Our New World with COVID-19 and Massage Therapy. March 16 Update from ABMP and Ruth Werner

!  Read the Latest Information on Coronavirus for the Massage Profession COVID-19 Updates

Dear ABMP members,

Thank you for reaching out to us over the past couple of days as COVID-19 escalates. Last week, our conversations circulated around massage therapy hygiene protocols and ensuring safe space for clients. Today, waves of heightened CDC warnings, associated closures, and suspensions are prompting many massage therapists and bodyworkers to temporarily shutter their practices. They want to ensure their safety and that of their clients. We understand and support their decisions.

It’s always been ABMP’s mission to support practitioners wherever, however, and whenever they want to manifest their skills. However, we are in a unique time in our country; taking precautions aren’t enough in this environment. We strongly encourage you to suspend your practice on a short-term, temporary basis. Given the virulence of the virus, and the general sense of fear in the population, you may not have a choice—either by government decree or the reality of vanishing demand. And please read what Ruth Werner has to say at the end of this note.

This time is daunting in several respects. None of us have any idea how long closures, isolations, and suspensions will last, and how long it will take the virus to run its course in the United States, let alone the world.

Through this, please remember your dedication to your profession and your clients; now is the time to practice physical and mental self-care. Remain positive and informed to the best of your ability. Reflect on the good work you’ve done. Hold close your success stories. Give yourself space and time to work on your practice wish list. Polish your treatment space. During your self-distancing, take advantage of the free online continuing education that’s part of your ABMP membership. Revamp your dream list for marketing your practice. Recall what drew you to the profession and what you love about it. When this coronavirus veil lifts, your clients will need your supportive, therapeutic massage sessions more than ever.

Do your best to avoid panic at this point. Focus on the things you can change: your actions, decisions, and responses. Those you have control over.

As states and the nation trigger emergency operations, know those make way for key funding for maintenance and recovery initiatives. It’s too early to know how individual business owners will be able to access that funding, but stay tuned to your state and county departments of public health websites for evolving information and, of course, the US Centers for Disease Control (www.cdc.gov/coronavirus/2019-ncov/index.html).

ABMP will continue to update our members about ways they can take advantage of any relief opportunities created in response to the COVID-19 outbreak, and, as always, we will continue to offer excellent service to our members, striving to live up to our motto: expectmore.

Les Sweeney
President
Associated Bodywork & Massage Professionals

If you have ideas for ways that the profession can support our community and one another during this time, please share them with us at expectmore@abmp.com. We’d love to hear from you.

 


Following is a message from our Massage & Bodywork columnist and Pocket Pathology partner Ruth Werner and her own advice for the profession.

Ignore My Earlier Advice. Shut It Down.

By Ruth Werner

My friends and colleagues, it’s time to shut it down. It’s past time to shut it down.

I wrote a piece two weeks ago that provided some ideas about how to take care of your practice, assuming you were still seeing clients. I hereby rescind that advice, and I apologize to anyone who was misled.

Close your practice.

For how long? Who knows?

If it were me, I would start with four weeks and re-evaluate after three.

Wouldn’t it be great if we had all the information we needed to make informed, non-panicky decisions that we knew would maximize effectiveness against the spread of COVID-19 virus, and minimize financial hardship?

Sadly, we don’t have that data.

No one is going to make this decision for you. Not your membership organization, not your state board, only you.

No one is going to make this any easier for you.

This is your call. And if you want my opinion (and presumably you’re interested, because you’re reading this), here it is: close your practice.

Here are some things we know that have led me to this point of view:

1. The time between exposure and symptoms can be up to 14 days.

2. The virus is contagious for days before symptoms develop, so your “healthy client” might not be.

3. The virus stays intact on surfaces for several days; it stays intact in the air for several hours (at least).

4. COVID-19 is extremely contagious, and it doesn’t take a lot of exposure to spread from one person to another.

5. The virus appears to be contagious after symptoms subside—but we don’t know how long.

6. At this point, older people and those with impaired immune systems are not necessarily more likely than others to catch the virus, but they are more likely to need extensive medical interventions. (Although that may be changing. In some countries the number of people in hospital care are skewing much younger.)

7. We don’t have enough medical capacity to manage what’s coming—which makes it even more vital not to add to that load in any way.

