Plan for Return to Clinical Practice in Respect of COVID-19

This plan details the protocols implemented with the goal of minimising the risk of exposure to the virus that causes COVID-19.  It will identify the actions I commit to, and that all visiting patients must commit to, in order to resume massage therapy treatments.  For the remainder of this document I will refer to myself as ‘therapist’.

Please note, these protocols may change when required to reflect any new guidance being provided by the BC Centre for Disease Control (BCCDC), the Provincial Health Officer (PHO), and WorkSafeBC.  All patients will be notified of any changes prior to treatment.

The aim of these protocols is to reduce potential virus transmission by;

• On-going self assessment for signs of illness related to COVID-19 of both patient and therapist.
• Reducing non-treatment time in the treatment room
• Hand hygiene requirements
• Avoiding face touching
• Enhanced cleaning protocols
• Use of Personal Protection Equipment
• Meeting professional obligations regarding informed consent

This plan will clearly explain what the practice environment will look like in terms of;

• Pre-screening and self assessment for symptoms
• What to expect upon arrival
• Use of Personal Protective Equipment
• Hand hygiene
• What to expect inside the treatment room (physical changes and enhanced cleaning procedures)
• What to expect post treatment
• Schedule changes
• Professional obligations

How COVID-19 Spreads

Health experts believe that Coronavirus is transmitted via liquid droplets when a person coughs, sneezes or talks within proximity.

• It is believed COVID-19 spreads when infected droplets reach the eyes, nose or mouth
• The virus is not known to be transmitted through airborne transmission
• It does not transmit through the skin
• It can be spread by touch if a person has used their hands to cover their mouth or nose when they cough or sneeze
• It can be spread by people not showing any symptoms

Preventative measures

• Wash hands often, with soap and water for at least 20 seconds esoecially after being in a public place, coughing, blowing your nose or sneezing
• If soap and water are not available a hand sanitizer containing at least 60% alcohol can be used
• Avoid touching your eyes, mouth and nose with unwashed hands
• Clean and disinfect high-touch surfaces regularly
• Keep 2 meters apart

Self Assessment for Symptoms of COVID-19 for both Therapist and Patient

• Therapist will undergo daily screening for any mild illness symptoms and will stay home if necessary
• The patient will be prompted to complete an online screening questionnaire at the time of booking, the therapist will call the patient for verbal screening 1 day prior to the appointment.  Upon arrival the patient will be asked to complete and sign a paper form of the BC COVID-19 Self Assessment Tool. This can be found here: BC COVID-19 Self Assessment Tool
• Appointments must be cancelled if either the therapist or patient presents with even mild symptoms that could be related to COVID-19 including;
  • Cough
  • Stuffy or runny nose
  • Fever
  • Chills
  • Sore throat
  • Loss of sense of taste and/or smell
  • Headache
  • Fatigue
  • Loss of appetite
• Please do not downplay any symptoms. COVID-19 can present mildly or severe and mimic seasonal allergies or cold symptoms
• As part of the online screening questionnaire, patients will be required to acknowledge and sign that although all precautions are being taken to minimise risk of transmission, this risk cannot be reduced to zero
• Treatment cannot proceed until this has been signed. This risk will also be discussed and agreed upon during the appointment prior to treatment
• Patients who are immunocompromised or above the age of 65 should consider postponing treatment at this time
  • Patient and therapist must both agree that the benefits of treatment outweigh the risks involved before treatment can commence
• Patients who cancel appointments due to symptoms will not be charged any cancellation fee

Upon Arrival

• The patient is advised to wait in their vehicle until the time of their appointment
• Only 1 patient is allowed in the treatment room at one time. Patients must come unaccompanied
• The patient will be required to wash their hands upon arrival to the treatment room
• The patient must confirm they have no symptoms and have completed the Self Assessment tool, the Therapist will do the same
• Masks will be worn by both the therapist and patient.  Patient is required to bring their own mask but there will be one available to them when needed.  The therapist will change masks between each appointment

