What does in clinic physiotherapy look like in the midst of the COVID-19 pandemic?

I’m finally allowed to go back to work! Last week, the provincial government amended its directive to include physiotherapy clinics in its list of essential businesses. As clinicians, we have been eagerly looking forward to this day for quite some time. However, with that excitement comes along a healthy amount of concern about protecting our patients and ourselves from COVID-19.

Yesterday, I had my first in person patient since March 14th. It is safe to say that I was nervous—it almost felt like I was starting my career over again, with the added complexity of personal protective equipment (PPE) use. Prepping for the session brought me back to the time I spent studying for the national certification exam, mentally walking through each aspect of the visit to make sure that I would be prepared for any possible outcome.

Once the session started, it was as if I’d never left the clinic. It’s amazing how quickly things come back to us after taking time off. I had myself convinced that going back to work during a pandemic would be much scarier than it was. I thought I would spend every second of my day worrying about the ways I would inadvertently put a patient at risk by breaking infection prevention protocol.

When it comes to preventing the spread of a communicable disease like COVID-19, we are simply building on our existing protocols to create more robust and effective ones. In many cases, this practice re-evaluation is long overdue, and physiotherapists will come out on the other side of the pandemic as experts in cleanliness. If you’re unsure what an in-person physiotherapy session will look like going forward, here’s how it looks at the clinics I’m working with:

1) All patients are screened on the phone prior to their session with a Ministry of Health COVID-19 questionnaire to determine whether they are appropriate for in person care or virtual care.

2) All patients and therapists will answer the questionnaire again in person prior to entering the clinic.

3) All patients and therapists have their temperature read upon entering the clinic.

4) If patients answer “Yes” to any of the COVID-19 screening questions, or if they have a fever, care will be deferred and they will be recommended to contact their local health network.

5) All therapists wear a surgical mask when providing patient care or when they are within proximity to others. Patients wear their own mask, or the clinic provides them with a mask while in clinic.

6) When doing manual therapy on an area near to a patient’s face, therapists wear a face shield.

7) Appointments are staggered between each therapist to reduce the number of people in the clinic at the same time.

8) There is a 15-minute buffer between each patient to allow the therapist to sanitize any surfaces that they or the patient have contacted during the session.

9) Hand hygiene, hand hygiene, hand hygiene. Both the patient and therapist wash their hands before and after the session. The therapist sanitizes their hands after contacting any surfaces before touching the patient.

10) All therapists are self-monitoring their symptoms and contacts with anyone suspected of having COVID-19 and will self isolate as needed.

The list goes on. All this goes to say that, although this is an ongoing process and things change rapidly, the Ministry of Health and the College of Physiotherapists have been working tirelessly to provide physios with the necessary information to protect their patients and themselves. When adhering to proper policies, we mitigate the risk of infection while continuing to provide high quality care to those who need it. If you have any questions or concerns regarding physiotherapy during the COVID-19 pandemic I highly recommend you reach out to your local physiotherapist or read up on the information provided by the Ministry of Health. And if you’re not ready to head into a clinic, telehealth is a highly effective option! Stay safe everyone.

#COVID19