Covid-19

And this is what it is.

Novel coronavirus is SARS-CoV2 (severe acute respiratory syndrome coronavirus 2). It is NOT a flu virus or anything like the flu virus.

The symptoms are cough, difficulty breathing, fever, chills, body aches and pains, blood clots, kidney failure, heart failure, pneumonia, lung damage. It can cause headaches, fatigue, gastrointestinal symptoms and loss of smell/taste.

It is spread through droplets from the mouth and nose that land on objects and are picked up by another person on their hands and is transmitted to their mouth or nose or eyes. It can be picked up in the air before it lands on surfaces. It is thought to be in the air at least 6 feet away from the source yet the number is really just the best information we currently have.

The incubation period is 2-15 days and people can have it and not know it. Symptoms are often non-existent to mild to severe. People with other health conditions like immune system problems, lung problems and diabetes get it worse along with the elderly. We don’t know why some healthy people also get very bad cases of it.

There is no known treatment or vaccine.

There is no way to effectively screen clients for having COVID-19 without having a test but even the tests are inaccurate.

There are not enough tests yet in the US. Anyone with a cold or other symptoms could have this. Many could have had it last fall and early January as there were no tests being done. Many massage therapists are coming up with intake forms to try to do this and talking about taking people’s temperatures and O2 levels but this will NOT rule out that they have it.

Liability waivers will not protect you from law suits. Your liability insurance does not cover the spread of disease and pandemics. There are law suits already starting. They are mainly involving negligence on the part of the spa or massage therapist.

Our professional liability companies have yet to say whether or not we are covered if we are found to be spreading the virus. Then there is the added risk of being an employer and not having proper PPE or protocols in place to also keep your employees safe from getting or spreading the virus.

If you are an employee and are not provided the required PPE and the place you work is not providing adequate cleaning and social distancing, you could report them to OSHA or even sue them if you get it.

States are starting to implement contact tracing that will be able to trace where the virus is coming from and who came in contact with it. You will be required to share information with your clients and with the government contact tracers.

The tests are inaccurate. Negative tests are 30-40% inaccurate meaning if you test negative you still could have it. (My neighbor was tested a few weeks ago and was told this.)

Testing is one of the keys to getting things back to normal. There still are not enough tests. People need to be tested and then if found positive, tracked to see where they have been and quarantined. People who are found to have been in contact with the person will also be quarantined. Contact tracing is allowed under HIPAA Privacy Laws.

When You Open

This is not written to scare you, it is written to inform you. If you feel like it is some scare tactic or fear mongering then it might be good to check to see what is driving that feeling you are having. It may be because you know that the risks of being a massage therapist and spreading this disease are great and there is much to think about and have in place to reopen.

You should know how to clean your office at this point from all of the information out there. No amount of cleaning will stop this. A person with the infection can come in and spread the virus all over the office.

The most effective way of stopping it is social distancing. Next after that is having a set up where you can keep the virus particles from hitting you if you are less than 6feet away. (See hierarchy of defense by the CDC.) That of course is impossible for giving a massage. You are in a closed room, less than 6 feet apart making it the highest risk of spreading the virus. The last line of defense is wearing a facemask and eye protection. That is not 100% effective either but it is the best chance you have of not getting it and spreading it to your clients. Most of the facemasks that are available are just dust masks and do not stop the spread of the water droplets. The N95 masks will protect you from getting it and spreading it but they need special fitting and they need to be worn all day long and taken off in specific says to reduce the spreading. Massage therapists are not trained in the use of these masks. They also need to be reserved for nurses, doctors, police and fire departments.

Still researching masks…most of them for sale are just dust masks. https://healthcentricadvisors.org/wp-content/uploads/2017/04/3_MaskEnomics_Poster_2012.pdf

Posted by Massage Practice Builder on Thursday, May 7, 2020

Surgical masks are the next best thing. I am starting to find them on Amazon Business where they are reserving products for healthcare providers. You have to have an NPI number to be able to purchase them. I also found hand sanitizer and eye protection there. I am not yet sure if they are able to fill the supply to hospitals and doctors, nurses, police, firefighters and rescue workers who need them first.

