March 17, 2020

The Canadian Physiotherapy Association (CPA) has developed the following advocacy statement that forms the basis for our ongoing advocacy with the federal government related to the outbreak of COVID-19. We want to ensure the federal government is including the essential role and contributions of physiotherapists as they develop policy, implement Canada’s COVID-19 response, and make any new investments to mitigate the impact of the virus on Canadians.

We want to ensure our members are aware of our approach, messages, and asks, as well as the steps we are taking to make sure the government is aware of the essential role of physiotherapists as they face the escalating outbreak of COVID-19. This statement is part of the CPA’s advocacy strategy and will be shared with federal Minister of Health, The Hon. Patty Hajdu, as well as other relevant federal decision-makers this week, and we commit to keeping you updated on our outreach and any responses.

The CPA's Statement on "The Role of Physiotherapy in Keeping Canadians Safe During the COVID-19 Pandemic"

  • Physiotherapy and rehabilitation play an essential role in the context of infectious disease outbreaks.
  • Physiotherapy can mitigate adverse impacts due to respiratory and mobility complications associated with infectious disease outbreaks.
  • The care and treatment offered by physiotherapists is crucial in keeping Canadians healthy and active, and in preventing the need to access urgent or emergency services in-hospital.
  • Physiotherapy can reduce the burden on the medical system through improving patient function and independence, and allowing them to return to their homes sooner, freeing up much needed hospital resources.
  • Physiotherapy is important to improve physical and mental well-being for patients diagnosed with an infectious disease, as well as for those in isolation and self-quarantine.
  • Physiotherapy can help Canadians to return to their communities, families, and employment faster, thus reducing the societal and financial impacts of infectious disease.
  • As health care professionals, physiotherapists are trained in, and adhere to, strict infection control practices to keep Canadians safe.
  • The CPA urges members to frequently check in on the advice provided by your provincial regulator and by the Public Health Agency of Canada.  

The Role of Physiotherapy in the COVID-19 Response and Urgent Care Provision

As front line health care service providers, physiotherapists play a crucial role in:

  • Infectious disease symptom recognition;
  • Patient education and direction to support appropriate and timely treatment decisions;
  • Treating and advising patients who have experienced adverse outcomes, in both the acute phase and in longer term recovery; and
  • Treating respiratory conditions due to the infection, and in maintaining function, flexibility, strength, and mobility while mitigating secondary complications from isolation conditions, such as muscle wasting, blood clots, weakness due to de-conditioning, and negative effects on psychological well-being.

The CPA Calls on the Government of Canada to Support and Protect Physiotherapists through the COVID-19 Response by:

  • Including physiotherapy in urgent care centres and the treatment of individuals affected by infectious diseases.
    • Providing care early reduces long-term effects, improves patient function, and allows individuals to return to work sooner. Thus, reducing the social and financial impact of infectious disease for all Canadians.
  • Providing priority access to, and funding for, provision of personal protective equipment for physiotherapists and physiotherapist assistants.
    • Access to personal protective equipment ensures that physiotherapists and physiotherapist assistants can provide essential quality care to patients while observing necessary infection control protocols.
  • Recognizing physiotherapists as health care service providers eligible to access government funding to support tele-rehab and virtual provision of care.
    • As clinics respond to, and comply with, social distancing protocols, it will be increasingly important to enable delivery of care by virtual means.
  • Providing funding to support physiotherapy clinic owners who temporarily close to respect the social distancing protocols being adopted in Canada.
    • Compensation to offset losses faced by clinics who suspend services to flatten the curve will help stabilize access to essential rehabilitation services as a component of a longer-term response.

 

References

Center for Disease Control and Prevention. (2018, October 15). Planning Resources by Setting: Outpatient Clinics and Urgent Care. Retrieved from: https://www.cdc.gov/cpr/readiness/healthcare/outpatient.htm

Hong, Y.P., Lee, H.C., & Kim, H.T. (2015). Treadmill exercise after social isolation increases the levels of NGF, BDNF, and synapsin I to induce survival of neurons in the hippocampus, and improves depression-like behavior. J Exerc Nutrition Biochem, (19)1: 11-8. doi: 10.5717/jenb.2015.19.1.11

Howlett, P.J., Walder, A.R., Lisk, D.R., Fitzgerald, F., Sevalie, S., Lado, M., N’jai, A., Brown, C.S., Sahr, F., Sesay, F., Read, M.J., Steptoe, P.J., Beare, N.A.V., Dwivedi, R., Solbrig, M., Deen, G.F., Solomon, T., & Scott, J.T. (2018). Case Series of Severe Neurologic Sequelae of Ebola Virus Disease during Epidemic, Sierra Leone. E,erg Infect Dis, 24(18): 1412-1421. doi: 10.3201/eid2408.171367.

Jacobs, M., Rodger, A., Bell, D.J., Bhagansi, S., Cropley, I., Filipe, A., Gifford, R.J., Hopkins, S., Hughes, J., Jabeen, F., Johannessen, I., Karageorgopoulos, D., Lackenby, A., Lester, R., Liu, R.S., MacConnachie, A., Mahungu, T., Marin, D., Marshall, N., Mepham, S., Orton, R., Palmarini, M., Patel, M., Perry, C., Peters, S.E., Porter, D., Ritchie, D., Ritchie, N.D., Seaton, R.A., Sreenu, V.B., Templeton, K., Warren, S., Wilkie, G.S., Zambon, M., Gopal, R., & Thompson, E.C. (2016). Late Ebola virus relapse causing meningoencephalitis: a case report. Lancet, 388(10043): 498-503. doi: 10.1016/S0140-6736(16)30386-5.

Lowe, R. (2013, October 28). Emerging trends in global health: Infectious diseases. Retrieved from: https://www.physiospot.com/opinion/emerging-trends-in-global-health-infectious-diseases/

Martin, D., Howard, J., Agarwal, B., Rajalingam, Y., Athan, B., Bhagani, S., Cropley, I., Hopkins, S., Mepham, S., Rodger, A., Warren, S., & Jacobs, M. (2016). Ebola virus disease: the UK critical care perspective. Br J Anaesth, 116(5): 590-6. doi: 10.1093/bja/aew098.

Millet, R. (2015, January 7). Feber pitch: Treating patients with infectious diseases. Retrieved from: https://www.csp.org.uk/frontline/article/fever-pitch-treating-patients-infectious-diseases

World Confederation for Physical Therapy. (2016, March). The role of physical therapists in disaster management: WCPT report [PDF file]. Retrieved from: https://www.wcpt.org/sites/wcpt.org/files/files/resources/reports/WCPT_DisasterManagementReport_FINAL_March2016.pdf

World Health Organization. (2018, January 30). WHO Launches Rehabilitation Standards for Emergency Medical Teams. Retrieved from: https://extranet.who.int/emt/content/who-launches-rehabilitation-standards-emergency-medical-teams

World Health Organization. (2016). Minimum Technical standards and Recommendations for Rehabilitation – Emergency Medical Teams [PDF file]. Retrieved from: https://extranet.who.int/emt/sites/default/files/MINIMUM%20TECHNICAL%20STANDARDS.pdf