Updated coronavirus policies - Living with COVID

This webpage helps explain my ongoing policies and procedures, clinic setup (ie. Infection control), and therapist PPE. My policies and procedures have been continuously adapted and updated throughout the pandemic using in-depth risk assessment and extensive consideration of government guidelines, professional association/CNHC/GCMT advice and indicated coronavirus legislation. As we progress towards ‘living with COVID’ as an endemic disease, and have developed a greater awareness of how transmission occurs (ie airborne predominantly), I have eased some of my control measures, which are no longer indicated. However, your safety, and keeping the clinic open, are still my priority.

AAB Coronavirus (lockdown) Risk Assessment update 16-2-21

Ongoing coronavirus control measures/policies

  • I will (indefinitely) continue to wear a disposable type IIR surgical face mask while treating/consulting with clients. Disposed of daily.

  • Clients are expected to complete a (shortened) ‘coronavirus pre-treatment checks’ form, the night before their treatment (via email/text). This form will check they are COVID & cold symptom free, have not tested positive, and have not had a prolonged COVID exposure in the last 10 days (eg. household member).

  • New clients will be refused treatment without first completing a ‘new client questionnaire’. This includes a coronavirus section, to check they are not infected and are safe to treat. It will be emailed to them to complete in advance of their consultation, to reduce potential transmission time.

  • Appropriate infection control signage to be displayed in clinic, on entry and by hand-wash sinks.

  • Advanced hand/forearm hygiene (20 second wash with antimicrobial hand-soap) to be performed by Kipp on arrival at the clinic, between clients and after lunch.

  • Clients will be encouraged to wear a mask while in the clinic (unless exempt or face down, couch roll substituted). This is however, no longer mandatory.

  • Clients are encouraged to sanitize (or wash) their hands on entry to the clinic. Sanitizer in clinic and on the windowsill outside the clinic.

  • Used laundry will be put in a red lidded laundry box after use, and washed at home. To return to clinic in green ‘clean laundry box.

  • Cliniko clinic software now used for booking appointments, and to avoid the use of paper files. Reception in Complete Feet no longer used for waiting/booking.

  • You are not required to give the standard 24 hours’ notice for cancelling an appointment if you have COVID-19 symptoms, or a positive test (you will have to contact Kipp directly though, as you won’t be able to cancel via Clinko within 24 hours) or have been exposed to coronavirus. No cancellation fee will be charged in this instance.

  • Wipe clean chairs, bolsters and treatment couch. Sanitized after use with specialist antimicrobial cleaner.

  • A blue plastic box is provided for mask, phone, wallet, keys etc in BLUE plastic boxes during consultation/treatment. This will be sanitized after use.

  • Visor used if requested by client, if working around the face of a vulnerable client, or if indicated for other reasons. Gloves and a waterproof apron (ie full PPE) can be worn on request of client.

  • You may be refused treatment if you appear ill, have an unexplained cough, or have a temperature (I may ask to check your temperature with a contactless thermometer).

  • It is ESSENTIAL that you follow my coronavirus policies, to keep therapists/clients/the clinic safe, or you may be refused treatment.

  • You must contact me if you fall ill with coronavirus symptoms within 2 days of treatment, as I will need to test & monitor myself post exposure, and potentially notify the client after you.

  • If you have recently had coronavirus, 10 days must have passed since symptom onset or your positive test, or 2 consecutive days negative tests taken, for you to be treated at the AAB clinic.

  • If you have had severe coronavirus infection (ie. been hospitalize) I cannot treat you for 3 months after discharge without reassurance that you have checked with your doctor that there is no medical reason (contraindication) that you should not be treated (due to post CV-19 complications/clotting issues). Please consult your doctor before treatment.

    • I will contact any clients I have treated within the last 48 hours, if I come down with COVID, or have a positive test, to inform them of the potential exposure.
  • If a client contacts me to tell me they have developed COVID within 48 hours of an appointment, I will test before each clinic for 10 days from this appointment. I will also contact the client after this appointment, to let them know they may have been exposed (ie via airborne viral particles).

  • To aid ventilation/reduce transmission risk I will have the window open, if weather allows. I will also have an air purifier (with HEPA filter) with UV germ killer running at all times in the clinic, to reduce transmission risk.

  • I will take a weekly LFD test, In case of asymptomatic COVID infection, and cancel the clinic/s if positive.

  • I will close the clinic when infected with COVID. I will either not work for 10 days from positive test result/symptoms, or unless I have two consecutive negative tests (from day 5), whichever is sooner.

