Part 2

The rationale that I originally proposed behind my petition in my original submission (of which the Board did not publish) is of utmost relevance, and so I post it here:

RATIONALE

These regulations are necessary due to the thousands upon thousands of examples in Virginia where patients and prospective patients were denied their right to necessary physical therapy services or were informed by a practitioner that they would not provide necessary physical therapy services solely because of the patient’s individual choice to not take the COVID-19 vaccine, or the individual’s choice to not wear a mask.  Both mask wearing and the vaccine have now been shown (based on years of peer-reviewed scientific studies and empirical data) to be ineffective in preventing contracting the virus that causes COVID-19 disease, or in preventing transmission to others. Numerous studies provide the factual basis behind these statements:

https://www.lifesitenews.com/news/47-studies-confirm-inefectiveness-of-masks-for-covid-and-32-more-confirm-their-negative-health-effects

https://aapsonline.org/mask-facts/

https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a-H.pdf

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410

https://brownstone.org/articles/more-than-150-comparative-studies-and-articles-on-mask-ineffectiveness-and-harms/

https://lcaction.org/vaccine#cases

Prior to February 2020, no citizen in the Commonwealth of Virginia was required to wear a mask as a condition to receive necessary physical therapy services.  Yet, unfortunately these instances surrounding COVID-19 occurred thousands of times across the Commonwealth within the past 2 years by practitioners, and still continue to this day, even when all mask restrictions in the Commonwealth have been lifted by the Virginia Board of Health. I myself am still required to wear a mask to receive physical therapy services post-surgery after receiving ankle surgery in February 2022 here in Fairfax County, despite the Centers for Disease Control, Virginia Board of Health, Virginia Board of Education, Virginia Department of Labor and Industry, and Virginia Safety and Health Codes Board lifting all mask requirements, and states such as New York, Massachusetts, Florida, and Texas now having no mask mandates.  Why does Virginia still allow this?  Corporations and practitioners that practice physical therapy in the Commonwealth do not have the authority to act as agents of the Board of Health to enforce mask or vaccination restrictions by claiming it is “company policy.”  Company policy has no force of law or regulation.  I am a survivor of COVID-19 disease from August of 2021, and have recovered fully, with documented natural immunity through antibody testing. My practitioner still will not accept any of that information as relevant, and assumes all patients as possibly infected (an unethical and unscientific practice, by the way), and therefore requires me to wear a mask in the office when receiving physical therapy.  Practitioners and their employers have even threatened patients (through administrative staff) with cancelling a necessary appointment, or conditioning receipt of care with such outrageous, exclusionary, and discriminatory pre-conditions as only allowing therapy on a patient in a separate room if the patient does not wear a mask (a practice which does not prevent infection and is not based on any science whatsoever) and only if the practitioner agrees to treat the individual in this separate, exclusionary, and discriminatory room.  This practice is also extremely racist. All of this I have witnessed first-hand, despite overwhelming evidence that masking does nothing to stop the spread of the COVID-19 virus or prevent transmission of the virus.  It is unconscionable that licensed practitioners, their subordinates, and administrative or office employees can still refuse to treat patients if the patient chooses to not wear a mask.  This discriminatory practice must end immediately.

Licensed Practitioners, their Employers, and the Board of Physical Therapy Have No Legal Authority Under Existing Virginia State Law or Regulation to Force Patients to Wear a Mask

On February 16, 2022, the Virginia Department of Labor and Industry announced a 30-Day Comment Period on Proposed Revocation of the Virginia Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus that Causes COVID-19, 16VAC25-220.  On February 17, 2022 the Virginia Safety and Health Codes Board adopted a proposed finding that there is no longer a continued need for the Virginia Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus that Causes COVID-19, 16VAC25-220, based on emerging scientific and medical evidence that the current widespread variants of the virus no longer constitute a grave danger to employees in the workplace under Va. Code §40.1-22(6a), and as discussed in the U. S. Supreme Court’s decision in National Federation of Independent Businesses, et al., Applicants v. Department of Labor, Occupational Safety and Health Administration, et al.  The Safety and Health Codes Board adopted the action repealing the Virginia Standard for Infectious Disease Prevention of the SARSCoV-2 Virus That Causes COVID-19 (16VAC25-220) on March 21, 2022 (http://register.dls.virginia.gov/details.aspx?id=10202).  This Standard was officially revoked in the Virginia code 16VAC25-220-10 through 16VAC25-220-90.  The revocation of the Virginia Standard revokes the requirement for employees in the Commonwealth to be required to wear masks, so how can the Board (e.g., By allowing practitioners or physical therapy employers) allow this same mask-wearing requirement upon patients (or prospective patients) by practitioners, when the Board of Physical Therapy has no such legal authority to do so? As the Board with direct oversight over the conduct of licensed physical therapists, this Board has a legal duty to take action to stop this practice immediately. 

Overwhelming Evidence Shows Masks Do Not Stop the Spread of COVID-19

In addition to the numerous internet citations provided above that document overwhelming evidence that neither masking, nor the COVID-19 vaccine prevent the contracting of the virus, nor stop transmission of the virus, of particular relevance is a comment submitted by Mr. Mark Fraser, PhD, Aerosol Scientist and OSHA Safety Officer in support of revoking the Virginia Standard for Infectious Disease Prevention of the SARSCoV-2 Virus That Causes COVID-19 (16VAC25-220).  Mr. Fraser’s comment shows that masking is completely ineffective as a means of infection control against the SARS-CoV-2 Virus, summarized below:  (https://townhall.virginia.gov/L/viewcomments.cfm?commentid=120823)

“The Standard, subsection 40(G), specifies the mandated Personal Protective Equipment (PPE): “employees shall wear a face covering or surgical mask that covers the nose and mouth to contain the wearer's respiratory droplets and help protect others and potentially themselves.” This selection of PPE was unfortunate because these types of masks bear no certification of effectiveness against germs and viruses and, in fact, were known to be ineffective against these pathogens at the beginning of the COVID outbreak¹. . .  Sufficient data have been acquired to allow the performance of Mask Mandates to be assessed.  The unmistakable conclusion is that COVID infections were driven largely by seasonal and endemic factors, whereas Mask Mandates had no discernable impact on infections here in the U.S.⁴ . . . . . (emphasis added).

