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\begin{document}


\def\RunningAuthor{Priti Desai et al.}
\firstPage{1099}
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\title{Comprehending and Executing \textit{Aacharrasayana }in the context of COVID 19}
\author{Priti~Desai\textsuperscript{*}\textsuperscript{1},  
            Anita~Wanjari\textsuperscript{2}, 
            Deepali~Giri\textsuperscript{3}~\\[5pt]{\textsuperscript{1}Department of Rachana Sharir, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe University of Medical Sciences (Deemed to be University), Salod (H), Wardha, Maharashtra {\textendash} 442001, India}~\\{\textsuperscript{2}Department of Rasashastra and Bhaishajya Kalpana, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe University of Medical Sciences (Deemed to be University), Salod (H), Wardha, Maharashtra {\textendash} 442001, India}~\\{\textsuperscript{3}Department of Rachana Sharir, Datta Meghe Ayurvedic Medical College, Hospital and Research Centre,  Wanadongri,  Nagpur, Maharashtra {\textendash} 442001, India}}

\begin{abstract}
The COVID 19 pandemic had disrupted the lives of all socio-economic groups of the global population. The lockdowns, social distancing, financial adversities, continuous fear of being a victim to the virus had left every individual desperate with a feeling of vulnerability. Irrespective of all possible efforts at the global level, no ultimate solution to get rid of this virus is available till date except for the preventive measures. Various medicines and formulations are into practice, which may boost one's immunity to fight against the virus. This catastrophic scenario had resulted in an impact on the human being in all aspects, physical, mental, emotional, social and behavioural. Ayurveda, the science of life has encompassed all these aspects through its preventive and curative principles. \textit{Aacharrasayana}, code of conduct or behavioural discipline is one such modality that entails perfect mental, physical, social and spiritual health of the human being. The execution of \textit{Aacharrasayana} in this situation can immensely contribute in restoring mental, spiritual and social health. This review aims to interpret the implementation of various aspects of \textit{Aacharrasayana}in context of COVID 19 and its utility in combatting the dreadful crisis. 
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Aacharrasayana,\newline Code of conduct,\newline COVID 19,\newline Pandemic,\newline Social Health
\end{keywords}
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\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Priti~Desai~\\ Phone:\ +91-9923020425~\\  Email:\ drprdesai2@gmail.com
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\section{Introduction}
The globe had witnessed several epidemics in the early decades of the 21\ensuremath{^{st}} century, like SARS {\textendash} Severe acute respiratory syndrome(2003) countries. In 2009, a novel influenza virus, H1N1, 2012-2013, a new virus surfaced in the Middle East, causing an epidemic of what became MERS {\textendash} Middle East respiratory syndrome, Ebola epidemic in West Africa (Guinea, Liberia, and Sierra Leone) in 2014, 2015, the Zika virus, transmitted by the Aedes Aegypti mosquito, Nipah virus \unskip~\citep{895348:20425855}.  However, the Coronavirus of 2019 had created catastrophe infecting a huge population all over the globe setting out records. Considering the widespread nature and severity of this virus and taking a vast number of the toll of deaths, the World Health Organization (WHO) has declared it as COVID 19 - Pandemic \unskip~\citep{895348:20425858}.

Coronavirus disease (COVID-19) caused by SARS-COV2 is a matter of great global public health concern \unskip~\citep{895348:20425860}. By the mid of August, the world has a breathtaking figure of more than 20 million cases, India contributing to more than two million \unskip~\citep{895348:20425865}.

Governments all over the world are toiling day and night to design the action plans to mitigate the devastating effects of this pandemic. Health organizations are synchronizing the course of information and issuing directives and guidelines to overcome the impact of this disaster. The scientist is striving with determination to reveal the facts about the route of transmission, the clinical spectrum of disease, new diagnostics, and prevention and therapeutic strategies \unskip~\citep{895348:20425855}. Many clinical trials are going worldwide to come out with the vaccines as a countermeasure to fight against the coronavirus. 