There are so many things about this situation that should have been different. I could list a bunch, but (A) it wouldn’t help and (B) isn’t our blood pressure high enough without recounting all the ways our systems have failed us? And this frustration doesn’t even include some of the nutso crazypants stuff I’ve seen on Facebook and other outlets. For the record, keeping your throat moist will not prevent you from getting sick with COVID-19. Neither will holding your breath for 10 seconds.

But if we all commit to extreme social isolation, it is practically for sure that the impact of COVID-19 in this country will be less extreme, at least in the short run. While roughly the same number of people will get sick, it will happen over a longer period of time. This “flattening of the curve” means our health-care facilities might be able to keep up with our needs (see link here), which means the mortality rate will fall. And the day will come when we might be able to look back and say, “Wow, that wasn’t so bad—weren’t we silly to over-react?”

This will demonstrate that we did it right.

The naysayers and virus-skeptics and my-immune-system-is-strong-so-I’ll-do-what-I-want folks will point fingers and scoff and say we all fell for a huge hoax. Let them.  They are wrong.

There’s a parallel in our recent history. In the 1970s, massive changes were put in place to limit the type of air pollution that caused acid rain. At that time, rain was literally melting our forests and corroding our buildings, not to mention what it was doing to groundwater. The changes, while expensive and inconvenient for many industries, worked. Acid rain is no longer considered a threat. And the result: some people (including some politicians who should *swearword* know better) suggest that the changes were unnecessary, because look: acid rain isn’t really a problem! Argle bargle. You can’t *swearword* win.

Let’s Make Some Lemonade!

The financial burden of losing several weeks’ of business is undeniable. I’m sorry, there’s no easy way out of this. Once this crisis has passed, it will be important to plan ahead for the next one. Financial planners recommend having at least a month’s worth of expenses put in an accessible savings account—just for events like this.

That said, having some dedicated but unscheduled time to devote to business holds a lot of potential.

This is a great time to do a really thorough cleaning of your office. Go in when it’s empty, and disinfect your equipment and surfaces. Do a top-to-bottom refresh. Dust, launder, swab, decontaminate, and shine up all your stuff. Listen to loud music while you do it. It will be fun. And when you go back to work—oh, such a joy it will be to enter your gorgeous, sparkling workplace!

This is a great time to take some continuing education online. Go shopping in the rich ABMP collection of online CE classes, here. You could take some business classes, and use this time to make plans for a grand re-opening. You could take some research literacy classes, and go on a PubMed.gov treasure hunt for articles that are up your alley. Have you always been curious about a certain technique or approach to bodywork? Here’s an opportunity to explore it to see what you might want to pursue in live classes.

Do you send out blogs or newsletters for your clients? Get ahead on your writing, and put some pieces away for later. It’s more important than ever to keep those lines of communication open, so this is a good investment of your energy. Let your clients know that while you can’t see them in person, you’re thinking of them.

It’s tax time: get ahead of your taxes for this year, and set up your books for easy use next year.

If you are caring for children during this time, include them in appropriate activities. Make them your model while you watch a technique video. Learn, or re-learn, some anatomy together. Make this time a gift.

Most of all, breathe deeply and be kind. Let’s take care of each other and help each other through a scary time. We’re going to be OK. We will emerge, poorer in money, but richer in experience, because we took the right actions. And we will be ready to help our clients and our communities come back up to full speed when the time is right.

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Comments

Ruth, You mentioned losing weeks of income, but from all I see and hear (from governmental sources) that this will be months long, not weeks. I think that there will be many of us therapists that will no longer be in business when this is all said and done.

I closed my massage business on Monday, March 15. My clients and I all agree that we cannot practice "social isolation" during a massage. Several of them verbalized concern for ME more so than themselves!  I DO set aside 3-4 months worth of money and I also take an extended vacation during this time of year so it will just be a bit longer.  To all my fellow Massage Therapists....BE SAFE AND STAY HEALTHY!        Janis

Thank you Ruth for your strong leadership and bravery. This is what we need to hear. It came upon us all so fast. 

It would be nice for the members of ABMP if our professional organization would lobby the government on our behalf  for some relief for its members with something other than the low interest loans the government is offering small businesses. 
If the AMBP could also consider refunding a part of our membership fee, even enough to buy a bag of groceries or fill a gas tank would be appreciated by those of us who rely solely on bodywork as our source of income. 

I agree we should receive a small refund of our membership fee considering we are not covered at this time since most of us were state ordered to close our businesses.

