The coronavirus 2019 (COVID-19) pandemic has resulted in a surge of patients with acute respiratory distress syndrome (ARDS). Prone positioning may be used in such patients to optimize oxygenation. Severe infections may leave survivors with significant functional impairment necessitating rehabilitation. Those who have experienced prolonged prone positioning are at increased risk for complications not typically associated with critical illness. This case report describes the course and clinical findings of a survivor of ARDS due to COVID-19 who was prone positioned while in intensive care and subsequently admitted to an inpatient rehabilitation facility. Her related complications, as well as those described in the literature, are reviewed. Critical elements of a comprehensive rehabilitation treatment plan for those who have been prone positioned, including implementation of preventive strategies, as well as early recognition and treatment of related injuries, will be described.

Increasing population exposure to extreme weather conditions, a hallmark of this era of progressive climate change [1], creates a compelling urgency to safeguard individuals living with special medical needs who may be particularly challenged by such events. Here we discuss the heightened vulnerabilities and unique preparedness needs of individuals with spinal cord injury (SCI) in the context of climate-driven hurricanes. We outline a set of physician roles aimed at preparing patients, caregivers, and providers to proactively mitigate these risks.

Hurricane Dorian's devastating trajectory over the Northwest Bahamas was the most recent Atlantic storm to call attention to the catastrophic impact of climate change. Although disasters create adversities for all members of the affected population, people with disabilities and special medical needs are disproportionately challenged by such events and are more vulnerable to the conditions they create. This point-counterpoint series highlights the hardships faced by individuals living with spinal cord injury (SCI) when disasters strike. This commentary focuses on the time-urgent need to improve storm readiness among at-risk individuals living with SCI before the start of the upcoming hurricane season. We review the evidence indicating that tropical cyclones are becoming increasingly destructive in the era of climate change and consider how this trend may magnify the difficulties that those with SCI may experience before, during, and in the aftermath of a hurricane. We then review the ways in which health professionals caring for individuals with SCI can help them better prepare for hurricanes while also enhancing their own readiness to provide care during and after an extreme storm.

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