Abstract

The COVID-19 pandemic has revolutionized the habits of entire communities, having even more profound negative effects on assistance for the chronically ill. The sudden demand for extraordinary resources caught all worldwide countries unprepared, highlighting shortages in provision of care services. This applies to all patients, affected by COVID-19 or not, as many need continuing access to chronic diseases treatments. Almost all of the energy available has been directed toward care of COVID-19 patients, and almost nothing has been done to continue therapy for patients with spasticity. This study builds on a recent article and discusses its results as a basis for highlighting the ethical dilemmas and unintended consequences of health systems changing their priorities during the pandemic. The above mentioned study has shown increased patient-perceived spasticity during lockdown (72.2%) with reductions in perceived quality of life (70.9%). Telemedicine tools have proved insufficient, with access by only 7.3% of these patients. Despite the health emergency, it cannot be denied that this situation is a violation of these patients' rights and dignity. The healthcare system will also have to bear increased costs in the future to recover the loss of previous therapies benefits, because of their interruption. The real challenge will be to exploit the critical issues emerged during the pandemic, and to resolve the measures needed to take the care to the patient, and not vice versa. This applies particularly to fragile patients, to respect their dignity and right to care.

Highlights

  • The influence of the COVID-19 pandemic goes well-beyond the evident immediate clinical impact on the entire community

  • Clinical evidence of the role of botulinum toxin (BoNT-A) in the treatment of spasticity is well-supported [13,14,15,16,17]. This neurotoxin helps to prevent deformities, improves motor function, and relieves symptoms in subjects suffering from spasticity of various etiologies

  • The current pandemic has required significant changes in the organization of healthcare and its facilities, and the management of both inpatient and outpatient hospital activities. It has highlighted significant ethical and medico-legal problems relating mainly to the suspension of treatments for spasticity, or other disability or chronic disease, which has shown clear deterioration in the quality of life perceived by the patient

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Summary

INTRODUCTION

The influence of the COVID-19 pandemic goes well-beyond the evident immediate clinical impact on the entire community. Clinical evidence of the role of BoNT-A in the treatment of spasticity is well-supported [13,14,15,16,17] This neurotoxin helps to prevent deformities, improves motor function, and relieves symptoms in subjects suffering from spasticity of various etiologies. Personal care management worsened, due to increased difficulties with washing, dressing and eating These deficits have clear repercussions on their quality of life and functional independence, and they were significantly more relevant in severe spasticity patients. They complained of greater difficulties in their daily use of aids for walking. Social and economic differences in the population have severe negative repercussions in the equal distribution of care

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