covid-19 reopening plan

COVID-19 Reopening Plan at Harbour Massage Therapy 

We’re pleased to be able to begin offering massage therapy treatments again. Navigating this virus and reopening paramedical healthcare is something that will require a calculated process, and you may notice that things are looking a little different at Harbour Massage Therapy. Our intention with the following “Reopening Plan” is to be able to provide much needed therapy while maintaining safe practices and minimising the risk of exposure to COVID-19.
Upon reopening, the following procedures will be implemented. We recommend you read through the information below and contact us if you have any questions. It is important to understand the risks associated with receiving treatment are at this time, and what we can and will do to mitigate those risks.

THERAPIST COVID SCREENING:
All of the RMTs at Harbour Massage Therapy will conduct self-screening before coming in to work each day. We will not go to work if we are not feeling well, even if our symptoms are mild and we are uncertain of whether it is COVID-19 or not. Should we need to miss work we will contact our patients scheduled for that day ASAP to reschedule their appointments. Should we develop any symptoms of illness we will call our family physician, a walk-in clinic or public health unit, complete the COVID-19 self-assessment (https://bc.thrive.health/covid19/en), or call 811 and follow their instructions. If we test negative but are still unwell we will stay at home until we are better. If we test positive for COVID-19 we stay away from work for at least 10 days beyond the onset of symptoms, AND until the fever is gone without medication, AND we are feeling better AND we have been cleared by a public health official. In the event that one of us should test positive for COVID-19 we will contact our patients to inform them to monitor for symptoms. We will follow the instructions of public health officials including instructions to self-isolate if necessary: http://www.bccdc.ca/Health-Info-Site/Documents/Self-isolation.pdf
If a close contact, a spouse, or someone we live with becomes ill we will stay home and self-isolate with our family. We will follow the instructions from the BC Centre for Disease Control: http://www.bccdc.ca/Health-Info-Site/Documents/Self-isolation_caregivers.pdf. We will only return to work once our close contact has been tested and results for COVID-19 come back as negative and they are well OR after self-isolating for 14 days and having no symptoms or fever develop OR being cleared by a public health official.

PATIENT COVID SCREENING:
1.  Via a mandatory COVID-19 Pre-Screening Survey sent to you via email 24 hours prior to your appointment with a link to the BC COVID-19 Symptom Self-Assessment Tool which you will be required to complete. This MUST be completed at least 2 hours prior to your appointment.
2. When you first enter the treatment room

PROTOCOL UPON ARRIVAL FOR YOUR APPOINTMENT:
1. Do not arrive more than 5 minutes prior to your appointment time 
2. You will be required to remove your shoes and have the choice of putting on a pair of freshly disinfected slippers upon entering the practice space.
3. You will be required to use hand sanitiser upon your arrival
4. You will be encouraged to wear a mask during the treatment and have the choice of wearing your own cloth or paper mask or using a paper one that we will supply for $2. The face cradle will be covered with a pillow case to allow you to remove your mask while lying face down. 
5. Your massage therapist will conduct a COVID-19 screening with you 
6. Your massage therapist will discuss informed consent surrounding COVID-19 exposure risk with you and you will be required to sign an informed consent form
7. When possible, we will maintain a distance of 6 feet between us
8. You will be reminded of the importance of avoiding face-touching as coronavirus can be spread by touch if a person has used their hands to cover a cough or a sneeze. We suggest that you use a tissue if you have an itch must be addressed; we have tissues on-hand at all times.

TREATMENT ROOM CONSIDERATIONS:
The following considerations have been implemented: 
• A waterproof barrier has been added on the treatment table covering the table heater to provide a layer that can be disinfected
• As always, dirty linens are kept in a separate closet from clean linens and dirty linens are regularly sent out to be professionally laundered
• In addition to the fresh set of linens that you are accustomed to on the treatment table, you will also be provided with a freshly laundered blanket for your treatment 
• The wicker patient chair in the treatment room has been replaced by a plastic chair
• There are now a dedicated plastic bins for your possessions and you will be encouraged to use them or the patient chair to store your belongings and to avoid using hooks to hang your clothes 
• Non-porous surface covers for all bolsters, pillows, heating pads, for easy cleaning.
• Room dividing curtains now have curtain rods in place so they can be drawn and opened without touching the fabric
• Reusable cups have been replaced with disposable cups that are kept in an enclosed container 
• Clutter that cannot be washed/wiped and sanitised has been removed from the treatment space. 
• All pillows, linens and items that are not being used for the treatment in question are enclosed in a cabinet or plastic bag

CLEANING SUPPLIES  AND EQUIPMENT:
• We use Cavicide, a hospital-grade disinfectant that is known to be effective against COVID-19: https://www.metrex.com/en-ca/news/2019-novel-coronavirus-outbreak-canada 
• Hand sanitiser (70% alcohol) readily available 
• Hand soap  
• Paper towels for drying hands after washing and for disinfecting with Cavicide 

THERAPIST INFECTION CONTROL PRACTICES:
From a risk management perspective therapeutic treatment takes place in an enclosed space where the therapist and patient are unable to socially distance. No in-person appointment is risk-free even if the patient and massage therapist appear well. As such we will attempt to minimise the risk via the following requirements:

CLEANING PROCEDURE:
Appointments have adequate cleaning time scheduled in between. Between every appointment we will use Cavicide disinfectant spray and paper towels to disinfect the entire treatment room’s touch surfaces including:
• Office door handle inside and out
• Cabinet handles
• Desk, devices (including computer, tablet, phone etc), pens used
• Practitioner stool
• Massage table with special attention to the headrest and table legs near the headrest
• Patient chair
• Bins for patient belongings
• Water cooler
• Faucet/sink
• Closet handles
• Curtain rods on room-dividing curtains 
• Practitioner oil bottle 
• Bathroom keys and keychains 
• All pillows touched during the preceding treatment 
• Rubber slippers used by patient 

• Any other surfaces touched by the RMT or the patient during the preceding treatment 

PERSONAL PROTECTIVE EQUIPMENT (PPE):
• Procedural/surgical or cloth masks changed between treatments
• Depending on comfort (we will have this available for use if requested): Safety glasses/goggles or shield
• Depending on comfort (we will have this available if requested): Bibs, clothing covers, scrubs, or changes of clothes to be changed between treatments.
• Depending on comfort (we will have this available if requested): Gloves

ADDITTIONAL MEASURES:
• Hands will be thoroughly washed for at least 20 seconds with soap and water before and after treatment and hand sanitiser will be used regularly by the RMT

ADMINISTRATION:
Due to the extraordinary circumstances we find ourselves in, no charge of penalties will be levied for cancelled appointments due to patient illness, or due to the patient being denied treatment in the screening process. There will still be a charge of fees for an appointment missed with no notice or explanation of the reason, and for reasons other than illness or genuine emergency.

Because of the extra financial burden these measures have placed on us, we will be adding a $3 + GST per-treatment COVID surcharge for the duration of the additional infection control requirements. Once the threat of COVID has passed this surcharge will be dropped. 

References:

CMTBC Interim Guidelines for Return to Practice: https://cmtbc.ca/registrants/interim-guidelines-for-return-to-practice/  
Metrex Products Cavicide for COVID-19: https://www.metrex.com/en-ca/products/surface-disinfectants/cavicide  
BC Centre for Disease Control COVID-19 Symptoms: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/symptoms  
BC COVID-19 Symptom Self-Assessment Tool: https://bc.thrive.health/covid19/en