GDA Action April May 2020

42 • April/May 2020 Please note the date that this article was written (April 21, 2020) as the Georgia Dental Association (GDA) Action does not work at the pace of the Internet. Things may have changed since this article was submitted for publication. At the request of our association’s Board of Trustees (BOT) and our Executive Director, the GDA Innovation Task Force was put in action. Our mission is to be the innovation guidance and resource team for the Georgia Dental Association. Our scope is to clarify all of the innovation for our member dentists and to be a resource of information to help our members effectively restart their businesses. The members of this task force are doctors Chris Adkins, Bo Broadfoot, Mark Causey, Ryan Fulchi, Alan Furness, Brad Hall, Tim Hamilton, Ben Jernigan, Jr., Marshall Mann, Robin Reich, and Margaret Scarlett. GDA liaison staff includes Frank Capaldo, Scott Lofranco, Scott Piper, and Jeannie Watson. This task force is chaired by Peter Shatz. The task force met via teleconference in early April and has been meeting on a weekly basis. It was charged with helping the GDA filter the information during a very dynamic public/ global health emergency. The task force includes members from The Dental College at Augusta University, a past CDC scientist/ dentist and innovators from our state. Three workgroups were created: Legislative, Science, and Public Relations/Office of the Future. From the perspective of the COVID-19 pandemic we reviewed the new federal and state guidelines, the science of the contagion, testing, infection control, professional liability, potential lobbying avenues to protect the public and the profession, and finally how all of this impacts the perception of dentistry by the public. Parallel to this, the American Dental Association (ADA) has been publishing recommendations for reopening dental practices. So, let’s look at the three workgroups and their accomplishments so far. SCIENCE The common thread among all changes to our industry, and truly, among our entire civilization, is that all the new protocols are interim . Once there is effective disease therapy and prevention, we can return to something similar to “the good old days.” However, until that happens our working environment is to be based upon evolving science, our ability to monitor and detect COVID-19 and ultimately humanity’s ability to treat and prevent the infection itself. The Dental College of Georgia at Augusta University (DCG) has itself set up a return to clinic task force. Fortunately, the chair of the DCG task force is part of the GDA task force. DCG will be openly sharing their new operation protocols with the GDA, and the GDA will be passing this along to our members. As a public institution, some of their initiatives will include remodeling the clinics to reduce risk of cross contamination, air filtration, isolation rooms, patient flow through the building, and PPE use. The school is even looking at temporary plastic walls. Although our member dentists may not be able to afford to do all that DCG is doing, there will be valuable lessons for all our members to learn. The task force knows its members will no longer see their own practices in the old light. Private practice will be most affected by guidance from the Centers for Disease Prevention and Control (CDC) and the Centers for Medicare & Medicaid Services (CMS). This will impact what level of personal protective equipment (PPE), facility modifications, scope of work permitted, amongst a myriad of other implications to all aspects of our industry. The greatest stressors for dentists will likely be in delivering hygiene services (high aerosol production, frequent dentist checks, high patient counts and short visits); pediatric and orthodontic practices (with open bays common in the industry and high patient flow); and ultimately scheduling (how can we return to production rates of the pre-COVID-19 world). PPE & testing will be rate-limiting steps in our industry. The big questions are: • How will the dental industry compete for supplies of all types against the needs of frontline providers like hospitals? Ultimately the supply chain will improve, but until it does the pace of dental practices may be affected. • The task force recommends that dentists be allowed to test, but know that dentistry will be in competition with commercial, state, and federal labs for test kits and equipment. We are also aware that in-office testing may not protect the dental team or the patients due to the type of test being run (antibody vs virus). The task force recommends that our members base their practice management decisions on science-based facts. If we look at data from other countries, premature re-opening of practices could result in another smaller peak, resulting in reclosing of offices. All of dentistry wants to avoid that, if possible. We recommend that our members follow the phased approach to reopening our economy which has some strong public health science behind it. That we can do something does not necessarily mean that we should do something. The task force realizes that the Governor of Georgia and the Board of Dentistry have given the green light to open back up. They have to balance the needs of our economy and our public health and there is no clear, good answer. For this reason, guidance for Georgia dentists has been murky, and the GDA’s Government Affairs Team has been diligent in advocating on our behalf to obtain further clarification for us. The best way to avoid reclosing is to carefully analyze local data. We need testing, isolation of positive patients, contact tracing, and quarantine of contacts to assess the epidemic in a particular area. Absent that, the best we can do is to look at last week's hospital admissions for respiratory illness compared to prior weeks, deaths compared to prior years from respiratory illnesses, any testing information, and availability of PPE. GDA Innovation Task Force Takes  By Dr. Peter Shatz