Since 1951, September 8th has been World Physiotherapy Day of Physiotherapy, a day that signifies a time of unity and solidarity with the worldwide physiotherapy community. Every year there is a new theme to draw the attention of the professions and this year the theme is Rehabilitation and Long COVID [1945900].
The Impact of COVID-19 on Fragile Health Systems and Vulnerable Communities
The pandemic has exposed the fragility of health systems in all environments. While there are many vulnerable communities and fragile health systems in low- and middle-income countries, the pandemic has also exposed the fragility in the health systems of many higher-income countries.
COVID-19 has highlighted the insidious growth of the socio-economic divide in health outcomes between rich and poor. The fact is that COVID-19 affects the poor disproportionately and the economic decline of the pandemic will be felt for years to come.
We know that exposure to COVID-19 was greatest among people engaged in precarious, poorly paid manual activities that could not be done at home. Often times, these people live in densely crowded urban areas with no access to outside spaces, which is also associated with poor health outcomes. Poorer communities are also more prone to severe COVID-19 infections due to higher levels of previous illnesses. Therefore, they develop COVID symptoms for a long time.
These increased infection rates lead to a loss of income, which puts immediate pressure on the most financially vulnerable and continues a downward cycle in health outcomes. This is proof of the importance of the interplay between health, wealth, community and the environment.
The fragility of rehabilitation services exposed
In fragile health systems, rehabilitation services are not seen in the same light as other medical or curative services. This leads to a underfunding which creates a discrepancy between supply and real demand.
During the pandemic, many rehabilitation services were suspended to allow staff to be redeployed into services focused on managing the acute phase of the pandemic. This has resulted in a significant backlog in service delivery that is a serious challenge. As rehabilitation plays a critical role in helping people return to work and contributing to their communities, the economic impact of inability to access rehabilitation is not fully understood. Given the current backlog in rehabilitation services and clinical fatigue among health care providers, this will have a significant impact on people in need of rehabilitation care.
Add long-term COVID and we have a serious problem with not only those with existing rehabilitation needs lacking access to essential services, but potentially a wave of thousands in need of rehabilitation after COVID-19 . In addition, the type of rehabilitation people need after suffering from Covid extends beyond physical rehabilitation to psychosocial support. This is a challenge for many services that do not provide these essential services today.
As World Physiotherapy rightly states in their Briefing-Paper physiotherapists need to emphasize their worth more than ever by playing the role Emphasize Rehabilitation helps reduce overall disability and the burdens on a country's economy ”. Physiotherapists have both played an important role in managing the COVID-19 crisis and will continue to be vital in helping people return to functioning health.
So for this World Physiotherapy Day, think about what you can do to promote the role of rehabilitation in your community and to raise awareness of the importance of access to rehabilitation for everyone, especially those with long-term COVID Life.
What is long COVID
About one in ten people who become infected with COVID-19 will experience a multitude of long-term consequences, both mentally and physically. The umbrella term for this is long-term COVID.
One of the most common and misunderstood symptoms that people with prolonged COVID struggle with is Post-Stress Symptom Exacerbation (PESE) . Although it is an internationally recognized cardinal sign of diseases such as ME / CFS .
Essentially, a person struggling with PESE has difficulty producing energy on demand, causing symptoms such as tiredness, exhaustion, difficulty thinking and pain; all exacerbated by exertion. It is a vicious circle and can have a real impact on a person's quality of life.
This exertion is not limited to physical exertion but also includes cognitive and emotional exertion, which underscores the need for more than just physical rehabilitation. PESE symptoms vary in severity, intensity and consistency which means that treatment in a single session is difficult, which further impairs service delivery. The ME / CFS South Australia INC website has some great resources to learn more about PESE. Also check out the DePaul Post-Exertional Malaise Questionnaire, a reliable and validated tool to assess the severity of PESE symptoms.
What you can do now
Read the World Physiotherapy Briefing Paper (available in 9 languages with and 5 more to come)
Keep an eye out for research results such as the REGAIN study . This is a multicenter RCT that compares different forms of online, 1: 1 and group rehabilitation, as well as supervised home rehabilitation for people with longstanding COVID.
Learn more about Long-COVID with an online course
Vitis die long-covid.physio website
Take part in our MOOC to deepen your understanding of health systems
Be grateful to health care providers who do everything they can to improve a person's quality of life.
If you have been treated, are treated or know a physical therapist, acknowledge their efforts and be an advocate of their profession. Thank you to a physiotherapist today!
