People recovering from COVID-19 continue to face challenges to their return to full health long after they have been discharged from hospital.
Fortunately they are not alone as their recovery is supported by dedicated teams of allied health professionals (AHP) and healthcare science professionals from a number of disciplines who are tackling a wide range of rehabilitation needs while adhering to social distancing guidelines.
Minister for Health and Social Services, Vaughan Gething, said:
“Leaving hospital after an extended period of critical care is a wonderful moment for people struck down by this terrible virus, but this is only the first step on the road to full recovery.
“Dealing with the long term physical, psychological and emotional impacts of the virus require the expertise of professionals from a variety of Allied Health Professions and the increased demand for their services, coupled with social distancing, has led to a change in working practices and new ways of doing things.
“The willingness of all our health and social care staff to innovate and adapt is not only helping us in our fight against the pandemic but will contribute to our plan for A Healthier Wales to provide care closer to home within the community and in people’s homes.”
People can access a range of rehabilitation advice and treatment from dietitians, orthoptists, occupational therapists, podiatrists, paramedics, physiotherapists, psychologists, orthotists and prosthetists, speech and language therapists and art, music and drama therapists.
When recovering from covid, people can experience ongoing respiratory problems, fatigue, nutritional issues, problems with swallowing and communication, loss of physical fitness and psychological issues.
Health boards, trusts and local authorities have introduced a number of measures to not only meet the demands caused by the pandemic but also for people who have non-covid related illnesses such as strokes and heart disease.
Ruth Crowder, Welsh Government’s Chief Allied Health Professional Adviser explained:
“We have seen the introduction of virtual assessment, intervention and support strategies and the use of new remote and distanced practice.
“This includes the use of ‘attend anywhere’ video consultation, telephone advice and guidance, which has resulted in four times as many virtual contacts to face-to-face contacts in community stroke and Acquired Brain Injury teams.
“Dietetics, occupational therapy and physiotherapy services are also providing more community based services including using virtual assessments and treatment to support people at home or in care homes as well as in specialist rehabilitation units.
“And at Cwm Taf Morgannwg University Health Board they have created a virtual hub to triage patients, identify their needs and allow access to a range of AHPs.”
One of the biggest challenges facing people recovering from covid after a stay in hospital is regaining lost muscle mass and function through the proper nutrition.
Dietitians are key in helping them overcome this and as Zoe Paul Gough, Head of Nutrition and Dietetic Service at Hywel Dda Health Board explained, their role is not just one of rehabilitation but also prevention and education.
“The Nutrition and Dietetic team have responded to COVID-19 in many ways. Our initial response was to upskill our wider team to be able to support our small team of critical care acute dietitians in anticipation of an influx of seriously ill patients.
“We know that the inflammatory response associated with covid can lead to around 20% loss of muscle mass in 10 days.
“These patients are often ventilated and sedated or have extremely high nutritional requirements and require the dietitian’s expertise and skills to advise on ensuring nutrition is delivered in the safest possible way to improve outcomes and minimise loss of muscle mass and function.
“Our team has also provided training and education to upskill the wider workforce to assist in recognising and managing an increasing number of nutritionally vulnerable individuals to support them to stay well at home.”
The pandemic has meant Zoe’s team has had review its existing working practices.
“For those under our care we are using use alternative means of assessment and communication with our patients, such as those undergoing cancer treatments who have reduced immunity, and this has included using video or virtual consultations
“Initial feedback has been positive and we are also looking at new and innovative ways of supporting our service users including holding virtual clinics, developing our staff and public facing information, social media support and opening a telephone help-line, along with resources to support self-management for a number of chronic conditions, and promoting self-screening for Nutritional Risk across the Health Board.
“The use of virtual platforms and access to technology will all no doubt be valuable additions to our service offerings into the future.”
To find out more about how the Nutrition and Dietetics team at Hywel Dda responding to the pandemic see Zoe’s blog below.