Reducing the risk of Covid-19-related deaths

Covid-19 should be a wakeup call to focus on healthy lifestyle changes, reducing the risks associated with any new waves of the virus or future pandemics, writes the University of Otago's Dr Margot Skinner 

Globally more than 500,000 have died as a result of Covid-19. We know that people living with non-communicable diseases (NCDs) such as high blood pressure, diabetes, chronic respiratory disease and cancer are at higher risk of severe Covid-19-related illness and death.

In fact over 90 percent of people who contract and die from Covid-19 also have at least one NCD.

These sorts of statistics should be a wakeup call to all of us to focus on healthy lifestyle changes and reduce the risks associated with any new waves of the virus or future pandemics.

Much of the emphasis to date has been centred around bed shortages in intensive care units and lack of ventilators and personal protective equipment. While these are important, it is just as important to understand that survivors of severe Covid-19-related illness have a long road to recovery, often over months, and may not ever get back to full health.

Physiotherapists have a key role in managing the survivors’ rehabilitation.

The severity of the acute inflammatory response leads to critical illness complications, so time spent by those patients in the ICU can be drawn out. 

Physiotherapists work with these patients in the ICU to counter the negative effects of lying in bed and to reduce respiratory complications as well as to restore function.

Once the patient is able to be moved into the ward, intensive input by the health team continues. Physiotherapists focus on maximising long-term functional outcomes such as walking and preparing the patient for ongoing therapy once they are ready to transfer home or to a rehabilitation facility.

Patients and their families are encouraged to set goals to achieve as rehabilitation continues e.g. “By tomorrow, walk to the bathroom using a frame and only one helper”.

To get a sense of perspective around goal-setting and recovery, the physiotherapist will also spend time educating the patient about how the body functions and realistic timeframes in which to achieve the goals.

Lifestyle education such as not smoking, and aiming for a healthy weight is also included as part of the management.

Lifestyle management is fundamental to the care continuum for the patient with Covid-19. But we could do better, by focusing on healthy lifestyle behaviours in the general population of all ages and by addressing NCD risk factors.

During Levels 3 and 4 of the pandemic, prevention and treatment services for NCDs in New Zealand were severely disrupted - a disruption that's still ongoing in many parts of the world.

A survey from the World Health Organization showed that more than 50 percent of services for high blood pressure are partially or completely disrupted.

Rehabilitation services have been disrupted in almost two-thirds of countries, even though rehabilitation is key to a healthy recovery following severe illness from Covid-19.

There is an unparalleled opportunity for physiotherapists and other health professional colleagues to be supported by stakeholders including legislators and the Ministry of Health, to lead the campaign to reduce NCDs through a population-wide public health initiative “Living a healthy lifestyle through exercise campaign”.

In this way we could do better and reduce the risk for New Zealanders of Covid-19-related deaths

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