Tuesday 31 March 2020

Coronavirus antics #1

This blog post was started some time ago but rapidly changing events have caused several rewrites. This post will be short - the longer the post the more quickly it will be out of date. There will be future posts looking at different angles.

Accredited Registers Statements
The Society of Homeopaths (SoH) is not the only Professional Standards Authority (PSA) Accredited Register with members who offer complementary therapies. The Federation of Holistic Therapists (FHT) in a statement on their website were very clear -
Q. Should I stop practising? 
Yes. The Prime Minister’s announcement on 23 March has made it very clear that everyone should stay at home unless carrying out four essential tasks. Providing complementary, holistic beauty and sports therapy treatments in a one-to-one situation does not fall into any of the four essential tasks he outlined.
The FHT seem to be doing quite well as keeping members up to date with the developing situation. The Complementary and Natural Healthcare Council (CNHC) also have a statement although less prominent.


All disciplines should cease providing face to face therapies 
In the light of this announcement you must cease face to face therapies (that is, those that require simultaneous physical presence) with immediate effect. CNHC appreciate the impact this will have on livelihoods, but we support the Government decision as it is the right thing to do to assist in stemming the spread of coronavirus which can be transmitted by those who do not develop any symptoms. We have a duty of care to do all we can to help end this world health crisis.
The SoH and the British Acupuncture Council (BAcC) have not made public statements. They may have instructed members via email or in closed forums but there is nothing on their public websites or social media.

Whilst some members will not need to be told not to see clients face to face, there is a history of some not believing that legal and regulatory restrictions on practice apply to them. Some seem to believe that they are primary care practitioners, that they offer an alternative to medical treatment. That they are a vital service. This is not the case by any stretch of the imagination.

It is possible that members are complying but are failing to update websites, social media and third party listings to reflect this. Along with public statements this kind of thing is important in managing client expectations. Of course, many people will heed Government advice but there will always be a minority who will not. 

There was a statement released agreed by all the Accredited Registers on 06/03/2020 but very quickly it became of date. At around the same time the SoH and other homeopathy associations released this statement. Some of the content is unremarkable but -

How can I increase my immunity?Eating healthily, including at least 5 portions of fruit and vegetables a day.Staying well-hydrated.Regular, moderate exercise.Getting enough sleep. 
Additional measures for which there is some evidence for reducing the length and/or severity of upper respiratory tract infections include regular supplements of probiotics, vitamins C and D and Zinc. 
Can homeopathy help?Homeopathic medicines have been used extensively for flu-like symptoms and in epidemics around the world. If you decide to take a homeopathic medicine, this should be in addition to the various measures outlined above and should not be your only approach. Selection of the most appropriate homeopathic medicine is based on an individual’s unique symptoms. However, Gelsemium 30c and Bryonia 30c are commonly used for flu-like symptoms and have a long-established, traditional usage over many years. 
Homeopathic options can form one part of your approach to the current Covid-19 outbreak but should always be used alongside other measures. If you have current symptoms or are concerned that you may have been exposed to coronavirus, it is important to call 111 to seek appropriate advice, in keeping with current guidelines.

The SoH make the mistake of lumping those supplements together (evidence levels vary) but it is the second part that is of concern. Even with the the caveat that homeopathy should be used in conjunction with other measures, homeopathic medicines have not been used extensively for epidemics in the grand scheme of things. Implying that they could be is questionable.

More recently the SoH posted this business as usual message which presumably relates to the functioning of the SoH as even by 20/03/2020 it was clear that for members it was going to be anything other than that. The SoH have announced that their Conference isn't going ahead and will be replaced by something online but nothing has been said yet about its AGM.

Misinformation
A future post will look in more detail at the kind of misinformation put out by UK homeopaths in particular. In short the main types are -

  • Underplaying the risks of COVID-19
  • Portraying pandemic as media hype and so on
  • Creating distrust of medical treatment
  • Bogus treatments/cures including prophylaxis

Misinformation is widely shared on websites and social media. Government and other agencies are so concerned by misinformation regarding COVID-19 that legal measures are being considered. Social media providers are cracking down. The ASA are as well

Already there have been media stories about bogus treatments/cures for COVID-19. Typically these stories include a lot of content about scams targetting vulnerable groups. There are likely to be more but they are unlikely to make quite as much of a splash as complementary therapists seeing clients face to face. 

Implications for Accredited Registers
How Registers respond to the Covid-19 crisis is likely to be a consideration in future Accreditations. To quote for the Standards for Accredited Registers -
Standard 2: the organisation demonstrates that it is committed to protecting the public and promoting public confidence in the occupation it registers. 
The organisation will need to demonstrate that its purpose and directives are focused on public protection. Additionally, the organisation will need to show that in carrying out its voluntary register functions public interest is paramount and that professional interests do not dominate or unintentionally subvert that interest. 
Evidence of this might include board or committee discussions where issues have been debated and conflicts of interest identified or the ethical interests of parties weighed in the balance; decisions made about admittance to the register where the documented rationale shows due consideration of public protection; outcomes of complaints; particularities of governance arrangements. 
Not making it clear that members must not see clients face to face certainly would not meet that standard. Registers might have to discipline rogue members who carry on seeing clients face to face. 

This is true of members sharing misinformation. The example of the SoH having to prohibit anti-vaccination misinformation (as discussed here) sets a precedent not just for the SoH but all Accredited Registers. That social media had to be considered is also important.

Another implication is that if Registers did not include pandemics/epidemics in their risk registers before, they will have to going forward. 

Membership numbers and Money
The current lockdown will hurt some complementary therapists more than others. Obviously manual type therapies will be particularly hit but whilst there there will be some help for the self employed, the rules are complicated and likely many therapists will not qualify for it. As a career (as opposed to a part-time hobby), being a complementary therapist is generally not very lucrative.

Registers with large cash reserves might be able to help members by temporarily waiving all or part of membership fees but some Registers don't have large cash reserves, have been running at a deficit for some time. If many of their members are forced to stop practicing completely, find other employment or retire, they could be financially compromised.

This would compound the current problems of the SoH. It has lost some members already due to its very belated attempts to restrict members practice regarding CEASE therapy and anti-vaccination misinformation. 







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