COVID-19 PRACTICE FAQ
This FAQ will be updated as new questions come in and as additional information and details become available.
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GENERAL PRACTICE | COVID-19 VACCINE | PPE | CLEANING & SANITATION | SCREENING & SELF-ISOLATION | TRAVEL & SELF-ISOLATION | FINANCIAL SUPPORT | INSURANCE | MTAM MEMBERSHIP
Q. Are there any restrictions to my clinic reception area or other public common areas?
A. No. While there are no longer restrictions in place it is recommended that clinics use phyisical distancing strategies in the public spaces of your clinic. This helps to ensure the safety and comfort of your clients and helps to prevent too many people congregating at the same time. If possible continue to use staggered schedules and otehr strategies to help manage your indoor public spaces effectively.
PERSONAL PROTECTIVE EQUIPMENT (PPE)
Q. Do both RMTs and patients need to wear masks?
A. RMTs and patients no longer have to wear masks in public spaces. However, the MTAM Board of Directors strongly recommends the use of masks for both therpists and patients whenever physical distance cannot be maintained in order to reduce the transmission of airborne diseases. Check with your clinic owner, individual clinics may have their own masking policy.
Q. What kind of mask should we wear?
A. RMTs may wear medical or non-medical masks. Reusable non-medical masks must:
- be made of at least 3 layers
- 2 layers should be tightly woven material fabric, such as cotton or linen
- the third (middle) layer should be a filter-type fabric, such as non-woven polypropylene fabric
- if you have a 2-layer mask they can often be modified by opening the side and inserting a filter-type fabric layer in the middle and re-stitching the side
- be large enough to completely and comfortably cover the nose, mouth and chin without gaping
- allow for easy breathing
- fit securely to the head with ties or ear loops
- be comfortable and not require frequent adjustments
- be changed as soon as possible if damp or dirty
- maintain its shape after washing and drying
Hearing Impairment and Masks
For some Manitobans, the use of masks may create additional communication challenges. If you're hearing impaired, or interact with people who use lip-reading to communicate, consider wearing a clear mask.
If a clear mask isn't available:
- use written communication or decrease background noise as much as possible
- if writing, don't share writing items. Provide a sanitized pen/pencil for the person to use.
- maintain at least a 2-metre distance if you must rely on lip-reading to communicate
- only the person speaking should remove their mask while communicating
Clear masks can also be used in settings where facial expression is an important part of communication.
Health Canada has guidelines for the use of non-medical masks, including those that are home-made, how to add a filter layer, providing general information, directions for how to put on, remove and clean masks, and sew/no sew instructions.
Q. What is the proper procedure for wearing and storing a mask?
A. The following resources and videos demonstrate how to don (put on), doff (take off) and store a mask. Proper procedure for wearing eye protection is also included.
Donning and Doffing Face Masks (MTAM Video)
How to properly don PPE (video) (Shared Health MB)
How to properly doff PPE (video) (Shared Health MB)
https://sharedhealthmb.ca/files/extended-use-of-face-masks.pdf
Q. What is the process for storing masks in paper bags?
The process for storing masks in paper bags is available here: https://sharedhealthmb.ca/files/extended-use-of-face-masks.pdf. Re-use of masks after breaks is only applied to masks in green zones.
A video demonstrating the process is also available here: https://vimeo.com/403797242
Q. How do I properly dispose of single-use masks and other disposable PPE? Are they considered hazardous waste?
A. While soiled/used masks and PPE are not considered hazardous waste, they should be disposed of with care.
Use a covered trash receptacle. Touch-free trash cans lined with a trash bag are recommended.
Perform meticulous hand hygiene after handling used PPE.
Q. I find that some PPE causes skin related issues – how can I prevent injuries? Please reference the following Shared Health MB document: COVID-19 Tips for Extended PPE Use. This document contains information to assist with a variety of concerns including:
- Mask wearing
- Eye protection
- Face shields
- Dry hands due to frequent hand hygiene
Q. Do I need to wear eye protection?
A. Eye protection is still recommended high risk situations.
While eye protection can be warm and uncomfortable, droplet contact precautions require you to cover your mucous membranes – including your eyes, as these are the points of concern with both direct and indirect transmission.
