key: cord-280031-0w6wn7u8 authors: Pedersini, Paolo; Corbellini, Camilo; Villafañe, Jorge Hugo title: Italian Physical Therapists’ Response to the Novel COVID-19 Emergency date: 2020-04-13 journal: Phys Ther DOI: 10.1093/ptj/pzaa060 sha: doc_id: 280031 cord_uid: 0w6wn7u8 nan This epidemiological transition in Italy is continuously updated with characteristics of patients with Covid-19 who have died, including: average age (78 years old), sex (70% men), pathologies before hospitalization (Patients with 0 pre-existing pathologies 2%; patients with 1 pre-existing pathology 21%; patients with 2 pre-existing pathologies 26%; patients with 3 or more pre-existing conditions 51%). Lombardy has registered 66% of the Covid-19 deaths in Italy 1 . On February 20, 2020, in Lombardy, a man was admitted with an atypical pneumonia that later proved to be Covid-19. 2 When it was identified that community transmission was occurring, including several cases without any connections to previous cases or travel histories to China, Lombardy raised its pandemic preparedness alert level establishing red zones in the affected areas. A series of gradually increased countermeasures has been implemented involving all professional groups, including physical therapists. In conjunction with this, an important document was drafted by the 2) to transform all non-essential treatments into a tele-rehabilitation modality and to manage clinical cases through telephone or webcam counselling in order to skills. In fact, in the acute phases of the pathology, the respiratory physical therapists support the work of intensive care physicians, pulmonologists and nurses by: providing qualified care in the different modalities of non-invasive mechanical ventilation (NIV); monitoring and addressing respiratory fatigue; preventing the complications of prolonged immobility; prone positioning to improve gas exchange in severily ill subjects; participating in the weaning from invasive mechanical ventilation protocols; and assisting in the recovery of the patient's autonomy in activities of daily life, which is often compromised by long periods of sedation and prolonged hospitalization. In a quick response to the increasing demand of patients in intensive care unit, the "Associazione dei riabilitatori dell'Insufficienza Respiratoria" (ArIR) had written an outstanding position paper that covers everything regarding physical therapy practice in intensive care units. 6 In Italy, at the beginning of the spread of the epidemic, there were approximately 5,200 beds in intensive care units. 7 The situation in the epicenter area has been described as terrifying with overcrowded hospitals and lack of medications, ventilators, oxygen, and personal protective equipment. 8 So, it is also very important to reduce the length of hospitalization and therefore to free up places more quickly and allow other patients to be accommodated, given the serious shortage of beds compared to the growth of the contagion. Many colleagues from Milan, Lombardy, and surrounding cities are organizing themselves into a sort of "physical therapy task force", to help each other to quickly improve their skills and knowledge but also to take action where necessary. In addition, Covid-19 emergency preparedness frequently does not take into account issues specific to rehabilitation patients, when patient and staff safety have to be at the forefront of providing rehabilitation services to our community. Besides being physical therapists, they are first and foremost health professionals and, before that, citizens who want to make their contribution to support the whole population and all the components of the health system responding efforts to this emergency. Covid-19 -Situazione in Italia Coronavirus Disease 2019 (COVID-19) in Italy Emerbenza Covid-19: Indicazioni per fisioterapisti e pazienti Rapid Response to COVID-19: Health Informatics Support for Outbreak Management in an Academic Health System COVID-19: fighting panic with information. The Lancet Clinical research as foundation for the advancement of respiratory physiotherapy. Monaldi Arch Chest Dis COVID-19 and Italy: what next? Lancet At the Epicenter of the Covid-19 Pandemic and Humanitarian Crises in Italy: Changing Perspectives on Preparation and Mitigation. NEJM Catal Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic Coronavirus: more countries will adopt Italy's measures, says Austrian leader. Support The Guardian Web site Wind of Change: Brexit and European Rehabilitation The authors completed the ICMJE Form for Disclosure of Potential Conflicts of Interest and reported no conflicts of interest.The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article.