Important Reopening Considerations

We understand there is a fine line between getting back to work and earning an income, and protecting the safety of our clients. 

• We are abiding by the guidelines and recommendations of our state and/or local governments, as well as our massage regulatory agencies regarding reopening our practice.

• Following CDC guidelines is imperative to offering the safest experience for our clients. Much of the information that follows draws from CDC guidelines, which are available for your personal reference at www.cdc.gov/coronavirus/2019-ncov/index.html.

• A likely requirement in a reopening plan is the use of personal protective equipment (PPE)

• Specifically face masks. Face masks will be utilized in treatment rooms to help prevent the spread of COVID-19; we encourage that both our therapist and our client wear a face covering.

• We understand that PPE is scarce and any available supplies are being redirected—rightly so—to frontline workers and health assistance staff who are still operating without the proper supply of equipment they need to work safely. Diverting supplies for non-emergency equipment requests at this time would be dangerous and unethical. We have Considered other options for face coverings for our clients and ourselves in the interim.

• Following stringent sanitation protocols between each client is critical. We are using EPA-certified disinfectants on all surfaces, doorknobs, chairs, etc., that a client might have touched.

• Changing all linens, fleece blankets between each client.

• We will use gloves where practical.

• We will stagger client appointments times and when you arrive at our clinic we will ask you to wait in your car until we call you to let you know that we are ready for you so there is no more than one client at a time in common areas.

• In our reminder phone call, on our intake form, even when clients arrive for their appointment. We ask them: Have you had a fever in the last 24 hours of 100°F or above? Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath? Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms? If they answer yes, then we will ask them to reschedule, without penalty.

Cleaning

• We are doing a daily deep clean of all spaces. Using EPA-approved cleaning products and protocols on all surfaces in our clinic, top to bottom. Following the disinfectant contact time, per the product manufacturer.

• We have establish a cleaning schedule for a bathroom in our clinic and wiping down bathroom surfaces after every client visit.

• After each client cleaning of bolsters, tables, chairs, and stools as directed by the CDC and product manufacturer.

• Clean light fixtures and switches; doorknobs, doors, and door frames after each client appointment.

• We have hand sanitizer, cleaning wipes, and facial tissues available in all massage rooms.

• Disposable paper towels are available at every massage room to use when handling doorknobs.

• Have a hard-surfaced, nonporous chair or large hard-surfaced/plastic basket for clients to put their clothes on/in.

• Lidded trashcan that are operated by a foot pedal are located in the treatment room.

• We have installed a no-touch soap and paper towel dispensers in our restroom and added a lidded, foot-pedal trashcan. Also placed a CDC handwashing guidance posters inside our restroom.

• We have added a high-efficiency UV HEPA particulate air purifier in each massage room. Their use with similar viruses indicates they might help in some situations, and it would be logical that these filters could reduce concentrations of COVID-19 particles that remain airborne.

More than ever, protecting ourselves and our clients starts before they arrive for an appointment. We have added information to our website, health intake forms and review our pre-screening appointment confirmation process.

Health-Intake Updates: We have included COVID-19-related questions on our Health Intake form:

• Have you had a fever in the last 24 hours of 100°F or above?

• Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?

• Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?

• Included informed client consent language about the risk of infection on our Health Intake form.

Sample language: I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved and give consent to receive massage and bodywork from this practitioner

Massage Practitioner Preparedness 

At Body & Soul Massage Therapy hygiene protocols remain standard and customary. The CDC recommends we: 

• Take steps to ensure everyone adheres to respiratory hygiene, cough etiquette, and hand hygiene.

• Provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%–95% alcohol, tissues, and no-touch receptacles for trash disposal.

• Have our mask on and adjusted before our client arrives. To further protect ourselves and clients. Keep hair up and away from our face. All other practitioner hygienic protocols apply—no long nails, jewelry, open-toe shoes, flip flops, or sandals.

