In March, 2020 the World Health Organization (WHO) declared recognition of outbreak of a new koronavirusny infection (COVID-19) caused by a coronavirus activator of a heavy acute respiratory syndrome of SARS-CoV-2 a pandemic. Messages about cases of COVID-19 arrived from all countries and territories of the region of North and South America. WHO, PAOZ and bodies of health care take measures for control of distribution of COVID-19 and mitigation of the consequences of a pandemic worldwide. While most of patients transfers COVID-19 in a moderate or uncomplicated form, approximately about 14% of cases are connected with developing of a heavy acute respiratory infection (SARI) and can demand hospitalization and oxygen support, and in 5% of cases the direction in intensive care unit and an intensive care (ORIT) is required. According to information which arrived at the initial stage of a pandemic from China, the average duration of stay of patients with COVID-19 in ORIT was about 8 days.
In process of recovery of patients after the postponed koronavirusny infection questions concerning rehabilitation of these people even more often began to be brought up. Rehabilitation promotes improvement of consequences of a disease for patients with severe forms of COVID-19 and promotes improvement of work of a health care system due to optimization of consequences for health and functions of an organism: rehabilitation can promote decrease in number of the complications connected with stay in ORIT such a PIT-syndrome. It is directed to optimization of process of recovery of the patient and reduction of the period of restriction of operability of an organism. Interventions at a stage of rehabilitation can promote removal of many consequences of hard cases of COVID-19, including disturbances of physical, cognitive and deglutitory function and also rendering psychosocial support. Elderly patients and also the patients who at the time of hospitalization already had other associated diseases can be more vulnerable to consequences of a serious illness, and rehabilitation can be especially useful to them in terms of preservation of the previous level of independence.
The second positive aspect of rehabilitation: acceleration of an extract. In the conditions of deficiency of hospital beds there can be a need of earlier, than usually, extracts of patients. Rehabilitation plays especially important role in training of patients for an extract, coordination of an extract in the complicated cases and ensuring continuity of treatment.
The third moment which is provided by the competent organization of rehabilitation actions it is reduction of risk of repeated hospitalization. Rehabilitation helps to provide lack of an aggravation of symptoms of patients after an extract and reduces the frequency of need of repeated hospitalization that also plays an extremely important role in the conditions of deficiency of hospital beds.
There are two more aspects of rehabilitation actions in aspect of the current pandemic. First, rehabilitation specialists work "at a front line" health care systems and participate in treatment of patients with severe forms of COVID-19. Patients with hard cases of COVID-19 pass various stages of treatment. Rehabilitation needs to be provided at all stages of treatment: within the treatment of an acute phase performed in intensive care units and an intensive care during a subacute phase on which treatment is performed in hospital chambers or in auxiliary medical institutions and also at a long-term stage of recovery of the patient after return home. Secondly, rehabilitation specialists provide necessary care of some groups of the patients who are not infected with COVID-19 as from the beginning of a pandemic this group of patients did not disappear anywhere and continues to need rehabilitation actions. Moreover, there is evidence of possible risk for some patients and deterioration in consequences for their health when for separate groups of patients rehabilitation stops or becomes inaccessible. Therefore services in rehabilitation for these groups of patients should be considered vital and to continue their rendering during the entire period of a disease outbreak.
Proceeding from the aforesaid, rehabilitation should be considered in planning of emergency measures in the field of health care in connection with COVID-19 for each state, including to apply rehabilitation in work of the operating divisions of the emergency help. It needs to be made at the first opportunity with involvement of specialists and also professional associations and public institutions in the area of rehabilitation. The practical mechanism is inclusion of the representative on rehabilitation in the structure of the structures and centers exercising control and coordination in the field of health care. When planning rehabilitation services it is necessary to consider needs of the people infected with COVID-19 and also priority groups of the patients who are not infected with COVID-19.