Florida Governor DeSantis Executive Order #20-112 Potentially Allows Florida Massage Therapists to Open Amid Confusion with High Risk

Florida Governor DeSantis Executive Order #20-112 Potentially Allows Florida Massage Therapists to Open Amid Confusion with High Risk

By Don McCann, MA, LMT, LMHC, CSETT

On Thursday, April 30, 2020, Florida Governor DeSantis issued Executive Order 20-112 that potentially reopens massage therapy in the state of Florida. This Executive Order was vague at best as massage therapy was never mentioned directly but does fall under the wording of “all other health care practitioners.” However, it is impossible to maintain the recommended social distancing while doing a massage treatment making it very hard to guarantee that you do no harm which is the basis for practicing ethical massage therapy.

These CDC Guidelines for opening businesses are the most definitive guidelines I have seen so far. As quoted from these guidelines:

Under Phase I in Florida

  • Reopen only if business can ensure strict social distancing, proper cleaning and disinfecting requirements, and protection of their workers and customers; vulnerable workers are recommended to shelter in place.

Under phase 2 in Florida

  • Reopen only if business can ensure moderate social distancing, proper cleaning and disinfecting requirements, and protection of their workers and customers; vulnerable workers are recommended to shelter in place.

Under Phase 3 in Florida

  • Reopen only if business can ensure limited social distancing, proper cleaning and disinfecting requirements, and protection of their workers and customers.

Under these guidelines it appears that either Phase 2 or Phase 3 would be more ethical and appropriate for opening Florida massage establishments, even though it is not prohibited under the Executive Order.

There are some counties in Florida that are still maintaining that massage establishments are to remain closed. I suggest that you check with your county before you consider opening. Another consideration is whether your liability insurance company will cover you if you open. There are clauses in insurance coverage that have to do with obeying state and local laws that could be argued by the insurance company to deny coverage during this COVID-19 pandemic. The medical PPE’s that are suggested for health care practitioners that would make it safer for massage therapists to practice are being reserved for the hospitals and doctors who need to work with COVID-19 patients. This may make massage therapists not using the full medical PPE’s practicing outside of what is legal and covered by insurance. Check with your insurance company to avoid a lapse of liability coverage during a time that our liability is risky.

Each of you will have to look at the ethics of reopening. Can you reopen and not do any harm to yourself, your family or your clients. If you feel you can, then ethically you could reopen. If you feel you cannot, then it would be unethical for you to reopen at this time. Open up only if it is ethical for you.

If you are financially stable enough, or were able to get a SBA loan, you could be financially secure enough not to have to open your practice even though the Executive Order 20-112 would allow you to. Hopefully, many of you are in this position so you don’t have to open, as this seems to be the most ethical and appropriate course of action to take in Phase I in Florida until circumstances with COVID-19 improve.

If financially you really need an income from massage therapy to survive now, and you feel it is ethical to open, you may have to open. This will be a personal choice and it’s important that you know the risks. It does not appear that enough testing to actually see the extent of the spread of COVID-19 will take place anytime soon. Stay at home restrictions are being eased which means people will be more socially active and have a higher risk of exposure. Many who contact the virus will be symptom free for at least the first 4-5 days but still contagious, while others will be symptom free the entire time of their infection. Given these conditions, if you open your office for massage therapy, there is a significant possibility that someone who is contagious with COVID-19 is likely to attempt to book treatments. To successfully work at this time there are a number of procedures and tools that could make all the difference.

The following two screening forms can be accessed from our website – www.StructuralEnergeticTherapy.com – by clicking on the two buttons at the top of the article on safely re-opening your office.

1. A screening form at the time of booking a session with your client over the phone can help identify clients who are a larger risk of having been exposed to, or having, COVID-19. If the client is identified as a high risk client, the client could be asked to wait 30 days before having a treatment. This would also give you a better picture of the client’s risk of exposure, and, if you decide to book the client, some peace of mind about your client’s health.

