COVID-19

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

This plan was developed based on recommendations from the College of Massage Therapists of British Columbia and Using Provincial Guidelines with the goal of reducing the risk of exposure to the virus that causes Covid-19 for both patients and the practitioner within our clinical setting. Here, we identify the actions that the practitioners at Holistic Healing Complete Manual Therapy commits to, and that all visiting patients must commit to in order to resume massage therapy/Osteopathy services.

The overall aim of these protocols is to reduce potential coronavirus transmission by:

• Requiring ongoing self-assessment for signs of Covid-19 related illness in both patient and therapist
• Reducing all physical, non-treatment related interactions amongst all people within the practice environment
• Hand hygiene requirements
• Avoiding face touching
• Enhanced cleaning protocols
• Appropriate use of personal protective equipment (PPE)
• Meeting professional obligations, particularly related to informed consent and liability insurance

Self Assessment for Symptoms of Covd-19: For Patients and Therapists

Pre-Screening/Prior to Arrival

A link to this document will be placed on the website, and the online booking software will send them a link to self-assessment and consent information with their reminder emails.

• One day prior to their booked appointment, the patient will be required to complete the online BC COVID-19 Symptom Self-Assessment tool and to inform their therapist of their requirement to stay home if they experience symptoms of COVID-19
• The tool can be found here: Https://bc.thrive.health/covid19/en
• The therapist will phone their patient one day before their booked appointment to verify that pre-screening has been done and discuss any concerns.
• The therapist will use the self-assessment tool themselves daily and commits to cancelling all appointments if symptoms appear.
• Symptoms of Covid-19 are similar to other respiratory illnesses and seasonal allergies. An appointment must be cancelled immediately if either the patient or the therapist presents with 2 or more of even mild symptoms that may be signs of Covid-19 including:
  • Fever
  • Cough
  • Chills
  • Shortness of breath
  • Sore throat or pain with swallowing
  • Stuffy or runny nose
  • Loss of sense of smell or taste Headache
  • Muscle ache
  • Fatigue
  • Loss of appetite
• Covid-19 symptoms may range from mild to severe. Patients and therapists are required to cancel appointments if they experience what they determine to the ‘just the sniffles’, ‘seasonal allergies’, or ‘just feeling under the weather’.
• As part of the consent form, patients must commit to understanding that while we are taking all possible measures to minimize the risk of viral transmission, the nature of massage therapy/Osteopathy means that physical distancing is not possible in the treatment room.
• In order for massage therapy/Osteopathy treatment to commence the therapist and patent must agree that the therapeutic benefit of massage therapy/Osteopathy outweighs any potential consequence of treatment, including the possibility of viral transmission.
• Patients must confirm that they have not been in contact with anyone displaying illness or signs and symptoms of Covid-19 within 14 days prior to their treatment for each treatment.
• Patients with higher risk profiles and/or weakened immune systems should consider alternatives for care and postpone treatment
• Patients who develop even mild symptoms or illness should cancel booked appointments, even with no notice.
• Late cancellation fees will be waived for cancellation due to sickness during this time
• Please come from your home directly to the clinic without stopping at other businesses on your way. Leave all non-essential items in your car, such as coats, bags, cell phones, sunglasses. Cell phones are not to be used or touched once you enter our space to reduce the risk of viral spreading.

Upon Arrival:

• Please be on time for your appointment, not early and not late. Any patients more than 10 minutes late for their appointments will be considered a no show and missed appointment fees will be charged.
• Patient will wait outside in their vehicle until the therapist comes to bring them into the clinic. The therapist will open all doors.
• Therapists and patients will be required to wear masks.
• Patient will be provided hand sanitizer before entering the treatment room and are to go directly into designated treatment room.
• Therapists have access to masks, gloves, goggles and aprons should the patient or therapist feel this equipment is necessary for their protection. However the therapist reserves the right to cancel the treatment at any time for the protection of everyone.
• The treatment will be cancelled immediately if the patient does not meet the pre-screening criteria upon physical presentation at the clinic.
• Only 1 patient is permitted in the common clinic space at a given time. Patients must arrive unaccompanied.      
  • Minors must be of age to be able to arrive and attend appointment alone.
• The therapist will exercise all distancing protocols within the clinic space with other therapists and all patients.
• The therapist and the patient will both maintain a space of 2 meters (6 feet) distance between each other in all clinic areas outside the treatment room.
• Couches, chairs, tables and counters are not to be used at this time.

Within the Treatment Room:

• Personal items will be placed in the bin provided inside the treatment room, this bin is disinfected between each patient.
• Therapist and patient will discuss their self-assessment results before any further assessment or treatment is performed.
• The patient and therapist acknowledge it is not possible to maintain physical distancing while in the treatment room and assume any risks associated by agreeing to continue with the treatment.
• Payment for service will occur prior to treatment and touchless methods or payment are preferred. Receipts will be emailed.
• Rebooking will not occur in the clinic at this time in the common areas, please discuss the best method for rebooking with your therapist.
• Patient must use the hand sanitizer provided after their treatment and proceed to leave the clinic space immediately to allow the therapist sufficient time to sanitize for the next patient.
• All high touch areas will be disinfected between patients.

Restrooms:

• At this time there will be no patient access to restrooms. Patients should make sure they take care of restroom needs prior to arrival for their appointment.
• If the patient requires use of the restroom in an emergency situation they take full responsibility of the risk of viral transmission in areas not under Heritage Hills Complete Manual Therapy’s control.