This MTAM video demonstrates proper Donning and Doffing of Eye Protection
Q. When storing eye protection/goggles in plastic bags, how often should the plastic bag be replaced?
A. If goggles are being disinfected as per the PPE protocol and with appropriate hand hygiene done prior to accessing the bag, it is expected that the bag will be usable a minimum of a full shift. In the event that it becomes damaged or contaminated, replacement will be required.
Q. Do you have a list of suppliers for PPE and cleaning supplies that I need?
A. This may be an ongoing challenge from time to time depending on the supply chain and current demand.
MTAM has found some ADDITIONAL PPE SOURCES to assist members.
Q. What should I be using to clean surfaces between patients?
A. Common touch areas include those in both customer and employee accessed areas. These surfaces need to be cleaned and sanitized between each patient and as needed using:
- diluted bleach, i.e., 20 ml (4 teaspoons) bleach for every litre of water
- alcohol solutions with at least 60 per cent alcohol or
- Health Canada approved household disinfectants
- Shared Health Manitoba approved disinfectants
For additional cleaning and sanitization information also refer to the PPE Resource page.
A NOTE ABOUT CLEANING TOOLS USED IN YOUR PRACTICE:
Any tools used in your practice, including but not limited to IASTM tools, cups and hot stones, must be able to be sanitized.
Tools that are made of porous materials may not be able to be properly sanitized and should not be used at this time.
IASTM Tools and Cups:
- Wash your tools and cups thoroughly with soap and water.
- Sanitize tools and cups in a bath of one of the following chemicals:
- 6% to 7.5% hydrogen peroxide;
- 2% glutaraldehyde;
- 0.2% peracetic acid; or
- 2% to 7% enhanced action formulation hydrogen peroxide and 0.55% ortho-phthalaldehyde (OPA).
Once the tools/cups have soaked in the chemical bath of your choice for the contact time indicated by the manufacturer or the table listed in either of the two references below, then the instruments can be removed from the bath, rinsed with water and left to dry. Once dry, they are ready for re-use.
Click here for more details
Ontario Agency for Health Protection and Promotion (Public Health Ontario). Provincial Infectious Diseases Advisory Committee. Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd ed. Toronto, ON: Queen’s Printer for Ontario: April 2018 https://www.publichealthontario.ca/-/media/documents/bp-environmental-cleaning.pdf?la=en
Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. Guideline for Disinfection and Sterilization in Healthcare Facilities. (2008): February 2017 https://www.cdc.gov/infectioncontrol/guidelines/disinfection/tables/table1.html
Hot Stones:
- Allocate 20 minutes for sanitizing stones after each hot stone treatment.
- Add 1 TBSP (15 ml) of bleach to mild dish soap or stone wash and hot water.
- Place stones in the sink or basin. Wash and scrub each stone. The small amount of bleach will kill bacteria.
- Drain and rinse stones well with clean, hot water.
- Lay all stones on a clean towel and allow to air dry.
- Prior to use, heat stones at 56 °C / 130-140 °F. Use a few drops of tea tree essential oil in your tank for additional anti-bacterial and cleansing properties.
Alternatively you may also place the stones in a dishwasher on the sanitize cycle.
Hydrocollators: MTAM contacted one of the larger manufacturers of hydrocollators (Chattanooga/DJ Orthopedics) to inquire about sanitization procedures. Their response is as follows:
If you keep the hydrocollator unit set at the recommended temperature (160F) at all times, no additional sanitization is needed in relation to the covid situation.
Covers should be laundered between every use and the packs themselves can be cleaned with soap and water.
MTAM also recommends that you use a wipeable plastic or vinyl cover on the packs for easier sanitization. Plastic or vinyl pillow covers may be useful here.
Q. Do all items used/contacted by a client need to be replaced or sanitized after each client?
A. Yes. Whether the item was contacted directly or indirectly by the client, it must be cleaned and sanitized before being reused with another client. If it cannot be cleaned and sanitized, it should not be reused.
