Volume 7 • 2020 • Issue 4

we gave away,” says Dr. Wolanski. “Including all that stuff that I had bought back in February.” For Dr. Wolanski, the donation felt like a good first step. Then he started working to try to ensure that dental practices in his community would survive an extended closure, emergency dental care was available to patients who needed it, and dentistry could adapt to a world that included COVID-19. The Challenges When Dr. Wolanski spoke with CDA Essentials at the beginning of April, he’d calculated that dental income for B.C. was down 99%. “I've been spending time trying to figure out how to minimize the cash flow out of practices,” says Dr. Wolanski. “We still have bills to pay. Rents or mortgages. Younger dentists have practice loans. We’re trying to find ways to get loans deferred so we can keep bank accounts from going into the red.” Dr. Wolanski said that after less than a month of closure, his practice accounts were more than $50,000 in the red and similarly his personal accounts $10,000. “I’m not sure how long we can handle it,” he says. Dr. Wolanski spoke to his patients on the phone and triaged them. Most could be treated with prescriptions for antibiotics or painkillers. “Here in Nanaimo, we're asking every dentist to handle their own patients and we’re operating an on-call telephone help line,” he says, “If people call the hospital with a dental problem, they get referred to the help line. We rotate who answers these calls, each of us take it for week.” Emergency dental treatment was limited. “In Victoria, there are about 10 dentists doing it now, but here in Nanaimo, we have one general dentist and oral surgeons providing emergency care,” says Dr. Wolanski. The general dentist treated four patients per day and didn’t ask his staff to assist because he didn’t want to expose them to possible infection. Dr. Wolanski spent much of his time on the phone with other dentists and reading breaking science about the novel corona virus. One of his closest friends, a classmate from dental school, had a deal to sell her practice that fell through when the pandemic arrived. Dr. Wolanski attended online meetings and town halls held by the British Columbia Dental Association (BCDA). “We’ve had close to 700 dentists on some of them,” he says. He felt like many dentists shared the same anxieties and concerns. “There are just so many unknowns,” says Dr. Wolanski. “Will patients come back in large enough numbers quickly enough that our businesses survive? What will infection control protocols be like once we reopen? Will open concept offices be a thing of the past? How much investment will we need to make to reopen?” How It Feels Dr. Wolanski was used to working and being involved in his community. “When I can’t do those things, I feel frustrated and a bit helpless,” he says. But during March and early April, he was isolating with his family at home. “There's different levels of risks that everybody is willing to accept,” he says. Living with his wife, who was due to give birth in May, and his father- in-law who had chronic obstructive pulmonary disease and was dependent on oxygen meant “we are very risk averse,” Dr. Wolanski says. When asked if he saw any silver lining to the challenges of the pandemic, Dr. Wolanski shared his thoughts. “I think this will prepare us for the future,” he says. “We are learning, as a society, how to deal with a huge global problem. This won’t be the last pandemic, so if we can learn how to respond now, we’ll be better prepared the next time.” Follow Up In early May, Dr. Wolanski said that three general dentists were now providing emergency care in Nanaimo. “I have spoken with some dentists who have done this for a number of weeks now and a couple of them are feeling burned out. One has had to stop due to the stress involved,” he says. Every week, Dr. Wolanski helps run a peer support webinar, which is co-hosted by the BCDA and the Doctors of British Columbia. Dr. Wolanski says that there was a lot of concern about pandemic insurance benefits being denied in B.C., but he’s relieved to hear that they will be paid. “The BCDA has been working tirelessly to support the dentists in British Columbia,” he says. He startedworking to try toensure that dental practices inhis communitywould survive anextendedclosure, emergency dental carewas available topatientswho needed it, anddentistry couldadapt toaworld that includedCOVID-19 Dr. Wolanski, with his wife Ivka, doing dental outreach in Kenya in 2018. I ssues and P eople 20 | 2020 | Issue 4