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COVID-19 Plan


To Our Valued Patients….

Thank you for your patience and understanding during our last few months of closure. We are all chomping at the bit to reopen and begin providing our services for your therapeutic needs, but not before we have all the necessary protective equipment, supplies and protocols in place.

There is no exact date for re-opening yet, however we are aiming for a soft-opening sometime in early June. Once all necessary items are procured, and staff are familiarized with the new protocols, we will be contacting you directly to begin the process of booking your appointments.

The first step is announcing our restart plan! This is a comprehensive and detailed plan, so pour yourself a coffee and read though the very important information below. There will be notable differences to how we operated before, however these alterations and safety measures are to ensure that risk is mitigated for yourself, the practitioners and the staff at DMTW.

Stay Well. Stay Safe.

The Dominelli Massage Therapy & Wellness Team

Dominelli Massage Therapy & Wellness Restart Plan

Getting Back To Work During the COVID-19 Pandemic

POSTED: 24 May 2020 – UPDATED: 29 Jan 2021

This plan was developed with the goal of reducing the risk of exposure to the virus that causes Covid-19 for both patients and the practitioner within our clinical setting. Identified below are the actions that Dominelli Massage Therapy & Wellness commits to, and that all visiting patients must commit to, in order to resume massage therapy services.

For a safe return to practice our staff and practitioners are committed to safety protocols in the following areas:

  1. Personal Practices – Understanding of how COVID-19 is transmitted and remaining committed to behaviours that prevent the spread of COVID-19 both in practice settings and in one’s personal life.
  2. Therapist Screening –Daily therapist self-monitoring for symptoms and consideration of one’s personal circumstances is important in determining whether working is appropriate.
  3. Patient Screening & Arrival – Every patient is screened carefully to reduce the likelihood of someone coming into the clinic with COVID-19. Further, being aware of the risk factors present with each patient is important. Patients that have new or emerging symptoms of cold or flu are not to be treated, and measures are in place to prevent their attendance in the clinic.
  4. Supplies: Considerations and Procurement – To make the treatment environment safe.
  5. Therapist Infection Control Practices – Factors considered in creating the safest treatment environment possible. The supplies needed to practice safely, the modifications to our treatment environment and cleaning process.
  6. Facility Practices & Logistics – Strategies we are implementing to maximize social distancing, keep common areas clean and sanitized and create the safest possible space for patients.


A return to work is not a return to normal. It is important that therapists and patients move about in their work and personal environments consciously. These rules apply to everyone as you do your part to help slow the spread of COVID-19.


  • Health experts believe that Coronavirus is transmitted via liquid droplets when a person coughs, sneezes or talks within a close proximity.
  • It is believed that COVID-19 spreads when infected droplets reach the eyes, nose or mouth.
  • The virus is not known to be transmitted through airborne transmission (by much smallerevaporated particles containing the microorganism floating in the air for long periods of time).
  • Coronavirus does not transmit through the skin.
  • The virus can be spread by touch if a person has used their hands to cover their mouth or nosewhen they cough.
  • Be aware that COVID-19 may be spread by those not showing symptoms.

To minimize personal risk of exposure, everyone should:

  • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, after blowing your nose, coughing or sneezing.
  • If soap and water are not readily available a hand sanitizer that contains at least 60% alcohol can be used. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Clean and disinfect high touch surfaces frequently.
  • Keep 2 metres or 6 feet apart where possible (social distancing).

How Covid-19 Spreads – http://www.bccdc.ca/health-info/diseases-conditions/covid-19/about- covid-19/how-it-spreads

For measures on prevention – http://www.bccdc.ca/health-info/diseases-conditions/covid-19/prevention-risks

For a brief summary –  http://www.bccdc.ca/Health-Info-Site/Documents/COVID19-Prevention.pdf


  • We will always avoid close contact with people who are sick.
  • Unless we are actively treating, we will remain at least 2 meter distance between ourselves andothers.
  • We will be particularly mindful of those at the highest risk of getting sick, including patients over65, or at any age with underlying medical conditions (e.g. chronic lung disease; moderate to severe asthma; heart conditions; immunodeficiency/immunocompromised conditions; severe obesity; diabetes; chronic kidney disease while undergoing dialysis; liver disease; etc.)


