Physical Therapists and Coronavirus

Now that the World Health Organization announced the Coronavirus (COVID-19) as a global pandemic with more than 100.000 cases reported worldwide by March 7, 2020, healthcare systems in various countries are being tested to their upper limits of resources and capacity. All healthcare professionals, from various backgrounds, have the responsibility to treat, care and support patients, families, institutions, governments and nations.

Here's a summary put together by the APTA about what we know so far.

Although virology and infectious diseases are not really the forté of Physical Therapists, they can play a highly beneficial role during these times.

Patient Education

Physical Therapists are among the most skilled healthcare professionals in patient education and communication of health-related messages. Most of systematic reviews of treatment interventions administrated by Physical Therapists comparing patient education to other modalities are finding patient education to be superior to other modalities and more beneficial for patient autonomy and self-management.

Not to forget that Physical Therapists, compared to other healthcare professionals, spend the most time around every patient (30 to 60 minutes /session). More time means more interaction; from one side it predisposes them to higher contamination risk in the case of an infectious disease but from the other side, they become a trusted figure from the patient's perspective which increases the likelihood of the patient (and their family) following health-related instructions and advice.

Teaching patients, families and the larger community about the proper ways to washing hands, social distancing, disinfecting surfaces, avoiding unnecessary exposure and other preventative measures to help "flatten the curve" are all things that Physical Therapists can champion.

Prioritizing patient care - Finding solutions

While most of Physical Therapists in practice are currently concerned about their patients and jobs, like all other professionals who are under the pressure of forced closure and quarantine; Physical Therapy treatment protocols, usually, follow a structured program over a period of time and now that everyone is forced to stay home and miss sessions (even home-based sessions), it is up to the Physical Therapists themselves to help their patients not fall off the wagon and stay on track:

• Enforcing the message of social distancing and unnecessary exposure by taking the lead and canceling the sessions of the patients that can be cancelled, for now.
• Taking the time and effort to develop a home-based protocol that is simple and practical for the patient to follow.
• Following-up on patient adherence (I like using the term more than "compliance" because of the small nuance) via scheduled video calls.

While the challenge might be difficult financially to cancel all sessions and chances are third-party insurance is not going to pay for the home-based protocol and scheduled video calls, but now is the time for us as professionals to go the extra mile and stick together, for our patients and communities.

Respiratory Physical Therapy and COVID-19

A lesser known sub-discipline in Physical Therapy is one that is very interesting and aims to help treat patients with respiratory tract illnesses and conditions - mostly in children.

While all professionals in the medical and healthcare industry are currently learning about COVID-19 day by day, our colleagues who practice in respiratory Physical Therapy are being asked to provide their expertise on the management of some cases of patients infected with Coronavirus and suffering from respiratory distress. One of our colleagues in England, Dr. Rachael Moses, was kind enough to share her treatment protocol on Twitter (below). A document of 12 pages in which she shares everything from preparatory techniques of suspected cases to treatment objectives of confirmed cases.

Whilst this is one document from one professional that got adopted in one hospital, it is definitely a great start and can provide a road map for our colleagues who are practicing in hospitals on the frontline of fighting the virus (who deserve a HUGE KUDOS), from which they can create their own protocols along the same line. Sharing experiences and learning from each other is how it should be done, especially when we're racing against time.

Professionals lead by example

Fighting against fake news

It is important to highlight - to patients and families - the fact that all these measures are temporary and Physical Therapy is an integrate, inseparable, part of the healthcare system.

The last thing wanted at this point is to fuel unjustified fear, anxiety and paranoia as reports of numbers of people suffering from mental health issues is increasing due to the spread of the virus.

Here's also an excellent summary put together by a good friend, Dr. Marco Bardus, on how to fight covid-19 misinformation on Social Media:

Another way Physical Therapists can help fight against fake news lies in the fact that Physical Therapy is becoming more and more evidence-based and Physical Therapists know how to process scientific evidence and should be able to tell the truth from the myth.

Especially now, when people are looking for all sorts of ways to prevent catching the virus and boost their immune system, some business owners from different backgrounds may promote some medicine, a herbal cocktail, a "magic syrup" as an immunity booster shot! Which is not surprising, and you may find it next to all the hand sanitizers, 10$ face masks and 5$ pair of gloves. For the same reasons, I wouldn't get surprised when I see the ads from opportunity-driven clinics offering "Immunity-boosting cupping", "Flu-fighting acupuncture" and "Ironman Kill-The-Virus drip".

Addendum: Around 24 hours after I pressed the "publish" button on this one, I managed to find these 2 examples - one is Italian, but you get the point. Note that none of which are supported by scientific evidence and might be borderline irresponsible and dangerous; yet again, some people went vegan after watching Game Changers and Gwyneth Paltrow's Goop is still attracting viewers so my case is made.

Note: Article above, in Italian, has been retracted from the website.

Physical Therapists can lead the fight against pseudoscience and fake news by providing proper evidence-based advice on how to lead a healthy lifestyle, staying hydrated and keep moving, even at home, for a non-compromised immune system, especially for the population at risk such as the elderly.

This too shall pass..

With more reports of success (containment of the spread with less admissions and bigger numbers of healed patients) coming out of China, South Korea and now Europe, hopes are high that the Coronavirus will be fully contained around the world by June, 2020. Until then, a lot of lessons will be drawn from this pandemic for the healthcare systems to learn from, in every country. As new social behaviors are being shaped, these times offer an great opportunity for the Physical Therapy profession to rise for the occasion and to support the fight with our colleagues in healthcare.