COVID-19: Disability and Rehabilitation

The World Health Organization defines disability as “an umbrella term for impairments, activity limitations and participation restrictions”. The vast majority (80%) of people living with a disability reside in developing countries. Across the world, people with disability have less access to healthcare services. Disability has primarily been on the rise because of aging populations and chronic health conditions like diabetes, cardiovascular disease, cancer and mental health disorders.

In the wake of the COVID-19 pandemic, there has already been a marked increase in the burden of disease and disability. Recent evidence suggests that COVID-19 is a multisystem disease. Currently established manifestations of severe COVID-19 include viral pneumonia, hypoxia, myocarditis, cardiac failure, movement-related fatigue, loss of muscle mass (as a result of vomiting, diarrhoea, restriction of movement and intensive care unit acquired weakness), Guillian-Barre syndrome, encephalitis and cerebrovascular accident. ICU survivors of COVID-19 have also  experienced cognitive impairment, depression and post-traumatic stress disorder. These clinical manifestations of severe COVID-19 highlight an increased need for rehabilitation services.

Rehabilitation is an essential component of universal health coverage along with promotion, prevention, treatment and palliation”. Rehabilitation therapists include physiotherapists, occupational therapists, speech therapists, psychologist, dieticians and social workers. Currently, jobs deemed as essential for the South African health care system include medical officers, medical specialists, professional nurses, pharmacists and radiographers. The essential healthcare worker list represents a tunnel vision of holistic patient care in South Africa; this deficit is being highlighted by the pandemic.  The South African health care system needs to take rehabilitation into consideration  its workforce planning and preparation.