Your state Department of Health or Governors office will inform you of the specific things you will need to do to reopen. Our professional associations AMTA and ABMP should be informing them about massage and our work to help them create the best guidelines. I did see where one state was asking for input from the Federation of Massage State Boards. Your AMTA State Chapters are working on this too and the states that have a lobbyist are using that to make the connections needed to give input into the best practices guidelines. Each state is different.

For more info on reopening see what some states are recommending as guidelines. Article Review for Best Massage Practices in a Post Covid-19 Economy For review to the New Hampshire Re-opening Economy Task ForceThursday May 7, 2020Prepared by Linda Garvey LMT

It is what it is.

When this pandemic started for me back on March 4 it took me a few weeks of grieving, researching, worrying and saying this can’t be right to get to the point of being able to say… It is what it is.

It is what it is

Posted by Massage Practice Builder on Saturday, March 21, 2020

Now 2 1/2 months later, I am getting to the same point of being able to say it is what it is. Everyone is on their own path of figuring out when it is the right time to reopen their massage business. The fighting on Facebook has to stop now. There is no right or wrong time to reopen. You just have to be able to handle the risks of opening.

I am watching the numbers. I am preparing what I can. I am thinking I might start reopening slowly and just have clients in who I know have been socially distancing and not taking any new clients at this time. It is just a waiting game now. Waiting for the specific guidelines for my state. Waiting to see if the PPE orders come in. (It looks like they are not coming in until June right now.)

I have worked to provide people with the best information that I found at the time and will continue to do so.

How can we all get to the point of not reacting and just being informed. This isn’t fear mongering. It isn’t stepping on your civil rights. You can have your fears and reactions but don’t let them have you. Can you just accept what it is and work towards reopening safely?

It is what it is.

Intake and Screening Clients

No amount of screening in a massage therapy office can effectively rule out COVID-19 or coronavirus. Intake forms may ask questions and you may be taking the person’s temperature but that does not mean that the person is free from infecting others with the coronavirus.

Since the virus is often undetected in people for 2-10 days before they get symptoms and also after they have had the virus, there is nothing besides a swab test that will guarantee that someone does not have the virus. Even that is not 100% effective as they could have just picked it up on the way to your office. The test is really inaccurate too and no one is talking about that. My neighbor was tested last week and it was negative but the doctor said that that does not mean he doesn’t have it. The tests are 30-40% false negatives.

It isn’t just older people and people with compromised immune systems. Younger people are having strokes and heart attacks.

People with muscle aches and pains could also have the virus. How will you be able to screen those people out?

Not even using thermal scanners will help.

No screening questions or processes can 100% rule out that the person does not have the virus.

Having waivers won’t protect you either from what I understand. They need to be written carefully by lawyers. I wonder if AMTA and ABMP have their attorneys on this to write effective waivers for their members?

Will your liability insurance cover you if the virus is spread through your office? How will anyone ever be able to track that? They are. The first wave of lawsuits are being filed now according to the news.

Facemasks

Should you wear them when you get back to the office? What kind? Will the home made masks protect you enough?

The wearing of face masks is more about protecting others from getting the virus in case you unknowingly have the virus (which is generally the case as people are contagious for 2-14 days before they show symptoms.)

The N95 masks will protect You from getting the virus but they need to be properly fitted and worn properly in order to do that.

The CDC guidance stated that masks are primarily meant to prevent the spread of disease from the wearer to others. The CDC has moved to recommending home made masks mainly because the other masks cannot be found anywhere and are needed for the frontline workers who are exposed to the virus.

CMS has this to say about facemasks for Recommendations Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase I

Consistent with CDC’s recommendations for universal source control, CMS recommends that healthcare providers and staff wear surgical facemasks at all times. Procedures on the mucous membranes including the respiratory tract, with a higher risk of aerosol transmission, should be done with great caution, and staff should utilize appropriate respiratory protection such as N95 masks and face shields.
•Patients should wear a cloth face covering that can be bought or made at home if they do not already possess surgical masks.
•Every effort should be made to conserve personal protective equipment.

The WHO still says you on their website that you do not need to wear a mask unless you are taking care of an infected person. I did some searching though and found that it was mentioned in one of their briefings on April 3.

It doesn’t negate the need for everyone to protect themselves and try to protect others so we can certainly see circumstances in which the use of masks, but home-made or cloth masks, at community level may help in an overall, comprehensive response to this disease and we will support governments in making those decisions based on the situation they find themselves in in terms of transmission, based on the context in which they’re dealing and the resources they have at their disposal.

