COVID-19 SAFETY PLAN
ProHealth’s COVID-19 Safety Plan is our commitment to keeping you and our community safe and well.
We will update this living document and our protocols as our knowledge of the virus changes, and in accordance with the recommendations by the Provincial Health Officer. If you have any questions, please discuss with your RMT.
About COVID-19 (C19)
“The new Corona virus is spread by droplets that come from the mouth and the nose. They spread from people who are infected when they cough and sneeze. And those droplets only spread about a meter to two meters. They don’t actually stay floating in the air. This is not an air-born virus. So, people who may be at risk of being exposed are people who are very close proximity to someone who is infected.
So what you can do, in order to prevent infection is to make sure that you wash your hands very regularly, especially after you’ve been in public places, with warm water and soap, for 20 seconds, and to avoid putting your hands to your face, as much as possible, because if you have virus on your hands, then you can transmit it to yourself by touching your mouth, your nose, or your eyes.”
— Dr. Eleni Galanis
“The virus is not known to be airborne (e.g. transmitted through the particles floating in the air) and it is not something that comes in through the skin.”
Good Advice from Dr. Bonnie Henry:
1. Physical distancing – Stay at least 6 feet away from other people when possible.
– Your RMT can’t stay 6 feet away while providing treatment.
2. Limit the number of people you’re exposed to – In Phase 2, we’re expanding our social interactions from about 30% to 60%, so we still need to limit the number of people we have close, prolonged contact with.
– Your RMT will probably see 4 new people every day they work (even with a decreased schedule); that is not a ‘small bubble’.
3. Being outdoors is safer than being indoors, if you’re near other people
– We work inside, in a smallish room, with the door closed, and no window to open.
This all makes the remaining points ALL that much MORE important for us making a safe, responsible, sustainable plan for returning to practice:
4. Wear a mask – Wearing a mask decreases accidental transmission of the virus from a ‘silent carrier,’ if you can’t maintain physical distancing.
5. Wash your hands frequently – for at least 20 seconds, with warm water, or using hand sanitizer if you can’t wash
6. Covering a cough or sneeze – with your elbow and/or tissue you can discard
7. If you have to touch your face – washing your hands before and after you do it.
Per the Interim Guidelines from the CMTBC, here’s how ProHealth Clinics will reopen, while taking all reasonable steps to slow the spread of C19:
INFORMED CONSENT IS ALWAYS REQUIRED
While ProHealth is taking all reasonable measures to minimize risk of viral transmission, the nature of massage therapy means that physical distancing is not possible in the treatment room.
At your first appointment, we’re required to make sure you’ve read the “Need to Know”s, had a chance to view our C19 Safety Plan, and a chance to ask any questions. When it’s clear that you understand both the risks and the potential benefits of treatment, we’ll have you sign a new Consent Form for your file, and be able to proceed to your treatment.
PRE-SCREENING – PRIOR TO ARRIVAL
- No one with signs and symptoms of illness will come to the clinic.
You must stay home if experiencing any symptoms of COVID-19, including fever, chills, cough, shortness of breath, sore throat, loss of sense of smell. If you are experiencing these symptoms and have not been tested for COVID-19, you are recommended to do so; start by calling 8-1-1.
- One day prior to your appointment, RMTs are required to contact you before you come for treatment, and to complete a short BC COVID-19 Symptom Self-Assessment with you, to clear you for your visit on the following day. We rely on you to answer the questions honestly, and will discuss the results of the assessment with you.
- If you need to cancel your appointment because of symptoms in the screening process (including simply feeling unwell), you will not be charged a cancellation fee.
For courtesy, we ask that you notify us as soon as possible.
- If you fail to show up for an appointment, and don’t notify the clinic ahead of time, regular no-show fees will apply, as outlined in our fee schedule.
- RMT and clinic staff will also use the BC COVID-19 self-assessment tool daily, and stay home/cancel appointments if experiencing COVID-19 symptoms.
SCREENING UPON ARRIVAL
- Upon arrival, the RMT will run through the same self-assessment tool with you, again – to confirm safety and trust in moving forward.
- The RMT shall cancel treatment if you don’t meet the pre-screening criteria on physical presentation at the clinic.
