Opera lessons rolled out nationally to help ‘long Covid’ patients breathe again

Over 90 per cent of people who used ‘art of medicine’ scheme say it works

A programme to help with breathlessness and anxiety in long Covid sufferers will be rolled out across England following a successful pilot last year, it has been revealed.

The ENO Breathe scheme – created in tandem by the English National Opera (ENO) and Imperial College Healthcare NHS Trust – uses vocal exercises and breathwork to “retrain” participants’ breathing, impacted by the sometimes-long-term physical and psychological effects of coronavirus.

Its aim is to provide people with “self-management tools” for “breathlessness, and the anxiety that this can produce” – the two most common symptoms of long Covid.  

Suzi Zumpe, ENO Breathe’s creative director, led some of the online sessions during its six-week trial.  

“One of the things that is really hard if you have been unwell for a long time,” she told the BBC on Thursday, “is that you have potentially never been particularly conscious of how you breathe when you were well, then it’s been a struggle, and so getting back to what normal feels like – when it isn’t something you’re terrible conscious of remembering – is difficult.”

ENO Breathe was initially offered to just 12 long Covid patients, referred by Imperial College Healthcare, for six weeks between September and November 2020. The group had an age range of early 30s to late 70s, with 41 per cent of participants being ethnically diverse – including 25 per cent black and 8 per cent Asian – and 25 per cent who spoke English as a second language.  

All had ongoing symptoms of breathlessness and anxiety 8-12 weeks after testing positive for coronavirus, and almost all (90 per cent) reported “definite improvements in symptoms and wellbeing” by the end of the pilot programme, according to the ENO report.  

Richard Stenning described his experience as “fantastic”, saying ENO Breathe “really aided me enormously with my breathlessness and also my anxiety a little around re-integrating myself back into society”.

Mr Stenning, who was put in intensive care due to coronavirus last year, also stressed that he “never was and never will be a singer” – but that “didn’t matter” for the scheme to work.  

“You’re there to learn to breathe properly, and how to sing lovely soothing lullabies,” he told the BBC.

Crucially, the self-proclaimed “holistic” online scheme tackles the emotional distress caused by Covid as well as the longer physical symptoms. So much so, 91 per cent of the trial’s participants said their levels of anxiety had dropped by the end of the six weeks.  

Another participant, Ludmila, said: “I’ve never before had an experience like this. I didn’t think things like singing could help me with my breathing and improve my recovery from Covid.

“It has really helped me emotionally and physically.”

As a result of the trial’s success, ENO Breathe will now be rolled out to up to 1,000 patients and 25+ post-Covid clinics across participating NHS trusts in London and northern England – including hospitals in Liverpool, Manchester and Newcastle.

The scheme is also set to make dedicated groups available to NHS staff who are recovering from the virus.

How it works

In weekly group sessions, all carried out virtually, singing specialists teach ENO Breathe patients to focus “constructively” on their breathing by singing, specifically, lullabies – using techniques the ENO said are usually executed “by opera singers”.  

Lullabies have been selected by the experts as a “musical starting point” because, they said, “traditional lullabies cross boundaries of culture, are accessible to all and their very purpose is to calm”.  

In a video created by the BBC, participants can be seen singing along with creative director Ms Zumpe – who is constantly feeding people words of encouragement and telling them to “stay tall”, among other musical directives meant to aid breathwork and vocal ability. 

Speaking about the trial’s success and imminent national rollout, Dr Sarah Elkin, a consultant in respiratory medicine and clinical director of integrated care at Imperial Healthcare NHS Trust said: “As we continue to respond to the latest surge in Covid-19 cases in the UK, we must also remember those patients who are still suffering with Covid symptoms long after their initial disease.  

“Ongoing breathlessness is debilitating and can be frightening. We hope this programme will support people to improve and help reduce their symptoms. We look forward to widening participation as the programme rolls out across the country.”

Meanwhile, ENO chair Harry Brunjes, described the project as the “unprecedented interface of the ‘Art of Medicine’ and the ‘Science of the Arts’”, saying: “Medicine and the arts have come to understand that they have more in common than they knew.”

Sheeba, another trial participant, said the scheme had helped her to overcome calling her “GP about anxiety brought on by breathing issues”.

“As a non-native English speaker, I wasn’t sure I was going to fit in with ENO, but it has been a fantastic tool that has given me my confidence back,” she said.

“It’s prevented me from calling my GP about anxiety brought on by breathing issues. I genuinely believe it will take pressure off medical facilities.”

In December, data released by the Office for National Statistics showed that one in 10 people infected with coronavirus experience symptoms that last for three months or longer.