WA State massage therapists are still considered essential workers and the Department of Health (PDF) has provided specific direction for working on clients and cleaning offices.

Ensure that massage therapists have the following personal protective equipment (PPE) and are familiar with its use: facemask (surgical mask with ear loops or mask with ties), eye protection (for example, goggles or disposable face shield that covers front and sides of face), gown, and Updated April 27,2020clean, nonsterile gloves. Alternatively to a gown or other covering, massage therapists can change clothes after each massage.

CDC’s Optimizing the Use of PPE provides guidance on actions to take when PPE is short or you do not have PPE, including contingency and crisis strategies. Using crisis measures is not ideal and could put health care providers at risk for disease.

Provide a face mask or cloth face covering for each patient to wear during the entire treatment.

Other resources on masks:

WHO – Advice on the use of masks in the context of
COVID-19 6 April 2020  |

CDC – Use of Cloth Face Coverings to Help Slow the Spread of COVID -19

Understanding the difference it types of masks -CDC

MSNBC video of how much masks protect you.

Cleaning and Preparing the Office

Think about everything that you touch on the way to the office. Think about everything that a client touches on the way to the massage office. Think about doorknobs, shoes, clothes and everything.

Can you effectively clean and manage everything?

Taking things out of your room like carpets and cloth furniture might help.

Will air filters and UV lights help with keeping your office clean?

Is cleaning really enough to stop the spread? It is just one part of this.

Gloves

Wearing gloves has not show to be necessary to limit the spread of Coronavirus since the virus is not transmitted through skin contact. If you wash your hands after every client and follow room cleaning procedures you should be OK.

What will it take for YOU to get back to giving massage?

The White House directives for reopening call for specific things to happen before reopening. Many states are not following the orders and have gone rogue. States like WA are following the science in hope that we only have to do this once! We need to have a consistent reduction of cases in each state and have the downtrend for 14 days consistently. We need adequate testing to be able to test everyone who needs or wants one to show they are not infected. (My neighbor was just tested and was told they were negative and the doctor said the negative tests were 30-40% incorrect so there is that to deal with and no one is talking about it.)

Governors and state health departments are beginning to reopen states and get businesses back to work but does that mean YOU have to go back to work? Our Governors and legislators don’t seem to understand what massage is about and that most have us have NOT been properly trained in the use of PPE, let alone are able to get the required PPE. (This is something that needs to be worked on after this is over–hopefully through our associations.)

We need to have systems in place to track who gets it and where they have been to notify those who were in the vicinity so they can get tested or be in quarantine until the infection phase is past.

We need to be able to limit the number of cases we have according to the number of hospital beds that we have to handle the cases.When there is a known treatment that works most of the time and when we get a vaccine that would help reduce the number of cases, opening up will be easier but both of those are a long way off.

One of the biggest issues is whether or not your unemployment will stop if you are ordered back to work. If you are employed you risk losing your job if you don’t back—or do you?

I don’t yet have an answer for this.…but we really need to find out.

As far as the other part of this in keeping your clients from getting this, keeping YOU from getting this and keeping your family and your clients families from getting this—what will YOU need to have in place in order to do that. This isn’t just about YOU anymore either. It is about everyone who you are in contact with and everyone your client is in contact with on a daily basis.

It also depends on where you live and how wide this virus is spread in your community. The thing is though that even if you are in an area that has low number of cases, the testing has to be adequate so you know it isn’t all around you. This was one of the problems when this first started. It was all around us here in the Seattle area with one of the first cases in January and we didn’t know it. Later it was found that there was actually a case in CA that was earlier and we again did not know it was all around us.

My criteria right now is facemasks. We need to have at least real surgical masks – not the homemade or dust masks that are available. We need real protection from spreading the virus. Since those are not available and probably won’t be for some time, the next thing would be that the number of cases has significantly been reduced and the hospitals have the capacity to effectively care for the number of people who have the virus. There needs to be enough testing and accurate testing so that people can get tested once a week or more. Accurate testing doesn’t seem like it will be here anytime soon.

There is just no way in hell that you can stay 6 feet away from someone—there is that.