- Pre- and during clinic visit: You should feel empowered to make your own decision on what you need to feel safe, in order to receive treatment.
AT OUR BUILDING
- Building management has designated the front door (facing Fifth Avenue) as the Entrance to the building, and the door that leads to the parking lot as the Exit, to limit congestion during busy times.
- We have 2 elevators in the building, both are limited to 2 people at one time.
Depending on when you arrive, there may be a short wait.
- For those who are inclined and able, the stairs are a great option.
The stairwell by the elevators has been marked as one for up, and there’s another for down.
- Immediately upon arrival at the 6th floor, enter the public washroom and wash your hands for at least 20 seconds.
WASHROOM FOR PATIENT USE
- The keys for the washrooms are in the doors, now; there is no longer a need to come borrow one from our front desk.
- Please use a paper towel to open the bathroom door as you exit it. There will be a trash bin in the hallway for your paper towel, before you enter ProHealth.
- Washrooms are cleaned and stocked by maintenance at least once a day, and will be cleaned/disinfected additionally by ProHealth and Sparrow Massage Therapy during the day.
- You and your RMT must maintain 2 metres / 6 feet of distance in clinic areas other than the treatment room, as best as possible within the practice setting.
- Our schedules have staggered appointment start- and end- times, which limit your exposure to other people in the clinic.
- Unless otherwise discussed with your RMT prior to arrival, you must arrive alone.
- Although we love that you enjoy the atmosphere in our waiting room, for this phase of returning to activity, we ask that you try to be no more than 5 minutes early for your appointment.
Ideally, your therapist will be waiting for you at the front desk, and lead you straight to your treatment room, after you’ve washed your hands in the public washroom.
- We will not be able to provide tea or water for the foreseeable future. If you’re likely to be thirsty during your visit, please bring your own beverage in a closed container.
- There is room for two people to physically distance in the waiting room, and in the unlikely event that the waiting room is ‘full’, there are tape marks in the hallway for responsible waiting.
- Please allow your RMT to touch the door handles of the treatment room for you.
- It is not possible to maintain physical distancing in the treatment room.
- Please limit what you bring into the clinic; if there are bags or coats you’re safely able to leave in your vehicle, please do.
- Pre-screening, physical distancing, hand hygiene, and enhanced cleaning help reduce the risk of transmission, and enable return to practice while minimizing risk of harm.
HUGGING & HAND SHAKING
- Until further notice, there will be no hugging or hand shaking between any of the ProHealth Team and the public.
- As previously mentioned, you’ll wash your hands upon arriving on the 6th floor, with soap and water for at least 20 seconds, followed by thorough drying.
- Clinic rooms that do not have sinks have a sanitation station with alcohol-based hand rubs for use as required (need to touch your face, or use a tissue for nose).
- RMT have always washed their hands often, using soap and water for a minimum of 20 seconds each time, and will continue to do so.
- Receipts will be emailed unless a paper copy is requested. Cash is not preferred but may be handled provided that anyone doing so washes their hands immediately afterwards.
FACE TOUCHING AVOIDANCE - e.g., avoid touching eyes, mouth, nose
- We’ll have a brief discussion to make sure it’s clear why ‘no face touching’ is a good policy (unless you wash your hands before and after); coronavirus can be spread by touch if a person has used their hand/s to cover a cough or a sneeze, or if they’ve touched something with fresh droplets, and then touches their own eyes, nose or mouth.
- Tissues have always been available for patient’s use in reception and each treatment room.
- Should you need to use a tissue to blow your nose or sneeze
- If possible, notify your therapist in advance of the actual sneeze
- We will provide a clean flannel towel for you to place your mask on, pass you tissues (by grabbing the whole box, and moving them within your reach).
- We will have a plastic bag in the room for your used tissues.
- After using the tissues, you will sanitize your hands again, replace your mask, and treatment will resume.
- We are using Spray Nine and a diluted bleach solution for cleaning and disinfecting the hard surfaces in the clinic, including all high-touch surfaces in between patients, regardless of appearance.
- Linens have always been single use only, and are laundered in hot soapy water.
