Rehab Policy/Planning Considerations for COVID-19

Updated: March 28, 2022
NEW Rehabilitation Care at the Time of Coronavirus Disease-19 (COVID-19) Pandemic: A Scoping Review of Health System Recommendations (January 2022)	Authors summarize health system recommendations specific to COVID-19. Key themes identified include: 1) recommendations for the rehabilitation inpatient facility setting, the discharge process and the outpatient setting; 2) recommendations related to health system elements e.g., rehabilitation equipment/workplace, human resources and telerehabilitation; and 3) precautions for patients and rehabilitation professionals
Count the cost of disability caused by COVID-19 (May 2021)	Commentary article outlines the importance of quantifying how COVID-19 contributes to ill health and impacts well-being and productivity. Authors suggest that focusing only on cases and deaths hides the pandemic’s lasting health burden on people, societies and economies.
Expanding our understanding of post COVID-19 condition: Report of a WHO webinar (April 2021)	Summary of an international discussion on the Post COVID-19 condition: lessons learned; what we know; discussion of clinical case definition and research gaps/methods.
Characteristics and outcomes of COVID-19-Positive Individuals Admitted for Inpatient Rehabilitation in Toronto, Canada (March 2021)	Article describes the sociodemographic features, impairments, and functional changes of COVID-19-positive individuals who underwent inpatient rehabilitation at three rehabilitation hospitals in Toronto, Canada.
Post COVID-19 Rehabilitation Response Framework Summary Report (March 2021) Post COVID-19 Rehabilitation Response Appendices: Pathways, Toolkits & Resources (March 2021)	Published by the Neurosciences, Rehabilitation & Vision Strategic Clinical Network of Alberta Health Services. Outlines 19 rehabilitation recommendations, pathways and considerations for providers across the continuum to assess functional impairment and determine the appropriate rehab needs for patients experiencing Post COVID-19 Syndrome. Appendices listed as a separate document. Published by the Neurosciences, Rehabilitation & Vision Strategic Clinical Network of Alberta Health Services. Outlines care pathways, tools for assessing functional status and symptom checklist among other resources. Summary report listed as a separate document.
Attributes and predictors of long COVID (March 2021)	Study analyzed data from 4,182 incident cases of COVID-19 in which individuals self-reported their symptoms prospectively in the COVID Symptom Study app.
In the wake of the pandemic. Preparing for Long COVID (March 2021)	Policy brief, published by the WHO, seeks to raise awareness of Long COVID and to provide a resource for those in decision-making roles.
Global COVID-19 Clinical Platform Case Report Form for Post COVID condition (February 2021)	The World Health Organization invites clinicians and patients to collect information on COVID-19 in a systematic way to expand knowledge on Post-COVID-19 condition and support patient care and public health interventions. The form has been designed to report standardized clinical data from individuals after hospital discharge or after the acute illness to examine the medium- and long-term consequences of COVID-19. The forms will be available in multiple languages.
Patient-made Long Covid changed COVID-19 (and the production of science, too) (February 2021)	Authors are patients and researchers with Long Covid, who have contributed to making ‘Long Covid’, and to advocacy around its definition and recognition.
The COVID Rehabilitation Paradox: why we need to protect and develop Geriatric Rehabilitation Services in the face of the pandemic (January 2021)	This commentary, published by the British Geriatrics Society, discusses the impact of COVID-19 on older adults, their subsequent need for rehabilitation and the challenge of limited rehabilitation programs to meet these needs as a result of the pandemic.
COVID-19 rapid guideline: managing the long-term effects of COVID-19 (December 2020)	Guideline jointly developed by the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP). Provides an overview of identifying, assessing and managing the long-term effects of COVID-19, (‘long COVID’). It makes recommendations about care in all healthcare settings for adults, children and young people who have new or ongoing symptoms 4 weeks or more after the start of acute COVID-19. It also includes advice on organizing services for long COVID including rehabilitation.
Response to the COVID-19 Pandemic Among Post Hospital Brain Injury Rehabilitation Providers (November 2020)	This paper describes steps taken to contain the threat by seven ABI rehabilitation organizations. It also describes the financial impact of reductions in admissions, services, and unanticipated expenses (e.g., PPE, more frequent and thorough cleaning) and indicates that providers continue to be challenged to adapt rehabilitative approaches and to reopen services.
The future of rehabilitation in the United Kingdom National Health Service: Using the COVID-19 crisis to promote change, increasing efficiency and effectiveness (November 2020)	Article provides a brief overview of the history of rehabilitation, discusses its development through a biopsychosocial model and suggests the COVID-19 crisis can be used to illustrate how rehabilitation is a vital part of any healthcare service.
Operational Considerations for Physical Therapy During COVID-19: A Rapid Review (September 2020)	This study provides a review of the pandemic and physical disaster management literature to summarize physical therapy–specific operational considerations to assist hospital-based leadership teams in planning and response efforts during the COVID-19 pandemic.
