Wave 2 is here in the US.

If you’re going to continue doing massage during possibly the worst phase of COVID-19, you need to step up your safety plan to keep your client and YOU as safe as possible.

In this post, I want to specifically talk about protecting yourself so that you don’t get sick, spread the virus and/or have to shut down.

How do you protect yourself from a client giving you COVID-19?

Implement mitigation strategies for contact transmission and airborne transmission.

Contact Transmission and Airborne Transmission

I’m assuming that you have the contact transmission of COVID-19 in check through cleaning and disinfecting protocols you follow.

I’m going to focus on airborne transmission of COVID-19 because we (massage therapists) break so many of the COVID-19 airborne transmission safety rules.

For one, we have to do our work inside, not outside (unless you live in the tropics).

We can’t social distance to do our job. In fact, we are in close contact.

And if you’re in close contact, less than 6 feet, with someone who has COVID-19 for 15 minutes or longer, then the CDC wants you to quarantine for 14 days. (https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html)

But, Mark, my clients don’t have COVID-19.

Actually, how do you know?

40% of COVID-19 cases are asymptomatic.

And a temperature check is just one data point that will only catch a potentially COVID-19 infected client if she/he has a high fever.

To be as safe as possible while you continue to do massage from here on out, you need to act is if every client that walks into your massage office has COVID-19.

By acting as if the client has COVID-19 you can potentially reduce the risk of you getting COVID-19 should the client actually have it.

I’m seriously not trying to scare you to the point of quitting massage. I’m simply providing a mental framework to keep you vigilant and on your toes so that you keep yourself as safe as possible while doing massage during the 2^nd wave of this pandemic.

Here’s how I mitigate risks of getting COVID-19 in the massage room through airborne transmission.

I create an environment that is more like outside than inside and I wear medical grade PPE.

PPE in the Massage Room

Let’s start with PPE.

I wear an N95 respirator.

Why?

Because it filters out at least 95% of airborne particles. It’s what healthcare professionals who are on the frontline wear. It’s what medical professional clients tell me to wear.

My advice is to not skimp here. Bite the bullet. An N95 is about $4 a piece, but you can re-use them by rotating them throughout the week. A box of 20 got me through 3 months. Read more about N95s and other masks here.

I put a fresh disposable mask over the N95 for each massage to keep the outer side of N95 cleaner. By cleaner I mean less likely to be contaminated with the virus if it is airborne.

I wear a face shield to protect from COVID-19 entering my eyes. I think there is enough evidence to warrant a face shield. You can decide for yourself: Massage Therapist—Wear A Face Shield During COVID-19.

Air Exchange in Your Massage Room

That’s PPE, now let’s talk about air exchange in the massage room: You want lots of it.

Why?

If a client has COVID-19, you ultimately don’t want to breathe in any virus.

Assume you’re wearing an N95. That’s good, but it’s an N95, not an N100, right? So, some particles are getting in and at some point you might be breathing in COVID-19 air.

Fresh air coming into the room and stale air going out helps with diluting the room air or getting the potential virus out of the room.

How do you get good air exchange in your massage room?

Simple. Just open a window and if you’re space allows it and your client is comfortable with it, open the massage room door, too.

Now, let’s talk about airborne transmission and viral load. If a client comes into your office and has COVID-19 but is asymptomatic and you have an N95 on and a window and a door open, you’re still probably not going to be able to dodge every COVID-19 particle in the room.

BUT if you reduce the amount of exposure time to COVID-19, you could be reducing the viral load, the amount of virus that gets into your bloodstream, and that could just be the ticket to getting a low-grade infection instead of a severe infection.

So, how do you minimize potential viral load?

By minimizing how much potential COVID-19 air you breathe in.

Masks help with that.

So does opening a window and a door by “diluting” the air.

An air purifier may reduce viral load by killing the virus, but they are expensive.

The good news is that there’s something super-inexpensive, in fact free, that you can do to potentially reduce viral load.

It’s work COVID-19 smart.

Work COVID-19 Smart

Did you ever see demonstrations of someone talking or sneezing with a standard cotton mask on? The area of droplet spray is around the edges of the mask, especially around the nose where there tends to be bigger gaps between the material and the face.

Think about that when your client is face up or even face down on the table. Where do you want to be in relation to droplet flow? Not above the nose, right?

This is a challenge for me because I love doing supine neck and face work. But since COVID-19 mask demonstrations I realized that the above-the-head position not only puts me close to the clients face, but also aligns me with where the biggest gaps in the face mask are.

So here’s how I’ve adapted to spend less time in the potential COVID-19 exposure zone. I…

(1) do less work at the head of the table by working from the shoulders.

(2) spend less time working at the head of the table in general, 1 – 3 minutes at time.

(3) have the client not talk when working at the head of the table.

(4) use a fan to blow client exhalation away when I’m at the head of the table (yet to try).

(5) turn off any heating or cooling device that is blowing the clients exhalation towards me while I’m at the head of the table working.

(6) work up and down a body instead of side to side so that I can break up the amount of time that I’m close to the client’s face.

(7) let my room air-out after the massage.

(8) rotate between two massage rooms.

(9) wear all PPE, N95 and face shield, when cleaning the room in case there still may be aerosolized COVID-19 particles in the room.

The idea here is to not to drive yourself crazy; it’s to give yourself ways to reduce your potential exposure time to the virus so that you don’t get sick (or die), become a long-hauler or spread the virus and subject others to the virus’s wrath.

We Got This

When my mom was in her last months and I was wearing thin between trying to take care of her and doing my work and not sucking as a husband, I remember hearing myself say, This is not forever.

The severity of COVID-19 will end. Yes, it’s going to be around for a while, and the 2^nd wave is here in the US, but it won’t be forever.

So, keep yourself as safe as possible during Wave #2 by acting as if your client has COVID-19.

Think about the strategies I just talked about.

Try them. Use the ones that seem to have merit to you.

You’ll think of more.

And we’ll get through this:-)

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