• Practitioners should take our own temperature before each work day begins to ensure they are not presenting with any coronavirus symptoms.

• Avoid shaking hands with clients or hugging. Consider sharing with clients that we will eliminate casual conversation and remain in minimal necessary in-session conversation mode through the duration of the session.

• Treatment table setup will look largely the same, but linens/bedding will be turned over completely for each client.

• Use products with non-permeable barriers, like mattress pads, to cover our table, table warmers, etc. On top of that barrier we can layer our washable fleece pads, sheet sets, blankets, etc. Put similar non-permeable coverings on bolsters and pillows. Apply a ready-made disposable face-cradle cover to the face cradle, and top it with a pillowcase, leaving a large hammock-type pocket underneath that could catch client aerosols when they are prone.

• Provide each client with a completely new massage table setup.

• Consider using a high-efficiency particulate UV HEPA air purifier, and to make sure it is on before our client arrives.

Client Arrival and Intake Information

• Assume Standard Precautions for all client care.

• Stagger client appointments times. When you arrive at our clinic we will ask you to wait in your car until we call you to let you know that we are ready for you so there is no more than one client at a time in common areas

• Use a no-contact thermometer to take the client’s temperature upon arrival; ask the client to reschedule if their temperature is 100°F or higher.

• Offer a cloth mask if the client is not wearing a mask as we requested during the appointment reminder , if available.

• Initiate doorway screening checklist questions:

1. Have you had a fever in the last 24 hours of 100°F or above?

2. Do you now, or have you recently had, any respiratory or flu symptoms, sore throat, or shortness of breath?

3. Have you been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or has coronavirus-type symptoms?

• Leave time for proper health history overview with new clients and updates with existing clients.

• Will discuss with our client their comfort in wearing a face covering during the session, after the health history overview.

• Remember that face masks, (including the homemade variety), protect other people from getting sick from us; but unless the client is also wearing a face mask, the massage practitioner is not protected.

• If the client is unable to wear a mask for health or comfort reasons, we will consider using an N95 medical mask for ourselves once they return to the marketplace in sufficient supplies.

• Ask clients to use hand sanitizer (per CDC, at least 60% alcohol) before going to the treatment room and ensure that it’s applied liberally and properly.

• Give instruction on how to proceed with the session, including new direction on where to place clothing, the availability of hand sanitizer in the room, and the cleaning protocols we want to share to put clients at ease.

• Explain to clients that the room has been fully sanitized, but to put them fully at ease, they are also welcome to wipe down any surfaces again.

• -Facial massage- Confirm with the client that they are comfortable with us applying hands-on work to their face; working through their face covering as needed to address sinuses, muscles around the temporomandibular joints, or lymph nodes in this area (if doing lymphatic drainage work), -we will consider using gloves for this part of the treatment-. Or, prior to the session, include this type of massage among the work we will not conduct during this time.

• Deliver customary pre-massage instructions to clients before leaving them to disrobe to their level of comfort.

• Wash our hands thoroughly, up to the elbows, using WHO guidelines for best practices before returning to room.

During the Massage Session

• Wearing a face mask while in the prone position could be uncomfortable for clients. We won’t require clients to wear a facemark while laying on the prone position.

• When switching from prone to supine position, we will our clients to put their face mask covering on before they turn over into the supine position.

• Noting the potential discomfort clients may have wearing a mask in prone position, we will consider using side-lying positioning to address the lateral and posterior aspects of the body.

• -Hand and Neck massage- We will leave any hand and neck work for the final part of our treatment protocol.

• Before leaving the treatment room, we will remove gloves (if applicable), apply a generous amount of hand sanitizer per CDC application guidelines (at least 60% alcohol), and use a previously readied paper towel to open and close the treatment room door while leaving the room.

Post-Massage Session Protocols

Immediately following a session, it is important to consider how we prepare for room sanitation. It is also imperative that we have a follow-up plan in place for open communication regarding any COVID-19 symptoms displayed by us or our clients after the session.