Along with the administrative approaches at all levels, a societal approach is required to handle this crisis, contemplating the role of all causative factors including biological, inheritable, ecological, environmental, social, behavioural, economical etc. The interrelation and cohesion of these factors aggravate the outbursts, which necessitates a multidimensional and multidisciplinary method to overcome \unskip~\citep{895348:20425854}

A collaborative approach of all systems of health is necessitated to deal with the COVID 19 pandemics in both in preventive as well as therapeutic aspect. It is observed that along with modern medicine, the traditional health systems of the respective countries are putting their best foot forward to control the situation. In India AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) is also engaged towards notable contribution for the fight against this threat.

\textit{Ayurveda,} the Indian system of medicine, better known as a science of life, promotes a four-dimensional holistic approach to life physical, mental, emotional, and spiritual \unskip~\citep{895348:20425864}.

It provides proper dietary management and lifestyle advice through \textit{Dincharya} (daily regimens), \textit{Ritucharya} (seasonal regimens), \textit{Aachar Rasayan} (code of conduct), \textit{Sadvritt} (ideal routines), \textit{Panchakarma} (bio purification), \textit{Rasayana} (rejuvenation) therapies for attainment of Physical, Mental and Spiritual health.

\textit{Aacharya Charaka} has mentioned the \textit{Aachara Rasayana} for perfect mental, physical, social and spiritual health of the human being. \textit{Aachar} means behavioural discipline, which guides and motivates the persons to have social happiness and mental stability \unskip~\citep{895348:20425859}.  

\textit{Aachar rasayan} is a unique concept in \textit{Ayurveda} that entails moral, ethical, and benevolent conduct: truth, nonviolence, personal and public cleanliness, mental and personal hygiene, devotion, compassion, and a yogic lifestyle. 
    
\section{MATERIALS AND METHODS}
The present review is done by referring the recent articles regarding prevention of COVID-19, \textit{Ayurveda's} principle of \textit{Aacharrasayana}, guidelines of WHO, Ministry of AYUSH, news updates, and opinions of experts.
    
\section{OBSERVATION AND RESULTS}
In the Context of COVID 19 pandemic, various guidelines are set by the government to fight against the situation with various medicines prescribed by the medical community. Massive efforts are going on a global level to bring out a vaccine for the coronavirus. Along with this, \textit{Aacharrasayana}, {\textendash}a code of behaviour or code of ethics is of paramount significance. Considering the large population of India, it would not be improper if we say that the virus has physically affected a smaller part of the population which is depicted in numbers, however, rest of the larger volume is under the fear and stress affecting their mental and emotional health with the social health at stake. With the various preventive aspects for enhancing immunity through various formulations, its imperative to follow the concept of \textit{Aachar rasayan} to change our behaviours to reverse the disease process and maintain the balance of mind, body, and soul. The essential key for long life, according to Ayurveda, is to follow \textit{Achara Rasayana}. One who follows all codes of conduct (A\textit{achar Rasayana) very optimistically } need not take other \textit{Rasayanas,} and those who take other \textit{Rasayanas } without following code of conduct do not receive the optimum results of \textit{rasayanas} according to \textit{Charaka. }

The concept of \textit{Aachar Rasayana} is to change our behaviours to reverse the disease process and stay in balance. Persons who are truthful and free from anger, who do not indulge in alcohol and sex, who stay away from violence (\textit{himsa}) or exhaustion, who are peaceful and pleasing in their speech, who practice \textit{japa} (incantation) and cleanliness, who are stable and steady, who regularly practice charity and \textit{tapas} (penance); who regularly offer prayers to the gods, teachers, preceptors and old people, who are absolutely free from barbarous acts, who are compassionate, whose period of awakening and sleep are regular, who habitually take milk and ghee, who acquainted with the measurement of (things appropriate to) the country and the time, who are experts in the knowledge of rationality, who are free from ego, conduct is right, who are not narrow minded, who have love for spiritual knowledge, who have excellent sense organs, who have reverence for seniors, \textit{astikas} (those who believe in the existence of God and validity of the knowledge of the \textit{Vedas}), and persons having selfcontrol and who regularly study scriptures, get the best out of rejuvenation therapy. If persons endowed with these qualities practice rejuvenation therapy, they get all the rejuvenation effects described above \unskip~\citep{895348:20425867}
    
