Update: Protecting Patient PT & Our Community from COVID-19

Want to help fight COVID-19?

Patient PT has come together with Bloomington Quilter's Guild and amassed a force of 250+ volunteers who are sewing and distributing free, clean, QC'd fabric masks to the Bloomington Community. If you'd like to volunteer or donate to support Bloomington Mask Drive, or just learn more, click here!

Fabric Masks: Safe & Effective Wearing

If you are going to wear and use fabric masks, please view this video post and list of bullet points on how to make and wear a fabric mask.

1. Patient PT is remaining open unless instructed to close in order to to reduce load on hospital systems and offer a safe and evidence-based option for those seeking musculoskeletal primary care during this unprecedented time of scarcity.

In the weeks since coronavirus has begun to affect the United States, there has been a nationwide shortage of a number of crucial items, the most dire of which is personal protective equipment (PPE) needed by our nation’s hospitals. Attempts to dissuade non-medical personnel from buying up supplies have backfired and led to significant public misunderstanding of the usefulness and utility of wearing masks during unavoidable interactions at grocery stores, non-pandemic related medical care, and other times when social isolation and non-contact precautions are less feasible.

As an outpatient physical therapist, I am a member of the healthcare professional community and eager to help in easing the pain of this pandemic in any way I can, but obviously I have little ability to help directly. I have been monitoring guidance from the CDC, local organizations, and awaiting recommendations from my professional association, the APTA. There has been little guidance that is specific to my situation and for the most part it is urged that we operate with an abundance of caution and use our best judgment as professionals. As a business owner who operates with full autonomy over my facility, this has been felt as an especially intense obligation, in a year when I have only begun to come to grips with the power and responsibility inherent in having had such a complex and specialized education.

To that end, this past week I have spent many hours disinfecting the Patient PT facility, removing and reorganizing things to minimize the presence of porous / difficult to disinfect surfaces, and trying to figure out what to do about day-to-day operations as things evolve on an hourly basis. Yesterday I learned that some of my respected colleagues in massage therapy have suspended services. This morning I heard that the local hospital and it’s auxiliary outpatient facilities are suspending services to all “non-essential” patients. Who is and is not an “essential” patient is once again left to the professional judgment of healthcare personnel.

Amidst this, community groups are pulling together to help in whatever way anyone can in order to minimize the spread and impact of this crisis.

As a cash-pay sole provider my position is unusual. There is no risk of crowding so I am unaffected by persons-per-facility guidelines. I don’t bill for insurance coverage, so Medicare/Medicaid/insurance limitations on Telehealth or other virtual services and home care visits don’t apply.

Meanwhile, I already specialize in helping folks that the rest of the medical system misses, misleads, and leaves behind. The unheard cries of patients with persistent pain ring loud and clear in my office, always. Giving space and time to allow people to share in the investigation of their bodies and find the root cause of their pain is my brand. To put all of my clients and patients on hold, indefinitely when they literally have nowhere else to turn is unfathomable to me, and makes no sense. If my office were bigger, if I had any other staff, if my building were high-traffic… Yes. But given my specific circumstances? Knowing my own clinic and procedures? I’m not so sure. If I had impact-free access to protective equipment, I think it would be a pretty straightforward decision for me to stay open, but I don’t.

I’m not alone. Elective surgeries and outpatient medical care have been all but banished indefinitely because medical professionals and administrators understand better than anyone that the spread of this virus must be controlled at all costs. I am among them. Unfortunately, not everyone in alternative medicine is on the same page as us.

It has come to my attention some seeking to take advantage of vulnerable people seeking the solace of hands-on care have begun marketing dangerous campaigns of misinformation that will not only provide a false sense of safety if believed, but will encourage spread through unnecessary contact. In the wake of the outpatient healthcare void that is rapidly deepening, I am concerned that this sort of behavior will only become more commonplace.

Chiropractor2
Chiropractor

For this reason, I have decided that for the time being, I will begin requesting that all clients and visitors to Patient PT cooperate with touch-free temperature screening and hand sanitation prior to entry, and reschedule visits if they are experiencing any symptoms of coronavirus, including non-productive cough, body aches and pains, fever, and excess fatigue.

Patient PT will continue to accept clients and patients in person with additional precautions (touchless temperature checks, mask-wearing,) unless otherwise explicitly directed to stop by the CDC, APTA, or other suitable authority.

Patient PT will continue to accept appointments via video conference.

Patient PT will expand services to include house-calls and out-call therapy to other businesses beginning next week, 3/23/2020. 

