ANJC Statement on Governor’s March 21 Closure of Non-Essential Businesses

Dear Members,

On March 21, 2020, New Jersey Governor Phil Murphy held a press conference in which additional measures were enacted to curtail the spread of Covid-19 and issued Executive Order 108 which memorialized additional restrictions placed on New Jersey citizens and businesses.  All businesses except those expressly excluded from the order were to close until further notice.  Specifically excluded from the order are “any health facilities that provide medically necessary or therapeutic services.”   The Order further states:  “Nothing in this Order shall be construed to limit, prohibit or restrict in any way the provision of health care or medical services to members of the public.”  Exec. Order 108 (3/21/2020)

When asked clarifying questions at the press conference, Governor Murphy confirmed that physical therapy services would be permitted and that “all healthcare services are considered essential.”  Accordingly, based upon the above guidance and until any further notice to the contrary, it appears that chiropractic offices may opt to continue to maintain their brick and mortar practice  and treat patients but need to do so with discretion and caution. 

Due to their often extensive and close contact with vulnerable individuals in healthcare settings, NJDOH recommends a conservative approach to HCP monitoring and restrictions from work to quickly identify early symptoms and prevent transmission from potentially contagious HCP to patients, HCP, and visitors.  Healthcare facilities (HCFs) should have a low threshold for evaluating symptoms and testing symptomatic HCP, particularly those who fall into the high- and medium-risk categories described in this guidance.  HCFs, in consultation with public health authorities, should use clinical judgment as well as the principles outlined in this guidance to assign risk and determine need for work restrictions.
 
Whenever possible, initial screening of patients should be done via phone or other electronic means to determine the patient’s risk for exposure to COVID-19. 

1. Have they traveled to an area with a CDC level 3 travel advisory?
2. Have they had close contact with a known individual with COVID-19?
3. Are they over 65?
4. Do they have any other serious underlying medical conditions? (Diabetes, heart disease, hypertension, etc?)
5. Do they have temperature of 100.4 or higher, cough OR difficulty breathing?

If you determine there is minimal risk, and the patient comes to the office, be prepared to take their temperature prior to having them enter your office/building. It’s recommended that they have a temp of 100.4 or less prior to being seen.

Take all other appropriate steps to decrease exposure while you are treating your patient.  ANJC recommends closing your waiting room area and calling patients in from their cars in order to maintain a 6-foot distance between staff and other patients the entire time they are in your office.  If you keep patients waiting, be sure they are practicing social distancing.

Disinfect equipment between all patients.

Additionally, it is ANJC’s recommendation that you screen your staff with the same criteria as above, every shift.  Document action steps per the Division of Consumer Affairs (see website linked below) in case your office becomes the target of an inquiry as a source of transmission.

The COVID-19 pandemic is a public health emergency and chiropractors have an important role to play.  Chiropractors, other healthcare practitioners, and staff are a part of the healthcare community and have a responsibility for the prevention and mitigation efforts during this pandemic while managing the urgent needs of patients during this crisis.  Everyone is at risk for the transmission and contraction of COVID-19.  Our top priority must be the health of the public and your patients.As much as79% of transmission has occured from asymptomatic/undocumented individuals (see reference below).

To reduce the risk of spread of COVID-19, ANJC urges all chiropractors to strictly follow Governor Murphy’s current and future direction.  Failure to comply with these requirements may result in enforcement action that could include citations, fines or license suspensions.

The ANJC continues to communicate with state agencies and other officials and will continue to disseminate information to its members as soon as we have clear and definitive information.

Below is a list of valuable links for guidance and resources:
 
New Jersey Department of Health, Division of Consumer Affairs info for healthcare professionals
https://www.nj.gov/health/cd/topics/covid2019_healthcare.shtml

New Jersey Department of Health, Frequently Asked Questions for Healthcare Professionals:
https://www.nj.gov/health/cd/documents/topics/NCOV/FAQs_For_HCW_and_COVID19_3_20_20_FINAL.108141.pdf

General Information on Coronavirus (COVID-19): 
https://www.cdc.gov/coronavirus/2019-ncov/index.html

Healthcare Professionals:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html

Businesses:
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fguidance-business-response.html

ACA Resources:
https://www.acatoday.org/News-Publications/Newsroom/Coronavirus-COVID-19

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2):
https://science.sciencemag.org/content/early/2020/03/13/science.abb3221