Covid Spiking and Acupuncture Access

They predicted this moment in March. They told us there would be a second Covid spike around October/November and here we are.

This fact concerns all of us, especially here at Louisville Community Acupuncture. We are worried about people in general and people who are at higher risk in particular.

Overall, we feel like we have addressed exposure issues as best we can. We work indoors, which is the biggest risk out there for spread. But we also:

1. Require masks at all times while in our building.
2. Have minimal talking while people are visiting our space.
3. Limit the amount of time people remain in the building for treatment (45 for treatment and slightly more for checking in and out, so roughly an hour).
4. Since we can’t have natural ventilation (windows open) we have air purifiers throughout the building (waiting room, community room, private rooms and in the back area) to try and keep as much of the air moving as possible.

Two recent articles demonstrate the factors that affect Covid transmission

Talking, Timing and Venting

The first, looks at differences in transmission indoors through aerosols. One important factor they look at is length of time in a setting. Regardless of how big the area is (living room, bar, church, classroom) the length of time people spend within it increases the amount of aerosols in the building’s atmosphere. This reason is mainly why we are limiting visit length: so that no one person (outside of the acupuncturist) is contributing aerosols to our environment for very long.

The article also compares modes of vocalization: minimal/no talking, normal talking, singing/shouting. The concentration of aerosols increases significantly with each change in communication. That is why we saw a large outbreak in a choir at the beginning of the pandemic: even with social distancing, singing is one of the best ways to build up concentrations in the immediate environment, and if you couple that with not wearing masks and practice lasting for over an hour then you can see how even just one initially infected person can lead to increased transmission. This is why we limit talking more now than we did before. So if it seems we are not talking with you much about an issue it’s because we are trying to cut down on aerosol spread in the building.

Covid on Surfaces

The second article looks into surface transmission of Covid. Initially, a lot of stories highlighted viral persistence. Researchers tested affected areas days and days after exposure and still detected the virus. So everyone wiped everything down, left packages outside, etc. And while it is not impossible, it seems highly unlikely that people contract Covid from surfaces. And if transmission does occur, it is probably due to not washing hands regularly.

Consider, Wyllie says, the extraordinary chain of events that would need to happen to successfully spread SARS-CoV-2 on a surface. A sufficiently large amount of the virus would need to be sprayed by an infected person onto a surface. The surface would need to be the right kind of material, exposed to the right levels of light, temperature, and humidity so that the virus does not quickly degrade. Then the virus would need to be picked up—which you would most likely do with your hands. But the virus is vulnerable there. (“Enveloped” viruses like SARS-CoV-2 do not fare well on porous surfaces like skin and clothing.) And then it needs to find a way inside you—usually through your nose or your eye—in a concentration big enough to get past your mucosal defenses and establish itself in your cells. The risk, Wyllie concludes, is low. 

Staying Safe at LCA

So overall we are trying to do everything we can to keep things as safe as we can, short of moving the shop to a big pop up tent in the church parking lot across the street.

Within our clinic, we have adopted the protocol of covering each recliner in the community room with a vinyl covering. We then use our regular sheets over that cover. We use each chair once per community shift. After a shift we remove the sheet and clean the vinyl covering. We clean the massage tables in the private rooms between each patient as well.

We understand if you have concerns and want to do everything to limit exposure. Please know that we miss seeing everyone as freely as we used to. But we also want to be open as much as we safely can. Because even with a virus running around people still have pain, still have migraines, still have anxiety and on and on and we want to be there for you as much as possible.