CPCA Statement regarding the Recommencement of Cosmetic Medical Procedures
On a global scale, the Coronavirus (COVID-19) pandemic has resulted in unprecedented disruption to health care systems, the world economy and fundamentally to our way of life. In Australia, the Federal Government’s response to reduce community transmission and “flatten the curve” has seen early success in limiting the tragic loss of life that we are seeing elsewhere around the world. While this is no time to become complacent, the recent federal government decisions to ease restrictions on elective surgical, IVF and dental practice are cautiously welcomed, as announced on the 21st April. The CPCA has been working through the various published information in an attempt to interpret announcements on elective medical (non- surgical) procedures.
In the absence of specific reference to cosmetic medical (non-surgical) procedures, the CPCA notes that The Honourable Greg Hunt, MP, has stated that the relationship between doctor and patient will not be interfered with. As doctors, we put the safety of our patients first. The following guidelines are provided for CPCA members to recommence some of the services we normally perform, in order to benefit the patient, within the context of the measures required to maintain patient and community safety.
The safe and responsible resumption of cosmetic medical procedures is supported by the College, to the extent where it is permitted by law and while it is underpinned by strict adherence to COVID-19 infection control guidelines which is only possible at this time within dedicated medical facilities with a doctor on site.
Recommendations from CPCA
The following recommended guidelines have been developed by the College for the aim of safe practice to the extent possible during the SARS-CoV-2 (COVID-19) pandemic when returning to Cosmetic Medicine.
These guidelines apply to the practice of Cosmetic Medicine within dedicated medical facilities with a doctor on-site, where universal precautions are being routinely applied. With the advent of the COVID-19 pandemic, extra measures are now required.
1. Typical patient journey, adjusted for the prevailing circumstances of the pandemic of COVID-19, when seeking information and/or treatment.
2. The clinical environment
3. Patient FAQs
1. The Cosmetic Medical Patient Journey
1.1 The Consultation
1.1.1 Questionnaire regarding COVID-19 should be provided.
1.2 Attendances at the clinic.
1.2.1 Point of entry should be controlled by a dedicated staff member while maintaining social distancing not less than 1.5m and the patient be provided with hand sanitisation and advised not to touch their face.
1.2.2 Patients with any respiratory symptoms should be excluded from entering the premises.
1.2.3 Temperature check upon entry. Patients who are febrile (>37.0C) should be handed printed advice regarding the nearest COVID-19 testing facility and not receive cosmetic medical treatment.
1.2.4 Patients should ideally be escorted directly to an individual consultation/treatment area. If a waiting area is to be used, it should conform to social distancing requirements with not more than 1 person per 4 square metres.
1.2.5 During face to face consultation the patient should be provided discretionary access to gloves, face mask and tissues. Special emphasis should be placed upon the potential for patients to cough or sneeze during treatment. Ready access of tissues for this purpose is highly recommended.
Removal of any mask worn by the patient may be required by request from the practitioner if the area of examination includes the peri-oral region.
1.2.6 Surgical masks, protective eye wear and other PPE should be worn by the health practitioner during procedures, including clean single use gloves, and scrubs as a minimum requirement.
1.2.7 Any procedures performed to head and neck should involve prolonged hand and face washing (>20 seconds) with soap or detergent and water. The patient should be instructed after this wash not to touch their face. The face or area of treatment should then be retreated with a suitable antiseptic. Antisepsis should be allowed to dry before proceeding with any treatment.
Please be mindful that both Chlorhexidine and Iodine alone are not effective against coronavirus so should not be relied upon solely as a skin preparation for patients.
1.2.8 Treatments should be of short-term duration, preferably not exceeding 30 minutes.
1.2.9. Special precautions should be taken when performing procedures in the perioral region.
1.2.10 Treatments with plume-producing energy-based devices and cooling devices that blow cold air are not recommended as the behavior of COVID-19 in plume has not been studied nor is it understood.
1.2.11 After each treatment all surfaces should be sanitised and the room not re-used until at least the time taken for surfaces to completely dry has elapsed. This will require extra time to be allowed for each appointment.
All other duties of care should proceed and occur as previously practised.
2. The environment:
2.1 One-way patient flow is highly desirable to the extent where possible. Arrow direction of patient flow should be clearly marked upon the floor. Where possible, patients should not exit from the point of entry.
2.2 High-touch points such as door handles, desks, examination couches, tabletops and toilets should regularly be sanitised.
2.3 Importantly, 1.5m social distancing between all persons except during active treatment should be maintained. Accompanying persons should ideally not be in attendance with the patient.
2.4 Staff should change into work clothing (scrubs) on-site and place used garments at the end of shift into a plastic bag for laundering.
2.5 The Five Moments of Handwashing https://www.hha.org.au/hand-hygiene/5-moments-for-hand-hygiene plus the Australian Government COVID-19 knowledge assessment and certification https://www.health.gov.au/resources/apps-and-tools/covid-19-infection-control-training using online assessment should be undertaken by every staff member.
3. Frequently asked questions
● How do I know if staff at the clinic, including the doctor has COVID-19?
Staff who are known contacts of COVID-19 positive patients are required by law to self-isolate at home.
Staff with symptoms of fever, cough and fatigue are required to stay home until well.
● Should I let the clinic know if I am unsure about people I have been in contact with?
Yes, you should. A determination of each circumstance will be assessed by the medical practitioner.
● Is it absolutely safe to have cosmetic medical procedures at this time?
It is safe to the extent possible, comparable to going to the supermarket, hairdresser, dentist and other similar places where social distancing disciplines are observed.
● Will cosmetic injections make me more susceptible to COVID-19 virus infection?
There is no evidence that cosmetic procedures make patients who are otherwise well more susceptible to disease processes, including COVID-19.
● If I develop side effects from my cosmetic medical procedure, how do I know if they are not related to COVID-19?
Side effects from cosmetic medical procedures are different to the effects of COVID-19 which are primarily shortness of breath, persistent cough, and fever.
● Can I bring a friend with me when I attend the clinic?
It is preferred that you come alone to your appointment, but if necessary, you may bring a member of your family if they reside with you.
● My children are at home so is it ok if I bring them with me to the clinic?
Children should NOT attend with you.
● If I develop a fever, a cough or feel unwell after visiting the clinic, what should I do?
It is essential that you advise the clinic should these symptoms develop as soon as they occur after your attendance.
● Will I be able to contact someone at the clinic after my procedure if I have any questions?
Yes. You will have contact details, including after-hours contacts, provided to you, or simply call the office.