Resources:

OSHA – Guidance on Preparing Workplaces for COVID-19

Georgia (one of the first state to open) Safety Guidelines for reopening Barber and Cosmetology Salons

In WA State, massage therapists are on the list of essential workers who are allowed to work during the coronavirus outbreak.

March 23, 2020 Proclamation 20-25
Essential Workforce

•Workers providing COVID-19 testing and workers that perform critical clinical research and development needed for COVID-19 response.

•Health care providers and caregivers (e.g., physicians, dentists, psychologists, mid-level practitioners, nurses and assistants, infection control and quality assurance personnel, pharmacists, physical and occupational therapists and assistants, midwives and doulas attending facility-based or home-based births, alternative healthcare providers, social workers, speech pathologists and diagnostic and therapeutic technicians and technologists).

As most other states shut down massage businesses it is difficult to understand why massage therapists are on still on the list of essential workers. Many of us here have tried everything to get us off of the list and to ask why we are on the list – contacting our legislators and the Governor’s office with no results. Many are also using it to justify continuing to work or keep the business open. Some are using it to reopen their business even now.

Why are we on the essential list of workers?

Many are asking: How can we not be on the list of essential workers? Touch is so needed. Pain relief is so needed. Stress is something we can help with.

Being essential in the time of a pandemic is not about touch or stress or pain relief. Being essential has to do with getting down to the basics of what types of services are needed to support the critical infrastructure of combating the virus and supporting the stay at home orders.

It is really complicated and we really don’t know for sure but from what I have been able to figure out is that it is because we are also Health Care Providers AND we are credentialed with health insurance companies under the Every Category Law that allows us to work with injuries and various health conditions and bill health insurance.

The essential worker list from Homeland Security DOES NOT include massage therapists either.

The advisory list identifies workers who conduct a range of operations and services that are typically essential to continued critical infrastructure viability, including staffing operations centers, maintaining and repairing critical infrastructure, operating call centers, working construction, and performing operational functions, among others. It also includes workers who support crucial supply chains and enable functions for critical infrastructure. The industries they support represent, but are not limited to, medical and healthcare, telecommunications, information technology systems, defense, food and agriculture, transportation and logistics, energy, water and wastewater, law enforcement, and public works.

But no one will die without getting a massage.

No they won’t, but massage therapy can keep people out of the hospital and from taking doctors time in serious situations like people who get debilitating migraines, people who wake up and can’t turn their necks or people who just wrenched their back working in the garden or doing home projects. It can help keep people off Opioids which isn’t the main concern here in the time of coronavirus but it is a main concern overall.

Working in the time of Coronavirus

Some massage therapists in WA continue to work either for themselves because they can or work as an employee for a chiropractor or other provider that is considered essential where they risk losing their job if they say they don’t want to work.

Little did we know that we could become part of the frontline of essential workers when we signed up for massage school and got our massage license here in WA State. Being a HCP and being able to bill health insurance meaning we are an integral part of healthcare means extra responsibilities. (What if nurses and doctors said no they won’t work?)

Today WA State Department of Health finally issued more directions on this.

COVID-19 Health Alert for Massage Therapists

Massage therapists should be aware that there is:

Widespread person-to-person transmission of COVID-19 in Washington. People with COVID-19 can spread the illness even when they feel or lookwell.

High risk of severe COVID-19 illness in persons older than 60 years.

High risk of severe COVID-19 illness in persons with underlying health conditions.

No method to completely remove the risk of person-to-person spread of COVID-19in a massage setting. Governor Inslee’s proclamation 20-25allows health care providers to continue essential health services. Many services provided by massage therapists are considered non-essential. No in-person appointment is risk-free, even if the patient and massage therapist appear well. To help control the spread of COVID-19, treatment should be limited to patients with a clear and documented urgent medical need.While the proclamation allows massage therapists to continue providing services, they are not required to do so. Therapists should weigh their own health risk and comfort when deciding whether to continue in-person services.

Actions requested:
Only provide massage to patients with urgent medical issues.Examples include, but are not limited to,lymphatic drainage issues, moderate to severe whiplash,and acute pain control.Simply having a prescription for massage is not sufficient to establish urgent care.
Cancel non-urgent massage appointments.

When treatment is medically necessary, screen the patient for symptoms of respiratory illness (e.g., fever, cough, difficulty breathing) before they enter your practice. If a patient has respiratory symptoms,do not provide treatment. Instead, refer the patient to their primary care provider.