\section{DISCUSSION}
The enormous global health crisis due to COVID-19 pandemic requires large-scale behaviour change. It places substantial psychological burdens on individuals, insights from the social and behavioural sciences may help in aligning human behaviour with the recommendations of epidemiologists and public health experts \unskip~\citep{895348:20425861}. This behavioural perspective can be accomplished by integrating\textit{Aacharrasayana}, code of conduct in daily routine. This frightful situation can be combatted to a considerable extent by applying the aspects of \textit{Aacharrasayana} as stated by \textit{Acharya Charak}. The various behavioural traits stated in \textit{Aacharrasayana} needs to be valued in the context of Covid 19pandemic scenario.

\textit{\textbf{Satya vadinah}}

It means being truthful. In a pandemic situation like the Covid-19 outbreak, social media becomes the most-searched venue for information-gathering. The speed at which information spreads on social media is unimaginable \unskip~\citep{895348:20425871,895348:20425850}. Most important is the truthfulness of the information regarding the COVID cases and the guidelines issued by the authorities. The people who are with the symptoms and those diagnosed positive should reveal the truth to avoid the spread of the disease. The medical and paramedical staff should be truthful while revealing the condition of the patients to their relatives and explaining the risks of it. The data sharing about clinical trials for drug development vaccines should be on truthful grounds.

\textit{\textbf{Akrodham}}

One should not get angry in this situation. Anger may be an emotional response in this critical situation. There are studies \unskip~\cite{895348:20425863,895348:20425856} who have reported anger during the epidemics. The lockdown situation with an inadequate supply of necessities, financial crisis, unavailability of domestic help, continuously being in the environment of fear and anxiety, handling elderly parents and kids together along with the work from the home situation is prone to evolve anger in the general population. 

\textit{\textbf{Madya Nivrati}}

It is non-indulgence in alcohol. Considering the higher level of stress and depression during the pandemic, there are fair chances of some people involving the consumption of alcohol. Reports have shown increased domestic violence and even alcohol abuse during quarantine \unskip~\citep{895348:20425863}. Alcohol harms the immune system by reducing the ability to fight off infections. It disrupts the function of the brain of maintaining the balance of neurotransmitters. Excessive alcohol consumption may lead to acute respiratory stress syndromes \unskip~\citep{895348:20425851}. To protect our respiratory health and enhance immunity, its imperative to avoid the use of alcohol.

\textit{\textbf{Maithuna Nivrati}}

It means to observe celibacy and the sexual act according to the code. Though there is minimal risk of household transmission of coronavirus, the infection is transmitted through contact with droplets from the nose and mouth, including the saliva of an infected person, which means there is a significant risk of contracting COVID-19 through kissing and physical intimacy. It is better to limit the sexual contact to the spouse only.

\textit{\textbf{Ahimsa}}

\textit{Ahimsa }means nonviolence. Though the number of incidence of communal violence is least reported during the pandemic due to lockdown and restricted social interaction, the domestic violence may be growing due to mental stress arising out of a financial crisis, emotional disturbances. Violent situations are prone to arise as an abundant caution by the police if the guidelines during COVID are not followed. The hospitals are the other most likely places where violence can arise from the relatives of the patient, the cause being the compromised management of COVID patients as perceived by the patient and their relatives. Also, the quarantine centres cannot be spared from the possibility of violent situations.

\textit{\textbf{Anayasaka}}

It is to avoid overexertion. Overexertion may cause fatigue and affect the immune system of the body, hence to restore and rejuvenate immunity, its necessary to avoid overexertion. Studies had revealed that overexertion lowers the immunity that increases the risk of infection or the occurrence of inflammatory symptoms \unskip~\citep{895348:20425866}. According to Ayurveda, overexertion may aggravate \textit{Vata dosha} Aggravated \textit{prana-Udana Vayu} dislodge\textit{ Kapha} from its usual place in the chest. 

