I’m just going to say this about our reopening day: Holy f***!
First, will my ears go back to normal or are Dumbo-mask-ears now part of the badge of honor for doing massage in the Covid-19 era?
Second, did I actually lose 15 pounds of water weight between my eyes and chin?
Third, clients touch a lot of sh**.
And this one is specifically directed to my client Doug: Dude, you coughed directly on my freakin’ arm. Seriously?!
I know, I was talking big a couple of posts ago. In fact, I was sort of taking a victory lap around the track before our reopening day even happened. After all, I’ve been doing this massage thing for nearly 30 years.
But, yeah, Mr. Veteran Massage Mark was a little shell-shocked on Reopening Day.
And it wasn’t like I hadn’t prepared myself for reopening.
As soon as the first client arrived in the parking lot I went through my checklist.
Mask?
Check.
HEPA air filtration system on?
Check.
Windows open?
Check.
Text the client to come in.
Check.
Send client straight into the room.
Check.
Take the client’s temperature.
Check.
Client on the table with mask on.
Check.
Get less than 6 feet away from away the client, no, actually get as close as you need to get to the client’s Covid holes—all three of them!—to do your job even though you’ve stayed 6 feet apart from everyone in your life except your wife for nearly 4 months.
…
I repeat get less than 6 feet away from away the client, no, actually get as close as you need to get to the client’s Covid holes—all three of them!—to do your job even though you’ve stayed 6 feet apart from everyone in your life except your wife for nearly 4 months.
…
Hello?
Oh f***, okay, check.
This is the tough one, right?
There are solutions for Dumbo ears, like stop shrinking your cloth masks by putting them in the dryer.
Even raisin face can be addressed by putting more time in between clients so that you can walk around outside with your mask off.
But addressing prolonged potential exposure to the virus when our jobs require us to be in a massage room for 60 minutes or more is not something we can change.
Which bring us to this question: Does increased exposure to the virus increase the chances of you getting it?
According to Dr. Ananya Mandal, M.D., the answer is yes.
However, it should be pointed out that she is referring to frontline medical workers who are working with patients who are infected with Covid-19.
In theory, a massage client who may have Covid-19 will be presymptomatic (has Covid-19 and is not exhibiting symptoms yet) or is asymptomatic (has Covid-19 but symptoms never develop).
In other words, Jamal is not walking through your door and getting on your table with a fever and a dry cough.
So, from the get-go we are going to see way less people walking into our massage room infected with Covid-19 than medical workers will see.
But here’s the thing, research suggests that asymptomatic transmission of Covid-19 could account for 30% to 45% of Covid-19 cases.
It’s really hard to find the asymptomatic cases if you’re doing everything right, like “screening, case investigation, contact tracing and isolation of infected persons during periods of community transmission.” (Source)
And when you’re not doing such a good job, like in the US, then we, massage therapists, have to accept the risk that the person who gets on the table could have Covid-19 and be asymptomatic or pre-symptomatic.
So, let’s play that out. An asymptomatic or presymptomatic Covid-19 walks in your door for a 60 minute massage.
Is there a greater chance of you getting Covid-19 from being in the room with that person for 60 minutes as opposed to 60 seconds?
Yes.
“A higher viral infective dose or more viruses a person comes in contact with can result in a higher risk of infection, and in some cases, the infection may be more severe compared to others,” says Dr. Mandal when talking about viral transmission.
The more severe infection part could be that more cells get infected when there’s more viruses present to infect cells.
The higher risk of infection is about probability.
An asymptomatic client gets on your table for 60 seconds and there are 12 to 20 breaths of his viral aerosols in the air.
If that same asymptomatic client stays on your table for 60 minutes, then there are now 720 to 1200 breaths of his viral aerosols in the air.
Which air do you want to be in?
It makes sense that your chances of getting Covid-19 are higher in the 720-breath air.
The ultimate defense against exposure and transmission of Covid-19 through pre-sypmtomatic and asymptomatic people has been 100% removed because we can’t do our jobs 6 feet away from the client.
So, we need our next best line of defense: masks.
A while back two hair stylists in Sprinfield, Missouri tested positive for Covid-19 after interacting with 140 clients and 6 coworkers.
Here’s the important thing: No one they interacted with was known to get Covid-19.
How did that happen?
Most experts think it was because both the hair stylists, fellow employees and customers wore masks.
Studies seem to be supporting this conclusion.
That’s worth repeating: In the hair stylists’ impromptu experiment experts think the reason why customers and workers alike didn’t spread Covid-19 was because they were wearing masks.
There’s no other way around this: Clients must wear masks.
Admittedly, the first day I made an exception to the client mask rule because a particular client was having a hard time breathing in his cloth mask when he was face down. But that was easily remedied the next day with another client who had the same issue by providing him with a disposable mask.
Having disposable masks assures that no one will be turned away for forgetting to bring a mask.
That said, it doesn’t necessarily help with the client who wants what he wants.
If you’re not a fan of saying no to clients, especially long-term clients who think that not wearing a mask is part of their special privilege package then you’re going to want to do this: Put up a sign in your office that states masks are manditory.
A “Masks Are Required” sign reinforces masks as the norm, not the exception. It sets the stage for compliance.
By the way, do you know what reinforces masks as the norm better than a sign?
More signs.
Put the “Masks Are Required” signs on the building’s front door, in the bathroom, down the hallway, in your waiting room, in your massage room, on your client…you get the point.
Speaking of establishing new norms, we now have Covid-19 Policy Notifications form for the client to sign.
It has a dual purpose. The client is made aware of the risks and the requirements for getting a massage now. It’s also a potential way to help protect ourselves and our business should someone accuse us of negligence.
We get this out to the client (email or text) before the client comes in to give the client time to digest the rules. If the client doesn’t want to comply, he can then contact us and cancel his appointment.
One more thing about signs—they’re cheap to do.
Ours are done with our printer on regular copy paper.
It’s probably the cheapest intervention that you can do with potentially the biggest safety bang for your buck.
So, you got the signs, you got the waiver, and you can call me to yell at (or fire) your client who refuses to wear a mask—but what about the type of mask you’re going to wear?
Here are three tips when picking a mask.
(1) Multiple layers are better than one.
(2) How well the mask seals around your face is important.
(3) Mask with valves for exhalation are not good.
This NPR article provides a comprehensive analysis for choosing a mask.
Personally, I double mask.
My first layer is a disposable mask and my second layer is a cloth mask. You might think that this would be too hot, but surprisingly it’s not AND the disposable mask feels better around my nose (makes the skin less itchy) than a cloth mask alone.
Why do I double mask?
I consider my wife, Lisa, to be high-risk because she’s a Covid-19 long hauler (someone who had Covid-19 and is still dealing with Covid issues weeks/months later).
We’re not sure if she has antibodies yet (and if she does, no one knows if antibodies equal immunity).
I’m going to do everything I can NOT to bring Covid back home.
So, yes, I will continue to keep a window open in the massage room.
I will continue to crack open the massage room door if the client is comfortable with the door being open.
I’ll continue to run the portable HEPA air purifier by the client’s head.
But most importantly, I will wear a mask and my clients will wear masks, too.
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