Pillows, bolsters, table warmers etc. must be covered by a non-porous, wipeable cover which can be cleaned and sanitized between each client.
All linens, blankets, towels etc. that were in contact with the client must be laundered after each client even if the item was not in direct contact with the client (see note below).
Note – Layering cloth/porous items between other cloth/porous items is not effective at preventing the transmission of COVID-19 (for example - a blanket placed between 2 top sheets or covering a cloth pillow with multiple cloth pillowcases). Cloth covers are porous and cannot be appropriately sanitized without laundering.
Q. What do I need to know about laundering linens?
A. Linens should be washed with detergent and water at the highest water temperature setting and dried at the highest temperature.
Store clean linens away from soiled linens. Enclosed cabinets or covered storage bins are recommended.
Q. Do I still need to screen clients and when should they be screened?
A. RMTs should be screening their client's general health before every appointment to determine if massage therapy is appropriate.
The Shared Health Screening Tool can be used for general health/respiratory illness screening and to identify if it is safe to proceed with scheduling/continuing with an appointment.
As always, MTAM Members must follow the MTAM Standards of Practice.
Standards 1, 3, 5, 9 and 15 specifically apply to public health, hygiene, and risk management for infectious diseases, and the use of personal protective equipment (PPE).
Q. Some clients do not pass/will never pass the Screening Tool depending on their occupation or other unique circumstance. Does that mean that I can never provide a treatment to them?
A. Frequently, RMTs will have to do a risk assessment and use their professional judgement to determine how to proceed.
Q. I'm an RMT who is showing mild symptoms consistent with COVID-19. What do I do?
A. Public Health recommends that you take a Rapid Antigen Test (RAT). Follow routine precautions and the Health Care Worker Return to Work Guidelines.
Q. I have received a negative COVID-19 test result but still have symptoms. Do I need to isolate?
A. Follow the Health Care Worker Return to Work Guidelines.
Q. I am a close contact of someone who has tested positive for Covid-19. Do I need to self-isolate and if so, for how long?
A. Follow the Health Care Worker Return to Work Guidelines
These Fact Sheets are made available by the Government of Manitoba and provide additional information on self-monitoring, self-isolating, and caring for individuals who are recovering from COVID-19 at home. Additional versions in other languages will be made available on the Government of Manitoba website.
- Isolation & Self-Monitoring For Symptomatic Individuals Recovering at Home (pdf)
- How to care for a person with COVID-19 at home (pdf)
- Temperature Self-Monitoring Form (pdf)
- Prepare and Prevent
Q. What are the current guidelines regarding out-of-province travel and self-isolation after returning from travel?
A. MTAM recommends that RMTs and massage therapy clients should be mindful of current provincial and federal travel restrictions and self-isolation requirements.
Full details on all other out-of-province travel restrictions and self-isolation can be found on the Government of Canada websites.
Every practice is different and staff may need to take additional precautions to minimize the risk of transmition to their clients and staff. If your clinic has determined that they require more stringent policies to minimize risk of transmission, RMTs and clinics should clearly communicate the policy to clients.
Q. I was required to self-isolate for 14 days by Public Health. Do I qualify for one of the federal benefit programs?
A. The Canada Recovery Sickness Benefit (CRSB) came into effect on September 27, 2020 and run until May 7, 2022 to workers where sick or self-isolated for reasons related to COVID-19. Workers who were sick or self-isolating between those dates may still qualigy. Full details are available on the Government of Canada website.
Q. Will I be eligible to collect the CRSB if I had to self-isolate longer than 14 days or if I have to self-isolate multiple times in the year?
A. The Canada Recovery Sickness Benefit (CRSB) came into effect on September 27, 2020 and run until May 7, 2022 to workers where sick or self-isolated for reasons related to COVID-19. Full program requirements are available on the Government of Canada website.
Q. I can't work because I need to care for someone due to COVID-19 (e.g., child care, caring for someone who has COVID-19). What federal benefit program might I qualify for?
