When information and evidence changes around the ever-changing coronavirus pandemic, it can create confusion and misinformation. That's why we've put together a simple, easy-to-use guide to make sure you are always up to date.
These are the first eBooks from Physiopedia. The PP team is much smaller than most people think, so putting something like this together alongside our usual jobs and PP tasks is not an easy task. Kim Jackson is the Content Manager at Physiopedia and she was the driving force behind the creation of eBooks.
“2020 was an unforgettable year. The COVID-19 pandemic brought many changes in physical therapy and a steep learning curve for many. With social distancing and the temporary shutdown of many services, we had to find another way to deliver services, mostly through platforms like telehealth. "
“For others, it meant adapting their skills and knowledge to deal with this new respiratory disease, while others spent the time re-qualifying to help in areas that were completely overwhelmed and understaffed. One thing that 2020 showed us was the resilience of physical therapists, their ability to adapt their skills, and also their willingness to work as part of a team, both within our discipline and as part of multidisciplinary teams. COVID-19 has been a real challenge on both a personal and professional level. "
Kim says everyone at Physiopedia has recognized the importance of keeping abreast of all new developments and many interventions that COVID-19 has asked of us. The PP team has created many new pages that guide doctors. These complement the Physioplus courses to ensure a comprehensive learning experience for doctors. The fact that all of these resources are available for free is even better and something the entire team is proud of.
The first eBook is an introduction to COVID-19 and the second is the COVID-19 rehabilitation program.
Both e-books will be available shortly! A registration form will appear shortly.
You will be able to download the eBooks shortly to ensure you have the knowledge you need about COVID-19 wherever you go. Even without an internet connection.
The Essential Physiopedia Pages
Kim has also selected her best Physiopedia COVID-19 resources for you. These pages are constantly updated by the Physiopedia team to ensure that the best evidence-based content is available to you.
These are the top pages for a reason. They contain evidence-based facts and information written in an easy-to-digest way for you to put them into clinical practice. These pages cover everything you need to know from pathophysiology to pulmonary x-rays and rehabilitation to PPE, your role as a physical therapist and ventilators. These are your go-to places to keep up with the latest changes in the evidence.
Don't forget that you can download the Physiopedia app for quick online and offline access to these pages.
Free COVID-19 courses on Physioplus
There are currently 21 Physioplus courses on COVID-19. All of them have been created by topic experts, each telling you how the coronavirus affected their specialty, and sharing the information with you through high quality videos and testing your knowledge with quizzes and articles. Many of these courses have also been translated into different languages!
The courses are available free of charge until the end of 2020.
The courses are free until the end of 2020 and are then available to all fully paying members of Physioplus. No doubt the Physioplus team will continue to update the courses and upload new courses as the evidence changes.
In order to gain access to the courses, all you have to do is open a test account . Be quick when time is running out!
Covid-19 Youtube playlist
Physiopedia's mission is to improve global health through universal access to physiotherapy knowledge. COVID-19 didn't put an end to this – it strengthened our determination to make sure we keep our community updated on everything they need to know, through every channel we can. This includes Youtube.
These Youtube videos are a mix of interviews and presentations that cover a wide range of topics from leadership and crisis management to clinical management of respiratory patients. Thank you to all clinicians who gave up their time creating the content. The entire #GlobalPT community is grateful for your time, but remember that these videos are not just for us. Make sure you share them with your colleagues.
The videos in the playlist contain:
Guided tour in times of COVID-19 with Emma Stokes
Crisis management with Jason Giesbrecht
Reflections on COVID respiratory treatment with Rachel Moses and Deborah Dent
Diet considerations with Joe Tatta
Treatment of tendinopathy during lockdown with Ebonie Rio
Play it safe with hand washing technology and cleaning with Liezl Naude .
In 2021 we will publish new and original YouTube content. So don't miss out. Subscribe and press the alert to be notified when we post our new content . The Physiopedia team is very excited about what we are working on. So don't miss out! We would be happy if you are part of it.
