A Message for CDA Corporate Member Provincial Dental Associations

Below is a snapshot of the Canadian Dental Association’s (CDA) pandemic work for the week ending June 19, 2020.

This Week’s Fast Facts: COVID-19 Situational Report

• Currently, there are approximately 8.7 million cases worldwide. This rate is unfortunately not slowing on a worldwide basis and case growth continues at nearly 15% weekly.
• In the United States (U.S.), the number of cases exceeds 2.2 million. There has been a resurgence in the U.S. and case growth week over week is now at 13%, exceeding the previous 4-week trend of 10%. Last week several states in the south, including Florida, reported record number of single-day cases. This spike is associated with the May long weekend and decreased compliance with public health social distancing recommendations. States such as Arizona are reporting reaching 80% of hospital capacity. In comparison, Ontario saw 30 new cases per million per day at its peaks, while Arizona currently exceeds 170 new cases per million and Florida exceeds 80 new cases per million.
• For Canada, there has been a 2% increase in new cases (lowest since early March) in the past week, with an 8.2% mortality rate largely due to outbreaks in health care settings, long-term care facilities, food processing plants, etc.
• The situation in Quebec and Ontario has improved significantly and these provinces are finally reporting minimal new daily cases in most regions and fewer deaths related to COVID-19. Quebec represents 64% of all COVID-related deaths in Canada and Ontario represents 31% of all COVID-related deaths in Canada.
• Ontario currently sees under 180 new cases per day. A number under 200 was the benchmark set by the Chief Medical Officer for further reopening of the economy in the province.
• The Government of Canada is anticipating a second wave, likely this Fall, and are stockpiling personal protective equipment (PPE).
• For the dental profession, there needs to be continued vigilance regarding the screening and pre-screening of patients.
• The Public Health Agency of Canada’s response to the pandemic has moved from a crisis response to one of long-term management.

Update: TripleGuard^TM Insurance Pandemic Coverage:

CDSPI advised that 933 claims still need to be paid. Of these claims, AVIVA is waiting on financial information for 481.

Based on the current data available, if all goes according to plan, all claims may be settled within the next week. CDA will report any further updates as information becomes available. For the latest information, please check out the FAQs on CDSPI’s website, last updated on June 1, 2020.

Advocacy Updates:

Update!Canada Emergency Commercial Rent Assistance (CECRA)
In late May, CDA reached out to the office of Finance Minister Bill Morneau to express our concerns on the administration and uptake of the CECRA program to help defray commercial rent costs, and to begin discussing other potential solutions to help dental offices and others.

CDA met with representatives of the Department of Finance and Canada Mortgage and Housing Corporation (CMHC) this week. It was confirmed that CDA has been heard on a specific issue that dentists are facing with regard to the treatment of insurance payouts through CDSPI’s pandemic coverage. CMHC has taken the wording and administrative information from the CDSPI policy through AVIVA, and confirmed that they are working with their legal team to address the issue to ensure that dentists are not disqualified from this program because of the insurance payout. CMHC has indicated that a clarification will follow in the coming days.

CMHC will also look at reassessing past applications that may have been rejected, or where the amounts granted were less than they should be. A resource will be produced which can be shared with dentists. In return, dentists who need to reapply can share the resource with their landlords.

Reminders:

• Pre-Budget Consultations 2020: Last week, the Standing Committee on Finance announced that they will commence the annual pre-budget consultation process. The theme of this year’s consultations will be “economic restart and recovery.” The deadline for briefs is August 7, 2020. CDA will circulate a brief for discussion in the coming weeks.
• CDA Appearance at Health Committee: On June 10, 2020, CDA appeared at the House of Commons Standing Committee on Health as part of its study on the response to the COVID-19 crisis. CDA was represented by Dr. Jim Armstrong, President, and Dr. Aaron Burry, Associate Director, Professional Affairs. To learn about the three recommendations CDA made to key Members of Parliament, view a copy of CDA’s opening remarks, and the webcast beginning at 16:42.

New: Federal Government Preparing for a Second Wave of COVID-19

This week the Public Health Agency of Canada indicated that its focus on COVID-19 will include:

• determining how to best manage a potential second wave of COVID-19 this Fall, in conjunction with the anticipated start of seasonal influenza; and
• examining the impact of transmission of COVID-19 among health care workers.

There is no data on the transmission of COVID-19 in the dental environment at this point in time. CDA will continue to share relevant case report discussions or outcomes, as they become available.

Personal Protective Equipment (PPE):

Federal Government Initiatives: The Government of Canada continues to work closely with partners to ensure Canadians have access to the information, resources and supplies that they need to stay safe and healthy in response to COVID-19.