  • I will take a test before each clinic if I have had a prolonged COVID exposure (ie over 1 hour, or a positive household member) in the last 10 days. I will contact clients to inform them of my exposure, offering to postpone their treatment till after the ‘10 days post exposure’ period.

  • I will take an LFD test is I develop any mild cold symptoms (eg a sore throat, runny nose, chest congestion, general malaise).

  • Regular sanitation of ‘touch points’, with specialist antimicrobial cleaner.

  • Appropriate cleaning/mopping of clinic with antimicrobial cleaner, at the end of each clinic.

Withdrawn control measures/policies

  • Mandatory mask wearing in clinic for clients.

  • Short and longer treatments are no longer available, all (hands-on) treatments now 35 or 50 minutes.

  • Extra time (15 minutes) scheduled between appointments, for airing and deep cleaning.

  • Therapist wearing of ‘full’ PPE (ie visor, apron, nitrile gloves). Kipp will continue to wear a mask.

  • Clothes/bag to be put in blue plastic box.

  • Attending clinic alone.

  • Avoiding face work, or working over the head.

  • Please pay by card, bank transfer or IZettle payment links, not cash.

  • Discouraging hands on treatment for vulnerable groups or the over 70’s.

  • If you have had coronavirus, I cannot treat you until you have been symptom free for a full 10 days.

  • NHS COVID-19 Track & Trace QR code poster displayed - taken down due to government advice.

You & your households health

I have many control measures and policies in place to reduce in-clinic transmission risk, plus I am now vaccinated, further reducing transmission risk. However, wherever humans are in contact a (small) transmission risk still exists. For most healthy & younger people the likelihood of serious illness is considerably lower, so they may be less concerned with a (low) infection risk. However, people who are older (esp 70+), or have health complications, would be wise to still consider infection risk in their movements & actions. The government has identified 2 groups more likely to get seriously ill with COVID-19; vulnerable and extremely vulnerable:

VULNERABLE A large number of people fall into the ‘vulnerable’ (moderate risk) category, including:

  • People 70 or older
  • People with a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis)
  • Those with heart disease (such as heart failure)
  • Diabetics
  • People with chronic kidney disease or liver disease (such as hepatitis)
  • Those with a condition affecting the brain or nerves (such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy)
  • People with a condition that means they have a high risk of getting infections
  • Those taking medicine that can affect the immune system (such as low doses of steroids)
  • Very obese (a BMI of 40 or above) individuals
  • Pregnant ladies

EXTREMELY VULNERABLE People at high risk from serious coronavirus illness include those who:

  • have had an organ transplant
  • are having chemotherapy or antibody treatment for cancer, including immunotherapy
  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer
  • adults with Down’s syndrome
  • are having targeted cancer treatments that can affect the immune system (such as protein -kinase inhibitors or PARP inhibitors)
  • have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
  • have had a bone marrow or stem cell transplant in the past 6 months, or are still taking immunosuppressant medicine
  • have been told by a doctor they have a severe lung condition (such as cystic fibrosis, severe asthma or severe COPD)
  • have a condition that means they have a very high risk of getting infections (such as SCID or sickle cell)
  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)
  • adults on dialysis or with chronic kidney disease (stage 5)
  • have a serious heart condition and are pregnant

Prior coronavirus infection

Another important factor I must consider with regards to your health is prior coronavirus (COVID-19) infection. I am able to treat people who have had coronavirus; however, it is very important that you let me know about severe COVID illness or long COVID. If you have been seriously ill (hospitalised) with COVID I will need you to check with your doctor that there is no medical reason which contraindicates treatment/massage. This is because coronavirus thickens the blood causing clotting problems and increasing the risk of thrombosis, stroke and pulmonary embolism (all contraindicated for treatment). If you have had any of these conditions, coagulopathy (clotting problems), or unusual pain/swelling/cramping in your legs you must let Kipp know prior to treatment, in case treatment is contraindicated. If you have any unusual rashes post infection, please let Kipp know, as these may make clotting issues more likely. Also let Kipp know if you have been put on blood thinners such as warfarin or heparin, or on steroids, prior to treatment.

Information sources

https://www.cnhc.org.uk/covid-19_government_guidance https://www.gov.uk/guidance/reducing-the-spread-of-respiratory-infections-including-covid-19-in-the-workplace https://www.gcmt.org.uk/covid-19.html https://www.ctha.com/

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