Authors (including presenting author) :
To YL(1), Chau MW(1), Chiu PY(1), Wan SY(1), Lam L(1), Li L(1), Kwan WS(1)
Affiliation :
(1)Working group on in-patient and day-patient service, COC-Grade(PT)
Introduction :
The Coronavirus Disease 2019(COVID-19) pandemic has greatly hampered the operation of the local healthcare system. To fight against the pandemic, physiotherapists are working together with other healthcare professionals to facilitate hospital beds turnover, patient discharge and retain them in the community with adequate support provided.
Objectives :
To report the roles of physiotherapy(PT) in managing COVID-19 cases in acute care.
Methodology :
A retrospective quantitative survey study by universal sampling from all physiotherapy departments in Hospital Authority (HA) was conducted in November 2022. Roles of physiotherapists in hospitals and clusters were retrieved with descriptive synthesis by the panel of working group on in-patient and day-patient service of COC-Grade(PT).
Result & Outcome :
According to the data retrieved from the Clinical Data Analysis and Reporting System(CDARS), there were 45,680 episodes of HA hospitals admission due to COVID-19 infection between February and May 2022 hallmarking the fifth wave of pandemic in Hong Kong. 38%(17,483) patients were referred for PT services. The average PT referral rates in group 1 hospitals were 40%, non-group 1 hospitals were 77% and Hong Kong Infection Control Centre(HKICC)/ Treatment Centre for COVID-19 at Asian World Expo(TCC-AWE)/NLTH were 6%.
Within local hospitals, physiotherapists were deployed to infectious triage wards in 53% hospitals while 67% hospitals established a special clinical team for those wards. To manage COVID-19 related symptoms in in-patient settings, chest physiotherapy (including dyspnea management, bronchial hygiene management and airway clearance techniques e.g. sputum suction) and mobility training (including early mobilization, fall prevention education and walking aids prescription) were the major interventions (>=97% hospitals).
Other physiotherapy services targeting at COVID-19 patients were also implemented in various clusters including pulmonary rehabilitation, weekend and holiday early mobilization, tele-care service and oxygen therapy prescription.
Besides, PT departments had deployed staff to support different departments and facilities, including AED, HKICC and TCC-AWE. In particular, 8 PT departments(47%) deployed staff to their local AEDs providing chest physiotherapy and mobility training there. Most PT staff (7 out of 8 deployed PT departments) provided fall prevention education and operational duty in some AEDs.
In order to support the rapidly established HKICC and TCC-AWE, physiotherapists from 28(78%) and 14 (39%) PT departments have been deployed staff to HKICC and TCC-AWE respectively. The profile of physiotherapy intervention in HKICC were found to be similar to those provided in other acute in-patient settings while the services provided in AWE were mainly focused on mobility training and fall prevention. However, it was noted with an exponential increase in demand for physiotherapy in HKICC.
In summary, the findings of vital roles of physiotherapy was in accord with recent systematic review in compliances to global recommendations of PT management for COVID-19. Additionally, local PT contributed to swift complemental roles in different aspects to work with the clinical teams for concerted management of COVID-19 pandemic.