I loved reading your message, Ruth.  It made me feel safer in my own skin and reminded me of my power to feel safe in this insecure time.  Thank you so much. 

Thank you! It's nice to have guidance at this time. 
Peace to all,

Carolyn

Thank you very much for updating and fleshing out your position AMBP! I came to the site on Saturday 3/14 looking for guidance and felt the statement had been written by an attorney rather than someone familiar with our industry: basically step up your normal hygiene and decide how you want to proceed. I am heartened to see that the details of this new pandemic are being brought to fore to help us make our practice decisions. Stay well and successful my sisters and brothers.

Can you cite your source for #3? 
I am inclined to think that's misleading and spreading misinformation at best, contributing to panic at worst. The CDC and virologists have stated that the virus spreads through respiratory droplets, which cannot hang in the air for hours. https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html has this directly listed. 
The next link is a communication from virologist James Robb (who has studied Coronavirus) specifying that the large droplets from an infected person (sneezing or coughing) are what spreads it. NOT the air. https://gellerreport.com/2020/03/coronavirus-realities-safeguards-projections.html/

 

Please do correct me if I'm wrong, through expert or scientific findings.

I have closed my practice for 2 weeks and said I would re-evaluate at that time. This being my sole source of income, along with many of us, is there any options we have to get some assistance during this time? We are not usually eligible for unemployment so what do we do for money?? Any help on this matter would be extremely appreciated!! 

I have been a massage therapist for twenty years, licensed by our state medical board, and had a semester of pathology, thanks to Ruth, included in my associates degree program. I have an extremely private office building, private bathroom, and am the only therapist/staff member. Even with over the top daily sanitation before the pandemic and my clients and myself feeling fine, I closed my office over the weekend. I was relieved to see Ruth's message urging others to do the same and expected to see other local office closure announcements. Instead I've seen regularly updated social media videos and emails from area massage therapists "reassuring clients" that they feel fine and are not closing. These forms of communication are adding to false sense of security and are making guarantees that individuals in our field are not qualified to make. We have never seen anything like this and cannot/should not be making guarantees of safety. 

Is there any way to notify local or state boards to help in the closures? What other ways can we get through to these therapists?

Mayors task force 317-327-4622 Health department 317-221-2000 They are the ones responsible for closing gyms and theaters. Please call and pass on to all service providers you know in our industry. Trying to get relief as soon as possible. Ask them to do a mandatory shut down for Salons and Spa’s

From my perspective.. If all of what is being said is true.. A clean massage clinic is still safer for me and my client than any grocery store or minimart.. And no one is shutting those down... 

The person handing me a drink at the coffee shop is as likely to be spreading germs.. But again drive thru is still open... Delivery drivers could be coughing and sneezing all over the contents of your safer home delivery and you wouldnt know...

If my clients want to come in... I will continue to serve them... Not for the money alone. But because for some of them the anxiety and pain of normal life is already thru the roof and this pandemic only makes is worse..

Having a one on one interaction with a client who is not coughing sneezing or otherwise showing signs of illness puts neither of us, or the next clients at greater risk than paying the gas station attendant or pumping your fuel after who know who has touched it..

If anything.. A clean healthy invironment, with an immune boosting, stress reducing massage seems like a safer alternative and better way for the people who are going out to spend their time... 

 

I for one will remain open until the government requires that i do otherwise... Not because i dont care about the covid19... But because its not the only contagion and there are worse ones we do nothing about... 118 billion infected and 30,000+ dead over the seasonal flu... Ebola outbreak of 2016 to 2019.. H1n1. Noro. Etc.. Thats why we have universal precautions... 

 

Just my .25 cents

 

I have sent out a newsletter to all clients stating our procedures and stepped  up cleaning. Common sense decisions that people have to make every day would lean toward the grocery store, the gas pump and restaurants and that "safe" delivery you are getting probably being rather higher risk than a single session for someone with their massage therapist.

