COVID-19 Q&A

To keep you informed on how the COVID-19 pandemic affects your practice, we update this Q & A regularly and email you with special bulletins for your province. We encourage you to share this information, our social media posts, and our COVID-19 resources with your contacts.

NHPC Documents for Members

COVID-19 Infection Prevention and Control Manual for Alberta Massage Therapists
Workplace Cleaning Log
Return-to-work Member Handbook
COVID-19: Caution to Clients Entering Clinic Poster
Proper Handwashing Protocol Poster
General COVID-19 Client Waiver
Alberta COVID-19 Client Waiver (Contact Tracing Opt-in)
COVID-19 Safety Precautions Poster

How will this impact my membership?

Although the NHPC office itself is closed as a precaution, staff are working remotely and can help you by email or phone between 8:00 a.m. and 4:00 p.m. (MT).
For members who are due to renew from March 30, 2020, and onwards, we are extending the deadline by one month without charging an arrears fee.
If you mail your renewal to us during this time, the processing time will be longer than usual (so online renewal is preferred).
If you are putting your practice on hold and you are due to renew soon, you can change to associate membership by submitting a change membership type application in your account.

How is the NHPC helping members?

We are monitoring how the pandemic is impacting our members and adjusting our measures as needed.

We currently have the following measures in place:

Renewal deadlines have been automatically deferred by 30 days with no arrears period.
At the time of renewal, regular members have the option to change to associate membership instead of renewing as a regular member. Associate membership is an uninsured membership type which costs only $150 (plus tax).
Associate members changing back to regular membership will have the remainder of the associate dues they previously paid deducted from the upgrade cost.

If you need further assistance, contact our Member Services Team at memberservices@nhpcanada.org.

How soon after receiving a COVID-19 vaccination should someone receive a holistic health treatment?

With any vaccination, there is a local contraindication to the site of injection. If there is redness and soreness, consider the entire limb as contraindicated for treatment.

Some people will have no side-effects after receiving the vaccination, and some may have mild to moderate flu-like or COVID-like symptoms. If your client has these symptoms, delay their treatment for 24 to 48 hours until their symptoms are gone.

As usual, all clients must be screened for COVID-19 symptoms prior to their appointment. Your client's answers to the COVID-19 screening questions will help you determine whether an appointment is appropriate or not.

COVID-19 symptoms that are new and not related to a known or pre-existing condition mean that the client is not eligible for treatment.

For additional information about vaccination, Alberta Health's Vaccination Q&A (PDF) answers many questions that are relevant to practitioners across Canada. Please refer to your provincial/territorial government website for location-specific topics like vaccination roll-out.

AstraZeneca Vaccine and Blood Clots

Health Canada has advised of rare reports of blood clots associated with low levels of blood platelets in AstraZeneca vaccine recipients.

If your client has received the AstraZeneca vaccine within the last 20 days, ask them the following question:

Have you experienced any of the following?

throbbing or cramping pain, swelling, and redness in an arm or leg
trouble breathing, chest pain, abdominal pain
sudden onset of headaches or blurred vision
change in colour, pain, or itching in an arm or leg

If they answer "yes," they should seek immediate medical attention.

If a client or other contact tests positive for COVID-19, do I have to self-isolate?

Self-isolation requirements depend on your province or territory. If you know of a client, co-worker, or family member who has tested positive for COVID-19 or has been in close contact with a confirmed or probable case of COVID-19, you may need to self-isolate.

Please check with your provincial or territorial government for whether you need to self-isolate or not based on your contact with the person in question.

AB – Information for Close Contacts of a COVID-19 Case
BC – Self-isolation and COVID-19 (PDF) & Close contacts
MB – Information for close contacts of positive COVID-19 cases
NB – Isolation
NL – Self-isolation and Self-monitoring
NS – Self-isolation requirements
NT – Mandatory Isolation
NU – COVID-19 Isolation (PDF)
ON – How to self-isolate & Self-isolation because of potential exposure
PE – COVID-19 Self-Isolation
QC – Instructions for people who have been in contact with a confirmed case of COVID-19
SK – Self-isolation & Who is a close contact?
YT – Self-isolation Information

Can I ask clients if they have been vaccinated?

A client's health history includes vaccination status and whether they have been infected with COVID-19 or not. However, you must have a valid purpose for collecting this personal health information before asking for it.