A fever is an indicator of COVID-19. Having a thermometer that can take a client’s temperature without touching them and possibly become contaminated is important. Taking clients’ temperatures before they come into your office can identify potential clients who may not know they have COVID-19. This is a good screening tool to protect you and your clients.

2. A screening form for clients when they arrive at your office is important. This can be very similar to the screening form for booking a session, but it will have a place for recording the temperature. The form will give you the up-to-the-minute state of the clients’ risk and possibility of having been exposed to, or having, COVID-19. The form has a place for clients to sign and date after they have finished filling it out. The clients’ signed form will be placed in their file folder as part of their record. At the beginning of every session the client will again complete this form so we are monitoring their health and risk factors before each treatment.

We are including with this email a link to the form for sanitizing yourself and your office between each client. This checklist that you initial will verify that you have sanitized the office and yourself. Using the checklist and sanitizing after every client protects everyone. For the client to see what you have done to protect them by sanitizing will also create a sense of security for the client. Putting this copy in their file will show measures you have taken before seeing the client if anything would ever be in question. It’s a win-win for everybody. Please CLICK HERE for a copy of this form, or click on the button provided with this article.

This is a lot to do between clients and will take around 40 minutes. However, since social distancing is not possible during our sessions, we have to be extra careful so that massage therapy produces wonderful results and does not have tragic consequences.

As far as work, err on the edge of caution. You are too valuable to be taken by COVID-19. Go cautiously in these uncertain times and take the precautions seriously.

Stay healthy, stay safe, and identify something you really like and do it often.

 

Creating a Safe Environment for You and Your Clients During COVID-19

Creating a Safe Environment for You and Your Clients During COVID-19

By Don McCann, MA, LMT, LMHC, CSETT

The COVID-19 is at least two times (2x) more contagious than the flu. This creates real challenges for us to minimize the possibility of contagion in our massage offices. Before a client even sets foot in our office, we need to prepare the by eliminating as many pathogens as possible. This is going to require some changes. Many of the comfortable items we have in our offices make it difficult to sanitize and disinfect. We need to set a stage that is easily sanitized and disinfected before and after each client.

In the future you will finally be able to reopen your office and begin booking clients. In preparation for that moment now is the time to make some important decisions for everyone’s health and safety. The first step is going to be deciding on a quality proven disinfectant. Choosing one that won’t be toxic on the skin is important as there could be an adverse reaction. In my office we use Benefect Decon 30 (Thymol) which takes care of 99.99% of pathogens and is non-toxic to humans. There are a lot of other disinfectants that can be used to sanitize. Just be sure that they are effective and will not cause adverse reactions for you or your clients.

The good news is COVID-19 dissolves with soap and water. This will be extremely helpful when washing and disinfecting laundry. I suggest you use a high grade laundry detergent with hot water and high heat when drying sheets, blankets, towels, face cradle covers, and clothes. Anything we use that a client can come in contact with will need to be disinfected and sanitized between each session. This unfortunately will make using nice fluffy table covers under our sheets or heating pads impractical as they would need to be cleaned and disinfected after each client.

Having at least 40 minutes between clients to disinfect and sanitize your office and treatment room is recommended. Implementing a scheduling policy where multiple clients do not wait in your waiting rooms unless secure social distancing of a minimum of 6’ is possible is important. Staggering the scheduling for sessions and asking clients to arrive within just a couple of minutes of their scheduled time will help you accomplish this. If possible, taking clients’ temperatures before entering the waiting room is recommended. If they have a fever they can’t receive a treatment and need to reschedule to an appropriate time.