When appropriate, consider instructing patients to implement self-care measures such as rest, hydration, light stretching, light or moderate activity,and self-massage to treat aches and pains until the restrictions on non-essential services are lifted.

Make sure patients practice social distancing of six feet in waiting rooms and other areas of the practice.

Closely follow CDC guidelines for hand hygiene and clean equipment and facilities between patients.

Remind sick employees to stay home. Do not require them to work.Allow all employees who are uncomfortable with continuing to work in the clinic to stay home.

Consider wearing a face mask or cloth face covering when providing massage and when within six feet of another person. Provide face covers and request use by clients when close proximity is necessary.

Updated April 6,2020 Background:The virus causing coronavirus disease-2019 (COVID-19), emerged in December 2019 and has since spread around the world causing a global pandemic. Eighty percent of cases are mild, but severe disease and deaths are more common in the elderly (older than 60 years) and in those with underlying health conditions. Health experts are concerned that increasing transmission in our state and an increase in severe disease will limit the ability of our healthcare system to provide urgent care to all who require it.

Additional resources for massage therapists:DOH Workplace Recommendations DOH Coronavirus (COVID-19) Web Page CDC Coronavirus (COVID-19) Web Page CDC Practice Preparedness ResourcesTorequest this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov.

The problem though is that many are working as usual and not limiting their care to emergency situations as outlined in the directive. Some of the chiropractors and even massage therapists are inaccurately saying that massage therapy boost the immune system so is essential to fight the virus.

Dual edged sword

While it is great the we have gotten the recognition we deserve here in WA, it comes with the risk of being on the frontline of battling this dreadful virus. Most massage therapists are not trained in the use of PPE let alone have the necessary PPE. Many are saying that they want to be able to work on the nurses/doctors and healthcare workers but that would have the added risk of coming in direct contact with people who have been exposed to the virus meaning that you would need to be able to quarantine yourself away from your family and everyone for two weeks or more to show that you do not have the virus.

Many massage therapists have been trying to get us off the list of essential workers with petitions, emails to the governor and our legislators but with no luck. It is also tricky because if we are saying we want to get off the list, the health insurance carriers might think we are not serious about our work with them and our role as a health care provider.

How do you get on the list of essential workers?

My guess is that you can’t make it happen now but you can work on it after this virus thing is over. You will have to make sure that you are considered to be healthcare providers in your state. That will take legislation if you are not already. Just being licensed by the Board of Health does not make you a HCP. Find the law that says you are a HCP.

After that, consider creating a campaign to get massage therapy covered by health insurance. I have it explained in my book Massage Insurance Billing. Being able to bill insurance is also a great way to sustain your massage business in any economy. People will come in weekly or even twice a week when they are injured and in pain and have someone else paying.

Help is coming

The Federal CARES bill has just passed and has been signed to create one of the largest recovery efforts ever seen.

The bill will allow everyone working including people who are self employed to receive unemployment benefits in your state PLUS receive an additional $600 a week for 3 months. This is really unprecedented. Usually self employed people are not allowed to get unemployment benefits as they have not paid into the unemployment systems.

Your states unemployment offices will have more information. It will take time to implement this so you don’t count on it for income for right now.

Small business loans will also be available through the SBA and your local banks.

ABMP and AMTA have also helped decipher what this bill means exactly on their websites.

Here is the full bill text (PDF) if you have spare time and want to read it.

Maintain your business even while on pause

There are many things you can be doing to maintain your business and prepare it for coming off of pause. Keeping in contact with your clients individually or in a newsletter can help ease their fears of the possibility that your massage business many not be able to open when this is over. Many clients are offering to pay for packages to help massage therapists stay in business. It is also time to get creative. Can you do something like create an fundraiser to give gift certificates to nurses, doctors and hospital workers along with Fire and rescue departments after this is over?

Update your website page by page. If you are using WordPress the software sends a message to the search engines that new information has been posted or updated making your online presence stronger. It is a great time to continue adding content. A good website will have about 30 pages or more of content making it more attractive to search engines…they like content. Here is a big list of ideas for content. Your potential clients will also come to know that you are the expert in the area making you stand out from all of the others in the area. Start with creating a page of resources for your local massage therapists with information that you are finding about getting financial help and CE’s during this time. You might want to also consider creating a whole website for your local massage therapists like I have for WA State –-www.wamassagenetwork.com It started with focusing on CE classes and also way to connect local area groups of massage therapists. Right now with CE on hold, I am using it to create resources and provide updates on the coronavirus.

