Covid-19 Updates

Dear UCPA Doctors: 

Last night, Utah Gov. Gary Herbert issued a statewide mask mandate as part of Executive Order 2020-73 which went into effect today at 1 pm and will remain in effect until at least Monday, November 23rd.  Since that time, I have had a large number of doctors contact me regarding the legality of the order and the consequences of not complying with the order.  Thus, this email is to address the main concerns being expressed at this time.

One of the main questions I am getting is whether Governor Herbert’s Executive Order binding as law.  The answer is YES, the executive order is binding law and Governor Herbert does not need to have it passed by the legislature.  Orders issued by the governor pursuant to the Disaster Response and Recovery Act (Utah Code 53-2a-209(1)) carry the “full force and effect of law.”  Thus, any fines for non-compliance can be enforced.

The second main question I am getting is what do chiropractors “technically” have to do to comply with the order?  Here is what the order states: 

  1. A business SHALL (not may):
    1. Require each employee and contractor to wear a face mask while at work;
    2. Require each patron that enters the premises of the business to wear a face mask, including coming and going;
    3. Require at least 6 feet of physical distance between each separate household group or separate party.
    4. Post conspicuous signage at each entrance of the business that:
      1. Lists Covid-19 symptoms;
      2. Asks employees and customers experiencing Covid-19 symptoms to stay home; and
      3. Provides Notice of face mask and physical distancing requirements.

The last main question I am getting is if there are still face mask exceptions?  The answer is YES, there are still exceptions to the order, but at this time chiropractors are not able to issue the exemptions. 

I fully recognize there are many contrasting views on this matter and I have tried to take my personal opinions out of this email.  For more detailed information on the governor’s order go to https://coronavirus.utah.gov

JEFF METLER – UCPA General Counsel

MACARTHUR, HEDER & METLER

4844 North 300 West, Suite 300

Provo, UT 84604

P: 801-377-1900

F: 801-377-1901

mhmlawoffices.com

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Sent: Sunday, November 8, 2020, 10:13:45 PM MST
Subject: Governor’s Order

Sunday night, Utah Gov. Gary Herbert issued a statewide mask mandate as part of an emergency order. 

The statewide mask mandate is for all Utahns in public, where six feet of physical distancing is not possible, which will “be extended for the foreseeable future.” The mandate is enforceable in all business settings, requiring employees to wear face coverings, promoting mask-wearing among patrons, and posted signage to the same effect. Any business that fails to do so will be subject to fines, the order says.

The governor’s orders go into effect Monday at 1 p.m. MT, and will remain until at least Monday, Nov. 23.  For more information on the governor’s order go to https://coronavirus.utah.gov

On behalf of the UCPA, we encourage all doctors to comply with the governors order.  
 
Sincerely,
 
Eric J. Harrison,  President UCPA
Jeff Mettler  Legal Counsel
Sent Remotely

You should have already added additional precautions to your practice: namely sanitizing all surfaces, implementing regular hand washing and sanitizing between patients, wiping down all commonly utilized surfaces on a regular basis or between each patient encounter. You may consider removing pens and touch screens and instead manually signing your patients in. You may also consider utilizing closed or individual rooms for adjusting. If your patients reach out to you with any symptoms of COVID-19 these questions should be reviewed to assess severity and help you determine need to refer for testing or home isolation. 

State of UT health department and mask recommendations can be found at coronavirus.utah.gov.

Utah county and regional health departments are here: https://www.naccho.org/membership/lhd-directory?searchType=standard&lhd-state=UT.

Have you been exposed to someone with COVID-19? (exposure >2 hours within 6ft of someone with COVID) (been coughed on by someone with COVID)

  • Do you have a fever?
  • Do you have a cough? Is it productive or dry?
  • Are you experiencing difficulty breathing?
  • Do you fall into the high-risk category? Older Adults (>65)

People with a serious underlying medical condition like:

  • Heart disease
  • Diabetes
  • Lung disease
  • Receiving immunosuppressive medications
  • Chronic kidney disease
  • Emergency warning signs (immediate follow up with medical or 911):
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Mildly ill patients should be encouraged to stay home and in isolation, contact their healthcare provider for guidance about clinical management. Testing recommended for symptomatic individuals of older age and individuals with chronic medical conditions and/or immunocompromised state, even with mild illness.

Home Isolation Discontinue Instructions

Time-since-illness-onset and time-since-recovery strategy (non-test-based strategy) Persons with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue home isolation under the following conditions: At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and, at least 7 days have passed since symptoms first appeared https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Legislative Update
 
The UCPA sent a statement affirming that doctors of chiropractic are essential healthcare providers, to our Utah Lt Governor. Read the letter here.
 
Best Practices for Keeping Your Patients and Office Safe
 
  • When scheduling and/or confirming patients, ask patients to stay home and contact their primary care physician if they have a respiratory illness, fever or if they have traveled outside of the country in the past 14 days and reschedule once they have the all clear from their physician.
  • Adhere to CDC guidelines to prevent infections https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html
  • Tell staff who are sick to stay home.
  • Schedule patient appointments and staff so you don’t have more than 10 people in the office at one time.
  • Once patients arrive:
  • Take their temperature (best practice is that the doctor or CA taking temperature should wear mask and gloves); if they have an elevated temperature, send them home with the COVID-19 hotline number: 800-456-7707
  • Ask them to sanitize their hands
  • Ensure they sit at least six feet apart in the waiting room, OR
  • Bring patients back to a room immediately, OR
  • Ask patients to wait in their car until the doctor is ready for them, then alert them via cell phone to come in
  • Disinfect treatment tables after each patient (preferably in front of the patient, so the see you are disinfecting it) and high touch areas regularly. The CDC does not have specific sanitizing information for healthcare providers, but does offer these suggestions for disinfecting homes with patients who have COVID-19:
  • Wear disposable gloves when cleaning and disinfecting surfaces. Gloves should be discarded after each cleaning. If reusable gloves are used, those gloves should be dedicated for cleaning and disinfection of surfaces for COVID-19 and should not be used for other purposes. Consult the manufacturer’s instructions for cleaning and disinfection products used. Clean hands immediately after gloves are removed.
  • If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.
  • For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.
  • Diluted household bleach solutions can be used if appropriate for the surface. Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against corona-viruses when properly diluted.
  • Prepare a bleach solution by mixing:
  • 5 tablespoons (1/3rd cup) bleach per gallon of water or
  • 4 teaspoons bleach per quart of water
  • Products with EPA-approved emerging viral pathogens claims are expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
 

Please reach out with any questions and review the above link from the CDC for any updates. You are expected to follow any updates from the CDC or from the Utah State Health Department. The Utah Chiropractic Physicians Association continues to monitor the COVID-19 situation and will keep you posted on what you need to know, via email, text and our website.

Salt Lake City has an application process for small business grants. Click on this link to apply.

Salt Lake City Economic Development

Utah Small Business Development Center COVID-19 Business Survival Tips

Initiative for a Competitive Inner City Small Business Resource Center

WaFD Bank Emergency Funding

 NCMIC Malpractice Policy:  https://www.ncmic.com/malpractice-insurance/coronavirus-covid19-resources/