I suggest you have sanitizing wipes available for clients to use when they first enter the office. If clients don’t sit in the waiting room you don’t need to worry about disinfecting chairs. However, anything the client touches will need to be disinfected before the next client can enter the waiting area. This includes water machines, doorknobs, light switches, pens, clipboards, credit cards and credit card machines, computer keyboards and the mouse, and bathrooms. It is recommended that your furniture can be easily wiped down. This makes cloth covered chairs impractical at this time. I suggest you have wood, metal or vinyl chairs so they can be easily disinfected after each client. It is extremely difficult to disinfect magazines and reading material, so it’s going to be necessary to let clients know there will not be reading materials available. If they want to have something to read ask them to bring their own.

Disinfecting your therapy room is extremely important. I suggest you disinfect your sheets before taking them off the table. Spraying both sides in a process that will not allow pathogens to become airborne is advisable. After removing sheets have a plastic liner for your sheet container and put the sheets into the plastic liner. Disinfect your table including face cradle and hi-lo buttons, bolsters, pillows, or anything else you have used or the client has touched.

Only put the amount of skin lubricating oil, lotion or cream that you need for one client in a small container that will only be used that one time for that client. That container needs to be cleaned and sanitized before being used again for another client.

I suggest that you have a minimum number of articles in the areas that clients would reach and touch. It’s important to disinfect these items after each client. This includes your tissue boxes and wastebaskets. Don’t forget to sanitize your light switches and doorknobs. Spraying the floor where a client has stood and walked is also recommended. Good quality air filters are really valuable in helping to keep pathogens down in the air in your room.

Have a check list of the procedures used to sanitize your room and office available for your client to see. This will not only help the client feel more secure, but will help you stay aware of all the areas you need to sanitize, and what you need to do personally.

Using the screening list to check the client for possible exposures or symptoms of COVID-19 is recommended as is having the client sign and date the list. You may also muscle test certain questions if there seems to be uncertainty on the client’s part as to whether he or she has been exposed or has COVID-19 symptoms.

Starting your session by washing your hands with soap and hot water is necessary. Follow this by wearing a mask, gloves, and clean clothing (at least a clean shirt) for each client. Have clients either use a mask or have a towel over the face so if they sneeze or cough any droplets will be contained and not become airborne.

At the end of the session, after your client has left, you need to disinfect yourself. Start with spraying yourself down including your shirt, pants, and soles of your shoes. Then carefully remove your shirt, then your gloves. Put your shirt in a plastic bag and your gloves in a covered wastebasket. Then wash your hands and put on a clean shirt.

These are some suggestions for starting to make your work environment safe and nurturing. Hopefully they will make you aware of how many ways you can be careful and guarantee your own safety and the safety of your clients. Now you can do your magic with your hands with the confidence of knowing you have done your best to create a safe, healing environment, both for you and your clients.

Make sure to document and put into your files the completed screening form signed and dated by the client. It is also recommended that you have a disclaimer form that releases you from any liability for the unintentional exposure due to COVID-19 caused by misinformation either given to you by the client or provided on a health history form, also signed and dated by the client.

These are suggestions most of which we will be using in my office. I hope they have given you ideas on how to safely open your office. If you would like copies of our checklist and disclaimer CLICK HERE to download and print.

Screening Clients for Scheduling During COVID-19

Screening Clients for Scheduling During COVID-19

By Don McCann, MA, LMT, LMHC, CSETT

The COVID-19 virus is real. It is worse than the flu because in my lifetime we never had a flu epidemic where bodies were being put in refrigerator trucks and ice rinks. The COVID-19 is new to us, and more is not known than is known as to the features of the virus and how it will mutate. We can hope that the mutations of this virus will be that it weakens, but we’d be extremely foolish to bank on that, and not approach the future with what we presently know about the virus – that it is deadly. Governors across the country are looking to reopen their states, put people back to work, and have a working economy. In Georgia they are already agreeing to opening massage therapy offices and keeping social distancing. This points out that governors are not massage therapists and don’t truly comprehend what we do. What is happening in Georgia is a precursor to what is going to eventually happen nationwide. Massage therapists will be able to return to doing massages. Now is the time to start looking at how our world will have changed. The COVID-19 virus will not have gone away entirely.