Personal Protective Equipment

• It is required that both the patient and therapist wear a mask
• The only time the patient can remove the mask is when laying face down, the therapist will keep the mask on for the full duration.  As we cannot continue physical distancing in the room, masks are required
• Patients are asked to bring their own clean mask; however, one will be supplied to the patient when needed
• The therapist will wear a surgical/procedural mask and change it between appointments
• The therapist will wear gloves and/or safety glasses if that is preferred by the patient

Hand Hygiene

• The therapist will continue to wash hands before and after each appointment
• The therapist will use gloves to touch soiled linens and will wash hands after
• The patient is required to wash hands upon arrival and departure
• Hand washing posters will be posted in the bathroom
• Freshly washed hand towels will be available for each patient, paper towels are also available to use as a barrier when opening or closing the door

Inside the Treatment Room

Please be aware it is impossible to practice physical distancing inside the room. The following actions are to minimise risk where possible.

• The therapist will clean and disinfect all high-touch surfaces between appointments. This will include the following.
  • Massage table
  • Stool
  • Desk
  • Patient chair
  • Bathroom door handle and door frame
  • Bathroom taps, soap dispenser, toilet paper dispenser and toilet
  • Lotion bottles
  • Treatment room door handle and door frame
  • Shelving and items on shelves
• The disinfectant used is approved by the government of Canada to be effective against COVID-19
• A checklist will be posted in the room confirming all items have been sanitised between patients
• The floor will be vacuumed and mopped at the end of each day
• All soft furnishings, including décor, will be removed if it cannot be wiped clean
• The patient will be asked to put clothes in a sanitized plastic bin for the duration of the treatment
• All laundry will be placed in a non-porous bag inside a hamper with a lid
• There will be a non-porous table cover over the warming pad
• The use of any other heating pad will cease
• Paper towels will be available to use as a barrier when opening the door at the end of treatment, there will be a hands-free waste bin near by to dispose of the paper towel easily
• An air purifier will be placed in the room

Post Treatment

• Both the therapist and patient will wash hands after the treatment
• Once the patient is dressed, paper towels will be available to use when opening the door
• Home care advice will still be given when appropriate, however, booking appointments is encouraged to be done online to minimise non treatment time in the room
• Please provide any direct billing information via email
• All payments will continue to be taken online

Scheduling Changes

• The time between appointments has been increased from 15 minutes to 30 minutes to ensure adequate time for extra cleaning
• The number of clients seen in a day is reduced to limit exposure for the time being

Professional Obligations

Insurance

• The therapist carries professional Liability Insurance through Wilson M. Beck as provided through the Registered Massage Therapist Association of BC

In the Event a Patient Tests Positive for COVID-19 Having Been to a Massage Therapy Appointment within 14 days Prior to the Onset of Symptoms

• The patient must contact the therapist disclosing the positive result immediately
• The therapist will self-isolate

In the Event a Patient Alleges they Caught COVID-19 from the Therapist

• The therapist will immediately call 811 to report the alleged transmission, providing the therapists name and contact details of the patient. 
  • The patient must agree to the release of information.
• All appointments will be cancelled, and the therapist will self-isolate until Public Health has investigated and provided direction

In the Event the Therapist Shows Symptoms of COVID-19 and Tests Positive

• The therapist will immediately self-isolate and all appointments will be cancelled.

Asymptomatic Spreaders

Asymptomatic spread of the virus is an unavoidable risk until there is an effective vaccine against COVID-19.

Informed Consent

In the current environment of COVID-19, informed consent requires the patient to be informed and understands the following.

• Any massage therapy treatment involves some risk of COVID-19 transmission
• The therapist is following strict protocol to mitigate risk where possible, but that risk cannot be reduced to zero
• The patient consents to treatment despite some risk
• The therapist will document the patients consent in advance and at every treatment