European Journal of Physical and Rehabilitation Medicine 2020 Apr 08
Copyright © 2020 EDIZIONI MINERVA MEDICA
First impact on services and their preparation. “Instant paper from the field” on rehabilitation answers to the Covid-19 emergency
Paolo BOLDRINI 1 ✉, Carlotte KIEKENS 2, Stefano BARGELLESI 3, Rodolfo BRIANTI 4, Silvia GALERI 5, Lucia LUCCA 6, Andrea MONTIS 7, Federico POSTERARO 8, Federico SCARPONI 9, Sofia STRAUDI 10, Stefano NEGRINI 11, 12
1 Past President of the Italian Society of Physical and Rehabilitation Medicine, Secretary General of the European Society of Physical and Rehabilitation Medicine; 2 Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy; 3 Spinal and Traumatic Brain Injuries Unit, Physical and Rehabilitation Medicine Department AULSS 2 Marca Trevigiana, Treviso, Italy; 4 Medical Rehabilitation Unit, Geriatric-Rehabilitation Department, University Hospital, Parma, Italy; 5 Rehabilitation Department, Spalenza Centre Rovato, IRCCS Don Gnocchi Foundation, Milan, Italy; 6 Rehabilitation Hospital, Sant’Anna Institute, Crotone Italy; 7 Neurorehabilitation Department, ASSL Oristano ATS Sardegna, Oristano, Italy; 8 Rehabilitation Department Versilia Hospital, AUSL Toscana Nord Ovest, Viareggio, Lucca, Italy; 9 Brain Injury Unit, Rehabilitation Department USL Umbria 2, Foligno, Perugia, Italy; 10 Neuroscience and Rehabilitation Department, University Hospital, Ferrara, Italy; 11 Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, Milan, Italy; 12 IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
This paper reports the immediate impact of the epidemic on rehabilitation services in Italy, the first country in Europe hit by Covid-19. In a country with almost 5,000 Physical and Rehabilitation Medicine physicians, the webinar had 230 live viewers (4.5%), and more than 8,900 individual visualizations of the recorded version. The overall inadequate preparation of the rehabilitation system to face a sudden epidemic was clear, and similar to that of the acute services. The original idea of confining the Covid-19 cases to some areas of rehabilitation wards and/or hospitals, preserving others, proved not to be feasible. Continuous reorganization and adaptation were required due to the rapid changes. Overall, rehabilitation needs had to surrender to the more acute emergency, with total conversion of beds, wards and even hospitals. The quarantine needs heavily involved also outpatient services that were mostly closed. Rehabilitation professionals needed support, but also acted properly, again similarly to what happened in the acute wards. The typical needs of rehabilitation, such as human and physical contacts, but also social interactions including patient, team, family and caregivers, appeared clearly in the current unavoidable need of being suppressed. These notes could serve the preparation of other services worldwide.
KEY WORDS: Covid-19 emergency; Rehabilitation; Immediate impact