Before we even schedule our first client we need to look at how to create policies and safety that not only guarantee our safety but that of our clients. Above all else we need to do no harm. Don’t wait until the governors say it is okay to start opening your practice. Now is the time to sit down, either by yourself or with your staff, and develop policies and procedures that will protect everyone. It will be too late if you start to book clients before you have developed the policies to keep you both safe.

In the future you will once again be booking clients, because at some point you will be reopening your practice. One of the first tools you will need for booking clients is a way to evaluate their overall health and risk factors for COVID-19. Developing a questionnaire that the client answers to determine their appropriateness for coming in for treatment is the first step. This questionnaire should start with an explanation of how you are protecting the client, yourself, and other clients by screening people.

For example:

Due to how highly contagious COVID-19 is and that some people have minor or no symptoms it is necessary to do risk assessment to protect you and all the clients that will be coming for massage treatments.

Follow this with:

  • Have you or anyone in your household come into contact with anyone displaying symptoms or testing positive for COVID-19 within the last 30 days?

  • Have you or anyone in your household traveled outside the country or outside your own city to an area that is considered a “hot spot” within the last 30 days?

  • Have you or anyone in your household exhibited COVID-19 symptoms or tested positive for COVID-19 within the last 30 days?

  • Have you or anyone in your household experienced the following symptoms in the last 30 days:

Dry cough

Nausea

Fever

Back pain

Abdominal discomfort or cramping

Loss of smell

Atrial Fibrillation

Pneumonia

Shortness of breath

Sore throat

Body aches (myalgia)

Chills

Stuffy nose

Fatigue

  • If you have experienced any of the above we need to further explore your health as they can be symptoms of COVID-19. They can also be normal aches and pains or body reactions to things other than COVID-19 so we need to discuss each of them to determine your risk factors.

  • How do you sanitize yourself when you go out?

Do you wear a face mask?

How often do you wash your hands?

What do you use to sanitize?

  • In order to ensure that it is safe for you to be worked on we will ask to take your temperature upon your arrival at the office. This will be a requirement for you to receive a session. If you agree and your temperature is normal we can proceed with the screening process prior to your session. If your temperature is not normal it will be determined that it is not appropriate for you to be worked on at that time and you will need to reschedule at an appropriate time.

  • A copy of this screening will be put in your file that will verify that you were scheduled only after satisfactorily answering these questions.

The above information will be made into a screening form that we will be using in our office, and we will make it available to you if you would like a copy. Just let us know. You can go over with your clients in the process of determining the appropriateness of making their appointments.

Update on Staying Healthy during COVID-19

Update on Staying Healthy during COVID-19

By Don McCann, MA, LMT, LMHC, CSETT

As more is found out about COVID-19 it becomes even more apparent that by boosting our immune system we can take responsibility to avoid having a catastrophic experience. Those who have compromised immune systems are leading in the statistics of those who do not survive this virus. Time and again doctors who understand that the immune system can be strengthened and that it is our best defense against COVID-19 are recommending regimens of immune boosting supplements. I am again reviewing some of the most important ones recommended by Dr. Andrew Saul with the Orthomolecular Medicine News Service, BioMed Center NE, Dr. Joseph Mercola, and Dr. Lee Cowden of ACIM. This list has expanded since I last wrote about supplements to boost your immune system.

(The following information is taken from several of Dr. Mercola’s articles – A Review of Antiviral Strategies, How to Improve Zinc Uptake to Boost Immune Health, Melatonin for Sepsis, High Heat May Kill the Coronavirus, and Could Hydrogen Peroxide Treat Coronavirus? Please go to each of these articles for expanded explanations and information – Dr. Mercola has footnoted his information references in all of his articles based on his extensive research and fact-checking his statements)

VITAMIN C

Dr. Andrew G. Weber, a pulmonologist and critical-care specialist affiliated with two Northwell Health facilities on Long Island, has stated: ”if you have vitamin C for prevention, you are much less likely to have a bad case of any kind of viral infection, including COVID-19. Doesn’t mean you won’t get it: it means that your immune system will be able to handle it, and that’s what your immune system does …”

For prevention, the Orthomolecular Medicine New Service Editorial Review Board and the Japanese College of Intravenous Therapy both recommend 3,000 milligrams (mg) of vitamin C a day in divided doses, 400 mg of magnesium … 20 mg of zinc …100 micrograms (mcg) of selenium … and 5,000 units of vitamin D, scaling down to 2,000 units of vitamin D a day after the first week.”

