Sickness Policy

Massage/bodywork is not appropriate care for any infectious or contagious illness. This covers a broad range of ailments and community-prevalent conditions including the common cold, seasonal flu, COVID-19, mpox, and RSV. Because symptoms are often similar and indistinguishable this also includes congestion, headache, upset stomach, sore throat, fever, rash, swollen glands, etc.

Please reschedule your appointment as soon as you are aware of an exposure to an infectious or contagious condition, or if you’re just not feeling well. If it is within the 24-hour cancellation window, the cancellation fee will be waived.

Seasonal INFLUENZA (Flu)

Everyone 6 months and older should get a flu vaccine every year. After a few mild seasons, we could see more flu this year as people gather indoors for holidays and during colder weather.

Those who are at highest risk include young children, older adults, pregnant people, people who smoke, or anyone with chronic conditions such as asthma, diabetes, or heart disease.

A flu vaccination is the best protection against influenza. When you’re vaccinated against flu, you are less likely to catch the flu and less likely to infect others, including people at high risk of developing serious flu complications or death. If you get the vaccine and still get the flu, your symptoms will likely be less severe and your chances of hospitalization or death due to flu will be lower.

Flu and COVID-19 have similar symptoms including fever, chills, cough, headache, body aches, sore throat and fatigue. If you become ill, it may not be easy to know which disease you have — the flu or COVID-19. People with symptoms of the flu should call their healthcare provider, and get tested for COVID-19. You will need to isolate while awaiting test results. Please stay up-to-date and current with seasonal flu and COVID-19 vaccines and boosters if eligible.

For more information, visit SF.gov or CA.gov.

I monitor WHO, CDC, OSHA, and local public health advisories and guidance. Please let me know if you have any health concerns, including seasonal flu or other contagious illnesses.

Respiratory Syncytial Virus (RSV)

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. While the vast majority of people with RSV recover without incident, it can sometimes result in more serious illness in infants and older adults. RSV rarely made headlines in the past, but cases are trending higher than normal and caution is warranted.

There is a new vaccine for RSV, recommended for people over 60, pregnant people at 32-36 weeks, infants younger than 8 months, and high-risk infants and toddlers 8-19 months. Please get your vaccination if you are eligible.

For more information, visit SF.gov and CA.gov.

I monitor WHO, CDC, OSHA, and local public health advisories and guidance. Please let me know if you have any health concerns, including RSV or other contagious illnesses.

Mpox (“em-pox” — ‘Monkeypox’ Virus)

San Francisco’s case numbers of mpox infections and potential exposures peaked in July and have sharply decreased due to vaccination and community-driven prevention efforts. Public health emergencies declared at the local, state, and federal levels bolstered funding, personnel, outreach, education, testing, vaccination, and treatment. SF ended the public health emergency on October 27, 2022.

While the practice of massage therapy involves touch and close contact, this infection does not appear to be communicable in asymptomatic people. If you have fever, malaise, or swollen lymph nodes, you need to delay your massage—that is true in all cases, not just for mpox. If you have undiagnosed blisters, pustules, or scabs that started as blisters, you should investigate this with your primary healthcare provider before receiving massage. Again, this is true for all circumstances, not just mpox.

How long after an infection should you wait to receive massage? Current guidance from the CDC says after the rash has fully healed (that is, the blisters have scabbed, and the scabs have fallen off), you are no longer contagious. That may take a few to several weeks.

A lot is known about mpox which was first discovered in monkeys in the 1950s and later identified in humans in the 1970s. It occurs most often and is spread to humans most easily by rodents, but it has also been seen in other mammals. Mpox is similar enough to smallpox that anyone vaccinated against smallpox has protection from mpox. However, since smallpox was globally eradicated the US stopped routine vaccinations in 1972. Like we learned with COVID-19, some groups are at higher risk than others but ultimately anyone can become infected with and spread mpox. However, unlike COVID-19, if someone is asymptomatic (no rash, blisters, or scabs) there is little risk for spreading or becoming infected with mpox.

SF offers first and second doses of the mpox vaccine though subcutaneous injection for eligible people who prefer this method over an intradermal injection. Both methods provide the same amount of protection against mpox. No matter the choice you make, it is important to get your second dose of the mpox vaccine if it has been at least 28 days since you received your first dose to be fully vaccinated against mpox.

People who live and work in San Francisco are eligible for a Jynneos  vaccine:

• Gay or bisexual men, or any man, trans, or nonbinary person who has sex with men, trans, or nonbinary people

• Sex workers of any sexual orientation or gender identity 

• Persons of any age and any gender who have had close contact within the past 6 months with someone with suspected or confirmed mpox

• Persons who had sex or close contact with others at a venue or event or within a social group within the past 6 months where a suspected or confirmed mpox case was identified. This includes persons who received notice from a venue or event of a potential exposure.

• Persons living with HIV

• Persons who are taking or are eligible to take HIV PrEP

• Sexual contacts of any of the persons above

• Persons who anticipate experiencing any of the above

• Laboratory workers who routinely perform mpox virus testing 

• Clinicians who are likely to collect laboratory specimens from persons with mpox

• Clinicians who have had a high-risk occupational exposure 

First and second doses of mpox vaccine are available at pop-up vaccination sites, neighborhood vaccine clinics, and events at health system providers. Appointments may also be made at the Adult Immunization and Travel Clinic, SF City Clinic, Strut, Kaiser Permanente, and UCSF. Click to get more information about the mpox vaccine at SF.gov.

Please get your vaccination if you are eligible, and a second dose of the vaccine if it has been at least 28 days since your first dose.

If you think you might be at risk:

• Cover exposed skin in crowds

• Don’t share bedding or clothing

• Talk to anyone you've had sex or close contact with about their health

• Stay aware if traveling

If you have symptoms:

• Cover the area of the rash with clean, dry, loose-fitting clothing

• Wear a well-fitted mask

• Avoid skin-to-skin, or close contact with others

• Talk to a healthcare provider as soon as possible

• Stay away from other people

• Let sex partners know about any symptoms you have

For more information, visit SF.gov or CA.gov.

I monitor WHO, CDC, OSHA, and local public health advisories and guidance. Please let me know if you have any health concerns, including mpox or other contagious illnesses.

SARS-CoV-2 Novel Coronavirus & COVID-19 disease

The San Francisco Bay Area has seen epic highs and lows over the last few years. Vaccines, boosters, tests, and treatments are widely available and local healthcare resources are now stable. However, a significant portion of the US population are not vaccinated and many others are not current on recommended boosters. As such, variants continue to emerge and seasonal surges of cases are expected.

Let’s keep ourselves and our community safe:

• Get the most recently recommended vaccination or booster,

• Wash your hands thoroughly and often, and

• Wear a face mask when near others of unknown vaccination status—especially indoors or while on public transportation.

For more information, visit SF.gov or CA.gov.

I monitor WHO, CDC, OSHA, and local public health advisories and guidance. Please let me know if you have any health concerns including COVID-19 or other contagious illnesses.