- Frequent cleaning and disinfecting common areas and high touch surfaces, at least twice a day, e.g. light switches, window coverings, cell phones, tablets, chairs, stools, table surfaces. We have a cleaning schedule posted in the kitchen.
- We have scheduled additional time between patients to thoroughly clean our treatment rooms.
- We sanitize the treatment table, table adjustment levers and headrest after each treatment.
- We clean equipment and supplies (table levers, lotion bottles, etc.) immediately after each patient.
PERSONAL PROTECTIVE EQUIPMENT (PPE)
- Masks will be the primary form of personal protective equipment used at ProHealth.
- Until otherwise indicated by the Provincial Health Officer, ProHealth recommends (and we require) all people in the clinic to wear a mask over their mouth and nose, to limit the transmission of respiratory droplets, for the wellbeing of the entire ProHealth community. Some people who come for treatment have less robust immune systems; something that might only manifest mild symptoms for one person could have a devastating effect on other people who also benefit from massage therapy. We understand that masks are new to many of us, and ask for your patience, kindness, and consideration while we try to keep everyone safe.
- Please bring your own mask with you – paper or cloth – something that will be comfortable for you to wear for the duration of your time in the clinic.
- This will be discussed with you in our pre-screening phone call with your RMT, the day before your appointment. Dr. Henry advises that people in B.C. use a mask when they’re in public and unable to physically distance. Since you’re coming to the clinic, we assume you’re prepared to have brief distancing challenges (as with grocery shopping), and have your own mask. Please bring it with you, and wear it over your nose and mouth for the time you’re in clinic. The only stipulation we have is that your mask Not have an exhalation valve on it (because that would allow your droplets to escape, and defeats the purpose of wearing it). If you have questions about mask wearing, please discuss it with your RMT at the time of your screening.
- Your RMT will also be wearing a mask.
I cannot emphasize enough that this is one of the few tools available to us, as RMTs who are in close contact with people, in a small room, for hours during the day. We can wash our hands, and clean like crazy, but if an asymptomatic carrier (no noticeable symptoms) comes into the clinic without a mask – droplets go everywhere, and the mask does not protect the Wearer, so that puts the RMT at risk of contagion. If we get sick, we can’t work. And you can’t get treatment; nobody wants that. This requirement will probably change over time, but for now – please help us. Mask up!
- It’s best practice to wash your hands both before putting a mask on, and after taking one off.
- Some clinics are using face shields, goggles and gloves during treatment. Please discuss this with your RMT, before you come for treatment.
PROHEALTH'S PROFESSIONAL OBLIGATIONS
No duty or obligation to return to practice:
- A return to practice protocol does not require RMTs to engage in practice if they individually assess the risk of practice as one they are not prepared to take.
- The decision to return to practice is a matter of individual judgment and requires following the guidance of CMTBC and governmental authorities
Patient alleges they caught COVID-19 from RMT:
- The RMT must immediately call public health at 8-1-1 and report the alleged transmission, providing both the RMT’s name and the name and contact information of the patient.
- The RMT must not provide any further massage therapy treatment to anyone until public health has investigated and has provided direction.
- The RMT must immediately self-isolate until the matter has been investigated and public health direction has been provided.
- If the RMT is working in a team setting, it is the RMT’s duty to immediately inform his or her colleagues of transmission risk.
What about asymptomatic spreaders?
- This is an unavoidable risk of practice until there is either an effective treatment or an effective vaccine against COVID-19.
- RMTs’ return to practice protocol has elements that mitigate risk:
- screening – An RMT can screen not only for symptoms, but for contacts, e.g., has the patient isolated within a restricted “bubble,” and if so for how long? Has he or she had extensive contact with individuals outside his/her immediate family, pod or unit (other than service workers at grocery stores, banks, other)? Is the patient aware of anyone in their contacts who has COVID-19 symptoms? The RMT should be prepared to share this information about themselves, as well.
- related is the question of trust – how well does the RMT know the patient – and trust the patient to have been prudent and cautious? Ethical practice requires that RMTs honour patients’ trust in their RMT – the trust relationship goes both ways.
- very strict adherence to hand hygiene, by RMT and by patient
- The risk remains, which is why the informed consent discussion at the outset of treatment is critically important.