Additional information about supplementation expanding on further building the immune system if you are feeling under the weather –Dr. Saul recommends taking vitamin C to bowel tolerance:

  • Take enough C to be symptom free, whatever the amount might be. Dr. Cathcart would say take vitamin C to bowel tolerance, and that’s exactly what you think it means. The sicker you are, the more you hold. So, if you are really facing an influenza outbreak, you’ll hold a lot of C before you get to bowel tolerance.

  • The more frequently you can take the vitamin C, the better off [you’ll be]. Vitamin C being water soluble is constantly lost … The more often you take it, the better results you will have, and you will need less to do so.

  • So, taking a small amount of vitamin C every half-hour is actually much better than taking a large amount of C twice a day. And taking a large amount of C twice a day is better than taking a huge amount of C every other day. So, the more often you take it, the friendlier it is for your body.”

VITAMIN B – (THIAMINE – best taken in a B complex)

The recommended daily allowance for thiamine is well below 2 mg. For acute illness or short-term prevention, Saul suggests taking 50 mg to 100 mg of thiamine per day, ideally in divided doses.”

  • Thiamine is safe, and you can excrete that. The excretion is an indicator of saturation. Thiamine, really, is best taken with the entire B complex. The B complex vitamins work better together

  • For prevention, most people will get a B complex, B50 … Generally speaking, what I would tell people to do is take a look at the RDA, and you can do that on the internet in seconds, and take more than that. A B complex is the cheapest and safest way to do that.”

Poor Man’s Coronavirus Defense’

Consumer advocate, investigator and author Bill Sardi, proposes imitating Zelenko’s protocol using natural remedies. (Vladimir Zelenko MD is a New York-based physician who has treated 699 consecutive cases of COVID-19 with complete 100% success). If you have symptoms of SARS-COV-2 infection and cannot obtain a prescription for chloroquine/hydroxychloroquine and a Z-Pak:

  • A natural antibiotic such as cinnamon extract or oil of oregano

  • Quercetin as a zinc ionophore (to enhance zinc entrance into cells)

  • Zinc, up to 30 milligrams per day

  • Vitamin B3 (niacin), 25 to 50 mg per day, and selenium to further boost bioavailability of zinc.

SELENIUM – 100 mcg per day (previously mentioned with Orthomolecular Medicine New Service Editorial Review Board and the Japanese College of Intravenous Therapy above)

QUERCETIN and EGCG (found in green tea)

A comparative study published in 2014 looked at two zinc ionophores: quercetin and epigallocatechin-gallate (EGCG found in green tea), noting many of the biological actions of these compounds may in fact be related to their ability to increase cellular zinc uptake.
As explained by the authors:

  • The ionophore activity of dietary polyphenols may underlay the raising of labile zinc levels triggered in cells by polyphenols and thus many of their biological actions.”

Quercetin is also a potent antiviral in its own right, and both quercetin and epigallocatechin-gallate also have the added advantage of inhibiting the 3CL protease – an enzyme used by SARS coronaviruses to infect healthy cells.”

