Since late February 2020 the world has witnessed the impact of the Coronavirus Disease 2019 (COVID-19) pandemic in Italy. Physiotherapists have contributed to frontline care during this time. With the number of cases slowing, three physiotherapists (Paolo Pedersini, Camilo Corbellini, Jorge Hugo Villafañe) have had the energy to share their experiences in a ‘point of view’ article that has been accepted for publication in the journal Physical Therapy.
Italy has one of the highest global burdens of COVID-19, with more than 77,635 cases and 12,428 deaths by the end of March 2020. In addition to sharing some epidemiology data, this article describes how physiotherapists responded to the pandemic with support from the Associazione Italiana Fisioterapisti.
One of the authors, Dr Camilo Corbellini, has talked to the PEDro team about his experiences. Camilo was born in Brazil and moved to Italy to undertake masters and doctoral studies in respiratory physiotherapy and physiology at Milan University. Since 2010 he has worked in a post-acute rehabilitation clinic (Casa di Cura Villa Serena) in Piossasco, which is about 150 km from Milan. Before the pandemic Camilo provided exercise training, respiratory physiotherapy, non-invasive ventilation, and lung function testing for people with respiratory disorders.
Working in post-acute care, Camilo and his colleagues did not have to respond to the initial impact of the emergency. They used this time to prepare clinical routines to treat potentially infected patients and to prevent the spread of the virus between patients and between staff and patients. Education in hand washing and social distancing was critical. With some staff in quarantine, Camilo worked flexibly in new roles to support the clinic (for example, doing temperature screening).
As the pandemic progressed, patients were restricted to their rooms and visitors were excluded. While patients are separated into positive and negative cases, everyone is treated as a potential positive case. Physiotherapists use personal protective equipment whenever they provide treatment. The work schedule is planned on a day-to-day basis, taking into account the number of patients requiring treatment and the availability of staff – many staff are at home in quarantine.
Despite taking these protective measures, Camilo was quarantined in early April. He experienced mild symptoms, but was not tested (this was based on screening guidelines in place at that time). During this quarantine phase Camilo received daily telephone calls to monitor his condition (temperature, oxygen saturation, respiratory rate, and even a 6-minute walk test). He has returned to work and all staff are now being tested. Camilo is waiting for his swab results.
Camillo concluded by saying: “extreme situations also present an opportunity to grow. As a physiotherapist, the emergency was the opportunity to do what I, my wife (also a physiotherapist), and my colleagues do best: helping people. I can guarantee that not one of us feels like a hero, asking ourselves ‘can I could do more?’. My colleagues and I are trying to describe and publish everything possible to share what we are learning, we know that it is just a brick in this enormous knowledge castle, but we are sure that our efforts will help make it stronger, for the best of everyone. Remember solidarity? Sharing is all about that.”
Pedersini P, Corbellini C, Villafañe JH. Italian physical therapists’ response to the novel COVID-19 emergency. Phys Ther 2020;100(7):1049-51