Founder Letter: The Return to Hands-On Care: What the Vaccine Means for Physical Therapists

Late January marked the anniversary of the first known COVID-19 case in the United States. For me, that milestone triggered a good deal of reflection on the past year. I think we can all agree that 2020 was a massive learning experience. Many of us learned how to balance homeschooling with being a working parent. Others—including some physical therapists—learned how to perform their job remotely.

In fact, this was a major development in our industry—one that ran counterintuitive to our very identity as hands-on providers. Not only did we learn that delivering PT services remotely is possible—we also discovered that there is a widespread demand for this mode of care. Of course, I know as well as you do that virtual care can never completely replace in-person treatment, because it’s missing one crucial component: human touch. And that’s especially true for physical therapists—which is part of why so many of us struggled (or outright refused) to adopt telehealth in the first place.

Hands-on contact is inherent to our profession—and our value. While virtual services have proven their worth during a time when social distance is at times essential, I know many PTs—and patients—are eager to return to the clinic safely. And there’s only one way to ensure that happens as quickly as possible: vaccination.

These times aren’t entirely “unprecedented.”

At the beginning of the pandemic, it was not uncommon to hear economists, sociologists, historians, and other experts wax on about our society and our very way of life being irreversibly and irreparably changed. And while, in some ways, this is certainly true, history tells us that most people will be all-too-eager to get back to their lives once it is safe to do so. The COVID-19 pandemic shares some startling similarities to the influenza pandemic of 1918. In the span of two years, 675,000 Americans lost their lives as a result of this pandemic, which was followed by an economic depression.

Throwing it Back to the Roaring ’20s

However, in the decade that followed, the United States experienced one of the most significant periods of economic growth and prosperity in our nation’s history (i.e., the “Roaring ’20s”). People rushed to socialize, connect, and engage with one another, seeking the human connection they had lost for those two long years.

In this article for The Atlantic, Yascha Mounk, associate professor at Johns Hopkins University, notes that “throughout history, humanity has, again and again, experienced pestilence. And though these bouts of infectious disease have had all kinds of long-lasting consequences...they never stopped people from seeking out one another’s company.” All that is to say that our desire for in-person human contact has not suddenly disappeared as a result of social distancing. In fact, many of us are craving physical connection even more than we did prior to March 2020. And your patients are no exception.

The next several months will be key.

Of course, if we want to get people back in the clinic, then we must remain vigilant. We’re not out of the woods yet when it comes to COVID-19: at the time of my writing this, cases are at an all-time high in many states—including my home state of Arizona—with many people growing restless of isolation measures and needlessly exposing themselves to potential infection. Furthermore, health officials have identified multiple new variants of COVID-19—some of which appear to be more transmissible than the original virus. But now that vaccines are being distributed—albeit slowly—there is reason to be cautiously optimistic. While recent studies—as cited by Dr. Anthony Fauci—indicate that the new strains could reduce the potency of the COVID vaccines, widespread vaccination is still our best bet to get the pandemic under control. That means getting as many people vaccinated as quickly as possible is of the utmost importance.

We have some massive hurdles to overcome.

To that end, it’s no secret that the vaccine rollout has been messy. States have struggled to dispense vaccines in an organized manner and communicate when eligible individuals may receive it. Furthermore, misinformation about the vaccine abounds. A common misconception I hear is that development was rushed, implying that important safety measures were overlooked. However, while the process moved quickly, the actual development and testing phases were no more rushed than those associated with any other vaccine. The difference was simply an abundance of funding and willing trial participants—not to mention an unprecedented sense of urgency.

Fighting Misconceptions in the Healthcare Community

While public concern over the safety of the new vaccine is disheartening, what is even more discouraging is the amount of misinformation and mistrust breeding among medical professionals. This is highly concerning, but in such extraordinary circumstances, it’s not altogether unexpected. That is why we must take it upon ourselves as healthcare providers to self-educate and rely on science, not alarmist social media posts or fear mongering. The research is there: the COVID-19 vaccines are highly effective, and none of the trials have uncovered any serious health or safety concerns. In my opinion, any healthcare provider who works directly with patients should be jumping to receive the vaccine at the first opportunity. It is our responsibility to those we serve. We must be the example, and we must make good on our professional oath to do no harm.

Vaccination is crucial to our ability to not only protect our patients and colleagues, but also our identity as healthcare professionals. There are so many patients out there who need our help—and our hands.

You can be a resource for patients who are unsure about the vaccine.

As physical therapists, we can play a critical role in dispelling misinformation and helping the vaccination process along—thus eliminating the barriers that keep us physically disconnected from our patients. In our discipline, we build strong relationships with the individuals we serve. And although we are not immunologists, our patients look to us for guidance on all health-related matters.

Answering Patient Questions

To be reliable resources on COVID-19 vaccination, we must all do a little prep work. First, familiarize yourself with the facts. The Immunization Action Coalition (IAC) has provided factsheets for vaccine recipients and caregivers, which can be found here. We can be invaluable resources simply by educating ourselves on:

• how the vaccine works,
• common misconceptions (and facts that dispel those misconceptions), and
• how patients can sign up for the vaccine when it becomes available.

That last point is especially crucial, as one of the major hiccups in the rollout process has been the dissemination of vaccine information to senior citizens. A lot of this information is housed online, which means digital literacy and Internet access present major barriers for some older adults. Because these individuals account for a large portion of our patient population, we have a unique opportunity—and responsibility—to keep these patients informed and up to date.

I can almost guarantee that you will receive questions about the vaccine from at least one of your patients, if you haven’t already. So, I’d suggest keeping a list of resources handy. Specifically, I’d recommend directing patients to the following websites:

• The CDC’s vaccine page
• The IAC’s COVID-19 page

Also, those who plan on getting the vaccine should pay close attention to their state health department’s communications. Follow your state department of health services (DHS) on social media or check the DHS website regularly for updates—and advise your patients to do the same.

Getting the Vaccine Yourself

If you’ve been vaccinated, don’t hesitate to let people know. I’ve seen many people share their experience on social media, which I feel is a great way to normalize it. If patients know their healthcare providers are getting the vaccine, it will help alleviate their own anxiety and doubt.

Additionally, the more people who get vaccinated now, the quicker the rollout will be and the sooner we can return to some semblance of normalcy. And I mean that quite literally. Most COVID vaccines need to be kept frozen, and once thawed, they cannot be refrozen. As a result, a limited number of vaccines are distributed to states at a time. If those vaccines aren’t used, the health department has no choice but to dispose of them. When this happens, the federal government sends fewer vaccines in the next shipment. That’s why anyone who is eligible for the vaccine right now—and plans to get it—should sign up immediately.

In my mind, physical therapy will never be an entirely remote profession. Our value as providers lies in our ability to connect with our patients, and touch is intrinsic to that connection. The vaccine is our glimmer of hope that our return to normal life—and our patients’ return to the clinic—is in sight, but we still have a ways to go. I know that at times, this pandemic feels unending, and many people—providers and patients alike—are eager to return to business as usual. But history has taught us that “business as usual” will only happen once we’ve effectively stopped the spread of the virus. We can do our part in moving that process along by educating ourselves and our patients, respecting scientific evidence and social distancing measures, and getting vaccinated as soon as possible.