Losing the ability to help clients in pain and losing income is tough, but the impact of spreading the new coronavirus is tougher.

That’s the feeling of three local practitioners of hands-on therapy about a state of Alaska health mandate that ceased hands-on treatments like massage therapy, rolfing, reiki, acupuncture, acupressure and similar services as of 5 p.m. Tuesday.

David Edwards-Smith is the chair of the Alaska Board of Massage Therapists. Edwards-Smith does not know the exact number the board licenses around the state, but he put that number at over 1,400.

Edwards-Smith does Active Release Techniques, a hands-on treatment shut down by the state mandate, at Kenai Peninsula Massage Therapy in Soldotna.

While noting he does not speak for the entire board, Edwards-Smith said Gov. Mike Dunleavy made the right decision to shut down hands-on modalities.

“All the decisions were made at the right time and it was data-driven decision-making, not emotional decision-making,” Edwards-Smith said. “I didn’t want knee-jerk reactions without information. I feel like the governor’s team did an incredible job.”

Edwards-Smith also is happy with the way the board has handled the outbreak. March 16, the board issued guidance to its licensees on the new coronavirus, urging therapists to take into account Centers for Disease Control recommendations on things like social distancing and self-touching of faces.

The board also made recommendations about screening clients for health concerns, screening them for cold, fever or cough, avoiding self-touching of eyes, nose and mouth, washing hands and disinfecting frequently touched surfaces.

Edwards-Smith said the board didn’t take a position on a mandate, trusting professionals to make an informed decision.

“My nonscientific impression is that the majority of massage therapists made the decision not to practice,” Edwards-Smith said. “Those that did practice, my nonscientific impression is they were taking extreme measures to ensure the safety of them and the client.”

For example, Edwards-Smith said therapists were only allowing one person in the clinic, or protecting themselves with equipment.

Edwards-Smith has no problem with the mandate coming when it did.

“I saw a very thoughtful team taking no chances at the level of the governor’s office,” Edwards-Smith said. “Rather than the board taking a dramatic position that everyone shuts down, we just trusted the process, and I think it’s worked out great.”

Edwards-Smith said he has been winding down his business in the last few weeks, taking only cases he can impact with one session, and not cases he thinks would take four or six visits.

“It’s a bummer,” he said. “There are people that have called me because they’ve learned they can rely on very quick changes and quick relief.

“But COVID is a bigger bummer. You know, you have to get your priorities right.”

Edwards-Smith said massage therapists are self-employed or work for a variety employers, but he said the financial impact on them will be extremely tough. That’s why Edwards-Smith supports House Bill 308, which expands unemployment benefits to Alaskans displaced by the new coronavirus. The bill was introduced March 18, passed the Senate 19-0 on Sunday, passed the House of Representatives 37-0 on Monday and now is headed to the governor’s desk.

Michael Koob of Koob Chiropractic has been in practice on the Kenai Peninsula for 32 years, including about 25 years at his Kenai location.

Koob said he has used massage therapy in his chiropractic practice for almost his entire time on the Kenai Peninsula.

“Having massage therapy makes my adjustments easier,” Koob said. “It’s easier to provide the technique, and the results last longer.”

Even with being such a strong believer in massage therapy, Koob started phasing out massage two weeks ago and has not had any of the seven massage therapists that work at his practice give any massages this week.

Koob worries about not being able to give his patients the best service possible.

“I do worry about it,” he said. “With the risk we’re going through with the coronavirus, that risk is just so overwhelming.

“Yes, there’s benefits to the massage of soft tissue. That’s invaluable. But when I balance that against the risk of the coronavirus, that’s a very easy decision to make.”

The health mandate still allows Koob to make chiropractic adjustments, which require hands-on treatment. He said he is aware that still carries risk.

Koob said he has sent all staff home from his office. Only one patient is being allowed in his office at a time. Koob completely cleans the area where the adjustment took place and even fills out paperwork for the patients, not even wanting them to touch a pen.

“I’m only working a couple hours a day on patients in acute pain,” Koob said. “I’m not seeing chronic musculoskeletal cases. If somebody has a new development they can’t get along with, that’s the only patients I’m seeing.

“I don’t know how much longer I can even do that.”

Koob said this is a stressful time, and stress leads to more pain, but added the public seems to be weighing the risks in the same manner he is.

“We’re not having a late, big rush for treatment,” Koob said. “The public is fairly aware of the dangers.”

Koob also said the public can deal with pain and stress through activity. He said appropriate, thought-out exercise has been shown to be superior to most passive treatments for pain in just about every joint condition in the human body.

For example, he said brisk walking is one of the best prescriptions for chronic lower back pain.

Ryan Rice grew up in Kenai and has now run Peninsula Rolfing in Soldotna for 2 1/2 years. He works full-time at the Dena’ina Wellness Center as a wellness management technician, doing his rolfing business on nights and weekends. Like massage, rolfing involves hands-on treatment.

Rice said he will typically have one or two appointments a week, with summer and fall getting very busy. He hasn’t had any appointments in two weeks and said he has had several cancellations due to the virus.

The mandate is a good idea, according to Rice.

“It’ll help, for sure, to set standards for controlling the spread of the virus,” Rice said. “It’s better to be proactive and maybe overdo what we need to do than play catch-up later.”

Rice said he loves using his training to help those in pain, but given the nature of his work, he said contracting the virus himself is a possibility. At that point, he can’t help anybody.

“Overall, if we can stop transmission somewhere, it’s worth it,” Rice said. “Right now there’s no treatment or vaccine for it if it gets spread at all. That person could turn around and infect who knows how many people before they realize they are sick. We have to play it safe.”