17 March 2020

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Covid-19: A needful effort

Lorenzo Breschi

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On March 11th, the WHO pronounced its concerns both about the alarming levels of spread and severity, and by the alarming levels of inaction. They have therefore made the assessment that COVID-19 is now characterized as a pandemic.

As of March 15, COVID-19 has been recognized in more than 100 countries, with a total of 142 539 laboratory-confirmed cases and 5393 deaths (WHO 2020). 

Humans of all kind, age and nation are today asked to fight all together against an invisible enemy. If that ever was a time in the modern history of our planet when we are all in this together, this is that moment.
It is therefore fundamental to act immediately to stretch the peak of the disease over a longer period so that our society is better able to cope.

As dentists, among with other health care workers, we are at the greatest risk of infection. Moreover, due to the characteristics of dental settings, the chance of cross infection is extremely high between dental practitioners and patients. We have then an important role in containing this pandemic and we must endeavor to reduce futile risks.

Up to now, there has been no consensus on the provision of dental services during the epidemic of COVID-19, however on the basis of our experience and relevant guide-lines and research, we strongly recommend to treat only dental emergency cases and adopt implementation of infection prevention and control measures.

When treating emergencies we must remember that the standard protective measures in daily clinical work are not effective enough to prevent the spread of COVID-19, especially when patients are in the incubation period, are unaware they are infected or choose to conceal their infection. Rubber dams and high-volume saliva ejectors can help minimize aerosol or spatter in dental procedures. Furthermore, face shields and goggles are essential with use of high or low-speed drilling with water spray. As respiratory droplets are the main route of COVID-19 transmission, particulate respirators  are recommended for dental practice (References: Transmission routes of 2019-nCoV and controls in dental practice, IJOS 2020 ;  Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine, JDR 2020 ).

Hand hygiene has been considered the most critical measure for reducing the risk of transmitting microorganism to patients.
COVID-19 can persist on surfaces from a few hours up to several days. This reinforces the need for scrupulous hand hygiene and the importance of thorough disinfection of all surfaces within the dental clinic.

In the midst of this unprecedented moment, as a man of science, I strongly advice you, dear readers, to listen to scientists, to researchers, to the medical community and to avoid unverified news and prevent to extent misinformation that could cause waves of uncontrolled panic.

And lastly of course, even if things seem tough now, remember that we will get through this epidemic, just as we have got through many tougher experiences before, if we look out for each other and commit wholeheartedly to prevent further damages.  

Sincerely Yours,
Lorenzo Breschi