Frequently asked questions

According to Québec.ca, “the risk of serious complications for people with COVID-19 increases with age, but it is present even in young adults. The risk of death from severe respiratory complications (pneumonia or acute respiratory syndrome) due to COVID-19 is particularly high in:

• People aged 70 and over;
• People with weakened immune systems;
• People with chronic diseases such as:
  • Diabetes
  • Heart disease
  • Lung disease
  • Kidney disease.”

In case of doubt, we recommend that you request a note from your client’s doctor to ensure that his or her condition does not put him or her at risk.

According to the World Health Organization, ” pregnant women or recently pregnant women who are  older, overweight, and have pre-existing medical conditions such as hypertension and diabetes seem to have an increased  risk of developing severe COVID-19. When pregnant women develop severe disease, they also seem to more often require care in intensive care units than non-pregnant women of reproductive age.

Due to changes in their bodies and immune systems, we know that pregnant women can be badly affected by some respiratory infections. It is therefore important that they take precautions to protect themselves against COVID-19, and report possible symptoms (including fever, cough or difficulty in breathing) to their healthcare provider. ”

The WHO also specifies that “pregnant women should take the same precautions to avoid COVID-19 infection as other people. ”

The Réseau recommends that you ask your client for a doctor’s note to ensure that no specific complications related to pregnancy put her at risk of a COVID-19 infection.

We invite you to consult the Quebec government website at the following address: https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/progress-of-the-covid-19-vaccination.

You can find out more right about the administration of the 2nd dose of the COVID-19 vaccine here: https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/progress-of-the-covid-19-vaccination/second-dose-covid-19-vaccine.

Depending on clinical assessment and epidemiological investigations by public health and government authorities, self-isolation instructions may vary. We encourage you to follow the public health recommendations your client has received.

The Réseau team regularly receives questions related to the self-isolation instructions to be followed. As a therapist, you must take the necessary steps if you have symptoms of COVID-19, are awaiting testing or have been in contact with a probable or confirmed case of COVID-19.
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Since isolation instructions may vary depending on the epidemiological investigation carried out by public health, we invite you to follow the recommendations issued by the person following up on your file or to communicate directly with the COVID line at 1 877 644-4545.

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You can also use the COVID-19 Symptom Self-Assessment Tool to get a recommendation on how to proceed or consult the self-isolation instructions.

According to public health authorities, to date, the therapist who performs a task within 2 meters of the client must wear a procedure mask.

As of July 6, the Réseau obtained information from public health that it is not required to change procedure masks between clients.

According to the INSPQ, the mask can be worn for a maximum of 4 hours without removing it for care given to several users within a cohort/unit. However, it must be discarded if it is visibly soiled, damaged or if breathing becomes difficult.

It is not recommended that the mask be removed and reused, but rather that the mask be worn for extended periods of time. If you need to remove the mask between clients, for example to drink water or eat, remove the mask according to the removal instructions as illustrated by ASSTSAS, fold the mask so that the outside of the mask is folded over and place it on a clean, disinfected surface or in a container or bag. After putting your mask back on, remember to disinfect the surface that has been in contact with the mask.

We remind you not to touch your mask while wearing it. Make sure it fits properly from the start of your massage. If you need to touch your mask, wash your hands before and after handling it.

The procedure mask recommended for the practice of massage therapy is a level 1 disposable mask with a bacterial filtration rate of 95% or more according to the standards of the American Society for Testing and Materials (ASTM). There are 3 classifications under the ASTM F2100 standard: level 1, 2 and 3. The N95 mask is not recommended for your practice; it is reserved for the medical field.

Source: 3rd question – What are ASTM standards for medical face masks?, Primed.ca, [Online], consult on May 27, 2020.

As of June 8, 2020, the Institut National de la Santé publique du Québec (INSPQ) has made changes to its interim recommendations for private practice therapeutic care.*

Overgarment are no longer mandatory. In addition, if it is worn, it is no longer necessary to change it between clients, just like the other clothing worn.

*Note that the English version of the Interim Recommendations for Private Practice Therapeutic Care do not appear to have been updated yet. We invite you to refer to the French version.

As of January 27, 2021, the Institut national de santé publique du Québec (INSPQ) has made changes to the interim recommendations for therapeutic care sector in private practice. It now states that “when the client receives care, it is recommended that the client also wear a quality medical (procedure) mask, given his proximity to the worker for an extended period of time”¹. The preferred procedure masks are those that meet the American Society of Testing and Materials (ASTM) F2100 compliance criteria. Masks according to EN 14683 (type IIR) can also be used. To ensure mask compliance, it is recommended that the client be provided with a procedure mask upon arrival.

[1] Free translation of Recommandations intérimaires concernant les soins thérapeutiques en cabinet privé

According to the latest update of the INSPQ’s interim recommendations for the therapeutic care sector in private practice, “in certain exceptional circumstances (for example, lying on his stomach on a massage table), the client may remove the mask”¹. Given that the Public Health Department of the ministère de la Santé et des Services sociaux had already confirmed that the mask could be removed during the period of care that requires it, the guidelines therefore remain the same. The procedure mask can be removed when:

• you massage the face;
• the client is lying on his stomach.

We encourage you to continue to exercise your professional judgment to determine if the mask needs to be removed during certain maneuvers.

[1] Free translation of Recommandations intérimaires concernant les soins thérapeutiques en cabinet privé

According to the INSPQ, “when conditions require it, floor-mounted air conditioners and fans can be used with caution by respecting certain measures outlined in the following sheet.” (Free translation by the Réseau)

According to public health, “if possible, examine the possibility of using alternative heat sources (e.g. moist heat towels – which would be changed between each customer). If this is not possible, and the heating blanket [or the hydrocollator] is used, it should be ensured that the sheet or towel separating it from the client is in good condition, properly positioned and replaced between each client”. (Free translation from the Réseau)

Make sure that equipment that cannot be disinfected or changed between clients does not directly touch your client. The use of a protective cover is strongly recommended. If this is not possible, we recommend that you do not use it.

As a precautionary measure, check with the supplier of your heated mattress cover to ensure that there is no risk of damage or even fire if it is covered. We also invite you to be well informed about the cover you choose to cover your mattress cover.

We invite you to read the section on legal obligations in the Workplace Sanitary Standards Guide for the Therapeutic Care Sector. For more information, contact CNESST directly to ask any questions you may have regarding the relationship between employee and employer in the context of the resumption of activities.

The Réseau aligns its guidelines and recommendations with those of the Public Health and CNESST. Its role is to transmit to its members the prevention measures implemented by the authorities concerned. The member has a legal obligation to comply with public health guidelines and also has an ethical obligation to comply with the measures implemented for the reopening of therapeutic care in private practice. Article 2.1.2. of the Code of Ethics states, “The Member must protect in his exercise, the health and well-being of the individuals he serves; on the individual and collective.”