In all scenarios of life, our practitioners and staff will:

  • Be aware they could spread COVID-19 to others even if they do not feel sick.
  • Use masks to act as a barrier to help prevent spreading tiny droplets to others when they areunable to practice social distancing.
  • Do their best to maintain social distance between themselves and others, even with a mask.

Note: Masks are not a substitute for social distancing.
For more information on masks: http://www.bccdc.ca/health-info/diseases-conditions/covid-19/ prevention-risks/masks


Practitioners and staff will:

  • Always cover their mouth and nose with a tissue, or into their arm if a tissue is not readily available, when they cough or sneeze, even while wearing a mask.
  • Throw used tissues in the trash.
  • Immediately wash hands with soap and water for at least 20 seconds, or they will clean theirhands with hand sanitizer that contains at least 60% alcohol when soap and water are not readily available.


Our practitioners and staff will commit to cleaning and disinfecting touched surfaces and maintaining the cleaning guidelines laid out by BC Center for Disease Control, both at home and in clinic. Further details about cleaning protocols are presented in this restart plan.



What we do in our day-to-day life matters. We recognize the importance to think ahead about how we can stay healthy and prevent the spread of COVID-19 within our practice and our community. Everyone does this by committing to the following:

  • Being conscious of the number of places we go to before and after work, and on days off.
  • Avoiding non-essential trips and group gatherings.
  • Limiting contact with high risk individuals.
  • Going outside to exercise but staying close to home and/or avoiding high traffic locations.
  • Practicing social distancing to the best of our abilities.
  • Strictly adhering to a 14-day quarantine upon feeling ill or after returning home from any travel outside BC.


Symptoms associated with a COVID-19 infection have included cough, fever, difficulty breathing, and pneumonia in both lungs. These symptoms may range in severity, and act similarly to that of a cold or flu. Both asymptomatic and symptomatic individuals may transmit the virus to others. Our staff and practitioners will self-monitor by:

  • Assessing their symptoms, body temperature, and number of contacts each day outside of the treatment room.
  • Avoiding the use medicines that reduce fever (e.g. acetaminophen or ibuprofen), or re-measure their temperature at least 4 hours after their last dose if they have taken any fever reducing medicine.

Other symptoms may include muscle aches, fatigue, sore throat, headache, loss of appetite, chills, runny nose, nausea and vomiting, diarrhea, loss of sense of smell or taste. In addition to self-monitoring, our staff and practitioners will:

  • Take their temperature every day before work.
  • Be mindful of the number of places visited or stopped at outside of work.
  • Disclose their number of contacts and/or places visited to their patients with full transparency.


Practitioners and staff will not go to work if they are not feeling well, even if their symptoms are mild and they are uncertain of whether or not it is COVID-19. We are committed to protecting our colleagues and patients, and will stay home if there is any doubt in mind. Furthermore, we expect to miss more work than usual to make sure that they are taking care of ourselves, our colleagues, and our community.

Our commitments:

  • Staying home (avoiding work, public places, etc) and not having home visitors if feeling mildly ill.
  • Contacting our family physicians, clinic, or local public health unit, and/or 8-1-1 and following theirinstructions, in addition to completing the COVID-19 self-assessment – https://bc.thrive.health/
  • Maintaining effective social distance from members of the same household while feeling ill.
  • To protect their patients and colleagues, if we test negative but still feel ill, we will stay home untilwe feel are better.
  • If any of us test positive for COVID-19, we will inform our patients to monitor for symptoms. For information on how to self-isolate – http://www.bccdc.ca/Health-Info-Site/Documents/Self-isolation.pdf
  • If any of us become ill with COVID-19, that individual will stay away from work for at least 10 days beyond the onset of symptoms, AND until the fever is gone without medication, AND they are feeling better AND they have been cleared by a public health official.


In the event a close contact (e.g. spouse; child; household member) becomes ill, that individual will stay home, self-isolate and follow the instructions from the BC Centre for Disease Control – http:// www.bccdc.ca/Health-Info-Site/Documents/Self-isolation_caregivers.pdf

Our staff and practitioners will only return to work:

  • When their close contact has been tested for COVID-19 and the results come back negative, AND they are well; OR
  • After self-isolating for 14 days and having no developing symptoms or fever; OR
  • After being cleared by a public health official.

