Issue link: https://www.massageandbodyworkdigital.com/i/1231077
if they know for sure that they are virus- free, and all the people in their life are virus-free. Further, I suggest they only work with clients who are also known to be virus- free. Any other choice would continue to put people at unnecessary risk. Would using masks and gloves during massage cut down on the risk of communicability? Possibly. Would it reduce that risk enough to make it safe to practice? My opinion (and it's just my opinion!) is no. I would be happy to be proved wrong. But the safest, lowest-risk option is to know that both parties in the massage therapy session are uninfected. Later, when a large portion of the population has been exposed or vaccinated, then I predict that massage therapy practices will be able to operate more freely. Even then, I still recommend that massage therapists work only if they are immune, either through a history of exposure, or by vaccine. I predict that when we reach this time, we will be busier than ever, and well- appreciated by other health-care providers who can recommend self-care, pain relief, and stress reduction through our work. (I know I can't wait to get on a table—I have never needed a massage more.) I have one more important point about opening up again. Even with a phase- in reentry, massage therapists must be prepared to close again if necessary. Many experts predict a second wave of infections a few months after our initial numbers recede. This may require that we go back into isolation for some period of time, although we should be better able to deal with another outbreak by then. If we plan ahead for this, we will be more able to anticipate all the factors that go into this decision. When We Reopen What kinds of changes do we need to make when the time is right to reopen our doors? I have a few suggestions: Testing For massage therapy (and other businesses) to be safe again, we need to know who has the virus now, and who has had it in the past—and we need this information quickly and accurately. This involves at least two different types of tests, possibly at multiple times. Who has it now? The test we currently rely on involves a nasal swab that is inserted way-the-heck to the back of the sinuses to get a mucus sample, which is then examined for signs of the COVID-19 genetic material. There are a couple of problems with this system. One is that it takes several days to get results, so a person who has been tested may be infectious but not yet be instructed to self-isolate. The other is that this test has a high rate of false negatives. That is, the person is pronounced COVID-free, even though they may not be. This has repercussions for their own health of course, but also for the well-being of everyone they contact. Having an accurate test that provides answers in hours (or even minutes) about a person's infectious status is a critical step in the transition back to normalcy. Who has already had it? The other test we need, a serum antibody test, looks for signs of past infection. Antibodies appear in the blood serum about five days after exposure, so it may be necessary to do this test twice. An antibody test shows a history of exposure, but it doesn't indicate current status—this is why the swab test is still necessary. Many people may already have been exposed to the virus and either had no symptoms, or assumed they had the flu. We need to know who they are! If a person is positive for the antibody, but negative for the nasal swab, this means they have some level of immunity, and it is safer for them to be in public than for others. Antibody tests are being used for people with confirmed infections now, and should be available to the general public soon. All this presupposes that exposure to the virus renders effective immunity, which is still an open question. We see in human and animal models with infections involving a similar coronavirus that exposure provides immunity for at least a few years. We also see that this virus has been slow to mutate. Those facts together suggest (but don't promise) that a history of exposure may offer some protection from new infections—protection that will probably last until a vaccine can be made available. The availability of fast, accurate swab tests and serum antibody tests are a high priority in making decisions about going back to work. People need to use them so we can collect important data. Until we have a clear idea of our own and our clients' infection status, it is not realistic to think about reopening a massage practice. The availability and accuracy of widespread testing is the factor that will determine the timeline—not a politician's announcement. 44 m a s s a g e & b o d y w o r k C O V I D - 1 9 s p e c i a l i s s u e 2 0 2 0