Covid-19

1. It is not recommended that American acupuncture clinics in the United States treat patients for the new COVID-19 (COVID-19) disease independently but are encouraged to cooperate with medical providers provided by US infectious disease laws and the CDC by participating in the overall treatment.  Although Chinese medicine has played an important role in the fight against the new COVID-19 in China, China and the United States have different national conditions and ways to handle the virus. Acupuncturists are not medical providers for the diagnosis and treatment of infectious diseases as permitted by US law.  Traditional Chinese medicine is mainly used for interventional treatment, but in the United States we mainly use acupuncture. Chinese medicine is not a drug under the FDA definition making it difficult for acupuncturists to participate in anti-epidemic treatment in the United States.  We do not have necessary and effective protective measures in place, therefore, our TCM acupuncture practitioners in the United States do not have the protocols to directly treat such patients. 
2. TCM acupuncture clinics are a place where people gather and there is a lot of direct contact with patients every day. In case of infection, close the clinic. It is more important to take responsibility.  Therefore, we recommended posting announcements and changing voice messages in the clinic that address the seriousness of the progressing situation. Please train all personnel, most importantly the receptionists, to inform patients with symptoms of respiratory infections and fever to call their primary physician. Patients are not to go first to the Chinese medicine acupuncture clinic. The CDC recommends all patients call their primary doctor or medical clinic for immediate diagnosis and treatment.  According to current U.S. law, acupuncturists are not authorized to engage in the treatment of infectious diseases independently. However, TCM clinics can complement, consult and communicate with relevant US departments to assist in treatment. Health teleconferencing is a good choice to integrate into practices.
3. Avoid advertising promotion of traditional Chinese medicine acupuncture treatment of new COVID-19 disease. Also, carefully identify suspected patients and refer them for conventional US treatment in a timely manner.
4. If the patient consults a doctor online via teleconferencing or other means, he can give some Chinese medicine treatment advice and provide Chinese medicine resources/retailers to assist western medical practices to protect patients by building immunity.
5. If other medical industries require us to participate in consultations and provide Chinese medicine, acupuncture, and auxiliary treatments, you can carefully intervene with sufficient protection to ensure safety and prevent the spread of infection.
6. We suggest that all TCM and acupuncture practitioners and clinic employees strengthen personal hygiene and self-protection practices; the clinics should be adequately disinfected and kept clean.
7. Protect yourself and your family members to avoid extension of family infections caused by contact with patients.  Your home and offices should be fully equipped with Chinese medicinal herbs and protective protocols and isolation equipment. If there is a suspicious situation, you should go to the appropriate medical institution as soon as possible and use Chinese medicines for prevention and treatment.

ATCMA / TCMAAA guidelines for self-protection and clinic disinfection for licensed acupuncturists in the U.S.

Prepare disinfectant and use clean paper towels.  Wash hands thoroughly with soap and running water for at least 20 seconds before and after each patient.  Use alcohol-based hand sanitizer with alcohol content of at least 60% to clean hands.  Avoid touching eyes, nose and mouth in general, especially with unwashed hands.

Replace and clean used sheets and pillowcases after each patient and follow the technical specifications of always using clean needles. The bed should be thoroughly disinfected.  Every office should regularly disinfect the air with ultraviolet light or essential oils that contain lemon, rosemary, tea tree, clove bud and cinnamon properties.  Clean and disinfect daily all surfaces that patients often touch such as door handles and stair railings.

Prepare a toolkit with thermometers, masks, gloves, goggles, gowns, oils and proper isolation equipment. To protect against COVID-19 exposure, doctors should wear N-95 masks when necessary.

Pay attention to relevant official epidemic information from the CDC. If you encounter a suspected case, please contact the relevant agency immediately and prepare a report of the situation. Share the epidemic prevention knowledge to the public as much as you can and help prepare others. Please download the official CDC report on how to handle the COVID-19 if it is suspected that a patient has contracted the virus: https://www.cdc.gov/COVID-19/2019-ncov/downloads/sick-with-2019-nCoV-fact-sheet.pdf(link is external)

Take full care of your health. Get the flu vaccine and maintain good eating habits.  Keep your physical health in the best condition, get adequate rest, avoid excessive fatigue, and exercise regularly Tai Chi and Qigong, yoga, or brisk walking to strengthen your physique and improve your immunity.