Hygiene:

• As usual therapists will wash hands with soap and water for a minimum of 20 seconds prior to and post massage/Osteopathy treatment, before and after putting on/taking off PPE and handle doorknobs with a cloth.
• Therapists will not touch their hair or faces during the massage/Osteopathy treatment.
• Handwashing, cleaning and mask protocols will be visibly posted.
• The therapist will communicate with the patient that coronavirus can be transmitted by touch if droplets are on the hand when it touches the face, as it can transfer those infected droplets to the mouth, nose or eyes.
• Tissue will be available throughout the clinic: in the common areas and treatment rooms in order that patients and the therapist may use tissue to address an itch and/or touch the face for any other reason.
• If a patient has an itch during treatment they will be provided with a tissue rather than touching their faces directly.

Enhanced Cleaning Protocols:

• Surfaces will be cleaned and then disinfected with a Canada Health Approved for use against Covid-19 disinfectant as listed here: https://www.canada.ca/en/health-canada/services/drugs-health-products/disinfectants/covid-19/list.html
• Additional time has been scheduled between patients to allow for thorough cleaning of the treatment room and commonly touched areas.
• Common areas will be cleaned and disinfected at least twice a day.
• All high touch areas will be disinfected between patients, including:
  • Doors and doorknobs, debit machine, electronic devices, chairs, counters, faucets,
  • Treatment table including table top and sides, legs, adjustment levers, floor beneath the face cradle, stool and face cradle,
  • Lotion bottle and any tools used during treatment,
  • Bins used to hold patient’s belongings during treatment.
• All linens used are single use and will be laundered using hot water and detergent between each use.
• No hydrotherapy supplies, table warmers or covers will be used until further notice.

Personal Protective Equipment:

• The therapist will wear a face mask at all times when with patients
• The therapist will additionally wear goggles and/or apron if this is deemed required or requested by the patient.
• Patients are required to wear a mask during their entire time in the clinic and specifically required to wear a face mask for face up treatment.
• The therapist will wear non-latex gloves if/when appropriate.
  • Gloves may be appropriate when over-use of cleaning and/or chemicals causes skin irritation, or when the therapist’s hands or skin of the hands are otherwise inured.
  • Hands will be washed prior to putting the gloves on and immediately after removing them.
  • Gloves will be worn by the therapist during treatment at the patient’s request.

Professional Obligations:

• The therapist is following all the health and safety guidelines outlined by the Registered Massage Therapists Association of BC, the College of Massage Therapists of British Columbia and the Provincial Health Officer and that they are taking all reasonable precautions to clean and disinfect the clinic and all the surfaces within the treatment room.
• No guarantees have been made by the therapist, that the patient may not come in contact with COVID-19 at or during an appointment.

Liability Insurance:

• Each therapist carries professional liability insurance

Covid-19 Transmission:

• In the event that a patient alleges they caught Covid-19 from the therapist:
  • The therapist will immediately call public health at 8-1-1 to report the alleged transmission, providing both the name of the RMT and the name and contact details of the patient – The patient must agree to the release of information in order to receive treatment.
  • All massage therapy/Osteopathy appointments will be cancelled and the therapist will cease to provide services until Public Health has investigated and provided direction.
  • The therapist will self-isolate until Public Health has provided further direction.
  • The clinic will be closed until further instruction by Public Health
• ·In the Event That a Patient Tests Positive for Covid-19 Having Been to a Massage Therapy/Osteopathy Appointment within the 14-days Prior to Onset of Symptoms
  • The patient will contact the therapist and inform her of positive test results and possible transmission of the virus immediately.
  • The therapist will immediately self-isolate.
  • The therapist will call public health at 8-1-1 to report the possible transmission and act on direction of Provincial Health.
  • The clinic will be closed until further instruction by Public Health
• ·In the Event That the Therapist Catches COVID-19 or Displays Symptoms of Covid-19
  • The therapist will immediately self-isolate.
  • The therapist will call public health at 8-1-1 to report the symptoms and request access to Covid-19 testing.
    • If testing is granted:
      • All massage therapy/Osteopathy appointments will be cancelled and the Therapist will cease to provide services until test results are returned negative.
      • If testing proves positive the therapist will follow Public Health directives in informing patients treated over the previous 14 days about potential transmission.
    • If testing is not granted:
      • All massage therapy/Osteopathy appointments will be cancelled and the Therapist will cease to provide services for a minimum of 10-days beyond the onset of symptoms, and/or until symptoms cease.
  • The clinic will be closed until further instruction by Public Health
• ·In the Event That the Therapist Comes into Close Contact with Someone Showing Signs of Illness or Tests Positive for Covid-19
  • The therapist will immediately self-isolate.
  • All massage therapy/Osteopathy appointments will be cancelled and the therapist will cease to provide services until:
    • The close contact has been tested for Covid-19 and the results proved negative and the therapist is well,
    • OR after self-isolating for 14 days and having no symptoms of fever develop.
    • OR being cleared by a public health official.
• Asymptomatic Carriers:
  • Asymptomatic transmission of COVID-19 is an unavoidable risk of practice until we have acquired herd immunity or there is an effective treatment or vaccine
  • We have put into place protocols to help mitigate that risk but 100% certainty is not possible.
  • No guarantees have been made by the therapist, that the patient may not come in contact with COVID-19 at or during an appointment

Informed Consent:

In the current environment of COVID-19 risk, informed consent requires that the patient be informed and understands that:

• Any massage therapy/Osteopathy treatment involves some risk of Covid-19 transmission,
• The therapist is following protocols set out by their regulatory board and approved by the Ministry of Health to help reduce or mitigate risk where possible, but that risk cannot be reduced to zero,
• The patient consents to the treatment despite some risk,
• The patient consents to follow safety protocols outlined in this document and safety instructions given by the therapist,
• And, the RMT/Manual Osteopath will document the patient’s consent in advance and at every treatment.