See also: Massage Business Basics
150+ Marketing Ideas

Restarting your massage business

The long term effects of the coronavirus on the massage profession is yet to be seen. There are many concerned that people won’t want to be touched after this. We have to start reframing their focus away from the touch aspect of massage and focus on the outcomes — less stress, less pain which means increased wellness as a result.

When will we be able to restart is a major concern of everyone’s. Everything you read anywhere is of course just conjecture so don’t let this get you overwhelmed.

Ideally going back to work will require that there be a vaccine and/or medication that can stop the virus. Could this ever get to a non-event and business will continue on as usual – with stringent cleaning protocols and clearer screening guidelines?

Learning to bill Insurance

Another concern is that many people are not working and the overall effect of this on people’s income and spending might change. As they become more frugal, it is again important to remember to focus on the outcomes– less stress, less pain and improved wellness. In some states, massage therapy is still seen more as a luxury although that seems to have changed over the years. Massage therapy is healthcare. It could be a big part of helping the Opioid Epidemic if only more doctors and health insurance companies saw it in that light. I have some ideas on how to make that happen and share the story of how WA State has been able to bill health insurance for over 20 years because of advocates in WA that made it happen.

In general, people who have their insurance paying for injuries sustained in car accidents or work accidents come in more often and the insurance will pay your going rate. Billing insurance in general could be a good way to stabilize your business. If you are not yet billing any insurance, you can start learning how to bill with my book The Massage Insurance Billing Manual. (I have checks coming in when we are on stay at home orders.)

Websites for making extra income

I have always recommended that massage therapists have another source of income. My personal second income is through things like this- having a website for massage therapists and writing ebooks etc. I also have a few other websites that I will now have more time to work on. Right now they have just been on hold and working on them very slowly so that they will be making me money when I planed to retire in 3 years. If you are an expert on a specific area of massage or any other topic, then maybe creating a website on that area/topic would be a great way to supplement your income. It won’t make you immediate income but when I started my first website to sell ebooks back in 2002, my first sales started coming in 4 months. Learn more about how to create residual income through a website. Here are some ideas for websites.Learn to bill insurance.

One of the things that is coming in handy right now is the fact that I have been billing insurance for clients – mainly health insurance which covers massage therapy in WA State. A few weeks ago and last week before everything went south, I billed insurance for about a dozen sessions. I will be getting paid in 2-4 weeks! Income doesn’t stop. People also will have a tendency to come in more often even during a recession when the insurance is paying. Learn to bill insurance (auto, workers comp and health insurance) and I wonder if we will find that more states need to adopt something like the Every Category Law like we have in WA that allows us to bill health insurance.

Some may close forever and change professions

It is inevitable that some massage therapists may have to close their business forever or some may want to come back only part time and choose another full time profession. As many close permanently, there will be less massage therapists in your area making YOU the expert. There has already been a big shortage of massage therapists that has been really affecting the massage franchises and small/large employers of massage. There will be more demand for massage therapists in the job arena making it so you can negotiate higher pay and benefits. What if massage therapists were also paid a fair hourly wage for every hour worked rather that the piecework method of pay?

Massage Schools. Many schools who were already struggling to attract people to the profession may close. The profession will need to change and adapt and come up with new ways of surviving. Schools are moving to online education. Why are they not doing this already for the anatomy, physiology and other non-handson subjects? Could that make massage school more attractive and less expensive? What if massage schools came together and created one online portal for all non-handson work so that everyone could be learning the same information and incorporating important things like the ELAP and the latest research into learning?

What does our profession need?

One of the things we are finding across the US is that governors and legislators really are not aware of who we are as massage therapists in healthcare. Here in WA State we have been considered to be essential workers during this time meaning that many are staying open until they are ordered to shut down. This is mainly massage therapists who work for chiropractors or others and don’t have a choice as to whether they should work or not. Read about the conundrum on my other website – www.wamassagenetwork.com

What if we had our associations or some association working to connect us to every governor and legislator to make them aware of what we do and who we are as a profession and were able to send one unified message to them all in the time of crises like this and anytime?

