bullet  Coronavirus (Covid-19) Restart:

Information last updated : Sat 20th March 2021 //
Note that guideline details can change - if on any doubt, please contact me directly.

morning sunlight

I am pleased to announce that my professional body, the CSTA has take legal advice on the new CV19 regulations and has confirmed I am able to provide hands-on treatments. I intend to do my best to continue to provide help and support throughout this period of transition and beyond to whoever needs it; and to apply appropriate measures to ensure your safety (i.e. the safety of everyone visiting the clinic) so far as possible.

I am now providing one-to-one hands-on treatments from my clinics in Hethersett (Thurs) and Norwich (Tues/Weds at the moment). Bookings for Exchange Street, Norwich are still through the reception desk. I am managing Rowan House, Hethersett bookings myself. See contact page for phone numbers and working days. For now, bookings are for 75 minutes : being just under an hours treatment time for you, plus 15 minutes for me to clear the room and prepare for the next person.

The medical evidence from several countries is that in the vast majority of cases, Covid-19 does not transfer if there are no symptoms. Many infections appear to be asymptomatic, especially children and people below the age of 45, who for the most part have not been affected by Covid-19 more than they would by any seasonal flu. In the case of a natural infection, we appear to retain T-cell immunity to Covid-19 for at least another 6 months, and that immunity will be booseted by further exposures. So for people who are already immune, it is probably better to mix freely rather than isolate - this being one of the many impossible contradictions that characterise the Coronavirus epidemic. There are no definitive estimates available of the number of people who do now have natural immunity (without vaccination), but that natural immunity plus the vaccination programme mean that the risk is falling rapidly.

Consequently hands-on treatments don't involve a high degree of risk, so long as the total infection rate in Norfolk is low. You can therefore come for treatment if you are in need of assistance (Government guidelines specify that people should seek assistance for non-trivial health conditions)- but also respect the general rules designed to reduce transmission. If you are concerned about risk and want to receive treatment for trauma or chronic pain, I can provide online sessions which work very well, and we can do face-to-face treatments later when some of the initial ground as been covered. For more information including online treatments please see here.

The simple version : what you really need to know

  1. BASIC PRECAUTIONS
    In order to be able to provide a treatment service during the second CV19 lockdown (starting 4th Nov 2020) I am legally required to "triage" - i.e. do my best to make sure that nobody comes into my practice who should be self-isolating. In particular, please respect myself and other patients abd do NOT come to the clinic (and cancel any appointments) if in the past couple of weeks you
    • have had any potential CV19 symptoms (or been in close contact with someone who has for more than 10 minutes)
    • have recently tested positive yourself, or live with someone who has tested positive
  2. LEGAL STUFF
    It is impossible to guarantee that Covid-19 will not transfer during a hands-on ("Close Contact") treatment. You will therefore need to have signed a consent-to-treatment form before I can . I also require a GDPR declaration so I know your wishes on data handling. If you can't print these forms to bring with you on first treatment, I can always supply a form when you arrive. If the forms below do not appear immediately on a new browser window/tab, they have probably been sent to your Downloads folder. Please please bring BOTH forms completed to your first appointment (if you can't print them don't worry - I will provide one in the clinic):
    1. The Consent-to-treatment form can be downloaded from HERE
    2. The GDPR/data processing form can be downloaded from HERE.
  3. MOVING THROUGH THE CLINIC
    The requirements for you when you pass through the public spaces of the clinic are posted at the clinic entrances. When coming to the NORWICH clinic, please(!) report to reception on entering the building so that they can record your presence and take a skin temperature scan.
  4. WHAT TO BRING TO EACH TREATMENT
    I have to open the window regularly to air the room, and for the time being cannot supply blankets (they present too many issue for sanitation). I therefore advise you to BRING A BLANKET to make sure that you stay warm during treatments.
  5. PPE IN THE TREATMENT ROOM
    Provided we sit more than 2 metres apart and the room is regularly ventilated, there is no need to wear masks. Once I approach you I will wear a face mask. This will be supplemented by a visor and gloves if I am carrying our intraoral work (e.g. for treating TMJ/TMD) or by a visor when working near the face for extended periods. Due to the fact that masks leak round the edges, they usually direct moist exhaled air up through the top of the mask. Masks do not protect the wearer - their function has always been to protect other people from exhaled water droplets. Therefore I usually prefer that you NOT wear a mask when lying on the treatment table. The decision is, however, yours, and I will accommodate whatever makes you feel most safe.
  6. OTHER CONSIDERATIONS
    • Rowan House Hethersett : Please wait in your car or outside in the car park and I will come to get you.
    • Exchange Street Clinic, Norwich : We have limited space in the waiting room. Please come as near as possible to the appointment time so that the waiting room space is kept clear.
    • If you are in the Vulnerable person (Moderate or High) risk group, or live with anyone who is, please talk to me before any appointments are made.
    • Longer term chronic CV19 symptoms (“Long Covid”) can persist after you cease to be infectious – see below, andcall me for information on how I might be able to help.
    • That's it! Simple :-)