In the event a patient alleges they were exposed to COVID-19 at an appointment, or around the time of having an appointment with a practitioner, and the practitioner has had an appointment with that patient within the past 14 days, the practitioner will immediately self-isolate and cancel all appointments. Regardless of when the last appointment occurred, the practitioner will call public health at 8-1-1 and report the alleged transmission, providing both the practitioner’s name and the name and contact information of the patient.

In this case, our practitioners will only return to work:

  • When the case has been investigated and proven false, AND the practitioner has not had any symptoms; OR
  • After self-isolating for 14 days and having no developing symptoms or fever; OR
  • Being cleared by a public health official.

In the event a patient has tested positive for COVID-19, and the case is proven true following investigation, the clinic/practitioner will immediately notify all patients seen since the last appointment or the past 14 days (whichever is longer).


Diligent screening of all visitors entering the clinic helps to ensure safety to the clinic, its staff, and patients. In the interim, the clinic will look and feel different to its patients. Clear communication prior to entering the clinic will help everyone understand the new process and what to expect during their visit.


It is paramount that this protocol is in place. Patients will be screened multiple times, including at least one screen prior to arriving at their appointment. Our staff and practitioners will ensure these three screening procedures will occur with each patient for each appointment:

1. At appointment booking, or appointment reminder email, using our clinic screening form or the BC Symptom Self-Assessment Tool;
2. During a phone call within 24 hours prior to the appointment;
3. When they first enter the clinic and/or the treatment room.

Our practitioners will document that the screening was done. Practitioners will refuse to treat if their patient refuses to participate in any of the three screening processes.


For the safety of visitors to the clinic, the patient must answer these questions to the best of their ability. This screening, based on the BC Symptom Self-Assessment Tool, is subject to updates as we learn more about COVID-19. If they choose, our practitioners and staff may direct patients to use our clinic screening form instead.

1. Do any of the following apply to yourself, or anyone in your household? (Please check all that apply and list the member of your household, as well as any other relevant information):

Heart Conditions; Undergoing Cancer Treatment, Moderate-Severe Asthma; Habitual Smoker; Chronic Lung Disease; Poorly Controlled HIV/AIDS; Type I or Type II Diabetes; Severe Obesity: Liver Disease: Age over 65; Chronic Kidney Disease (and undergoing dialysis); Nursing Home or Long-Term Care Facility Residency; Recent Bone Marrow or Organ Transplant; Current Pregnancy (# of weeks; complications; etc.); Corticosteroids or Other Immune Weakening Medications (type and duration), Other Immune System Deficiencies or Pre-Existing Conditions;

Practitioners will discuss the risks versus the benefits of anyone who selected any of the above. The decision to continue with the appointment will only occur when both the practitioner and patient fully understand the nature of the patient’s health condition, the possible added risk of COVID-19 to that patient, and both individuals are comfortable with the precautions in place.

2. Approximately how many social contacts outside your household have you had in the past week? Note: One social contact is one place or action visited outside your home. (e.g. grocery store; 2 meter apart walk with a friend; going to work; etc.)

The practitioner will also disclose their social contacts, giving the practitioner and the patient the opportunity to discuss and establish trust in each others’ approach to safety regarding COVID-19.

3. Have you, or has someone in your household, ever been diagnosed with COVID-19? If yes, please list the date of last symptoms.

If the answer is yes and the date is less than 10 days prior to the appointment date, the practitioner or staff member will cancel the appointment and re-book for a date at least 10 days after last symptoms.

4. Have you, or someone in your household, had close contact (whether or not for providing care) with a person having a presumed or confirmed diagnosis of COVID-19? If yes, please list the date of resolution of that person’s symptoms and/or the date of last contact with that person.

If the answer is yes and the date of resolution or last contact is less than 14 days prior to the appointment date the practitioner or staff member will cancel the appointment and re-book for a date at least 14 days after resolution or last contact.

5. If your answer to question #4 was yes, AND you are a healthcare provider working with COVID-19 positive patients, have you adhered to strict personal protective equipment protocol? What is your role in working with COVID-19 positive patients?