What if we had a National Political Action Committee who worked with the major massage associations to elect officials that understand and support massage therapists like the Physical therapists and chiropractors do? The PT’s and Chiro PACs raise a million or so each year for that reason and what if the massage profession could raise even more since there are about 350,00 of us around the US.

Help for this crisis was slow coming from our two major professional associations. Many massage therapists were looking for direction as to whether or not to close their business or how to handle this situation since the end of February and it was even mentioned in one local FB group at the end of January.

See also: Massage Therapists as Essential Workers

** This was written before the call for social distancing ramped up this weekend. If you can stay home for 2 weeks do it now. If you really really can’t, be extra vigilant in your cleaning, screening and care. It may come a time within the next week or so that the Federal or your State government will tell you to stay home. Help is starting to come in the form of bills and legislation that should help all. We need to start helping each other!
H.R.6201 – Families First Coronavirus Response Act

COVID-19 is all around us, hitting our communities hard with schools closing for 6 weeks, all major events closing and the stock marketing crashing. As massage therapists it is a really scary time not knowing if your business will survive or if you will be able to continue to work.

Decide if you want to stay in business or close

It’s a difficult choice. The call for social distancing is becoming louder and louder. WA State just closed ALL schools for 6 weeks. Restaurants are closing their doors all over. The guideline here is to stay 6 feet away from people yet students will be sent to daycare places where that is impossible. Costco and other big box/grocery stores are mobbed with shoppers. It’s mixed messaging to say the least and leaves massage therapists fending for ourselves to make the decisions.

My Massage Therapists Guide to COVID-19 provides the details you need to know about the virus, illness and keeping your office clean and inviting.

• Can you afford to close your business not just for 2 weeks but possibly longer –6 weeks, 2 months, 3 months?
• Are you healthy yourself with no underlying immune issues, heart or lung diseases or other things?
• Do you have family members at home that are risk for catching diseases and not being able to fend them off adequately? Are you taking care of family or friends with underlying conditions that are a higher risk?
• How do we deal with the guidelines for distancing vs staying in business? It may no longer be a quandary if/when the State Department of Health and the Board of massage shut us all down. There has been so much discussion over whether the mandates for social distancing – stay 6 feet away — apply to massage therapists. AMTA-WA has approached the DOH/BOM for their recommendations.

People Need Massage

Everyone has added stress from all the fears of the unknown that are now arising and we all know how stress affects most every system of the body. Many are in pain from working on computers and are also working on the front lines in hospitals and nursing homes and fire/rescue departments. While the risk may be too great for some massage therapists, the opportunities are there if you want them.

People are staying home now and working from home when they can. They have more time in some ways. It may take a week or so before people have made the needed changes in their lives to adapt to working at home and now having the kids at home so hopefully they will be coming out for massage as things get more settled.

Write an article on your website about stress and write about how massage can help.

First steps

Create a page on your website and send out a news brief to all of your clients either by email or regular mail. Think about the things that a client might be fearful of when coming into a massage office. Some of the things that they are concerned with is will they be safe coming into your office and laying on the table. The face cradle brings up extra questions and fears.

I just got one from the place that makes my glasses that is very well written.

• Tell people that you are not sick and have not been sick or around anyone that has been sick.
• Tell them what cleaning protocols that you use and have been using to keep the office disinfected.
• Tell them how you are responding to the pandemic and what you are doing to protect the spread of the virus.
• Invite them to ask questions and have a specific way for them to ask either by email, text or by phone.
• Offer them gift certificates for sale or package deals for sale to help keep your cash flow balanced. Ensure them that you will remain in business so that they will be able to cash them in or what you would do if you had to go out of business.
• Give them options for laying on the table without putting their face in the facerest. It is a great time for sidelying work!
• Offer then $10 off if they bring in hand sanitizer!

Screening clients

Everyone that comes into the office needs to be screened carefully which is part of building the clients confidence that you are taking this seriously and also keeping from spreading it through your office.

Have them wash their hands or
use hand sanitizer upon entering your office!