NEW Postdischarge symptoms and rehabilitation needs in survivors of COVID‐19 infection: A cross‐sectional evaluation (July 2020)	A purposive sample of 100 survivors discharged from a large University hospital were assessed 4 to 8 weeks after discharge by a multidisciplinary team of rehabilitation professionals using a specialist telephone screening tool designed to capture symptoms and impact on daily life. EQ-5D-5L telephone version was also completed to outline the nature and prevalence of post-COVID-19 symptoms after hospital discharge.
Rehabilitation after COVID-19: an evidence-based approach (July 2020)	Article discusses how the medical aspects of COVID-19 relate to rehabilitation, outlines rehabilitation interventions and considers how COVID-19 might precipitate change and improve UK rehabilitation services so that most COVID-19 patients could receive rehabilitation.
Toronto Star feature story (July 2020)	Story describing the challenges of maintaining rehab services amid the current COVID restrictions
COVID-19 Rehabilitation Units are Twice as Expensive as Regular Rehabilitation Units (June 2020)	Two month study in Milan, Italy of the COVID-19 rehabilitation unit compared with the previous year’s activity of the cardiac rehabilitation and motor rehabilitation units.
The Stanford Hall consensus statement for post-COVID-19 rehabilitation (May 2020)	Consensus statement provides an overarching framework assimilating evidence and based on input from an expert panel. Outlines the sequelae of COVID-19 and symptom-specific recommendations for multidisciplinary rehabilitation post COVID-19 illness. The consensus statement is intended for those planning at a population level for delivery of rehabilitation.
Rapid assessment of service delivery for noncommunicable disease (NCD) during the COVID-19 pandemic (May 2020)	Results of a snapshot conducted by the WHO on May 18^th 2020 across 155 countries to determine how the COVID-19 pandemic has impacted prevention, screening, diagnosis, treatment and rehabilitation for NCDs. Found that rehabilitation continues being wrongly perceived as a non-essential health service which results in compromised health outcomes, future increased need including longer inpatient stays, and preventable hospital admissions due to complications.
COVID-19 Scientific Advisory Group Rapid Evidence Report (May 2020)	Alberta Health Services ‘rapid guidance summary’ of the need for rehabilitation post-COVID-19 after discharge from the acute care unit (ICU or non-ICU) in a hospital.
Rehabilitation Medicine Response to the COVID-19 Pandemic (May 2020)	Experiences from a New York City academic medical center and its regional health care system, outlining the issues confronted during peak of the pandemic and the plans for the post-peak recovery.
Urgent Measures for the Containment of the Coronavirus (Covid-19) Epidemic in the Neurorehabilitation/Rehabilitation Departments in the Phase of Maximum Expansion of the Epidemic (April 2020)	Commentary that provides suggested approaches for how to organize neurorehabilitation and rehabilitation care across the continuum within the context of the COVID-19 pandemic.
COVID-19: maintaining essential rehabilitation services across the care continuum (April 2020)	Commentary describes adjustments to rehabilitation services across 12 low-income, middle-income and high-income countries in the context of COVID-19 and provides recommendations for decision makers on the provision and payment of these essential services.
Rehabilitation during and after the Covid-19 pandemic (April 2020)	Policy statement by the Chartered Society of Physiotherapy in the United Kingdom. Outlines five rehab “asks” of system leaders and policymakers.
Medical rehabilitation in pandemics: Towards a new perspective (April 2020)	Commentary describes reported clinical sequelae of COVID-19 and proposes organizational and operational recommendations for rehabilitation approach.
Global approaches for global challenges: The possible support of rehabilitation in the management of COVID‐19 (April 2020)	Letter to the editor.
Post Acute Care Preparedness for COVID-19 Thinking Ahead (JAMA editorial, March 2020)	This editorial projects a major surge in post-acute care demand following the acute hospital surge.
COVID-19 Response and Chronic Disease Management (March 2020)	Commentary in CMAJ supports continued focus on chronic disease management during this pandemic, given the potential impact of social distancing on vulnerable older adults (loneliness, depression, anxiety, accelerated functional and cognitive decline, and falls and fractures) and potential exacerbation of previously stable conditions.
The Novel Coronavirus (COVID-19): Making a Connection between Infectious Disease Outbreaks and Rehabilitation. Guest Editorial (March 2020)	Authors indicate that early evidence supports a role for physiotherapy and rehabilitation to mediate the short-, middle-, and long-term consequences of infectious disease. Propose that practitioners must be willing to advocate both at the time of an outbreak such as the current COVID-19 but also in less media-attractive moments such as emergency preparedness planning.
Impact of COVID-19 outbreak on rehabilitation services and Physical and Rehabilitation Medicine (PRM) physicians’ activities in Italy (March 2020)	Provides high level recommendations from Italian PRM Society for setting priorities for the provision of rehabilitation services across the continuum to continue to allow for access to services where possible.
Cochrane Rehabilitation REH-COVER (Rehabilitation – COVID-19 Evidence-based Response) action	To update the rehabilitation community on the growing evidence for the role of rehabilitation in management of COVID-19 patients, Cochrane Rehabilitation launched the REH-COVER action. The aim of this action is to focus on the timely collection, review and dissemination of summarized and synthesized evidence relating to COVID-19 and rehabilitation.