Assessing Your Risks in a COVID World
By Rebecca Barnett
You’re a kid with an overbite attending your routine check up with the orthodontist.
Your orthodontist is a tiny bit eccentric and a lot manic. He alternates between patients in 2 separate clinic rooms. You’re lying back in the dental chair in one clinic room waiting and listening to the orthodontist wrap up an appointment with another kid who has a class 1 malocclusion. You might even be hoping that the orthodontist doesn’t tighten the wire on your braces too hard this time so you can’t eat anything hard for a week. Like sultanas.
The orthodontist comes bolting into your clinic room, fresh from treating the other kid. He’s not wearing gloves. He hasn’t washed his hands. He asks you to open wide and then starts poking around in your gob with his unwashed, ungloved hands. You lie back praying that the kid he’s just finished treating doesn’t have a bad cold. Or anything really.
It’s not that you’re an infection control expert. You’re only, like, 14. But it does seem pretty freaky that another kid’s saliva is probably still on those fingers that are now in your gob and you’re not sure how many other kid’s gobs the fingers have prodded around in without being washed in between. And you may not know how to spell autoclave but it seems pretty pointless to heat all those instruments to bug-killing high temperatures and then throw caution to the wind with your hand hygiene. And seriously – how gross must it be to get slobbered on by pubescent strangers?
The whole scenario is obviously completely implausible.
And yet, that memory is etched into my brain indelibly. The scene is the dental unit at Royal North Shore Hospital in the early 1980s. It was host to a public orthodontic clinic once a month. My Dad ran the dental unit so I benefited from publicly funded braces during an era of extraordinarily laissez-faire, optional infection control. Washing hands between patients was obviously preferable and some dentists even routinely wore gloves but, man, things were remarkably loose. Eyebrows were no doubt raised by some of these slack practices but, if they were taking place in a hospital dental clinic, imagine how wild west things would have been in some private dental clinics around that time! Poor old Semmelweis would have been rolling in his grave.
And then, in 1982, the AIDS epidemic arrived on Australian shores and the dental profession was never quite the same again. The era of laissez-faire infection control came to a pretty abrupt ending. I never experienced an ungloved treatment again. The slick, routine infection control you associate with the modern dental clinic was born out of the threat of HIV.
It also explains why, when COVID-19 hit Australia and the pandemic started peaking, the Dental Profession could present a staged plan to the Australian Health Protection Principle Committee to close down certain procedures, identifying different levels of risk. They have a 38-year head start on us.
The massage therapy industry is now facing a similar reckoning to that which faced dentistry nearly 4 decades ago. Our safe, reassuring clinic rooms have taken on a sense of threat because of a virus that particularly likes being in enclosed spaces over a prolonged period. Massage therapists are putting in place protocols to manage the risk of virus transmission and our clinics will probably never look quite the same again.
As you know, AMT’s Biosecurity Planning Committee is working on a plan to guide massage therapists response to COVID-19. In this first phase, we are asking you to complete a self-assessment to identify how you can start mitigating the risks associated with the pandemic. It is with both pride and sadness that we make this tool available to you to start this journey into post-COVID practice. Please download our Return to Practice Self Assessment Tool here and get started.
If the last two months has shown us anything definitive, it is the extent to which our clients value massage therapy as a physical, emotional and existential agent of therapeutic goodness. Clients have been clamouring for massage therapists to reopen their practices. Let’s hope that, in the race to reopen, we don’t forget our first duty to do no harm and put our clients at risk by not implementing protocols and policies that mitigate the risks.
I hope you will walk the path with the AMT Biosecurity Planning Committee to re-imagine your practices in a COVID-19 world.
About the Author
As CEO of AMT, Rebecca Barnett is excited by the opportunities that the massage therapy profession has to purge itself of persistent myths through evidence and education. She also acknowledges that her purify through cheese diet will not protect her from COVID-19 but she is committed to it regardless.