More detailed information

How Viruses move

Viruses are so small that breathable filters (i.e. passive masks) are something like using chicken wire to stop a fly. Viruses do cling to water droplets, so a mask stops these droplets being projected so far from the body. BUT after a while standing still or sitting or lying down in stationary air, the whole body will have a fug of water droplets around it regardless of whether a mask is being worn. So passive PPE (e.g. a filter mask) provides only marginal protection for typical prolonged close contact work such as coming for a clinic treatment. In this light, if you are in one of the risk groups (or live with someone who is), you have to give a little more thought as to your degree of concern. Unfortunately at this moment in time nothing is completely risk-free. The risk of contracting and experiencing serious symptoms is still quite low in Norfolk – see notes on risk below.

What masks do

Masks do NOT protect the wearer against viruses, nor do they stop all virus transmission. They do reduce the quantity of virus that can be passed to other people provided that (1) contact is brief (up to a few minutes), and (2) you are not both in an enclosed space with no moving air. Masks also reduce the wearers’s ability to clear bacteria, moisture and fungus from the lungs. So they should really only be worn when it is clear that they might protect someone else – i.e. someone you come into contact with for a brief period (less than about 10 minutes) who you are not in regular contact with. Wearing them outside this optimum timeframe places you at greater risk of general respiratory infection, and therefore also places other people at greater risk. Unfortunately the Government guidelines only focus on protection from cross-contamination, and do not make consideration of immunological aspects to the wearer. Getting an optimum balance is not simple, and the Government is attempting to make its message as simple as possible for ease of communication. Please do NOT use essential oils or wood-based alcohols or formaldehyde or other antibacterials directly on the mask as disinfectants when you wear it, because these can cause inflammation of the mucosa and make you more susceptible to infection.

Safety from CV19 (or any other airborne virus)

We have typically dealt with many kinds of virus all the time, including coronaviruses, for thousands of years. So provided our immune system is functioning well, the risk is pretty low. Some viruses are more able to bypass the immune system, and CV19 is one of those. However, in most people, and particularly young children, we still have adequate immunological response so that we might get a few mild symptoms (or none at all) and then they go again. So the best measure we can take to be safe against CV19 is to have a healthy immune system. I talk about this a little more below.

The next best protection is to reduce viral load – the number of viruses that we take in. This is what the physical distancing measures and masks and hand washing attempt to do. In the case of the prolonged contact you get during a hands-on treatment, a circulation of fresh air in the room is probably far more effective than PPE in reducing viral load.

It is encouraging that tests reported in Germany (31/July/2020) have shown ... "It is now quite certain that a large proportion of the population has T cell immunity to the SARS-CoV-2 virus. The German researchers found T-cell reactivity against the virus in 83 percent of those who had been confirmed covid-19, but also in 35 percent who had not had coronavirus disease caused by SARS-CoV-2.". The situation in Sweden is also showing that once the virus spreads widely into the general population there IS a large degree of herd immunity and a substantial reduction in cases and in mortality.