Colorado governor amended the previous shutdown of all gyms and restaurants to also include non essential personal services and listed hair, nail, and massage services as of March 19th.  Shutdown to last until Apr. 30th.  Massage was my family's primary source of income.  And while we did have some savings, we will be defaulting on loans if this lasts more than a month.  I'm hoping there are better resources to help provide for the lost income as I search out other income sources that wont also put my family at risk of catching or spreading COVID19

We need to contact someone to make our closing an official health risk. The government has included bars, restaurants, and social gatherings of 10 or more.  Many salons have closed because they house more than 10 stylists at a time. My salin rarely has more than 10 people at a time in it. If that rule stands they will most likely be able to continue working. But it stands to reason that stylists, facial technicians and massage therapists come into close contact with people and they should be officially closed as well. That way we too can claim whatever benefits given to businesses being forced to close.  As it is my landlord is acting like she doesn't believe me when it just makes sense.(sigh) please everyone contact these law makers...

Mayors task force 317-327-4622 Health department 317-221-2000 They are the ones responsible for closing gyms and theaters.Please call and pass on to all service providers you know in our industry. Trying to get relief as soon as possible. Ask them to do a mandatory shut down for Salons and Spa’s

If we can't  get this, I fear we are screwed.

I have worked for over a decade for spas and other people that made big bucks off my labor of love.  This year, I finally was able to begin the process of opening my own clinic, from finding the perfect location, signing a lease, pouring my savings into preparing a beautiful space, great equipment, and all the software, amenities, startup costs, etc that go along with opening a business. 

This was the result of months of work, all my savings, and my heart and sweat and tears.  My wonderful clientelle have followed me from location to location and I had a huge amount of support from them for opening my own business.

However, all that I needed to know was how potentially dangerous COVID-19 is to my clients and myself, and it was a no brainer to SHUT THE DOORS AFTER BEING OPEN FOR LITERALLY ONE DAY.  My clients are all eagerly awaiting my reopening, which may be in 15 days, or 30. or possibly more.  Am I feeling the financial hit?  Absolutely. I'm a single mom and this business is my only income.  And I had just poured every bit of savings into the new business.  BUT... above all else, I care about the health and well-being of my clients and I know that the financial burden in the short term will be nothing compared to the potential harm that could be done to others or myself if I remain working during the COVID-19 Pandemic.

Stay strong and All will be well in time if we ALL choose SAFETY over MONEY.

Luckily a portion of my practice includes Distance Healing sessions & Bach Flower Consultations via telephone or email! I can't offer mobile or in-office body work appointments, but can schedule clients a few weeks out and offer gift card purchases or pre-paid sessions. We will get through this if we get creative ;)

Hello, I work for a Wellness Center/Doctor's Office, in our State these are still allowed to operate. We have Chiropractors, Acupuncturists, Nutritionists and Massage and Skin Care. Right now Skin Care would be the only service not needed to aid the community , by keeping people out of Urgent Care for non emergency issues. If we are not there to help with a neck ache, back ache or any other acute to chronic pain, they will go to an Urgent Care or Other Doctor's office, maybe their PCP. Those businesses need to be freed up in this time of crisis, not overloaded with care we are more than capable of providing. Maybe in your own communities, if you are part of business associations where you can talk to other professionals that will be overloaded in the coming weeks, ask them. I get that spas are to close, but if you are working in a healthcare capacity, a doctor's office or maybe Physical Therapy that is still allowed to be open in your State, I believe you can help the Common Good. I think we are to help our community in this capacity, but reducing the need in an Urgent Care. This Pandemic issue will definitely be on the next ethics exam we take for CEUs!

Everyone will do as they need. Personally I felt that the PS by Ms Werner was angry and political.  As a group we should be leading the world to become more unified, whatever your political affiliation. I am personally thinking of moving to AMTA after reading her comments. 

Thank You Ruth for your informed letter above. We must be diligent. The world has to readjust. We have to readjust. How that happens is the big question. I can probably be okay for 2 months, maybe 3, but that is not ideal. Never in my wildest dreams did I foresee this!

Illinois is now on lockdown, the order of stay in place has been issued.  As a canine massage therapist I can keep social distance from the pet parent. Must I cancel upcoming massages?

 I have a client that relies on me to help her dog be stable and walk. I can't imagine what would happen if I wasn't able to provide care. 

Thank you!

Although I am 99% sure I have COVid-19. I have a mild case and plan to get well with Vits, herbs, hot liquids, etc. This is a strange virus, just different in it's symptoms perhaps for many.
I plan to get the Titer test when I am better and it is available. This will tell if I have had it and then hopefully immune.
I hope I can then do massage with extra sanatizing of space bathrooms etc.
Massage boosts immune system 3 different ways;. Destress, Moves lymph fluids along with refreshing client's blood supply including new white blood cells.