MELATONIN

(See Dr. Mercola’s article Melatonin for Sepsis)

MAGNESIUM

400 milligrams (mg) recommended by Orthomolecular Medicine New Service Editorial Review Board and the Japanese College of Intravenous Therapy

VITAMIN D

5,000 units a day, reduced to 2,000 units a day recommended by Orthomolecular Medicine New Service Editorial Review Board and the Japanese College of Intravenous Therapy

HYDROGEN PEROXIDE THERAPY

Dr. Saul, along with Dr. Thomas Levy, recommends nebulized hydrogen peroxide therapy. Similarly, Dr. Robert Rowen has published a commentary about the use of ozone therapy against SARS-COV-2 infection. Both of these treatment alternatives are inexpensive and safe, and could be administered at home.

One point I [Mercola] want to stress after looking more deeply into this is that you may want to be careful about using regular 3% hydrogen peroxide, as they use proprietary stabilizers. By law, they’re not required to disclose those chemicals. So, ideally, you’d want to use food grade hydrogen peroxide and carefully dilute it to a 3% concentration.

According to Dr. Mercola in his article High Heat May Kill the Coronavirus, a sauna kills bacteria, fungi, parasites and viruses and boosts your immune function. He also states that Coronaviruses incubate in your sinuses for about three days before moving to your lungs, but could be destroyed by temperatures around 133 degrees which can be easily reached in a sauna.

Stay safe, stay healthy, stay happy.

Disclaimer: The information contained in this article including recommended dosages, specific supplements or suggested products is for educational purposes only and should not be substituted for medical advice from a doctor or healthcare provider. Please contact your healthcare provider before following any of these recommendations.

MORE FINANCIAL UPDATES DURING COVID-19 PANDEMIC

MORE FINANCIAL UPDATES DURING COVID-19 PANDEMIC

By Don McCann, MA, LMT, LMHC, CSETT

Hope your day is going well, and you are healthy. I have talked to many people who are struggling to keep their mood up and stay positive. On a consult with a well-known integrative medicine practitioner, he asked me if I am taking SAM-E. He said that SAM-E is a very good anti-inflammatory for small aches and pains but also gives a nice mood boost. He is recommending that all his patients take extra-strength SAM-E once a day to help with sleep challenges and handle the stress and the anxiety associated with the life changes due to COVID-19. It sounded like good advice to me so I am now taking it and I am passing his recommendation on to you.

FINANCIAL UPDATES

1. (link to article) I know that many of you are not able to make a living right now and are looking for the government assistance. For those of you who have gone through the unemployment process I know it has been a very difficult and long process. Some good news is the Florida DEO (Department of Economic Opportunity) has opened a new mobile friendly website where Floridians can apply for unemployment benefits. You can access the application at www.FloridaJobs.org/RAApplication . If you haven’t applied for an unemployment benefits claim please complete your application there. It’s important for any Floridian who lost a job due to COVID-19 to complete an application.

2. (link to article) Track your IRS stimulus payments now. First funds will go to people who have filed tax returns for the last two years and have authorized direct deposit. There will be an update on Friday, April 17th, on the “Get My Payment” tool that will guide users to submit banking information so they can receive their stimulus checks more quickly. Paper checks may not go out until May. There will also be a click here to check your payment allowing you to keep track of when and where your payment is.

3. If you are having difficulty with a bank for a Small Business Paycheck Protection Plan or don’t have a bank to apply through, there is good news. PayPal has opened a Small Business Loans Loan Builder where you can apply. (www.loanbuilder.com ) . Don’t hesitate to apply if your bank has not given you good service or you have not applied before. You can receive 2 ½ times your monthly payroll and if the money is used for payroll, rent, and utilities the loan can be forgiven.

4. (link to article) As the stimulus checks come out private debt collectors could grab them from your account. There is no provision in the CARES Act that prohibits debt collectors from garnishing stimulus money that is sitting in a personal bank account. “If people are worried about debt collectors they should take their money out right away,” says Lauren Saunders, Associate Director at the National Consumer Law Center.

Special thank you to Adrian Morell and Joel Rayburn for bringing the financial information to my attention so I can pass it on. Thank you very much.

Stay safe, stay healthy, stay happy.

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