COVID-19: A Call to Care

The pandemic created an unprecedented demand for acute medical care in 2020, straining our nation’s hospital systems. As part of the health continuum, Baylor Scott & White Institute for Rehabilitation (BSWIR) found itself uniquely positioned to answer the call for care. The question was how?

With so much unknown about COVID-19 and its trajectory at the time, we focused on continuing to deliver quality care to patients in need of rehabilitation following a stroke, brain or spinal cord injury, orthopedic trauma or other conditions. Our teams worked closely with Baylor Scott & White Health and Select Medical to monitor the progression of the virus and ensure – to the best of our ability – a safe care environment.   

We also prepared to act as a relief valve for acute hospitals on COVID’s front lines, strained by the by the influx of affected patients. Contingency plans were readied in the vent hospitals across North and Central Texas in the region reached critical capacity and needed to transfer patients. Although these plans never needed to be deployed, we remained on stand-by throughout the year. 

A novel virus leads to a novel program

As understanding of the virus and its consequences grew, we realized our expertise in medical rehabilitation would benefit COVID survivors, including those who became known as “long-haulers.” Our call to action was clear: Do what we have always done, helping people recover from a life-changing illness or injury. From that commitment also came our new Recovery and Reconditioning Program.

This outpatient program, developed in collaboration with Select Medical, launched in April, 2020.  It draws on the expertise of infectious disease specialists, physiatrists, internal medicine, pulmonologists, therapists and other medical professionals to address the multi-system complications of COVID-19, as well as other complex illnesses, such as pneumonia and cardiovascular diseases. The Recovery and Reconditioning Program targets the wide range of patient challenges, including weakness, fatigue, shortness of breath, headaches, balance and mobility issues, pain and cognitive deficits – all of which profoundly effect a person’s quality of life and the ability to perform daily activities. 

Proof in numbers

Studies show that after battling COVID-19, 55 percent of people experience ongoing fatigue months following their hospital discharge, 42 percent continue to have shortness of breath and 34 percent reported ongoing memory loss.[1] Furthermore, 78 percent of patients developed cardiac involvement following a COVID diagnosis with 60 percent of those developing ongoing myocardial inflammation.[2] This was regardless of pre-existing conditions, severity and overall course of disease.

Of more than 170 participants in BSWIR’s Recovery and Reconditioning Program, about 40 percent were never hospitalized for their COVID infection. Overall, the participants demonstrated considerable progress with over 78 percent indicating significant improvement, based on the PROMIS global health survey. They averaged about 15 visits that included a range of physical, occupational, speech and cognitive therapies, along with patient education. To maintain the health and safety of both patients and staff, inpatient and tele-rehab visits were made available. 

Lessons learned

Despite the pandemic’s many uncertainties, BSWIR was agile, adapting quickly, safely and effectively to meet the needs of our patients and communities. We leveraged our experience, monitored available data, followed state and federal guidelines and collaborated with our partners across the care continuum. As a result, we gained greater insight on treating individuals with COVID-19 that will help prepare us to successfully address future pandemics and other health crises.

[1] Dr. David Webber, UNC, September 20, 2020 Society for HealthCare Epidemiology Town Hall Meeting

[2] J Valentina O. Puntmann et al. “Outcomes of Cardiovascular Magnetic Resonance Imagining in Patients Recently Recovered From Coronovirus Disease 2019”. JAMA Cardiology. Doi:10.1001/jamacardio.2020.3557 Published online July 27, 2020.

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