Our practitioners will individually decide if they are comfortable treating healthcare workers who are in direct contact with COVID-19 positive patients. We completely understand and honour that our doctors and nurses are very well trained in the use of personal protective equipment (PPE) and have strict protocol to follow when PPE fails. Our practitioners who decide to treat healthcare workers will cancel the appointment if there has been a failure in the healthcare worker’s PPE within 14 days prior to the appointment, OR if the healthcare worker does not meet any other criteria in the screening process. The practitioner will also disclose to ALL or their patients that they are currently treating healthcare workers who are in direct contact with COVID-19 positive patients.

6. Have you, or has someone in your household, traveled outside British Columbia within the last 14 days?

If the answer is yes, our practitioners and staff will cancel the appointment and re-book at least 14 days after the patient’s (or household member’s) return home.

7. Are you, or someone in your household, experiencing any of the following symptoms (Please check all that apply):

Moderate-Severe Difficulty Breathing (e.g. struggling to breathe; speaking in single words; etc.); Severe Chest Pain; Difficulty Waking Up; Confusion; Losing Consciousness; Mild-Moderate Shortness of Breath, Inability to Lie Down AND/OR Manage a Chronic Health Condition because of Breathing Difficulties.

If the answer is yes to any of the above, the practitioner or staff member will cancel the appointment and direct the patient to do one of the following: 1) Call 8-1-1; 2) Go to https://bc.thrive.health/; OR 3) Contact their physician for further guidance and advice. The patient can reschedule later after they are safe to be treated.

8. Are you, or is someone in your household, experiencing any of the following cold, flu or COVID-19-like symptoms, even mild ones? If yes, please indicate if this is due to an existing condition (provide the name of the condition), or is a regularly experienced symptom.

Fever; Chills; Cough; Shortness of Breath; Sore Throat and Painful Swallowing; Stuffy or Runny Nose; Loss of Sense of Smell; Headache; Unusual Muscle Aches; Fatigue; Loss of Appetite;

If the response to any 2 of these questions is yes, the patient cannot have a treatment. Practitioners will cancel the appointment and direct the patient to do one of the following: 1) Call 8-1-1; 2) Go to https://bc.thrive.health/; OR 3) Contact their physician for further guidance and advice. The patient can reschedule later after they are safe to be treated.


Patients arriving for their appointments will be instructed by practitioners and staff to do the following:

  • Patients will arrive and wait in the hallway outside of the clinic door, until a staff member or their practitioner ushers them into the clinic at their appointment time.
  • Patients are to come into the clinic alone and not bring spouses or children, unless required for mobility or personal assistance. This is important to maintain social distancing in treatment rooms and our small lobby space.
  • Patients must wear a clean mask prior to entry. Upon entry into the clinic, patients must sanitize their hands with the provided hand sanitizer.
  • Patients bringing their own mask is recommended. In the event a patient does not have a mask, or the patient’s own mask is unclean or was continuously worn for a long period, the clinic will provide either a disposable mask for a fee.


The current risk of COVID-19 has made procurement of many items difficult or impossible. Below are considerations taken to ensure our clinic environment as safe as possible all visitors. If we find difficulty meeting our considerations and supplies can not be found, Dominelli Massage Therapy & Wellness will remain closed or temporarily cancel appointments until those necessities are in place.


The following furnishing considerations will be implemented:

  • Laundry hampers that are easy to clean and disinfect.
  • Frequently emptied garbage bins in common areas and treatment rooms.
  • Cleanable chairs in waiting and treatment rooms, albeit reduced or temporarily removed.
  • Treatment room and common areas furnishings that are washable or wipeable.
  • Dedicated cleanable areas for patients possessions.


  • Hard surface cleaners and vinyl cleaner/disinfectants approved and listed on the government of Canada’s website. Found at: https://www.canada.ca/en/health-canada/services/drugs-health- products/disinfectants/COVID-19/list.html
  • Reusable cleaning cloths for disinfecting and available for door opening (washed after every use).
  • Disinfectant wipes for all hard, non-porous surfaces.
  • Spray bottles for hard surface cleaners and vinyl surface cleaners.
  • Covers for all bolsters, pillows, heating pads, for easy cleaning and/or laundering.
  • Linens to be washed between every appointment in approved sanitization process.
  • Hand soap with touchless or cleanable pump dispenser in the washroom.
  • Freshly laundered hand towels for single use drying hands.
  • Hand sanitizer (at least 60% alcohol) in touchless or cleanable pump dispensers in the lobby and all treatment rooms.