\textbf{\textit{Prashantam}} \textbf{and\textit{ Priya vadinah}}

It means to be calm and soft speech, respectively. Accepting the fact that fear and anxiety during these uncertain times are natural emotions, one has to be calm and peaceful in mind. A relaxed and composed mind will be able to handle the situations and problems in a better manner. Meditation is one of the techniques that can be implemented to stay calm and focused. \textit{Priya vadinah}: During these challenging times of the pandemic, the stress and anxiety may be reflected unknowingly through harsh and rough words, however, with complete awareness while speaking, one has to be soft and pleasing. Your words should not hurt the feelings of people around you, maybe your family members, friends, colleagues or even helpers.

\textit{\textbf{Japa para}}

\textit{Japa para\textbf{\space }}is chanting of religious hymns. Engaging in personal religious activities and creating a stronger relationship with God in these days, when normal activities are at a halt, is the best use of this period. These may involve engaging in prayers, chanting mantras, meditation (\textit{Dhyana),} reading sacred books or religious scriptures such as Bhagavad Gita, Quran or Bible or any other; thinking about applying these sacred scriptures to one's life and memorizing scriptures. Performing a chain of \textit{Japa} (Chanting mantras) by the family members and friends in a virtual mode is commonly observed practice during this period. Remembering the creator of the Universe (God) my ways will help build spiritual health \unskip~\citep{895348:20425852}. 

\textit{\textbf{Soucha Para}}

This refers to the cleanliness to be practised to avoid infection. COVID-19 virus primarily spreads through droplet and contact transmission, which means by touching infected people and contaminated objects or surfaces. Thus, your hands can spread the virus to other surfaces and your mouth, nose or eyes if you touch them. The essential hygiene practice to be followed during the pandemic is effective hand washing to reduce the spread of pathogens and prevent infections. Washing hands with soap and running water and use of alcohol-based rubs before eating, preparing food, after coughing and sneezing, after caring for the sick, after using washrooms and contacting animals will help to flatten the curve and reduce the burden of the disease \unskip~\citep{895348:20425870}. Making a habit of taking a bath after coming back home from work or any outdoor business will prevent infections from unnoticed sources. 

\textit{\textbf{Dheera}}

This means patience, which is substantially needed in these challenging times. Right from home to the globe, every individual needs much patience even in dealing with day to day activities. It begins from home where the kids are prime members required to be handled with all endurance along with the elderly parents balancing the work from home situation. Shopping for the day to day requirements like groceries, veggies and medicines following social distancing, demands more waiting period. Repeated disinfecting procedures, inadequate or interrupted supply of necessities, protecting our self from the crowded market places demands the test of your patience. More specifically, The frontline health workers need immense patience to handle the cumbersome screening and diagnostic testing, that too with inadequate protective equipment with an expectation of optimum patient care \unskip~\citep{895348:20425857}.

\textit{\textbf{Dana}}

\textit{Dana\textbf{\space }}here refers to charity. The COVID pandemic has created a catastrophe in all spheres of life leading to unemployment and financial crisis that has resulted into a situation where many people are deprived of the basic needs of food, clothing and shelter. A humanitarian aspect of charity is expected at this crucial time. The government and non-government organizations and many trusts are doing charity in various forms by providing food, money for transportation, and shelter homes. Each one of us can do charity at least by providing breakfast/ lunch/ tea to our domestic service providers like watchman and security guards. The maids to be paid without cutting salary. We can also help others by providing sanitizers, masks and ingredients for the preparation of immunity boosters like \textit{AYUSH kadha}. Also helping out the senior population who are staying alone to avail the required day to day commodities like groceries, vegetables and medicines are a means of charity.

\textit{\textbf{Archana}}

\textit{Archana }is worshipping God and respecting teachers, preceptors and elders/cow/ teachers.

Along with worshipping God, it's essential to respect elders and teachers. This stands more appropriate for the young student generation. The present scenario has compelled for online teaching modality. The teachers, though not used to this modality of teaching, they are trying to cope up with the situation. Irrespective of this, the students fail to take the online teaching seriously, disrespecting the efforts of the teachers. Also, staying at home, there is frequent interaction with the elder members of the family. The generation gap may lead to misinterpretation of the communication. It's the responsibility of the young generation not only to respect the elders but also attend to their needs whenever required.

