Since the onset of the COVID-19 outbreak in Europe, Italy has been among the first affected Countries, and the number of reported cases is still the highest in the continent.
Since the beginning, the epidemic has had a huge impact in the acute sector of the healthcare system (especially the emergency departments, Intensive Care Units -ICUs, laboratory and imaging services), and these services have been experiencing an increasing pressure.
As the epidemic progresses, almost all the healthcare sectors will be involved, including the area of post-acute care and rehabilitation.
Two main factors are now characterizing the consequences of the epidemic in rehabilitation services and all physical and rehabilitation medicine (PRM) activities:
– The increasing pressure from the acute care services to transfer patients to inpatient rehabilitation units, so to facilitate new admissions of COVID-10 cases, as well as to ensure the care of patients affected by other medical conditions whose admission can’t be postponed.
– The increasing difficulties in providing rehabilitation care in the outpatient and home-based settings, because of the restrictions imposed by the National and local authorities in the movement of persons to prevent the spreading of the infection. This situation is expected to have a significant negative impact in the short term, mainly for those patients at higher risk of deterioration of their functional abilities and already suffering from important limitations in participation.
Such factors are rapidly re-shaping the entire organization of rehabilitation services; despite that, rehabilitation professionals are trying to do their best to provide adequate care to their patients, who are particularly vulnerable because of their health conditions and functional limitations.
The rapid evolution of the epidemiological scenario has been leading to a number of recommendations, provisions and rules issued by the National, regional and local authorities.
There are some differences in the existing preventing measures among regions and/or local health districts, only partially due to real differences in the organization of services. Moreover, the provisions address general aspects of the prevention or management of the infection, and are not tailored to the specific needs of the rehabilitation activities.
For these reasons, the Italian Society of Physical and Rehabilitation Medicine (SIMFER decided to produce a short document with the aim of providing recommendations fully compliant with the National and regional provisions, but specifically focused upon the rehabilitation sector, to support the physical and rehabilitation medicine physicians, other medical specialists, other health professionals, and policy makers in taking decisions in such an unusual and largely unknown circumstance.
The document presented here has been issued on March, 13 th by the SIMFER Executive Committee. Ongoing revisions of the document are planned, according to the evolution of the epidemiological picture.
SIMFER hopes that this document can be useful for colleagues in dealing with a similar situation.
European Journal of Physical and Rehabilitation Medicine 2020 Mar 16
Copyright © 2020 EDIZIONI MINERVA MEDICA
Impact of COVID-19 outbreak on rehabilitation services and Physical and Rehabilitation Medicine (PRM) physicians’ activities in Italy. An official document of the Italian PRM Society (SIMFER)
Paolo BOLDRINI 1 ✉, Andrea BERNETTI 2, Pietro FIORE 3, SIMFER Executive Committee and SIMFER Committee for international affairs
1 Past-President, Italian Society of Physical and Rehabilitation Medicine (SIMFER), General Secretary of the European Society of Physical and Rehabilitation Medicine (ESPRM), Italy; 2 Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, talian Society of Physical and Rehabilitation Medicine (SIMFER), Rome, Italy; 3 Physical and Rehabilitation Medicine, University of Foggia, Italy; Head PRM and Spinal Cord Unit Policlinico di Bari, President Italian Society of Physical and Rehabilitation Medicine (SIMFER), Italy