From a risk management perspective, therapeutic treatment takes place in an enclosed space where the therapist and patient are unable to socially distance. Further cross transmission is a risk given that practitioners will interact with a number of patients in a day. No in-person appointment is risk free, even if the patient and massage therapist appear well. It is essential that health care workers are kept healthy, safe, and able to provide care and service in all settings. As such, practitioners will adhere to the infection control requirements listed below.


  • All clutter, decorations, and items that cannot be washed/wiped and sanitized are removed from the treatment space.
  • All pillows, linens and items that are not being used during the treatment are either not in the treatment room or are enclosed in a cabinet.
  • Every surface that the therapist or the patient touches is to be cleaned and sanitized between every treatment. This includes oil/lotion bottles, treatment tools, linens, the treatment table (surface; face cradle; adjustment handles/knobs; raising/lowering bar; table legs near the face rest;), desk; chairs; doorknobs, light switches, music volume control; etc.
  • Chair and desk to be used as a cleanable space for patients to store their clothing and personal items during treatment. Hanging clothes on hooks will be discouraged, but will also be disinfected if inadvertently used.
  • Hand towels available for practitioners and patients to use when opening doors.
  • The clinic is equipped with a high-powered air ventilation system that has vents in every room.This system helps to reduce dust, allergens, cleaner fumes, various odours, and other potential causes for sneezing. While we are not certain of it’s affect to ventilate airborne droplets of COVID-19, we will use this system periodically to help keep the air as clean and safe to breathe as possible.


The practitioners and staff will be following these cleaning protocols listed below:

1. Between every appointment, using approved disinfectants and cleaning supplies on all touch surfaces, moving clockwise from the door around the entire treatment room, including but not exclusive to:

  • Door handles on both side of the door
  • Cabinet and drawer handles
  • Desk surface and sink/faucet
  • Stool and chair
  • Massage table with special attention to the head rest cradle, head rest cushion, and table parts near the head rest cradle
  • Any other surfaces touched by the patient or their belongings
  • Walls, door or door frames touched in self-care demonstrations

2. Between appointments using approved disinfectants and cleaning supplies on all touch surfaces, disinfect all high touch areas in the common spaces, including but not exclusive to:

  • Door handles
  • Washing machine and dryer
  • Laundry baskets
  • Cabinet handles and open surface areas
  • Front desk surfaces and barriers
  • Chairs/stools
  • HVAC and Air Ventilation Controls
  • Laptops, personal electronic devices and point-of-sale machine
  • Office Telephones
  • Writing utensils and clipboards

3. At least once daily, a full cleaning and disinfecting the entire common area floor.

4. Throughout the working day, laundering of all linens, blankets, and hand towels after every use.


Practitioners will place street clothes in an enclosed drawer, change into a fresh set of attire, and implement the following PPE protocol:

Required: Procedural/surgical or cloth masks worn in common areas and changed between treatments.

Depending on practitioner OR patient comfort: Safety glasses/goggles or shield

Depending on practitioner OR patient comfort: Bibs, clothing covers, scrubs, or changes of clothes to be changed between treatments.

Required: A cloth or disposable paper mask for the patient, supplied by the patient or provided by the clinic for a fee.

Depending on practitioner OR patient comfort: Gloves*

*Note: Gloves do not offer any protection over regular and rigorous hand washing that is typical of massage therapy practice. Gloves are normally used during cleaning, intra-oral work, and in the case of cuts or open injuries on the patient or the therapist. Gloves are always discarded after every use. If the patient is comforted by the use of gloves, they can be used.


We are adopting the following scheduling considerations for safety:

  • Appointments are to be staggered between practitioners to ensure that at any one time there is only one practitioner and one patient in the common area. For those appointments booked in close proximity, we will do our best to ensure that they scheduled in treatment rooms on opposite sides of the clinic to help ensure distancing.
  • Appointments will be either 45 minutes or 1 hour. Patients who cannot be treated for more than 30 minutes due preexisting health issues will require special authorization from the practitioner prior to booking. 30 and 90 minute treatments will be returning to the schedule at a later date.
  • Appointments will start and end on time as much as possible to ensure proper staggering of people in the common areas, and to ensure practitioners to perform their cleaning procedures between appointments.
  • Appointments have adequate cleaning time scheduled in between.


