of diseases. It can stimulate the dorsal region and the torso to fully expand and hence, make breathing more fuller.

1. Have your knees bent, feet on the floor, or with the legs straight pressed against the floor. Be sure to tuck your forearms and elbows up close to the sides of your torso.
2. Take the support of your forearms and elbows, lower slowly your body while placing the crown of your head gently on the floor. 
3. Try to arch the back to ensure that you hold your feet with your hands. 
4. Close your eyes and relax your body with gentle deep and slow breaths.
5. Hold in this pose at least for 30 seconds. Practice this by interchanging the position of your legs.