If you think these factors may impact your client's treatment plan, it is appropriate to ask them about it when you ask about their health history. Remember that this is considered part of their health history, and the same data collection and privacy safeguards should be applied.

Regardless of whether they have been vaccinated or not, you must continue to screen all clients for COVID-19 symptoms. Screening should not include asking whether a client has been vaccinated or not; that should only be asked as part of their health history during treatment.

If a client has been partially/fully vaccinated, do I still follow COVID-19 safety measures and practice protocols?

Yes. Vaccination is only one part of the overall infection control strategy, and safety and sanitation protocols must remain in place for all clients, regardless of their vaccination status.

Continue to follow all public health measures for prevention and control of COVID-19 infection and transmission.

For changes in quarantine requirements for those who have been fully immunized (i.e. received their first and second vaccine), check with provincial/territorial health authorities.

If a client asks if/when I've been vaccinated, do I have to tell them?

No. If a client asks whether you have been vaccinated for COVID-19 or not, you do not have to provide that information, as it is considered personal health information.

If you do not want to answer them, then let them know it is considered personal health information and that you choose not to disclose it.

If you want to answer them, simply state whether you have been vaccinated or not, and do not provide an explanation. A client may misunderstand an explanation as advice or counselling, which is outside the scope of practice of NHPC members.

What should I tell a client if they ask me for my opinion or advice about vaccines?

It is not within the scope of practice of any NHPC member to provide advice or counselling about vaccines. To avoid misunderstandings and liability, do not provide your opinion on vaccines to clients.

If a client asks you for your opinion or information on vaccination, refer them to their primary health care provider or provincial or federal health authorities for information.

Can I refuse to treat someone who has not been vaccinated?

Private businesses are free to decide who they serve to protect the health and safety of their clients and staff. However, NHPC members are holistic health care professionals who have ethical standards to consider when deciding whether to refuse treatment based on vaccination status or other criteria.

Currently, we do not recommend that you refuse to treat clients based on their vaccination status. Although the NHPC Code of Ethics (PDF) states that you can

retain and practice the right to refuse to treat any client if the provision of such treatment poses risk of harm either to the client or to the practitioner

by following all the COVID-19 risk mitigation protocols, such as wearing the required PPE and screening clients for symptoms and close contacts, you can still provide appropriate care in a relatively safe environment for clients, staff, and yourself.

Also consider that the Code of Ethics states that practitioners will refrain from discriminating against clients based on a medical condition.

If a client has a medical condition or disability that prevents them from being vaccinated or they choose not to be vaccinated due to religious beliefs, refusing to treat them may be a violation of the human rights legislation that protects Canadians against discrimination based on religion and disabilities.

Can I market on social media, websites, or signage that all therapists have been vaccinated?

Whether or not an individual is vaccinated is considered sensitive personal health information. We advise that you do not place vaccination status on a company website or booking site because it is personal health information.

Keep in mind that there are practitioners who cannot be vaccinated due to health conditions, disability, or religious beliefs, which are protected grounds under human rights legislation.

Should I close my practice?

If your provincial/territorial or municipal government has ordered that non-essential services must be suspended, then you must close your practice until they lift those orders. The NHPC Code of Ethics states that members must abide by applicable laws, regulations, and legislation, so you have both an ethical and legal obligation to follow any public health orders.

Please check in the Provincial and Territorial Bulletins section below to see if business/service closures have been ordered for your province or territory.

What do I need to do to practise safely?

If your province or territory has announced that your business type can re-open, you must take the required precautions in your workplace. This includes all sanitation, use of personal protective equipment (PPE), and physical distancing measures required by the government.

If you can't take the precautions necessary to reduce the risk of transmitting COVID-19 — for any reason or at any time — you should not practise.

Check the Provincial and Territorial Bulletins section below for required workplace precautions for your province or territory. You can use our Return-to-work Member Handbook (PDF) as a supplement to any government requirements.

If you own a clinic, hold an orientation for staff to ensure they know all sanitation and distancing procedures, and post the procedures where they can easily refer to them.

The following resources are also available for you to use in your practice:
COVID-19: Caution to Clients Entering Clinic Poster (PDF)
Proper Handwashing Protocol Poster (PDF)
General COVID-19 Client Waiver (PDF)
Alberta COVID-19 Client Waiver (Contact Tracing Opt-in) (PDF)

What financial assistance is available to me?

