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.
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
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.
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.
OSHA – Guidance on Preparing Workplaces for COVID-19
Georgia (one of the first state to open) Safety Guidelines for reopening Barber and Cosmetology Salons