Plan for Return to Clinical Practice in Respect of Covid-19
*Subject to change without notice*
This plan was developed with the goal of reducing the risk of exposure to the virus that causes Covid-19 for both patients and therapist within the clinic setting. This document identifies the actions that Lyrical Wellness and all visiting patients must commit to, in order to resume treatment services during this time.
“Coronavirus is transmitted via liquid droplets when a person coughs or sneezes. The virus can enter through these droplets through the eyes, nose or throat if you are in close contact. 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. It can be spread by touch if a person has used their hands to cover their mouth or nose when they cough. That’s why we recommend you cough or sneeze into your arm and wash your hands regularly.”
The overall aim of these protocols is to reduce potential Coronavirus transmission.
Self-Assessment for Symptoms of Covid-19 – For Patients and Therapist
Pre-Screening / Prior to Arrival:
- Patients will be informed about their responsibilities at the time of booking. A notice will be placed on the website and the online booking software will send patients a copy of these protocols as part of a Covid-19 specific consent form.
- Patients are required to review and sign this form electronically prior to arriving in order to keep their appointment.
- 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 stay home if they experience any symptoms of Covid-19.
o The tool can be found here: https://bc.thrive.health/covid19/en
- Therapist will contact the patient prior to their appointment as booked to discuss using the self-assessment tool, and to verify that it has been done.
- Therapist will use the BC COVID-19 Self-Assessment tool daily, and commit to cancelling all appointments if symptoms occur.
o Symptoms of Covid-19 are similar to other respiratory illnesses and seasonal allergies. An appointment must be cancelled immediately if either the patient or therapist presents with even mild symptoms that may be signs of Covid-19, including:
- Shortness of breath
- Sore throat or pain with swallowing
- Stuffy or runny nose
- Loss of sense of smell
- Muscle aches
- Loss of appetite
- Covid-19 symptoms may range from mild to severe. Patients are required to cancel appointments if they experience what they determine to be ‘just the sniffles,’ ‘seasonal allergies’, or ‘feeling under the weather’ on the day of their appointment.
- 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.
- The patient will be required to sign (electronically) a consent and liability waiver with respect to Covid-19 prior to every appointment.
- As part of the consent form, patients must commit to understanding that while we’ve taken all possible measures to minimize risk of viral transmission, the nature of treatment means that physical distancing is not possible in the treatment room.
- Patients with higher risk profiles and/or weakened immune systems should consider alternatives for care and postpone treatment.
- The patient and therapist must agree that the therapeutic benefit of their treatment outweighs any potential consequence of treatment, including the possibility of viral transmission.
- Patients who develop even mild illness or symptoms must cancel booked appointments, even without notice.
Upon Arrival / Pre-Treatment:
- The Therapist will advise the patient of their current results from online BC COVID-19 Symptom Self-Assessment tool.
- Patients will be asked to confirm their own current results from online BC COVID-19 Symptom Self-Assessment tool.
- Patients must confirm that they have done a pre-screening and have no signs of Covid-19 as outlined here: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about-covid-19/symptoms
- Masks must be worn at all times within the clinic space. If the patient has a mask, they are asked to bring it with them and wear it when they arrive. If they do not have a mask, a single-use mask will be provided and they will be asked to wear it upon entering the clinic space.
- Patients must confirm that they have not travelled outside British Columbia within 14 days prior to their appointment.
- The treatment will be cancelled immediately if the patient does not meet the pre-screening criteria upon physical presentation at the clinic.
Entering and Exiting Clinic Space:
- Patients are asked to arrive no earlier than 5 minutes for their appointments.
- Appointment times are scheduled to reduce the potential of patients crossing paths, and to allow for time in-between sessions for enhanced cleaning.
- Patients buzz in and enter at the front of the building as usual but leave through the side door that is located next to the door into Lyrical Wellness.
- Patients are required to wait in the waiting area outside the treatment space until the therapist comes to the door to call them in.
- The bench in the waiting area has been removed as have the fabric seat covers and couch it the treatment room.
- Please avoid unnecessary touching of items or fixtures.
- The patient will be required to use hand sanitizer upon arrival as well as other times throughout the appointment.
- Please note that if hands are noticeably dirty they must be washed with soap and water for at least 20 seconds and then dried.
- Only 1 person is permitted in the clinic space with the therapist at any given time. Patients must arrive unaccompanied. If a patient requires a chaperone, for physical or mental assistance, or to translate it is suggested that they postpone massage therapy at this time.
- The therapist and the patient will both maintain a space of 6ft distance between each other except during the treatment when that is not possible.
- The clinic door will be opened for the patient by the therapist and will be locked behind them to prevent anyone else from entering the space during the course of the treatment.
