This past week was long and exhausting, filled with confusion and frustration. We are in unprecedented times and, unfortunately, the stress of dealing with COVID-19, especially as leaders and advisors, has led to misunderstandings and miscommunications. It is unfortunate that we have all had to deal with the frustration that this has caused.

We continue to communicate with the Division of Public Health regarding our return-to-work timeline. We will update you on any changes as soon as we can.

As expected, I have been inundated with emails this week from concerned members, hygienists, spouses of hygienists, and members of the community. I have done my best to respond to them in a timely manner. I believe I am caught up, so if you did not receive a response from me, please resend it.

Amidst all that transpired this past week, I have continued to work on the Return to Work Guide from our Ad Hoc Committee Task Force. It was a little more time-consuming than I had originally anticipated. It is in the final stages, and we are working with our webmaster to determine how best to post it on our website. It will be available soon, and I apologize for the delay.

There are a few other updates that I wanted to pass along as well as answers to some commonly-emailed questions.

1. I have been in contact with Mike Terrell from Cincinnati Insurance regarding informed consent forms during the COVID-19 pandemic. Attached you will find a template that he recommends you have your attorney review for use. If you use Cincinnati Insurance for your EPLI, they are not mandating that dentists do or do not use a consent form, but they state that it is probably a good idea to use one. Click to download the form now: Consent Form Template
2. Delta Dental announced a $200 Million Covid-19 Financial Assistance Program available to its Independent Network Provider Practices, including those in Delaware. Partnering with Lendeavor, the loan assistance program launched April 30, 2020. For more information about the loan program, qualification details and application process, Delta Dental providers can visit: https://www.lendeavor.com/apply/refinance-delta-dental or call the Lendeavor program support line at 415-874-5420.
3. I have received multiple emails regarding fit-testing and availability of N95 masks. The ADA has been in contact with OSHA, and they state that fit-testing of N95 masks is only required if you are required to wear an N95 mask. According to OSHA, N95 masks are only required if you are treating a known or suspected (not just the asymptomatic patient that walks in your door) COVID-19 positive patient. We, as dentists, are not treating these patients. We are deferring treatment on these patients. Therefore, we are not required to wear an N95 mask. OSHA says it is strongly recommended, but it is not required. As for the availability of N95 masks, FEMA controls every N95 mask that is manufactured here or imported from other countries, and they estimate that supply will meet demand by July. We just need enough to get us through until then. You may want to consider the CDC's Recommended Guidance for Extended Use and Limited Reuse, which is summarized here. The CDC reports that prolonged N95 mask use (including between patients) can be safe for up to 8 hours and encourages each user to review each manufacturer's recommendations prior to following this strategy. Current guidelines encourage wearing a face shield over the N95 to decrease the chances of soiling the mask. As far as reuse, because coronaviruses lose their viability significantly after 72 hours, many organizations have promoted a rotation and re-use strategy. Assuming there is no soiling and minimal to no viral contamination to the mask, the CDC suggests that masks can be re-used up to 5 times with the following mask rotation strategy: Acquire a set number of N95 masks (at least 5 per the CDC), and rotate their use each day, allowing them to dry for long enough that the virus is no longer viable (> 72 hours). Proper storage for this technique requires either hanging the respirators to dry or keeping them in a clean, breathable container like a paper bag between uses. Make sure the masks do not touch each other and that you do not share your respirator with other people. A user-seal should be performed before each use. Importantly, when planning to reuse an N-95 mask, practice fastidious donning/doffing to avoid contamination of the inside or outside of the mask at all times. If the mask is damaged or significantly contaminated from aerosol-generating procedures or bodily fluids, the CDC recommends discarding it.
4. Just a reminder that the most recent modification of Governor Carney's State of Emergency went into effect on 5/1/2020. All patients that come to our offices for treatment are going to be required to wear face coverings. Click on the link for more information: https://governor.delaware.gov/health-soe/thirteenth-state-of-emergency/

I hope you all have a chance to enjoy the beautiful weather this weekend. Please feel free to email me at cathyharrisdmd@hotmail.com if you have any questions or concerns.

Sincerely,



Cathy Harris, DMD
DSDS President