To our patients with fever / respiratory symptoms:

Currently, cases have been reported of community transmission in the U.S. with confirmed COVID-19 infection, which raises a lot of concerns in our patients. Here are our recommendations:

If you have NOT traveled to an area of the world with sustained community transmission of COVID-19 within 14 days and you are symptomatic, YOU SHOULD FOLLOW the same steps that you would take if you thought you had the flu. This includes staying home from work / school, unless you feel that you need medical attention.

If you HAVE traveled to infected areas, or had contact with someone who has, and you feel sick within a 14 day period with a fever, cough, or shortness of breath, you should call your primary doctor’s office, urgent care clinic, or emergency department BEFORE GOING and tell them of your recent travel and symptoms. They can help make decisions about evaluating your condition and when and where this should be done.

– KEEP UPDATED w/

American TCM Association

                               TCMAAA

www.atcma-us.org   www.facebook.com/atcmaus(link is external)

Prevention is the key to avoid being exposed to coronavirus disease 2019 (COVID-19) 

There is no vaccine for this virus so far. CDC recommends everyday preventive actions to help prevent the spread of respiratory diseases, including:

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Follow CDC’s recommendations for using a facemask.

• CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
• Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

From https://www.cdc.gov/coronavirus/2019-ncov/

During the global pandemic of the novel coronavirus disease (COVID-19), the 
acupuncture clinic in the United States will resume work with the degree of 
epidemic control in each state after the peak period in the United States. It is 
unavoidable to contact patients with COVID-19 in the clinic after the resumption. 
We have established the guidelines for each American acupuncture practitioner to 
create a qualified epidemic prevention environment to resume the work of the 
Acupuncture Clinic: 
1.  Choosing the right time is the key to reopen the acupuncture clinic. 
The timetable for the resumption of work in different states of the United States is 
different, and the specific situation of each acupuncture clinic is different. We 
need a comprehensive assessment to determine when to resume work. Please 
refer to the following factors: 
 Comply with the administrative orders of the federal, state, county, and 
city agencies; 
 Listen to the suggestions of the person in charge of public health and 
the professional analysis of the industry; 
 Consider the regulations of the other healthcare professions, such as 
Western medicine, chiropractic and dentistry; 
 Check the coverage of the individual malpractice insurance; 
 Inspect whether the structure space and furniture arrangement of the 
clinic meet the requirements of isolation and disinfection; 
 Ensure sufficient reserves of protective disinfection supplies; 
 Evaluate the physical health and economic status of yourself and your 
family members. 
 Assess whether each employee has sufficient knowledge and protective 
skills for infectious diseases. 
The number of new confirmed patients in the community near your clinic is in a 
declining phase and tends to be stable, which is the premise for the acupuncture 
clinic to consider reopening. 
 
