It has been three months since many MiracleFeet-supported clinics closed due to the pandemic. The closures have affected over 9,000 children who are waiting for care, including patients born with clubfoot during this time who MiracleFeet partners anticipated reaching as well as those whose treatment was interrupted.

While clinic activity across all programs remains low, in countries where there has been a reduction in COVID cases, Paraguay and Cambodia for example, clinics have begun to cautiously reopen with additional safety measures in place.

Our priority remains the health and safety of our patients and providers. We are working with partners to devise reopening procedures, including increased safety precautions at clinic facilities to ensure providers can safely offer patients highly-anticipated care and treatment. MiracleFeet-supported clinics are subject to local government and hospital/facility-level safety procedures in response to coronavirus, and their decisions to reopen must comply with those policies, as well.

Clinical guidance for MiracleFeet partners

Below is a summary of general guidance to ensure the safety of patients and providers as clinics operations begin to resume.

Clinic safety: As the number of patients visiting clinics begins to return to pre-pandemic levels, we encourage clinics to strictly follow social distancing guidelines, thoroughly clean facility and equipment, screen for fevers, install extra hand-washing stations, provide masks to patients and accompanying family member, and continue to distribute information about preventing the spread of COVID-19.

Patient safety: To ensure patient safety we recommend some adjustments to treatment protocols including:

• Apply casts or removing casts in alternative locations when possible
• Perform tenotomies in clinic settings rather than surgical theatres
• Consider accelerated treatment as/if circumstances allow
• Provide two shoes sizes for braces to reduce clinic visits
• Utilize teleconsultations when possible.
• Prioritize treatment for infants whose care was suspended, infants waiting to start treatment, and patients in the bracing phase at risk of relapse.

Treating clubfoot in the close wake of a global pandemic presents a double challenge. We advise providers and clinic staff to be mindful of this and be prepared to offer moral support to patients and families, in addition to medical assistance, to help ensure they do not feel isolated or abandoned and help decrease the likelihood of relapse.