key: cord-0973395-jgjf8x7b
authors: Gopaul, Urvashy; Manie, Shamila; Amosun, Seyi L.
title: Is physiotherapy ready for the management of COVID‐19 in Africa? – Snippets of anecdotal evidences in two African countries
date: 2020-05-18
journal: Physiother Res Int
DOI: 10.1002/pri.1847
sha: 594b16d701254dcd6563a1a770d2abe57ace8ff4
doc_id: 973395
cord_uid: jgjf8x7b

nan

By the time COVID-19 was officially declared as a pandemic by the WHO on the 11th March 2020, more than 114 countries were already infected (Anjorin, 2020; Sohrabi et al., 2020. In Africa, there has been a comparatively lower number of cases of COVID-19 across the continent. However, in the first week of April 2020, the Africa Centres for Disease Control and Prevention (Africa CDC) reported that there were 10,075 cases of COVID-19 amongst the 52 member states of the African Union (Nkengason, 2020) . Though still under-reported, the two countries with the highest number of cases in each region of the continent were Algeria and Egypt (Northern), Cameroon and Democratic Republic of Congo (Central),

(Western), and South Africa and Zambia (Southern). In addition, the wide spread of non-communicable diseases in Africa, such as chronic obstructive pulmonary disease (COPD), heart disease, hypertension and diabetes are known risk factors for severe cases of COVID-19 (Guan et al., 2020) . This is a major concern for Africa as there are 19 million adults aged between 20 and 79 years, with 60% of the population with undiagnosed diabetes (International Diabetes Federation, 2019). The spread of COVID-19 in the African continent is therefore of great concern (Nkengason & Mankoula, 2020).

Acute respiratory distress syndrome (ARDS) is a common and often lethal clinical syndrome in CORVID-19 with a complex underlying pathophysiology (Hart & Black, 2019) . Physiotherapy intervention in the Intensive Care Unit (ICU) was associated with saving lives (Chung & Mueller, 2011) and decreasing mortality (Munshi et al., 2017) . The WCPT has developed guidelines for the physiotherapy management of COVID-19 in acute hospital settings (Thomas et al., 2020) , and these inform the protocols developed in member countries (Lazzeri et al., 2020) . There are currently no local Both countries seem to experience a relatively smaller epidemic of COVID-19 as compared to European counterparts. However, if Mauritius suffers from an exponential increase in COVID-19 contaminations, the number of cases is predicted to reach above 1,500. Similarly, an exponential increase in South Africa was projected to be over 4,000 by April 1, 2020. These exponential projections would put further demands beyond the current capacity of the national health systems. Since the implementation of the national lockdowns, both countries have managed to slow down the number of infections. Therefore, it is critical to pay attention to the preparedness of the healthcare workers and ensure the integration of physiotherapy into the multidisciplinary health care team for COVID-19. However, African countries still suffer from a critical shortage of physiotherapists (Frantz, 2007) . In addition to respiratory physiotherapy in acute hospital settings and critical care, three other clinical applications of physiotherapy to improve health outcomes after contamination have been identified.

First, provision of physiotherapy to initiate rehabilitation soon after the acute phase of respiratory distress needs to be prioritized so as to reduce the adverse effects of ARDS (Herridge et al., 2011) . Second, it is proposed that patients having mild to moderate symptoms should take part in monitored moderate intensity physical activity and exercise interventions to maintain or enhance their physical fitness, cardiorespiratory function and build their immune response (Martin, Pence, & Woods, 2009; Nieman &Wentz, 2019) . Third, it is proposed that delivery of physical activity and exercise interventions are explored amongst people in quarantine.

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