The spread of COVID-19 in Wuhan has sent an alarming message to the whole world, if the same pattern continues globally, the healthcare community will be facing one of the biggest challenges of modern times which it seems ill-prepared for, both in terms of experience and resources. Unfortunately, such situations can lead to a collapse of not only the healthcare system of many states, but also to a human disaster that will affect the physical, psychological and socio-economic infrastructure of the whole society.
Pakistan is a country of limited resources and scarce qualified medical facilities and professionals. The healthcare system needs to adopt a multidirectional proactive approach that better prepares the nation to face upcoming challenges. The focus of this plan should be to provide emergency healthcare to COVID-19 patients and promote community-based advocacy to inhibit the spread of disease.
Rehab professionals can be employed in multiple roles as a part of this newly developing complex healthcare system. In primary healthcare, they can play a vital role in bringing up or developing community based programmes that will be much needed for proactive management of people who are vulnerable to COVID-19.
Physical therapists working in tertiary healthcare facilities are most likely to be members of the front line team involved in the treatment of confirmed or suspected COVID-19 patients admitted in hospitals. They may also unveil physical fitness programmes for the elderly population focusing on their general mobilisation and respiratory health. Whereas mindfulness programmes, play therapy sessions and social support may be facilitated by occupational therapists along with clinical psychologists for better mental health of the general population.
As per the National Health Survey of Pakistan, one of the major reasons for the increase in diabetes myelitis and hypertension among the population is a sedentary lifestyle. In fact, many of the people are unaware of their condition and not even diagnosed. Around 18% of adults under the age of 45 are diagnosed as hypertensive, which is one of the major comorbidity prone to COVID-19. Both exercise and physical activity, can improve overall health outcomes such as reducing the risk of a stroke, cardiovascular disease and type-2 diabetes.
Involving rehab professionals for the health and well-being of the population at this hour will be wherewithal of the national health policy to meet the scarcity of health professionals nationally. Moreover, it will be a proactive measure by the national health sector for dealing with a pandemic-like situation and preparing the nation to combat viruses by adapting healthy eating habits.
Pandemics always bring out an atrocious environment full of stress, panic, anxiety and disheartenment, which manifests in the form of physical and physiological health issues. Emotional stress releases hormones called cortisol that activate the sympathetic nervous system which in turn increases ventilation rate. Increasing physical activity while staying home during the lockdown will promote endurance in dealing with stress. Programmes like wellness and physical fitness based on aerobic, anaerobic exercises and relaxation exercises for maintenance of physical and mental well-being can be launched on public social welfare forums, national media and the national health forum for public accessibility to rehab professionals.
Mental fitness at the same time is as significant as physical health as it improves intelligence, the emotional status, and the social and adversity quotient. One of the studies in the past has declared prevalence of 10–66% of mild to moderate psychiatric illnesses among general population with an additional 0.1% of mental illness.
Exercise stimulates the production of endorphins, a chemical in the brain that acts as the body’s natural painkiller and mood elevator. It is also responsible for the feeling of relaxation. The concept of mindfulness is incomprehensible among the general population, though we have spiritual healers and all, but keeping oneself busy or introducing activities that promote emotional wellness is considered a luxury.
Involvement of occupational therapists, clinical psychologists and counsellors in the national programmes for battling COVID-19 and its reducing impact on mental status of public may aggregate the spread and poor prognosis of people. The rehab professionals must perform researches and provide evidences that promote the inculcation and utilisation of their services in the time of such misery that is affecting humanity globally. Many researches had already been conducted in Wuhan that indicated the fall of overall health and wellbeing of the population bringing forth baselines for developing proactive programs for effective strategies in handling COVID-19 since it might turn into a major disaster in 2020.
Sumaira Imran Farooqui
Associate Professor, Principal
Ziauddin College of Rehabilitation Sciences
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