The new Canada Recovery Caregiving Benefit (CRCB) will be effective from September 27, 2020, for one year and provide $500 per week for up to 26 weeks per household to eligible Canadians.
Some examples of individuals who qualify for the CRCB include persons who:
- must take care of a child who is under 12 years of age due to reasons related to COVID-19
- must provide care to a family member with a disability or a dependent due to reasons related to COVID-19
Additional details on the eligibility requirements for collecting CRCB are available on the Government of Canada website.
Q. I’m still able to work but my income is reduced due to the pandemic. Is there federal support available to me?
Beginning September 27, 2020 the new Canada Recovery Benefit (CRB) will be available to workers who are self-employed or are not eligible for EI and who still require income support and who are available and looking for work. This benefit would support Canadians whose income has dropped or not returned due to COVID-19.
Additional details on the eligibility requirements for collecting CRB are available on the Government of Canada website.
Q. Because we were not mandated to shut-down by the provice I'm not eligible to apply for the new provincial Bridge Grant. Is MTAM advocating on our behalf to request a change to the eligiblity criteria?
A. Yes. The Board recognizes that the Premier's decision failed to address the drop in income that many small business owners/sole proprietors experienced due to client cancellations and overall decreased business that resulted from the move to a Critical/Red response level.
On December 8th the Premier announced modifications to the eligibility criteria for the Bridge Grant. These modifications currently do not allow Health Professionals to apply. Read the details here.
MTAM is strongly advocating to the government that they include health professionals in the eligiblity criteria to apply for the Bridge Grant program. Read the letter.
Q. I still have questions about CRB, CERB, CEBA and some of the other financial supports or relief available to me. Where can I find more information?
Here are several links that may be helpful:
Canadian Emergency Response Benefit (CERB)
Canada’s COVID-19 Economic Response Plan
Business Credit Availability Program
GST Tax Deferral FAQ
Business Development Bank of Canada (BDC): Support for entrepreneurs impacted by coronavirus
Manitoba Chambers of Commerce
Manitoba Hydro offering payment assistance
Canadian Federation of Independent Business
Q. Is our liability insurance in effect at this time?
A. Yes. Your regular professional and general liability insurance will be intact and in effect as you continue practicing at this time. You will still need to follow all current public health orders and MTAM practice recommendations.
There is still a limitation with regard to a COVID-19 related claim; however, BFL/Trisura would look at the details of any claim. Coverage can only be determined on a case-by-case basis, upon consideration of the particular facts of any claim, together with the terms, conditions, limitations and exclusions contained in the applicable policy.
This means that the insurance company takes into account all of the safety precautions and procedures that you use and how effectively you implement them in your practice. While this does not guarantee full protection it does minimize your overall risk.
Please continue to refer to the Return to Practice Guidelines and this FAQ as well as ongoing updates from MTAM.
Q. What is MTAM doing to help members protect their practices and recover as quickly as possible?
A. The MTAM Board and staff continue to work diligently to provide fast and reliable information to members. Information is meant to assist members in making informed decisions regarding their practices.
MTAM will continue to advocate for better financial support from the province during the pandemic for RMT small business owners, quicker inclusion of massage therapy into the RHPA, and the removal of GST from RMT treatment fees.
MTAM will continue create new resources and courses to help members adapt and recover from this situation. We will base new courses and resources on the questions and concerns we receive from members in the coming weeks as well as looking ahead to potential changes that may occur in the massage therapy profession in Manitoba.
Marketing and communication on behalf of members will take place to encourage Manitobans to resume seeing their MTAM RMT as long as it’s safe to do so. We will use a combination of media formats to get our message to the public. Digital media, social media, radio, TV and print ads are all being considered.
Additional business resources for self-employed RMTs, employees and employers/clinic owners are already posted on the COVID-19 page of the MTAM website.
Q. Will there be accommodations made to assist members who are in the 2019-2021 education cycle?
A. Yes. The Education & Continuing Competency Committee has elected to extend the 2019-21 education cycles by one full year to allow additional time to complete professional development activities.
Read the full ECC announcement here.