2.  Excluding of COVID-19 patients is the beginning of the reopening of 
the acupuncture clinic. 
As an acupuncturist working in the United States, we do not have the right to 
provide direct treatment for patients with COVID-19, so we should try to avoid 
contact with COVID-19 patients. After we return to work, we will inevitably 
encounter COVID-19 patients or asymptomatic virus carriers. For our acupuncture 
clinic, the first thing is to exclude the COVID-19 patients before the medical staff 
touches the patient: 
 In the clinic website and voice message, inform the patients that the 
clinic will not hold face-to-face appointment with the COVID-19 or 
suspected patients. Advise them to consult their family doctor or local 
public health bureau through the telephone hotline. 
 Make an appointment with every patient on the phone, ask patients in 
detail whether they have a fever, cough, shortness of breath, changes in 
taste and smell, digestive symptoms, recent skin lesions, etc., and 
whether there is a COVID-19 or suspected patient contact history. For 
any patients with suspected or confirmed COVID symptoms, it is 
recommended that patients not come to the clinic. No walk in patients. 
 Control the process of resumption of the clinic and gradually 
increase the opening hours, from three half days per week， to every 
other day, until the normal opening time. 
can check the list of registered disinfectant solutions of the State 
Environmental Protection Agency. 
 Keep each room well ventilated with fresh air, and open doors and 
windows if conditions permit. At the end of each day, use ultraviolet 
light or essential oil to disinfect the air in the clinic; use Lysol to disinfect 
the sink and toilet. 
 Every table should be strictly disinfected every time after each usage. Try 
to use disposable paper sheet and spread it directly on the treatment 
table. It is best to cover all surfaces making it easy for disinfection. The 
reusable linens, towels and cover sheets should be replaced and cleaned 
at a high temperature after the treatment. 
 Surfaces that are frequently touched by medical staff and patients, such 
as door handles, stair handrails, hand sanitizer 
handles, countertops, faucets, sinks, seats, toilet seats, water tank 
buttons, used cupping cups, electroacupuncture device surfaces and 
cables, should be cleaned and disinfected, by using alcohol or 
disinfecting wipes.  
 
3.2 Medical protection 
 Prepare personal protective equipment (PPE) such as masks, gloves, 
goggles / face masks, and isolation gowns. 
 The mask can be used for one day if you keep it clean and 
dry. If possible, it is better for doctors to wear N-95 masks. Between 
each patient, the mask can be changed. Wash your hands before putting 
on and taking off the mask. Don’t touch the inside of the mask.  
 It is recommended to wear gloves between each patient. Moving the 
replaced clothes, cleaning and disinfecting treatment rooms, gloves 
should be worn. When you remove the gloves, it is better to turn the 
inside out and discard it. After removing gloves, hands must be washed.  
 In addition to masks, face shields or goggles can protect the eyes and 
face. 
 It is recommended to wear surgical gowns or isolation gowns. Medical 
staff should have extra uniforms available in case of 
contamination. Clean clinic clothing at high temperatures every 
day. Before leaving work, change clothes to go home. After work, take a 
shower before coming into contact with family members. 
 
3.3 Doctor-patient contact 
 Prepare a thermometer, mask, soap, and disinfectant hand 
sanitizer (alcohol content is at least 60%). 
 Post a notice on the door, and let the patient waiting in the car outside 
the door. The accompanying person is also waiting in the car during the 
appointment (except for children). 
 Measure every patient’s body temperature, at the entrance, better outside 
the door. Patients should enter the exam room directly. If the patient’s 
body temperature is high (>100.4F), the patient should be referred to a 
specialist and report to the local public health department. 
 If the patient does not have a mask, prepare a mask for the patient and 
ask the patient to wear the mask throughout the entire visit. 
 Before and after each patient’s diagnosis and treatment, doctors should 
wash hands thoroughly with soap and running water for at least 20 
seconds, or use disinfectant hand sanitizer to clean hands. Avoid touching 
eyes, nose and mouth with unwashed hands. 
 Try to maintain a social distance between medical staff and patients. In 
order to minimize the droplets spread, avoid direct contact 
patients. Medical staff and patients should not be in a room for more 
than 15 minutes. 
 Appointments between each patient should be at least 30 minutes in 
order to disinfect the room. Patients are not allowed to enter 
different room to reduce the risk of infection. 
 Non-contact registration and payment are highly recommended. 
 If the staff in the clinic are suspected of infection, they should immediately 
self-quarantine; if the acupuncturist has COVID-19 confirmed, all patients 
should be called that are treated for the past 2 weeks. 
 
During the global pandemic of COVID-19, the situation in the United States is 
constantly evolving. Please follow our official website and social media. We 
will update the information and preventive measures of COVID-19 in time to 
ensure that the American acupuncture clinic resumes normal operation as 
soon as possible. 
 
 Executive Committee 
American TCM Association ATCMA 
 TCM American Alumni Association TCMAAA 
www.atcma-us.org www.facebook.com/atcmaus