COVID-19 rehabilitation
There are two different patient groups affected by the pandemic: those who need rehab because of the virus and those whose services are affected by the virus. Any rehabilitation strategy during the time of COVID must therefore take into account both the COVID-specific rehabilitation needs and the needs of those who need rehabilitation for reasons other than the COVID infection.
Otherwise, large numbers of people are at risk of unequal access to rehab, and if people who are deconditioned or otherwise in need do not receive effective rehabilitation, it can lead to poorer outcomes for those facing future pandemic waves not comfortable with COVID-19. It is therefore important that rehabilitation programs and proactive management resume as soon as possible. This will minimize adverse consequences for people with long-term conditions, people with gradual loss of function, and people in need of rehabilitation after an elective or emergency hospital stay.
The following is a list of the best resources and guidelines from around the world to help you ensure your services are as secure as possible.
Long COVID
The ongoing chronic symptoms of the coronavirus are still something the world is figuring out. As new information becomes available, you can be sure that we will update our Physiopedia pages. But for now, below is an overview of what we now know.
What you need to know
The current management after the first 3 weeks is unknown
~ 10% of people with COVID infection develop chronic symptoms
Many people with long-term COVID recover spontaneously, while others require MDT care with graded exercise and exposure to their usual pre-covid routine
If you are concerned about ongoing clinical concerns, seek medical advice. This includes respiratory, neurological, or cardiac symptoms
Most patients with COVID-19 recover and return to normal health. About 10% of patients have persistent symptoms that can be widespread and last weeks to months after the initial infection. This is reserved not only for sufferers, but also for those with mild or minimal symptoms who may develop chronic symptoms. Many multi-year studies are underway to fully investigate Long COVID, but for now we need to grapple with what we know so far.
The most common symptoms are
Fatigue
shortness of breath
to cough
Myalgia
Chest pain
Others are brain fog, bad mood, headache and palpitations.
The best way to prevent these symptoms is to prevent COVID-19 from occurring in the first place. This means maintaining social distance and wearing PPE whenever possible. There is evidence that persistent viraemia due to poor immunity, deconditioning, and PTSD all contribute to the development of long covid.
This infographic is from the BMJ, which has some excellent COVID-19 resources.
World physiotherapy and the COVIDPhysio-Register
World PT Day took place on September 8th and the topic for this year was COVID-19 rehabilitation, which will continue to be the focus of our thinking in the months and years to come. There is a COVID-19 information hub on the World Physiotherapy website that has all PT daily issues and materials in the COVIDPhysio register.
Our profession is uniquely positioned to add to and add to the challenge and help our most vulnerable people regain independence and quality of life in ways we have never seen before. Although it is easy to have COVID-19 fatigue at this stage and the thought of seeing and creating more resources is exhausting, this is our time to face the challenge. Make sure to check the COVIDPhysio registration to encourage collaboration and avoid duplication.
In addition, there are high quality educational resources for staff and patients, all of which are available free of charge.
Frailty & COVID-19
Elderly people who live with frailty do not react to the coronavirus like younger people. This is in part why many elderly people who are hospitalized become asymptomatic positive cases and accidentally spread the disease to other wards.
Important points
Elderly patients are at greater risk of mortality and may have delirium, postural instability, or diarrhea and without a fever
Social distancing and isolation can have negative consequences for older people unrelated to COVID-19
Elderly people are relatively excluded from clinical studies on COVID-19
In addition to age, male sex and the presence of comorbidities, specific laboratory and radiological findings are important prognostic factors
At this stage we all know that the typical symptoms of COVID-19 are predominantly respiratory symptoms (cough, sputum, sore throat, runny nose, earache, wheezing and chest pain), systemic manifestations (myalgia, joint pain and fatigue) and enteric presentation (abdominal pain, vomiting and diarrhea). Due to frailty and age-related physiological and immunological changes, older people often appear without these typical / classic symptoms.