Massage Practitioner Sanitation Protocols

• Upon leaving the treatment room, immediately undergo our hand-washing protocol while the client dresses. Wash hands thoroughly, up to the elbows, using WHO guidelines for best practices. We do not touch or adjust our face covering.

• Do not remove our face mask until we have taken payment for services and the client has left. If we must handle cash, check, or credit cards, we will do so using a pair of disposable gloves. Once the client leaves, dispose of the gloves, and wash hands before next removing our face mask carefully for additional uses.

• Hand hygiene after removing PPE or clothing is particularly important to remove any pathogens that might have been transferred to bare hands during the removal process. If hands are visibly soiled, use soap and water before applying alcohol-based hand sanitizer. For the removal of masks, the CDC says we must wash our hands both before and after removal.

• Begin room sanitation.

Post-Massage Session Sanitation

It takes 10 minutes for some cleaning products to effectively kill pathogens. Given this fact, and the other protocols necessary, we believe it is prudent to allow 45 minutes before our next client.

Massage Room Turnover Sanitation

• We have added a high-efficiency particulate UV HEPA air purifier to the each massage room.

• We remove all table setup items; fold linens in on themselves and place in lined, lidded hampers positioned outside the treatment space to minimize the possibility of dispersing virus in the air.

• We use EPA-approved disinfectants to clean anything the client came in contact with, including massage table, face cradle, stool, bolsters, door knobs, side tables, chairs, etc.

• We follow the product manufacturer’s recommendations for contact time (or how long a surface must stay visibly wet before the disinfectant destroys the pathogen). For some products, this can be 10 minutes.

• Per CDC recommendations, we clean all equipment, devices, and surfaces between each client interaction, including oil or lotion dispensers. This process includes cleaning:

Hard (Non-Porous) Surfaces: 

• If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection. For disinfection, use EPA-approved disinfectants .

• Follow the manufacturer’s instructions for all cleaning and disinfection products for concentration, application method, and contact time, etc.

• Follow manufacturer’s instructions for application, ensuring a contact time of at least 1 minute, and allowing proper ventilation during and after application.

Electronics: 

• For electronics such as tablets, touch screens, keyboards, remote controls, and ATM machines, remove visible contamination if present. Follow the manufacturer’s instructions for all cleaning and disinfection products. Consider the use of wipeable covers for electronics.

• If no manufacturer guidance is available, consider the use of alcohol-based wipes or sprays containing at least 70% alcohol to disinfect touch screens. Dry surfaces thoroughly to avoid pooling of liquids.

Linens, Clothing, and Other Items That Go in the Laundry: 

• In order to minimize the possibility of dispersing virus through the air, we do not shake dirty laundry.

• We’ll remove all linens, blankets, and table setups; fold items in on themselves before putting in a closed bin or hamper.

• Wash items as appropriate in accordance with the manufacturer’s instructions. If possible, we launder items using the warmest appropriate water setting for the items and dry items completely.

• Repeat hand washing protocol and reset the table and treatment space for next client.

Sanitation Between Clients

We will Continue to wipe down bathroom surfaces (doorknobs, toilet handles, sink areas, light switches, etc.), reception-area countertops, point-of-sale equipment, and chairs (arm rests).

Sanitation at End of Day

• Empty all trash cans (each trash can has a liner), then use cleaning cloths to wipe the inside and outside of the garbage can thoroughly.

• Do end of day post-client cleaning, including the phone, keyboard, thermometer, and all light switches and doorknobs, as well as the bathroom and any other surfaces clients came in contact with.

• Remove bagged laundry from the dirty bin for washing and replace the hamper with a new liner.

Post-Massage Session Client Interaction

• We have added to our protocol a post-session check-in with client 2–3 days later to ask typical session-follow-up questions, but also to ask about their overall health.

• We also created a protocol were that a client will call us and we will call a client if either start showing any apparent COVID-19 symptoms.