The Government of Canada is offering various benefits to help Canadians and businesses facing hardship as a result of the global COVID-19 outbreak.

What is COVID-19 Fraud?

There has been an increase in scams related to the COVID-19 pandemic, ranging from illegitimate product vendors to fake charities.

Familiarize yourself with common COVID-19 scams and report any fraud you encounter to the Canadian Anti-Fraud Centre.

Does the COVID-19 pandemic affect my liability insurance?

Pandemics are not specifically excluded from your insurance coverage. If you are a regular member, your medical malpractice insurance coverage is in effect as long as you are following provincial/territorial requirements (at minimum) for safety when practising.

Any cases brought against members due to the COVID-19 pandemic will be examined on a case-by-case basis by the insurance company.

Your medical malpractice insurance does not cover loss of income or business interruption due to the COVID-19 pandemic. It does cover client claims of negligence during their treatment resulting in bodily injury, sickness, or disease.

For further questions about your coverage, please contact AON, the plan administrator, directly at: aha@aon.ca or 1-877-766-3093.

Who do I contact in the government if I want clarification on their directives?

If you have additional questions that aren't answered on your provincial/territorial government websites, please contact your local Member of Parliament.

What can I do to take care of myself?

Please check with your provincial health authority to determine quarantine requirements for your location.

What safety precautions can I take?

WASH your hands with soap and water often – for at least 20 seconds
AVOID touching your eyes, hands, nose, and mouth
DISINFECT frequently touched objects and surfaces
COVER your nose and mouth with your elbow or a tissue when coughing and sneezing
DO NOT shake hands.
DISTANCE YOURSELF. Try to stay at least two metres away from people when in public.
POST our safety precautions poster (PDF).

How do I stay informed?

Regularly check municipal and provincial/territorial government health services for updates on the current status of the virus, hygiene practices for health professionals, and workplace preparation.

Also check your inbox for messages from the NHPC and this Q&A, which is updated frequently.

What kinds of Continued Competency Program (CCP) activities can I do from home?

organize an online discussion with other practitioners to discuss the impact of COVID-19 on your practice and what you can do (Learning Type: Informal Meeting)
read electronic books or journals (Learning Type: Publications)
complete an online course or learning module (Learning Type: Online Learning)
develop or continue a mentorship through online communication (Learning Type: Mentoring)
enhance your well-being through activities like meditation, yoga, qigong, or tai chi (Learning Type: Personal Development)

If you teach workshops in-person, think about if you could adapt your content to be taught via video or online webinar. If you can, not only does it count for CCP credits (Learning Type: Teaching) but it could also be another source of income.

Refer to our CCP Guide (PDF) for all the learning types and their credit eligibility.

How can I meet my First Aid and CPR requirements with physical distancing?

Since the Continued Competency Program (CCP) requires in-person First Aid and CPR training, you do not have to complete this requirement until it is safe to do so.

There is a difference in course price and length when renewing an active certificate vs. recertifying because your certificate has expired. Please contact your First Aid and CPR/AED provider for details on pricing.

Some providers continue to offers classes with participant limits to accommodate physical distancing if you don't want to wait. Other providers are extending the dates existing certification is considered valid to help practitioners whose certification would expire while physical distancing is in effect.

Please check with your First Aid and CPR/AED provider directly for their individual COVID-19 policies.

Can I deliver services via online or video communications?

You may communicate with existing clients this way. For example, a massage therapist could suggest home care and exercises for clients.

If you charge a fee for this service, you cannot bill it as "massage therapy" or any other touch-based modality because it does not constitute a full treatment. You must advise your clients that this online service may not be covered by their insurance provider.

You must also ensure that whatever platform you use is confidential and secure, so you are in compliance with health care privacy legislation.

Can I still treat family members during physical distancing?

If you treat family members, you must be able to maintain objective care, meeting all professional standards and requirements in every aspect of the treatment, including record-keeping, receipting, and maintaining client confidentiality.

Insurance companies may have specific policies on treating family members. Therefore, they may flag a family member treatment as potential benefit plan abuse or conflict of interest and not reimburse the claim. Contact the insurance company directly to ask about their policies before providing treatment.