THE IMPACT OF THE COVID-19 VIRUS PANDEMIC ON PHYSIOTHERAPY FROM COVID TO ‘CO-PHYS’… By: Resean Reece, Registered Physiotherapist
2. Cleanliness is a state of purity and clarity: It should be standard to keep any health care facility thoroughly sanitized, but being more conscious of our surroundings can only be more helpful. Patients will have a greater sense of security when using frequently sanitized equipment or exercise stations more so amid a global pandemic. Patients are appropriately reminded of practicing personal hand and face hygiene in protecting themselves and other patients. The move by myself and colleagues to wear and manage personal protective equipment (PPEs) will reduce the risk of spreading the COVID-19 virus and other harmful pathogens, which I believe we should forever sustain from this renaissance of safety and hygiene. With the significant implications of the pandemic outlined, I will downplay my bias for the private health care sector, to acknowledge our public sector counterparts; especially the physical therapists who work on the frontline such as in accident and emergency (A&E) departments, intensive care units (ICUs) and on the in-patient wards of the island’s hospitals. They have to employ a stringent screening process and set of protocols in treating patients who are either confirmed to have COVID-19, who is suspected of having it, or at least is predisposed to contracting the virus while being an in-patient in the delicate hospital setting. The doctors, nurses, and other primary health care providers are not exempt from our appreciation. How a patient is managed on the frontlines will impact their progress when release to continue treatment from private facilities. Our patient’s understanding and cooperation are vital, considering the currently eased soft-curfew restrictions by the Cayman Islands Government (CIG) and the approval of health care facilities to reopen with their own safety policies and guidelines in place. This will allow for safe practices and outcomes in the clinic as it relates to hygiene and sanitization. Most importantly, wash your hands, wear a mask, and maintain an appropriate distance from other individuals. Each physiotherapist will only be allowed to see one patient at a time for crowd control purposes. Hence, be punctual for your appointment, or at least communicate with us if you are delayed, so that the therapist can plan ahead. For more information on the compliance to anti-COVID measures for any health care facility, feel free to visit the CIG Department of Health Regulatory Services, or simply contact our facility at 345-943-8700. Please visit our Facebook ( fb.com/thephysiotherapycenterltd ) and website ( thephysiotherapycenter.com ) for more information. Most importantly and appropriately, keep safe and keep moving, as the whole world attempts to return to some semblance of normalcy and health. We look forward to assisting you in ‘Getting Back to Better Again.’
Skype or Physitrack) have been a magical tool in encouraging ongoing communication with our patients, and in equipping us with the ability to administer exercises and supervise tasks. Live and ongoing visual and verbal feedback is exchanged between therapist and patient based on the activity being done. Education has had a vital role in our online applications, which can be done in the form of specific and safe videos, presentation/discussion, or the citing of reputable medical websites and online journals. Despite these wonders of technology, we cannot ignore how tactile our profession is. We garner quite a lot of information by palpating muscles, joints, the quality of movement, etc., and observing the target tissue or affected function in a person, is vital. Additionally, manual therapy is carried out predominantly by the clinician’s hands, and the sense of touchwe provide during a task or exercise gives guidance and assurance to the patient. For health practitioners, the needed progress and complexity of exercises must be tempered, for the sake of safety or for a client who is understandably not adequately equipped for rehab at home. 3. Delayed treatment and recovery of patients: This has occurred with the highlighted limitations of technology, and the added responsibility of stay-at-home domestic, family-related, and work tasks. Nonetheless, we have adapted to providing meaningful physiotherapy services online. Clinicians and clients have had to be more patient in their rehab to achieve functional goals. This article would not be complete without exploring the fewer positives that we have gained during the COVID-19 restrictions: 1. ‘On-the-call Physio’: The pandemic saga has encouraged us as physiotherapists to be more creative and productive. By hosting online sessions, thereby having a more comprehensive and tested option in providing treatment to patients, in the long term of the post-COVID-19 era. We must be even more conscious of how clearly and coherently we communicate the necessary information to patients, using verbal tone, facial expression, and repetition, emphasizing a particular topic. Some patients have also felt more relaxed in communicating and working out from home. It is also easier to visualize what patients go through at home with functional tasks, ergonomics, and ease of mobility that are demonstrated or observed. Remember that many physiotherapy problems originate from doing something wrong at home, or at least their domestic environment has contributed to their discomfort. A patient’s inability or unwillingness to come to the clinic, does not negate them receiving any form of intervention in this age of technology.
It is disheartening to see the devastating effects the COVID-19 pandemic has had globally touching on every stratum of life. The demand for health services is dramatically increasing and is appreciated in the more acute or emergency setting, where intervention administered has a direct effect in managing confirmed COVID-19 cases. However, one must think about the secondary health care personnel as well more falling under the umbrella of The Professions Allied to Medicine, and the relevance they have in this COVID era. Keeping the ship sailing in all areas of the health field is of vital importance. Despite having to take precautions, including quarantining and social distancing, people still have to live and maintain a healthy lifestyle. Pharmacists will still have to prescribe much- needed medication, medical technologists still need to do body fluid-related tests/analysis, and nutritionists will still need to do dietary planning for clients. These scenarios are no different from the current need for physiotherapists that are continuing to facilitate rehabilitation, administer exercises, and encourage healthy physical activities. New post-op patients should receive early pain management and mobilization treatment as ordered by their surgeon. Also, returning patients with chronic musculoskeletal and neurological conditions need to keep up the momentum to aide their recovery. The following points listed outlines the negative impacts of this pandemic on physiotherapy. There is no doubt that some of these points may be applied in general to other areas of the health field. 1. The decline in clientele: There has been a reduction in the number of physiotherapy patients with the social distancing campaign and closing of non-essential businesses, which started in March 2020. Many patients who have been employees or owners of such companies, such as in the tourism industry now have less disposable income, with possible reduction or delays in being paid, while still needing to cover their expenses. Similarly, private physiotherapy clinics and fitness centers have had the added burden of having to increase time spent on sanitization and prospectively operational facilities with significantly less commission or income. One has to think that this delays the growth of that facility, which would have happened via tapping into the research, expanding staff, and purchasing new equipment. Home visits and outdoor hydrotherapy sessions would also be suspended. 2.Decreasedefficacyofservice: Physiotherapists are no less important at this time; however, our workhashad tobeconfined toonline interventions. Our Physiotherapy Center Telehealth services (via WhatsApp video call, Cliniko, Medbridge, Zoom,
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