Research – what works to prevent symptomatic Covid infection?

Of all the various things that have been tested, Vitamin D has been shown to be very protective against CV19. If you buy Vitamin D (e.g. as a spray), it is important to stick to the recommended dose.

Your immune system

One upshot of all the above is that viruses are here to stay, and are a normal part of the environment we have evolved in. So being frightened of them is not helpful. In fact, fear (of illness or anything else) is one factor that weakens the immune system. And our skin is also an important immune barrier because of the “friendly” bacteria on its surface. I have decided to use either common bar soap or a standard Ammonium laureth sulfate soap gel at work - rather than alcohol-based or volatile hand sanitisers. It is ironic that fear of illness plus excessive use of antibacterial hand sanitisers plus excessive mask wearing – in combination – is a recipe for increasing risk of contracting a respiratory infection. Simple actions that will strengthen the immune response of your body include :

  • Being happy and in the company of people you love
  • Being in fresh air and sunshine. Exercise.
  • Having a healthy ecology of digestive bacteria (the “microbiome”). This is helped by eating Organic food, raw foods (washed if not organic), moderate to no refined sugars, moderate to no alcohol, moderate volumes of food, fermented foods (such as sauerkraut), dark skinned fruits and other natural antioxidants such as turmeric or cumin, bitter skins (such as the brown skin on almonds – which contain a high level of anthocyanins) and Vitamin C.
  • Omega-3 oils and >Vitamin D
Also helpful is :
  • Adequate hydration (your urine should be clear), but fluid should not generally be taken within one hour either side of a main meal.
  • Keeping your sugar balance stable – some people need meat to achieve this, and protein is best taken in as breakfast
  • And if you are wearing re-usable face masks, wash them daily using hot soapy water and dry them thoroughly before re-use
Risk

Risk is not a straightforward thing to assess. There is no doubt that a substantial % of the population have already been infected and were asymptomatic, some possibly as far back as October 2019. And although there is ongoing scientific debate, T-cell immunity appears to be preserved for at least 6 months after active infection. Norfolk is something of a backwater, so we had less of the kind of international movement of people that has caused extensive outbreaks in large cities, Northern Italy, Belgium, etc. And the testing has a high false positive rate in that people who have had asymptomatic infections can potentially test positive up to 2 months after they are no longer infectious. So given the low prevalance of CV19 in Norfolk, the risk of cross-infection is very low – provided that we are all sensible and self-isolate if we have a symptomatic CV19 infection

CV19 Symptoms

CV19 has a sequence of common onset symptoms as follows :

  1. fever, followed by
  2. dry or hacking cough and/or muscle aches, followed by
  3. nausea or vomiting, followed by
  4. diarrhea, followed by
  5. other miscellaneous symptoms sometimes leading to "long covid" - loss of smell, tiredness/fatigue, difficulty concentrating etc.

This typical progression is not necessarily going to occur exactly in this way for every individual. The further the progression 1..5, the less active your immune system has been in containing the virus. If you experience the first two symptoms (fever, dry cough/muscle pain), it is important to act to improve your immune response. You can help to protect your digestive tract and reduce risk of further progression by simple measures such as :

  1. removing flour-based foods, milk and refined sugar from your diet, and
  2. eating small simple meals (i.e. reducing your food intake for a few days), and
  3. drinking plenty of water (i.e. not sweetened drinks) with fresh lemon juice
  4. separating fluid from food by at least 1 hour : i.e. fluids not taken in during the hour before eating, or during the meal, or during the hour after eating.
  5. Also see the notes on Vitamin D and "Your immune system" above.
REFERENCES
  1. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/910885/COVID-19_Infection_prevention_and_control_guidance_FINAL_PDF_20082020.pdf
  2. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/910594/Final_appendix_2_IPC_19082020.pdf
  3. https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/standard-infection-prevention-control-precautions-sicpsall-pathways
  4. https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-infection-prevention-and-control-guidance-low-risk-pathway
  5. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886217/Best_practice_hand_wash.
  6. pdf
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