Our government is following a general world-wide trend of beginning to loosen our social isolation so that society can get back to more ‘normal’ interaction patterns, work, and economic prosperity. Within this context, our team had to decide when we can start meeting with our patients, students, and participants in person again.
This decision can be motivated by science and safety on one hand, and socioeconomic considerations on the other. In the end, what counts for government is the balance between unknown, but “evidence-informed” risks of coronavirus transmission and the known negative economic impact of businesses remaining closed. For us, the potential benefits of meeting in person have to significantly outweigh the risks of infection.
We have to be able to maintain the sanitation standards suggested by Public Health. On a practical level, this means considering that our group rooms are carpeted, and chairs and cushions are fabric, and we don’t have the capacity or set up to be adequately cleaning the furniture and props on a nightly basis. The recommendation remains that we stay 6 feet apart, which would be a challenge in our group room spaces. Personal protective equipment for both staff and patients is recommended, which includes face masks. As psychotherapists, we need to be able to see the entire face, and not have to stare at masked people. This applies even more so to the many groups we run, in which the idea of staring at a sea of masked people is therapeutically counterproductive and affects group dynamics. Imagine also people crying with masks, which is of course a frequent occurrence in our line of work. Do they simply cry in their mask? Remove their mask and blow their nose? Where do the tissues go? The air is then contaminated, so what does that do to the safety of others? In short, the therapeutic value of seeing people’s faces online far outweighs the reality of physically sitting together in person with faces hidden behind masks, and all the complexities that come with it. If these considerations were not enough, we also have to clarify and deal with legal and insurance matters that affect our decisions.
In summary, as it stands right now, the potential benefits of meeting in person do not significantly outweigh the risks of infection. We will be navigating in the murky waters of a big grey zone for a very long time because pandemics do not just suddenly disappear (see this interesting article from the New York Times). What will guide our decision is not impulse and economics, but science and safety. Until we see a clear recovery pattern, which Canada is not yet experiencing (see this link: https://www.endcoronavirus.org/countries), and other health, safety, and therapeutic considerations are adequately addressed, we will continue our work with everyone online.
Dr. Stephane Treyvaud and team