In addition to the multisystem dysregulation involved in the frailty process, immune scenes are one of the main drivers for atypical presentations. If your body systems aren't working together properly, you won't have a typical response to homeostasis or infection. It makes the situation unpredictable.
Dive deep into frailty with Scott Buxton
A study recently published in Age and Aging has highlighted some atypical depictions in older people who live with a higher degree of frailty or who live in care facilities. Of the patients included in the study, the most common COVID-19 symptoms were hypoactive delirium, falls, anorexia, and fatigue. The mortality for a completely atypical presentation was 65% and the mean LoS was 11 days for the survivors.
For more information on how COVID-19 affects people with frailty, the British Geriatric Society has a COVID-19 resource hub.
COVID-19 Post Acute Rehabilitation
Frailty is a clinical condition that is associated with many negative consequences, including falls, accidents, and disability or death. It is estimated that 25-50% of the population aged 85 and over can be classified as frail and therefore most physical therapists encounter frail patients. In this course, you will learn about frailty and gain important insights into its effects on patients and their quality of life.
People with frailty often live atypically with COVID
News and Social Media Top Follows
The evidence for COVID-19 is constantly changing. That's why Physiopedia recommends staying up to date on the latest developments through Physiospot and reputable news outlets and social media experts.
We asked our Physiopedia community to let us know where they were going to catch up on the latest developments in coronavirus around the world.
The top members of our community include:
How does the vaccine # COVID19 get you?
Dr. @Kate_L_OBrien explained in # ScienceIn5 ⬇️ pic.twitter.com/VkHJ7AVTUv
– World Health Organization (WHO) (@WHO) December 5, 2020
The BMJ Twitter account contains the latest articles on COVID-19
The CDC Twitter account is a great following for the latest news
The European Medicines Agency for vaccine updates in the northern hemisphere
The Lancet for Developments in Latin America
The new scientist for the current and political analysis of COVID-19 developments
Coronavirus Myth Busters
Destroying myth at a time like this is crucial and there are some excellent articles on the internet. Always make sure it is from a trusted source and author, and look for evidence to support people's claims . Instagram and Twitter are excellent sources for quick and up-to-date evidence and infographics, but the good is riddled with misinformation. Make sure you are vigilant and if it sounds sensational or too good to be true then it probably is. Below is a list of the truths and the resources they come from. Make sure you know everything you need to know as a physical therapist.
Does alcohol gel kill COVID-19? – Yes.
Are surgical face masks useful? – The leading thought right now is that COVID is transmitted via droplets, which means that masks are useful in collecting these droplets. This is not infallible, of course, as droplets can still get through your eyes and onto your skin, and later get transferred to your face. It's also worth noting that surgical masks are useful only in close proximity to people.
There is also a lot of misinformation about the size of the virus and the filtering ability of masks. An infographic allegedly made by Unicef has made the rounds on WhatsApp and Twitter, claiming that the coronavirus is 400-500 nm wide and therefore sufficient to be stopped by masks. This is actually not true and the virus is 50-200nm wide. As explained above, a mask doesn't always stop the virus.
What is the incubation period for COVID-19? – The WHO reports that this is between 1 and 14 days and that the symptoms appear most frequently after 5 days. This is where the 14 days of self-isolation come from.
How long does the virus live on surfaces? – There is no precise answer to this question. The current thought is that COVID-19 behaves like other coronaviruses and persists on surfaces for a few hours to several days, but there is evidence that it can last up to 28 days on surfaces like your phone. This is a broad span of time, but this is because it all depends on environmental conditions which vary massively even within a person home. The sensible advice is to disinfect surfaces regularly if you think they are contaminated.
WHO has some great infographics that you should definitely share with patients, colleagues and friends. Here's one that breaks the myth that soaking your body in chlorine or alcohol will kill the coronavirus.
