Think about it. You can clean and clean and rearrange your room and disinfect and change your clothes and shoes and put up sneeze guards and buy fancy table covers and face rest covers and in walk the client who unknowingly has the Novel coronavirus. They don’t have a temperature (many don’t) and no symptoms of a cold or cough or anything that resembles allergies or whatever. They talk for an hour in your closed room that may now have a fancy air filter, but you are standing close to them and sitting at the head of the table working on their neck and shoulders sharing air. They are laying face down breathing into your pants, legs, shoes and the facerest and the endplates of the massage table.
The longer you stay in the room with the virus, the more likely you are to get it and to get a worse case of covid-19. The closer you are to someone, the higher the risk of you inhaling or getting the virus in your eyes.
SARS-CoV-2, the virus that causes COVID-19, spreads primarily through respiratory droplets emitted by infected people when they cough, sneeze, talk, or simply exhale; the droplets are then breathed in by others. (Loud talking has even been shown to generate measurably more droplets than quieter talking.) This is why physical distancing is so important. We have all now learned the six-foot rule for preventing transmission of contagion-containing droplets. ~Atul Gawande, a surgeon and public-health researcher, became a staff writer at The New Yorker in 1998.
Social distancing is the main way to stop the spread of the virus. When you can’t social distance you need to be wearing a facemask.
But it is soooo uncomfortable.
Yes it is. It makes breathing challenging. It also depends on the type of mask you are wearing. Think of it as a new breathing exercise. Nurses and doctors, police are wearing them…you can get used to it too. Think it violates your freedom of choice? How about when you spread it and people end up dead? Wearing clothes can be uncomfortable.
If you think this is uncomfortable, you really won’t like a ventilator. ~Facebook meme
Learn to wear a mask and teach your clients how to breathe comfortably wearing one.
Clients may be uncomfortable wearing a mask especially lying prone. I have seen many variations of the new facerest cover that uses a pillow case or other material placed in a way to allow breathing but it is not made out of protective material that actually stops the virus from spreading.
Help them learn to breath comfortably or use the sidelying position to allow for better breathing.
People may be prone to anxiety attacks from wearing a facemask especially when lying prone so be sure to be prepared and be able to help someone through it all. If you as a therapist get anxiety attacks from wearing them, it is best practices to stay home and not go back to work until the pandemic is over.
Not all facemasks are the same. The blue and white facemasks that are so readily available are just dust masks as far as I can tell.
Surgical masks and N95s are the top rated masks but there is still such a shortage that these are reserved for healthcare providers, police and people on the front lines…oh wait…we are healthcare providers. N95s or equivalents need special fitting that massage therapists are not trained in.
A proper surgical mask is usually made of three layers, including an outer hydrophobic non-woven layer, a middle melt-blown layer, and an inner soft absorbent non-woven layer. These three layers have their specific functions: the outer layer is intended to repel water, blood and body fluids; the middle melt-blown layer is the critical highlight of a surgical mask, it is designed as the filter to stop germs from entering or exiting the mask; and the inner layer is intended to absorb water, sweat and spit. the biggest difference between surgical masks and ordinary face masks is the melt-blown layer in surgical masks.
Beckers Hospital Review provide some info on the difference between procedure masks and surgical masks.
Procedure masks are easily identifiable by the presence of two ear loops to secure the mask to the face and are used on hospital floors, isolation units, and labor and delivery units, among other areas of the hospital. Additionally, these masks may be used in the emergency department and the intensive care unit for bedside procedures. However, they are not suitable for use in the operating room.
Surgical masks are primarily used by OR staff and have two straps that secure the mask to the face instead of loops. They are intended to protect against a high risk of fluid exposure.
They further clarify the levels of protection for masks:
Three levels of ASTM barrier protection
ASTM International tests products to improve quality and safety. It defines more than 12,500 international standards across a wide variety of services and industries, including barrier protection standards for medical masks. Here are the three levels of ASTM barrier protection:
Level 1: low barrier protection for general use for low-risk, nonsurgical procedures and exams that do not involve aerosols, sprays and fluids. An ear loop mask is a level 1 mask. ASTM level 1 masks are the general standard for both surgical and procedural use.
Level 2: moderate barrier protection for low-to-moderate levels of aerosols, sprays and fluids.
Level 3: maximum barrier protection for any situation that has the potential for exposure to heavy levels of aerosols, sprays and fluids. Cardinal Health recommends this level as a best practice for supporting OR safety initiatives.
Health care workers who use these n95 or n100 respirators are required by law to undergo an annual fit test — a check to make sure the mask forms a tight seal on the wearer’s face so that contaminated air can’t leak in. If you are wearing one and can smell the coffee in the grocery store or the scented lotions in your office, they are not working properly.
Since we don’t do fit tests and don’t have N95s anyway the other options don’t do as much to protect the spread of the virus unless both parties wear one correctly.
Homemade facemasks are NOT considered to be PPE but the shortages of official PPE have made them popular despite them not being very effective to protect the wearer from getting the virus.
Before the pandemic, half the world’s face masks were made in China and most US companies that have converted the factories to make N95 face masks get their melt-blown fabric from China.
We have guidelines from everyone.
CDC Guide to Masks
ABMP recommendations PPE Use -says use them but not what type and recommended number of uses. Cloth masks are not official PPE and not effective from stopping one from getting the virus but they supposedly protect others from getting the virus. Face masks, surgical masks or procedural masks protect from spreading but not from getting. Wear an N95 mask if client refuses to wear one. (Make sure it is not the N95 with the valve on the front.
Federation of Massage State Boards recommendations in their Guidelines to Practice (PDF) says wear masks but not what kind, how many uses, or any specifics.
The AMA and others are saying things like “we urge you to use the highest level of PPE available when treating patients to reduce the risk of exposure. If masks and either goggles or face shields are not available, there is a higher risk for infection; therefore, the use of professional judgment is key along with knowing the patient’s risk factors.”
This is just the best way of saying our country has messed up big time and we are caught without the best protective gear so we are trying to hide that so just use your best judgement and hope/pray you don’t get sick. We do not have an adequate supply chain in place so just make toilet paper masks if you don’t have anything else.
Masks and information everywhere but what should you and your client wear?
The great mask shortage of 2020 will go down in history on our country leaders shoulders.
But what if our associations were to step up and get the correct masks and provide them for their members like the WA State Dental Association did for dentists in WA State. I have heard that ABMP members have a link to some site for a discount on N95s- the one’s that need fit tests to work properly.
The N95s are just starting to come back into the supply chain. There is also the option to purchase masks that are similar called HN95s but some of them have been found to be not as effective as they have been claimed to.
But as I researched the fit tests it was beyond me.
As far as I can tell those blue and white masks available on amazon are mainly dust masks and most say they are not meant for medical procedures. I could only find a few that actually say they are a Level 1 or Level 2 Facemask.
You can also purchase masks and other PPE on www.amazon.com/business when you have an NPI number. Click on the orange button at the top that says sign up for access.
Wearing a facemask helps others from getting the virus from you. If your client does not wear one, you will need a fit tested, N95 to protect YOU from getting it. If both are wearing a mask, it helps prevent the spread.