WFC releases “Coronavirus: Advice for Chiropractors”

On March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization (WHO). As at March 26, 2020, there have been over 416,000 confirmed cases in 197 countries, areas or territories. There are currently over 18,500 confirmed deaths. Chiropractors are primary contact health care professionals and to protect themselves, their patients and their communities they must stay current with the latest scientific evidence, information and advice. In many countries around the world chiropractors have ceased providing direct, hands-on care to patients in response to governmental or health policy advice. The global situation regarding COVID-19 is evolving daily and advice may change over time pending developments and emerging scientific knowledge. This advice note is current as of March 26, 2020 and has been produced with advice and guidance from the WFC Research Committee and WFC Public Health Committee.

Key messages

1. The WFC acknowledges the service of chiropractors around the world in contributing to the health of nations. We recognize that this is a challenging time and that we are in unprecedented territory with regard to the global outbreak and spread of COVID-19. As a worldwide community, the WFC understands that there are many questions being asked of chiropractors and that the situation varies from country to country. In order to support the global efforts of our fellow health professionals it is of critical importance that chiropractors communicate information to their patients and communities that is scientifically accurate and comes from authoritative sources.

2. Advice communicated to patients by chiropractors and their staff should be based on advice from WHO and official national public health agencies in their country.

3. There is no credible scientific evidence that chiropractic spinal adjustment/manipulation confers or boosts immunity. Chiropractors should refrain from any communication that suggests spinal adjustment/manipulation may protect patients from contracting COVID-19 or will enhance their recovery. Doing otherwise is potentially dangerous to public health.

4. Chiropractors must comply fully with all government directives in relation to the COVID-19 pandemic, which may include ceasing the provision of direct-contact patient care.

5. COVID-19 may be transmitted from person to person and may be contracted from surfaces on which the virus is deposited. Where they are continuing to provide essential services to patients, it is of critical importance that chiropractors, their staff and all visitors to their facilities are scrupulous about personal and clinic hygiene, including the practice of hand washing, respiratory etiquette, physical distancing, sanitization of all equipment and surfaces and appropriate use of personal and protective equipment.

6. Current evidence is that the elderly and those with co-morbid health conditions are particularly at risk. Care must be taken to minimize potential spread of COVID-19 to these special populations. Multiple nations and regions of the world are now subject to special measures including enforced physical distancing.

7. While most fatalities have occurred in the elderly population, it is now known that young people, including children, have died from COVID-19. Those not exhibiting symptoms can still carry and transmit the virus.

8. Chiropractors and their staff should ensure they are familiar with information about COVID-19, which is set out below. They should monitor the WHO website, government directives, advice and guidance from regulators and official sources of public health advice in their respective nations, states and provinces.

9. WHO recommends that those with mild signs and symptoms of COVID-19 disease are isolated and cared for at home. It is important that care-givers take all necessary precautions to protect themselves. This means that the patient and the care-giver should wear medical masks. Patients should sleep in a separate room and use a separate bathroom. One care-giver, who is in good health, should be assigned to care for the patient, and should practice rigorous hand-washing and sanitization procedures as set out below. These measures should continue for 2 weeks after patients have stopped exhibiting symptoms.

10. COVID-19 is spreading to low income countries. It is not known at this stage how it will affect communities with a high HIV-positive prevalence or who are malnourished. Chiropractors working in these communities should be particularly mindful of measures that will help prevent transmission.

Recommendations for patients and health professionals

• –  Regularly and thoroughly wash your hands with soap and water or alcohol-based hand cleaner.
• –  Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
• –  Avoid touching your eyes, nose and mouth.
• –  Follow good respiratory hygiene. Cover your mouth and nose with your bent elbow or

  tissue when you cough or sneeze. Dispose of the used tissue immediately.

• –  Clean surfaces with disinfectant.
• –  Avoid unprotected contact with farm or wild animals.
• –  Within health care facilities, enhance standard infection prevention and control practices

  in hospitals, especially in emergency departments.

• –  If you feel unwell, stay at home and isolate for at least 14 days.
• –  If you develop fever, cough and difficulty breathing, seek medical advice promptly as this

  may be due to a respiratory infection or other serious condition. Call in advance and tell

  your provider of any recent travel or contact with travelers.

• –  Stay informed on the latest developments about COVID-19. Follow advice given by your

  healthcare provider, your national and local public health authority or your employer on how to protect yourself and others from COVID-19.

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