The Standard also failed to address the possibility of short and long-term health issues raised by prolonged use of PPE.  These issues include: difficulty in breathing, skin rashes, and CO2 intoxication.4 

Conclusions: Considering the PPE specified under the Standard provided little or no protection against the SARS-CoV-2 virus and long-term use presents health risks to employees, the Standard should be revoked.”

The overwhelming body of evidence demonstrates that employees are not protected against COVID-19 using masks, and the same rationale applies to patients or prospective patients. Practitioners and practitioner’s employers cannot be allowed to continue this practice of forced masking.  Forced masking violates patient autonomy by requiring a patient to wear ineffective facial masks that actually can be shown to make individuals sick, as is clearly outlined in multiple studies cited in the above internet links (for example, University of New South Wales. (2015, April 22). Cloth masks: Dangerous to your health?. ScienceDaily. Retrieved March 19, 2022 from www.sciencedaily.com/releases/2015/04/ 150422121724.htm) and https://www.lifesitenews.com/news/47-studies-confirm-inefectiveness-of-masks-for-covid-and-32-more-confirm-their-negative-health-effects. Retrieved March 31, 2022.

Requiring a patient or prospective patient to wear a mask as a condition to receive necessary rehabilitation treatment, or conditioning necessary treatment unless a patient wears a mask, is coercive, inhumane, and unethical. No patient should have to choose between the possibility of getting sick by wearing a mask that is a breeding ground for bacteria, fungus, and other infectious agents (by coming into contact with a wet, soiled mask, causing re-entrainment of one’s own exhaled spittle and aerosols for hours at a time), or being able to recuperate from a recent injury by receiving necessary, compassionate physical therapy services. 

In addition, the possibility of short and long-term health issues raised by prolonged use of masks/PPE by patients must also be considered. These issues include: difficulty in breathing, skin rashes, reduced oxygen intake, and CO2 intoxication.  Physical therapy almost always involves physical exertion through increased respiratory activity.  Requiring a patient or prospective patient to wear a mask restricts their oxygen intake one needs in order to properly perform the correct rehabilitation exercises prescribed by their doctor, and negatively impacts proper pulmonary function necessary for therapy exercises to be effective. Mask wearing also restricts oxygen intake required to respire normally when resting, or awaiting treatment.  Restricting oxygen intake through forced mask wearing is dangerous, especially for repetitive and strenuous physical therapy exercises.  By continuing to allow practitioners and practitioners’ employers to require this dangerous activity, the Board of Physical Therapy is literally putting patients’ lives at risk for reduced cardio or pulmonary function. With many elderly or frail patients with impaired health as frequent physical therapy patients, it is inhumane and unethical to continue to place such vulnerable patients at further risk of injury or possible death such as a stroke or cardiac arrest by forcing them to wear a mask and reducing their oxygen intake.  This practice must be terminated immediately.

One of the main principles of the Hippocratic oath is to First, Do No Harm.  Demanding that a patient wear a mask (when multiple, peer-reviewed studies documenting the adverse effects of mask wearing is well established), is harmful to a patient and violates patient autonomy.  It must be their choice to wear a mask, not mandated by an individual practitioner or business, when local and State Boards have lifted masking restrictions for all business establishments. Patient autonomy and patient rights must be respected. 

Even Children Don’t Have to Wear a Mask at School

It is also ridiculous and an outrage to patient rights that licensed practitioners can still demand that patients, prospective patients, or family members accompanying them wear a mask as a precondition to receiving treatment, (and as a consequence, can refuse or deny treatment for a patient when they exercise their right to not wear one), when it is now state law in Virginia that no child who attends a school is required to wear a mask (Senate Bill 739).  If a child has the legal right to not have to wear a mask while in a school environment, of which that child is potentially indoors for periods of up to 6-8 hours a day, five days a week, in close proximity to potentially hundreds of other children each day, how can the Virginia Board of Physical Therapy still allow practitioners, their employers, employees of practitioners, or Trainees to continue these blatantly discriminatory and coercive practices of mandatory mask wearing, or demand proof of a COVID-19 vaccination in order for a patient to obtain physical therapy services? How do children now have this right, but somehow physical therapy patients now do not? 

Requiring a patient to wear a mask indoors for physical therapy services for any duration of time, was never required on a widespread, Commonwealth basis prior to 2020 and no practitioner required it.  Even during periods of high flu transmission (which consequently, has similar infection fatality rates as the virus that causes COVID-19), mask wearing and vaccination for the flu was never required.  At this point continuance of these policies is nonsensical and unsupported by any scientific basis. The facts are clear: masks and the COVID-19 vaccine do not stop one from contracting the COVID-19 virus, nor do they prevent transmission of the virus that causes COVID-19 disease.  The Virginia Board of Physical Therapy has a legal and moral obligation to put an end to unethical, coercive, and discriminatory practices by practitioners requiring mask wearing and demanding proof of vaccination as a precondition to receiving necessary physical therapy services.