Managing the Rehabilitation Wave: Rehabilitation Services for COVID-19 Survivors

The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on the provision of medical care. As the curve progresses and patients are discharged, the rehabilitation wave brings a high number of postacute COVID-19 patients suffering from physical, mental, and cognitive impairments threatening their return to normal life. The complexity and severity of disease in patients recovering from severe COVID-19 infection require an approach that is implemented as early in the recovery phase as possible, in a concerted and systematic way. To address the rehabilitation wave, we describe a spectrum of interventions that start in the intensive care unit and continue through all the appropriate levels of care. This approach requires organized rehabilitation teams including physical therapists, occupational therapists, speech-language pathologists, rehabilitation psychologists or neuropsychologists, and physiatrists collaborating with acute medical teams. Here, we also discuss administrative factors that influence the provision of care during the COVID-19 pandemic. The services that can be provided are described in detail to allow the reader to understand what services may be appropriate locally. We have been learning and adapting real time during this crisis and hope that sharing our experience facilitates the work of others as the pandemic evolves. It is our goal to help reduce the potentially long-lasting challenges faced by COVID-19 survivors. •Rehabilitation care of coronavirus disease 2019 (COVID-19) recovering patient can be safely provided starting in the intensive care unit.•Redeployment of outpatient therapy workforce was useful to provide rehabilitation to patients recovering from COVID-19 in the acute medical care.•Objective functional assessments allowed for a tailored rehabilitation approach based on the individual patient’s needs.•Changes in Medicare regulation allowed for the provision of acute inpatient rehabilitation services outside the rehabilitation unit. COVID-19 patients were able to receive acute comprehensive inpatient rehabilitation level of care while still recovering from the acute infection.