I feel it is my duty to continue to accept patients and clients in need of medical support during this frightening time if I can safely do so, in order to provide comfort and pain relief to those whom have had to delay elective surgeries, suspect PT through their regular care provider, and most especially to give an alternative to those who would otherwise seek the services of a misinformed or unscrupulous provider.

 

2. Patient PT is offering and coordinating the creation of washable fabric masks for internal use and offering clean fabric mask kits with nose fittings for $5.

To address the lack of availability of personal protective equipment while respecting the priority of hospitals to receive all available high-grade PPE, I have been working with a local seamstress to design a reasonably effective alternative for myself and other care providers, such as home health aides, midwives, physical therapists, and of course any physicians and other health professionals who are still accepting patients or making house-calls to help everyone else get through this unprecedented time of need and hardship. I have consulted as many sources as I have been able to locate (listed below*) in order to develop a reasonable “second-best” alternative, the most scientifically reliable of which was conducted by Cambridge University.

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Here is what I learned. Surgical masks look like paper, but they are made of super-thin non-woven melt-blown fabric. Basically, that means “felted” material, in laymen’s terms.

croppedmask

Many fabric masks, including this initial prototype, recommend the use of interfacing, a common non-woven fabric, to provide filtration. However, in the meantime new research has become available that lead me to change this design slightly. However, masks provided for in-clinic visits and offered for sale include a thin filtration layer and a guidewire that allows a closer fit across the top. I have ordered a gross of white 6 inch twist ties so I can remove the wire, wash, and reuse them.

All that is required to make these masks is bias tape, interfacing, twist ties, skinny elastic, and thread. I wore one for several hours yesterday and then washed it with hot water and detergent, then air-dried it to see how it would hold up. Other than being slightly wrinkled, they appear no worse for wear, so I have ordered a supply of them for my office and will have extras available for clients and patients. I will provide one to each of my patients and clients who would like one free of charge, keep an adequate supply for my needs, and make the rest available to others at cost, $5/per, cash/check/charge. I will have the masks available for pickup by appointment at my office beginning Thursday, March 18.

Photo of Dr. Kelly Clark wearing a fabric facemask
Testing mask prototype in my empty office. The elastic was too long, otherwise very functional and comfortable.
Testing mask prototypes in my empty office. The elastic was too long, but otherwise this was the winner.

Locals who want these masks can email patientphysicaltherapy@gmail.com or call 812-558-0708 to inquire about availability and make an appointment to pick them up. No-contact pickup required for non-clients. If my supplies run short priority will be given to existing Patient PT clients and patients, other ancillary health providers, and those whom are immunocompromised.

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Mask prototypes after washing / air drying.

3. Bloomington Mutual Aid & Bloomington Quilter's Guild need volunteers to sew fabric masks for healthcare providers and other local service organizations.

I ran into Nola Neher Hartman of the Bloomington Quilter's Guild at the fabric store while I was gathering materials for my masks. A pediatrician friend of hers reached out for masks a week or more ago, and now local healthcare and service organizations are inundating them with requests for more. I have volunteered to help coordinate this effort and will continue to update this post with more information. Here is a link to the pattern we recommend.

IF YOU NEED MASKS:

Please add your organization to this form

IF YOU CAN HELP MAKE MASKS:

Nola Neher Hartman represents the Bloomington Quilter's Guild, and I have volunteered to help her coordinate all the NON-SEWING related parts of this effort.
Please register as a volunteer who is making masks, volunteering a sewing machine, or any other non-monetary offers of assistance via THIS form, regardless of whether you are a member of the guild.

IF YOU WANT TO DONATE MONEY:

Funds will initially be used to ensure adequate materials are available to all volunteers who need them. Any additional funds will be used to reimburse volunteers for donated materials and time when this effort begins to wind down.
Funds are being collected with Nola's blessing on behalf of the Quilter's Guild.

4. Bloomington businesses that are still operating also need masks, and there are others working to make and provide masks for them as well.

Local seamstresses are offering fabric masks similar to those being made by the Quilter's Guild and our volunteers at a cost of $8- $15. If you are an individual seeking a mask and do not want to wait, I would encourage anyone who would like a customized mask to get to sewing or to contact your favorite local seamstress to discuss it, their business has been affected by this pandemic as have so many other local businesses.

The Cambridge study showed that all the masks made of household materials blocked at least 50% of the .02 micron particles tested, so regardless of what you may have heard, if you need to go out in public places even a homemade mask will provide you with significant added protection over nothing at all, and will absolutely help protect others from you in the event you are unknowingly carrying the virus.

 

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