• Have you been sick with a flu or cold in the last few weeks? I have added colds to the list too. Many cases of COVID-19 are going undetected because of lack of testing. Many cases are so mild that they think it is just a cold or maybe regular flu. If someone is sick, they need to be tested and if positive for COVID-19 quarantined until better and cleared of the virus.
• Has anyone in your immediate household been sick with a flu or cold in the past few weeks? If someone is sick in their immediate household the risk is too great that they might have it and not know it.
• Have you been in a building or store where it has been declared that someone infected with the illness was there in the past few weeks? While this is getting tricky to determine where people have been and what they have done, it is more about making people feel safe.

Keep clients coming in the door

• Update your Google Business listing daily with offers and posts to reassure potential clients that it is still safe to get a massage.
• Find local Facebook groups that are in your specific area and share information and let people get to know you before making a post to tell people about your business. Many working at home are looking to support local businesses.
• Find your local area on www.nextdoor.com and get to know people there and offer your services.
• Get involved in your community by checking in on your neighbors, having small get togethers in coffee shops and do what you can.
• Change your hours to accommodate people having to stay home.
• Let them bring their children in.
• Consider adding services like foot massage.
• Consider going into people’s home – but there is a risk there too. Bring your own cleaning supplies!
• Consider setting up for chair massage for employees of stores like Costco and local grocery stores that have to stay open and are dealing with such overwhelming shopping.

If you have employees

Having employees makes it even more of a difficult decision as you are partly responsible for other people’s income. In WA State, they are implementing extra unemployment benefits for those affected. Check to see what your state is doing. Some large employers are choosing to pay their employees even when not working to keep things in place and provide for them.

Train them in cleaning protocols and help them manage their fears. Teach them how to talk with clients. Provide ways for them to talk about it among themselves and with you to help alleviate their fears.

Other ways to make money

Get Massage and pay for it from other massage therapists! You will need it!

Taking insurance cases. This is more of a long term solution. This virus is not going away anytime soon. There are many businesses closing and people out of work permanently. People are more likely to continue to come in when their insurance is paying. Most states allow massage therapists to bill for car accidents or work related injuries. More and more health insurance companies are paying. Insurance will take 2 weeks to a few months or even a few years to pay so in a way it provides income during slow months. It may be a good time to start working on getting massage therapy covered by insurance. The world is really going to need it! I have it all explained in my book — The Massage Insurance Billing Manual

Add stretching to your list of services. This will allow people to leave their clothes on which is another measure of protection and they don’t have to lie in the face rest.

Become a delivery driver. The community will be scrambling to take care of each other. With restaurants closing or being faced with the threat of closing, many are moving to expanded delivery of food and products. Grocery stores are moving to that more too.

Become a census taker. These are temporary positions that may help you survive this. https://2020census.gov/en/jobs.html

Offering Consultations for support and teaching home massage techniques. I have seen some massage therapists talking about doing that. It is important to stay within your Scope of Practice though.

Look into making money with a website and sharing your expertise. I always have a source of income through my many websites. It won’t help you immediately but will help you survive, thrive and weather any future emergency events.

Grocery stores and Big box stores are getting slammed and are hiring people to work.

Self Care

Taking care of yourself is mandatory. You won’t be able to help anyone if you are run down or stressed about this. Find your support groups on Facebook or start a local support group. With supplies like hand sanitizer and sanitizing wipes, think about sharing them with others if your business takes a downturn or you have extra supplies.

If you have a mentor or supervisor it is a good time to set up phone meetings or online meetings to talk through your fears and struggles so you don’t take them into the massage room.

Go outside and get back to nature for walks around your community. Stay grounded.

If you get sick

If you get sick with any kind of illness you will need to stay home. It could be the coronavirus so check with your doctor. If you do have a confirmed case of COVID-19 you will have to quarantine yourself away from your family and others until you are cleared medically. Some are saying you just have to have 72 hours where you are tested to be virus free and in other places I have read that you should quarantine for 2 weeks after getting and having the virus. Only your doctor will know what is right for you.

If/When you have to close

Things are happening so quickly and things change minute by minute. Your City, County, State and our Federal Government will have to do something to help every single person affected by this which could be millions and millions. in Seattle our state is making it so people with jobs can get unemployment benefits and are working on getting funds for small businesses and even the homeless may finally get the help they need. It probably will take time and we don’t know for sure what is coming or not. Our communities will have to start taking over and help each other.

Hang in there! You are not alone!