Hi everyone. I wanted to share with you the Washington State Department of Health's latest recommendations on massage. As you can see below, as of a few days ago they are still recommending that we hold off on giving massages except in the most dire cases. Additionally, getting a massage is going to look quite different than it used to, at least for a while.



Updated April 27, 2020
COVID-19 Health Alert for Massage Therapists

Massage therapists should be aware that there is:

--Widespread person-to-person transmission of COVID-19 in Washington. People with COVID-19 can spread the illness even when they feel or look well.
--High risk of severe COVID-19 illness in people older than 60 years or with underlying health conditions.
--No method to completely remove the risk of person-to-person spread of COVID-19 in a massage setting.

Governor Inslee’s proclamation 20-25 allows health care providers to continue essential health services. Many services massage therapists provide are considered non-essential and most are considered non-urgent. No in-person appointment is risk-free, even if the patient and massage therapist appear well. To help control the spread of COVID-19, treatment should be limited to patients with a clear and documented urgent medical need.

While the proclamation allows massage therapists to continue providing essential health services, they are not required to do so. Massage therapists should weigh their own and their patients’ health risk when deciding whether to provide in-person services.

Actions requested before providing services:
--Provide massage only to patients with urgent medical issues. Examples include, but are not limited to, lymphatic overwhelm issues, severe whiplash, and acute pain control. Simply having a prescription for massage is not sufficient to establish urgent care
-- Cancel non-urgent massage appointments.
-- When appropriate, consider providing self-care ideas to your patients and reinforcing the self-care instructions you provided prior to current restrictions on non-essential services.
-- When treatment is urgently medically necessary, ask the patient if they have symptoms of respiratory illness (e.g., fever, cough, difficulty breathing) before they enter your practice. If a patient has a fever or respiratory symptoms, do not provide treatment. Instead, suggest the patient contact their primary care provider.
-- Make sure patients practice social distancing of six feet in waiting rooms and other areas of the practice. Consider having patients wait outside rather than in a waiting room so complete cleaning can occur between patients.
-- Remind sick employees to stay home. Do not require them to work. Allow all employees who are uncomfortable with continuing to work in the clinic to stay home.


Actions requested when providing services:
-- Familiarize yourself with standard, contact and droplet precautions.
-- Ensure that massage therapists have the following personal protective equipment (PPE) and are familiar with its use: facemask (surgical mask with ear loops or mask with ties), eye protection (for example, goggles or disposable face shield that covers front and sides of face), gown, and
clean, nonsterile gloves. Alternatively to a gown or other covering, massage therapists can change clothes after each massage.
-- CDC’s Optimizing the Use of PPE provides guidance on actions to take when PPE is short or you do not have PPE, including contingency and crisis strategies. Using crisis measures is not ideal and could put health care providers at risk for disease.
-- Provide a face mask or cloth face covering for each patient to wear during the entire treatment.

Environmental cleaning and disinfection actions:
-- Between all patients, clean with soap and water or other cleaning agent to disinfect surfaces touched by the patient. This includes: the massage table’s face cradle, table legs and bolsters, and bathrooms, if used by the patient.
-- Use clean linens, including blankets, for each patient. Launder linens in hot water and dry completely.
-- Throughout the day, wipe high-touch areas (door knobs, handrails, etc.) with a disinfectant.
-- Use EPA-approved disinfectant from List N along with CDC guidance for cleaning and disinfection.
-- Diluted household bleach (at least 1,000 ppm sodium hypochlorite: 5 tablespoons [1/3 cup] bleach per gallon of water or 4 teaspoons bleach per quart of water) can be used to disinfect on surfaces not damaged by bleach.
-- Read the label before use of any disinfectant and follow the label’s instructions. Never mix household bleach with ammonia or any other cleanser.

Background:
The virus causing coronavirus disease-2019 (COVID-19), emerged in December 2019 and has since spread around the world, causing a global pandemic. Eighty percent of cases are mild, but severe disease and deaths are more common in the elderly (older than 60 years) and in those with underlying health conditions. Health experts are concerned that increasing transmission in our state and an increase in severe disease will limit the ability of our health care system to provide urgent care to all who require it.

Additional resources for massage therapists:
DOH Workplace Recommendations
DOH Coronavirus (COVID-19) Web Page
CDC Coronavirus (COVID-19) Web Page
CDC Practice Preparedness Resources

To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov.