Dear colleagues and friends,
We at the VDA are doing our best to keep you updated with all of the information we get. That information is coming in not just daily but hourly and from so many different directions that it provides a huge challenge.
That said, who thought that a week ago we were deciding whether or not to have our Leadership Conference and here we are now self-quarantined and practicing a term called “social distancing.” (Who even know what that was?) I honestly had no idea that a virus which started in China could have the effect it has had on my country, impacting businesses and lives nationally.
You should have received a link to the video that I did with the experts at the VCU School of Dentistry. (If not, here
it is) Let’s just say that I have not received any Oscar nominations from the scripted, relatively awkward presentation from the make shift studio in my living room, but the information is nevertheless informative and impactful. The science supports over and over again the decision the Board of Directors made to ask our colleagues to make the very difficult decision to close their offices for the health and safety of their teams, their families, their patients, and themselves. Many of you went to work on Monday, took care of business, and, in many cases I am sure, tearfully told your team that you would be closing your offices to all non-emergency care for at least two weeks. As I have said before, the decision is an easy one from a health perspective, but a very difficult one from a business perspective. Thank you. Thank you for doing the right thing even when it is difficult.
With that decision we enter the realm of “what is an emergency?” The ADA recently came out with a directive to assist us in that definition. The link to that is here
. Basically, your charge is to treat anyone who is in pain or who could potentially end up in a hospital or an urgent care clinic. Our hospitals are going to be taxed by this pandemic and we should do all we can do to keep our patients out and to contain the virus. Please do not perform any hygiene unless it is an emergency- NO MAGNETOSTRICTIVE OR PIEZOELECTRIC USE! Please do not perform restorative procedures, periodontal procedures, orthodontic procedures, endodontic procedures, or begin crown preparations unless that is the only way to keep your patient out of pain and out of the hospital. I would also ask that you consider taking a look the stock of PPE that you have and consider donating any excess to your local organization that manages emergency services. I have heard that the Charlottesville area is in particular need of masks, gloves, and gowns.
I understand that 50% of dental offices here in Virginia are still open and continuing business as usual. Please take a moment and consider the health of those around you. You may not be in a high-risk category but someone on your team may be, or one of your patients may be. We are by definition scientists; please take a look at the science and make your decision based on the facts. There are four science-based reasons for the transition to emergency care only in our practices:
First, we need to do our part to reduce the risk of spreading the infection. Dental practices are at high risk to spread the virus due to the procedures that produce aerosols that transmit the COVID 19. The virus stays in the air and contaminates the surfaces of our offices for extended durations. N95 masks and full coverage PPE are needed to treat a patient that screens positive for COVID-19 and these are not typically available in our practices.
Second, without wide community-based testing for COVID-19, we cannot identify which patients are positive for the virus; we know that patients carry it before they show symptoms and we do not need to be treating those patients.
Third, we need to do our part for social distancing. Not having patients and ourselves moving in and around the community and our practices will reduce the spread of the virus.
Lastly, we will be conserving valuable resources needed to treat those that become the sickest from the virus (65+ and immune-compromised individuals).
Please know that as I write this, Washington State has issued a mandate on non emergency medical and dental treatment until May 18. Unless we do what is right and comply with the recommendations that are currently in place, we may be in the danger of the same regulations.
On a personal note, am I afraid of the financial implications in my practice? Yes, I am. Have my partners and I looked at our monthly office bills and our lack of monthly income and had heart palpitations? Of course we have. But as dentists and as medical professionals, this is our opportunity to put what is right before what we would prefer to do. We have an opportunity to lead the country in taking control of this pandemic and making a difference. By proceeding with an inordinate amount of caution on the front end we will hopefully lessen the repercussions on the back end. And I should add that the ADA is working non-stop in Washington to make sure policymakers understand the position this puts dental offices in and takes it into account with any recovery package that’s put forward.
Thank you for doing what is right for everyone. Thank you for caring enough. Thank you for making your team and your patients proud. Virginia is always a leader in our profession; we are the best of the best. Let’s live up to that and show that we can make a difference in this pandemic!
Dr. Elizabeth Reynolds
Virginia Dental Association