- At the end of the appointment the clinic doors will be opened by the therapist for the patient to leave without touching the door knobs.
Within the Treatment Room:
- It is not possible to maintain physical distancing while in the treatment room.
- Patient and therapist are both required to wear face masks that cover both the nose and mouth at all times throughout the whole appointment.
- Tissue will be available throughout the clinic: in the waiting area, treatment room, and washroom in order that patients and the therapist may use tissue to address an itch and/or touch the face or for any other reason.
- Patients will be asked to keep all personal belongings and removed clothing within a plastic bin, which will be sanitized between patients.
- Patients are asked to remove from the clinic everything that they bring in with them.
- Musculature of the face will not be palpated or treated at this time including intraoral and external TMJ treatments.
- Payment occurs online. Cash will not be accepted at this time. Receipts will be emailed.
Restroom for Patient Use:
- The restroom will be for emergency use only. Patients are asked to use the washroom at home before coming to their appointment.
- Soap and a fresh hand towel will be available in the event that a patient must use the restroom or sink. Hands must be washed with soap and water for at least 20 seconds and then dried.
Additional time has been scheduled between patients to allow for thorough cleaning of the treatment room.
Visibly soiled surfaces will be cleaned followed by disinfection with a Canada Health Approved for use against Covid-19 disinfectant as listed here:
- Common areas will be cleaned and disinfected at least twice a day, including the restroom
- All high-touch surfaces will be cleaned and disinfected between clients, regardless of appearances. High touch surfaces include (but are not limited to):
- Light switches
- Door knobs
- Table surfaces
- Treatment table
- Face cradle
- Oil bottle
- No hydrotherapy supplies, thermophores, table warmers, or plush table covers will be used at this time.
- A Cleaning & Disinfectant for Clinic Setting Poster will be on Display in the clinic.
- All linens, including blankets and pillow cases, are single use only and will be laundered using high heat and detergent between each use.
- A disinfected plastic bin has been placed in the treatment room. The client will be asked to keep all of their personal belongings in this bin during the treatment.
- Bins will be disinfected between each client before cycling back into use.
Personal Protective Equipment
- Everyone will wear a face mask at all times.
- The therapist’s face mask will be changed between each appointment.
- Patients are required to wear a clean face mask that does not have an exhalation valve in the clinic at all times.
- If patients have their own fabric face mask, they are requested to clean it prior to use, and to arrive at the clinic wearing it.
- If patients do not have a fabric face mask, a single-use mask will be provided at the time of their 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 practitioner’s hands or skin of the hands are otherwise injured.
- Hands will be washed prior to putting the gloves on and immediately after removing them.
- Gloves will be worn by the therapist at the patient’s request.
- The therapist carries professional liability insurance.
- 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.
- Therapist is taking all reasonable precautions to clean and disinfect the clinic and all the surfaces within the treatment room.
- No guarantees can or have been made by the therapist that the patient may not come in contact with or contract COVID-19 at or during an appointment.
- In the event that a patient tests positive for Covid-19 having been to a treatment appointment within the 14-days prior to onset of symptoms, the patient must contact the therapist and inform them of positive test results and possible transmission of the virus immediately
- The therapist will immediately self-isolate and call Public Health at 8-1-1 to report the possible transmission and act on direction(s) of Provincial Health.
- 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 their name and the name and contact details of the patient.
- The patient must agree to the release of this information under these circumstances in order to receive treatment.
- All treatment appointments will be cancelled and the therapist will cease to provide services until Public Health has investigated and provided direction(s).
- The therapist will immediately self-isolate until Public Health has investigated and provided direction(s).
- In the event that the therapist catches COVID-19 or displays symptoms of Covid-19, the therapist will immediately self-isolate and call public health at 8-1-1 to report the symptoms and request access to Covid-19 testing.
If testing is granted:
- All treatment 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 treatment 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.
- 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 treatment appointments will be cancelled and the therapist will cease to provide services until one of the following takes place:
- The close contact has been tested for Covid-19 and the results proved negative and the therapist is well,
- After self-isolating for 14 days and having no symptoms of fever develop.
- Being cleared by a public health official.
- Asymptomatic transmission of the Coronavirus is an unavoidable risk of practice until there is an effective treatment or vaccine against Covid-19.
- We have put into place protocols to help mitigate that risk as outlined in the preceding documentation.
- In the current environment of Covid-19 risk, informed consent requires that the patient be informed and understands that:
- Any treatment involves some risk of Covid-19 transmission.
- The therapist is following protocol to help reduce or mitigate risk where possible, but that risk cannot be reduced to zero.
- The patient consents to the treatment despite some inherent risk.
- The therapist will document the patient’s consent in advance and at every treatment.
- The patient can withdraw consent verbally at any time.