I will wait to see if clients will be interested in massage. I am hoping clients will have means left to be able to afford massage even though my practice is very small and my rates are low.

Stay well and boost your immune system in all the ways you have heard of. Our Country needs all of it's Bodyworkers now in time of crisis more than ever.

Most of us have shuttered down the practice to ride out the storm. However, at some point we need to reopen the doors. This storm won't pass quickly.  Our social distancing efforts are mostly for giving the healthcare system more time to handle the influx of patients. The disease will still be here in the winter so what are we to do? Obviously we can't stay closed.  When to reopen is a balance between health and economics. My state ordered us closed until Jun 10.  I certainly won't be able to go back to a full biz model for quite some time after that.  My advise is plan on only seeing demand for your practice to be at 40% of what is was at its height before the pandemic. Don't expect it to increase much beyond that until a vaccine is circulated or the population develops herd immunity. Take the time now to redo your biz plan (or personal financial plan) based on realistic numbers for the next year to two.  Once you/we do reopen, you have to practice as if it were a continuous flu season. Clean and screen appropriately. Clients will have to make the decisions on their own health risks when deciding whether to continue or start massage. Covid-19 is our first hurdle, the next will be the recession / economic impact to our clients lives.  If you plan well now, you will get through this and can rebuild your practice quicker. Especially since half the industry will be likely to be out of business leaving those who survived in a better place from a competition standpoint.

I live in Michigan. ALL personal care services are deemed non-essential. Our Governor may slowly start allowing people back to work. I imagine the safe distancing protocol will still be in effect. Due to the nature of our business, we cannot adhere to that rule. This means we may not be included to return to work in many states. Our elected officials need to know some safe protocols we can institute to keep ourselves and clients safe. Most of us have been sanitizing our work areas after each client for years. However, ABMP needs to step in and be our voice. I think it would be helpful if ABMP contacted or drafted a letter to our Governors or Health Department heads with a list of protocols the members will follow. Such as wearing a mask during sessions, requiring our clients to wear a mask ( many of mine will with no hesitation), having clients sign a waiver or information form indicating they don't have any signs of illness related to COVID-19 or flu or cold. If so, we ask them to quarantine at least 14 days until symptoms are gone. (many of us have clients that will adhere to this because they desperately need the bodywork and pain relief we provide them). We need ABMP and other associations that represent personal care to step in as soon as possible and be our voice before we have to close our businesses indefinitely. Our economy depends on us, our clients need us, we provide immediate benefit to our communities and I believe we are willing to take every additional effort to promote and practice with increased health and safety. But if ABMP doesn't speak up on our behalf, our leaders may not know we can do all of this. We don't have time to sit and idle because it may be too late for many therapists.

maybe this is an opportunity for change - ABMP take the reins! acupuncturists, osteopaths, physical therapists are allowed to operate. ABMP's published protocols are great except for questions about symptoms. asymptomatic transmission is huge and we should not let our clients be complacent about not being contagious simply because they don't feel sick. let's codify these guidelines further and get some lobbyists or government regulation specialists to get us included as essential personnel. then it will be our choice whether or not to operate. we are health professionals damn it! sadly in NJ we are not viewed as such. we have had to charge SALES TAX since 2006 when they added "tanning salons, massage parlors and tattoo artists" lol to the list of taxable services. 

ironically a lot of the pre-existing conditions that seem to intensify peoples' reactions to this virus are stress-related such as diabetes, cardiovascular etc. hmm wouldn't it be nice to have professionals around that can offer simple manual therapy to help boost immune function and relieve stress - oh.

 

Missouri is opening up on May 4, 2020 for non-essential businesses to open and includes massage businesses. They will give us guidelines next week, however I would like a COVID-19 waiver for clients to sign indicating they are not exhibiting symptoms or signs of illness and as well as a liability waiver for COVID-19 to protect me since your insurance does not cover law suits where a client claims they contacted COVID-19 from my business.  I am unsure if I will open then until I know what guidelines I will have to follow since they will be maintaining social distance of 6ft. Nor do I want to put any of my clients at risk at this time.

I have been searching for anything that is geared towards helping my small business. So far everything I have found I meet most of the requirements but one. I am only one. All of the emergencies funds except payroll loan require 2 or more employees.  ABMP please make a page to help with this.