\textit{\textbf{Anrushasyaparam \& Nitya karuna vedinah}}

It means not to be cruel to anyone, treating each one with love and compassion. \textit{Nitya karuna vedinah} conveys to be merciful to all who require help. The catastrophe due to COVID 19 had resulted in profound distress and uncertainty for all. Many people have lost their jobs, business at a fixed point resulting in stressful livelihood. At these crucial hours, when every individual is facing trauma in one or other aspect, it's essential to treat each other with love and compassion. Keeping oneself calm and composed is a challenge during this period. There might be numerous people, especially in the low socio-economic group who need help for even meeting their daily needs. Helping them with humanity may release their anguish at least to some extent.

\textit{\textbf{ Sama Jagrana {\textendash} Swapna}}

It means maintaining balance in waking and sleeping. Not staying awake long into the night and not sleep during the daytime. The pandemic had elevated the anxiety and stress levels, and the spike in the cases is contributing to it. This may result in disturbed sleep during the night time and compensating the same during the day. There should be an appropriate balance between waking and sleeping time which will maintain the biological clock and result in the restoration of health. Many studies have reported sleep difficulties and anxiety during the COVID 19 \unskip~\citep{895348:20425868}

\textit{\textbf{Nitya ksheer ghritashinah}}

It refers to the inclusion of milk and \textit{ghee} in moderation in the diet. 

\textit{Charaka} mentioned cow's milk as the best. It acts as a vitalizer and rejuvenator (\textit{Rasayana}) \unskip~\citep{895348:20425853}. Adding a pinch of ground turmeric, and a few pinches of ginger to the milk reduces the heaviness of the milk and reduce any mucus-causing side effect. The consumption of Golden milk' is recommended in the AYUSH guidelines for COVID 19 The key active ingredient of, `Curcumin', the active ingredient of turmeric has antioxidant and anti-inflammatory properties. Addition of pinch of black pepper may increase the benefit of turmeric \unskip~\citep{895348:20425862}

Ghee helps with balancing both \textit{Vata} and \textit{Pitta doshas}, lubrication, clearing toxins and promoting agni, ojas and working incoherence and equilibrium for all the functions of the body. Ghee is said to be versatile medicine in \textit{Ayurveda. } It is proved to have antioxidant and detoxification property. Amongst the multiple benefits of ghee, of utmost importance, is the fact that ghee increases \textit{ojas } in the body, which is the underlying basis of immunity and the essence of all bodily tissues \unskip~\citep{895348:20425869}.

\textit{\textbf{Desha-Kala-pramanagya}} \textit{\space }

This is to be aware of the place, time, and measures of activities.

\textit{Desha-Kala-pramanagya} in context of this pandemic is indicative that one should be aware of the day to day happenings related to the spread of the disease, number of cases in the nearby locality and most important about the guidelines and circulars from the government and local administrative bodies from time to time. However, it is observed that nowadays the all types of information are spread quickly by social media, internet, mobiles and other communication technology. Many times the information is found to be rumours creating misunderstanding, fear and anxiety in the minds of people during the tough times of pandemic. To avoid all such rumours, it is better to download the Arogyasetu app, which provides appropriate information and directions to take care accordingly. 
    
\section{CONCLUSION}
The COVID 19 pandemic is a significant challenge for the global population. Curtailing the spread of the disease by protecting oneself is the only way to be in a safer zone. Along with the physical health, the mental, spiritual and social health has to be given equal importance in this situation. Following the various aspects of \textit{Aacharraasayan } in the daily regimen will be beneficial in sustaining the spirit, staying away from stress and fear, boosting our morals to deal with the disastrous situation of this pandemic.

\textbf{Funding Support}

The authors declare that they have no funding support for this study. 

\textbf{Conflict of Interest}

The authors declare that there is no conflict of interest for this study.
    

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