Our common area is quite small and it is challenging to maintain two meters distance with more than three people present at one time.


To reduce the need for prolonged use of our common area and to reduce touch surfaces needing disinfecting, we are implementing the following practices:

  • Patients will be invited to fill out all consent and screening forms, online or via email, at least 24 hours prior to their appointment to limit time spent in the common areas, as well as touching shared objects such as pens, paper and clipboards.
  • Patients will be asked to wait in their car or in the outside waiting area until their therapist is ready for them.
  • Patients and practitioners will be instructed to wear masks in the common areas, and in the treatment rooms.
  • Patients will be asked to share all direct billing and payment details prior to their appointment to limit time spent in the common area and touching of the point-of-sale machine. Pre-payment for services will be recommended to patients, and can be paid for over the phone with our reception staff.
  • Patients will be issued an electronic receipt for services rendered to limit shared objects touched, such as paper and pens.
  • Doors to treatment rooms will be left open when the rooms are not in use to reduce door handle touching.
  • Patients will be instructed to arrive well in advance of their scheduled appointment to help ensure treatments start on time, and limit any possibility of crossing paths with others in common spaces.
  • Patients will be instructed to be efficient in their preparation to leave the clinic to limit time spent inthe common areas and to give the practitioner time to prepare a safe space for the next patient.
  • Water is available on request and will be given in a filled cup after both practitioner and patienthave sanitized their hands. If available, bottled water will be provided for a fee.


Due to the extraordinary circumstances we find ourselves in, no charge of penalties will be levied for cancelled appointments due to patient illness, or due to the patient being denied treatment in the screening process. Missed appointments with no notice or explanation of the reason, or for reasons other than illness and cancelled within 24 hours of the appointment time will be charged the full treatment fee (without exceptions). This will be strictly enforced.


Washrooms on the premises are shared by patrons and staff from other clinics on the same floor. Signs educating for safe use and hand washing are posted on the washroom doors. It is encouraged that patients use their own washrooms prior to arrival at the clinic, in order to avoid using the shared washrooms on site. However, in case of absolute need, a staff member or practitioner will provide a key on request. The key and key holder are cleanable, and will be disinfected before the patient is provided the key and after the patient returns it.


Contaminated linens can transmit disease via direct contact or by aerosols of contaminated lint generated during sorting, and handling of contaminated items. Practitioners and staff will:

  • Avoid shaking out laundry before placing into the washing machine it deter from creating aerosolized particles.
  • Use proper hand washing after touching and processing dirty laundry, as well as cleaning and disinfecting of the buttons, knobs, and doors of the laundry area.
  • Linens, scrubs, and cleaning items will be washed using regular laundry soap and put through a dryer cycle until completely dried. Cloth face masks will be ironed after drying as an added disinfection practice.
  • Clean linens will be emptied into a cleanable bin, then folded and stored in enclosed cupboards within the treatment rooms.



Public Health Agency of Canada [PHAC]. 2016. Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings (1-100-22038-0, 978-1-100-22038-3). Retrieved May 2020 from: https://www.rmtbc.ca/wp-content/uploads/2020/04/routine-practices-precautions-healthcare-associated-infections-2016-FINAL-eng.pdf

BC Centre for Disease Control. Accessed May 2020 from: http://covid19.bccdc.ca/

WorkSafeBC https://www.worksafebc.com/en/about-us/covid-19-updates/covid-19-industry-information/health-care

Saskatchewan (April 2020). Re-Open Saskatchewan. A plan to re-open the provincial economy. Saskatchewan.ca/COVID19. Retrieved April 26th from: https://www.saskatchewan.ca/ government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/ emerging-public-health-issues/2019-novel-coronavirus/re-open-saskatchewan-plan/re-open- saskatchewan

Government of Ontario COVID-19 http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/ docs/2019_patient_screening_guidance.pdf

Washington State Department of Health COVID-19 Alert for Massage Therapists. Accessed May 11, 2020 from: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/ COVID19LMTRecommendations.pdf