The Government of Canada’s Supply Hub brings together available resources for organizations to buy and sell PPE. As organizations re-open for business, they need reliable information on how to buy and sell the necessary supplies required to keep themselves and others safe.

The Supply Hub aims to connect Canadian organizations from coast to coast to coast with federal, provincial, territorial and other resources and information about PPE, including consumer guidance. As Public Services and Procurement Canada continues to engage with our partners and advisory groups, the hub will evolve to include additional resources.

Update: PPE supplies remain problematic. CDA continues to monitor stock supplies, and it appears that the gaps between orders made at the federal level and orders received are getting wider. CDA anticipates that the next PPE shortages will be for surgical masks, gowns and potentially gloves. CDA will report new information as it becomes available. An announcement that all NATO countries were immediately be stock piling PPE for a potential second wave will place additional strains on immediate supplies of PPE.

Update: U.S. vs. Canadian N95 Stock

CDA has received some questions around the possibility of obtaining PPE from suppliers in the United States (U.S.) Unfortunately, it continues to be difficult for Canada to secure N95 respirators from the U.S. because these products are not allowed to be exported to Canada. Hospitals and other health care facilities in the U.S. have priority to rebuild their stock in efforts to be more prepared for a potential second wave of COVID-19 in the Fall.

Update: USC&LS Service Codes and Provincial Implementation

CDA has recently approved two codes for provision of enhanced PPE materials during a pandemic. One code pertains to the PPE required for non-aerosol generating procedures, while the second is for the PPE required for aerosol generating procedures.

CDA is pleased to report that it has received confirmation from most users of the USC&LS on their plans to adopt the PPE service codes in their respective fee guides.

Reminders:

• Any fee recommendations are outside of CDA’s mandate and are the exclusive domain of Corporate Member PDAs. CDA’s role is limited to the definition of codes to support the publication of fee guides and the adjudication of dental claims. For any details about the inclusion of these codes in fee guides, inquiries will be directed to PDAs.
• These codes are not to be used for the additional time dentists require to use these materials (donning and doffing) or the additional time required to see the patient.
• Claims that include these codes can be transmitted with CDAnet and insurance companies will be able to adjudicate those claims as soon as they make the necessary adjustments to their adjudication systems. Decisions on whether to reimburse these costs will be made by insurance companies on a plan-by-plan basis, and in collaboration with the plan sponsors.

CDA’s Return to Practice Task Force (The Task Force):

The Task Force includes representatives from all Corporate Member PDAs. The Task Force will now meet bi-weekly to discuss deliverables for:

1. information exchange on return-to-practice status across the country;
2. strategies for obtaining and securing PPEs; and
3. communications to the public on dentists returning to practice.

Upcoming: Tips on Extending the Life of PPE
To assist the Task Force in its work, CDA Oasis is in the process of putting together a video series with dentists from across the country related to their experiences in return to practice; tips on how to extend the life of PPE in their part of the country; and stories of small companies helping dentists to be creative in managing the PPE shortage. The series will also explore dentists' return to practice processes; how they prepared their staff; and patient communications. CDA Oasis has over 16 dentists lined up to be interviewed, with some already completed. The recruiting process is continuing. As such, should Corporate Member PDAs have a dentist in mind to be interviewed for this series, please forward details to Dr. Chiraz Guessaier. Stay tuned for more information.

CDA is planning to issue a news release in the near future, which will be supported by a small social media campaign. Corporate Member PDAs will be supplied with a bilingual social media promo pack to use, like and share, as deemed appropriate.

Reminder: The Task Force continues to review and prioritize its list of deliverables. Any specific expectations or special requests of the Task Force should be fed forward by Corporate Member PDAs to their PDA member Task Force representative.

Knowledge and Information Broker:

CDA Oasis is CDA’s primary channel of communication for delivering urgent information to the dental community during the COVID-19 pandemic.

CDA Oasis produces a series of video interviews with members of the CDA Board, CDA’s COVID-19 Team, and other relevant subject matter experts. The following video was published this week:

• Dental Industry Initiatives During COVID-19
  We host a Q & A with three key dental industry professionals to hear how they have adapted in the face of the COVID-19 crisis, and ask what initiatives they have introduced to help support dentists in Canada and across the globe. (June 16)

This week’s CDA Oasis Bulletin collated relevant and timely “news that you can use” related to COVID-19.

Reminder: CDA Essentials Issue 3 is available online and Issue 4 will be available shortly.

Mental Health and Wellness:

It's completely normal for situations like COVID-19 to affect your mental health. Everyone experiences these events in their own way. It is natural to feel stress and concern during these times, and so it is important to practice positive coping strategies. Visit these websites for more information on how you can improve your mental and physical health during this challenging time.

Helpful information:

• Government of Canada: taking care of your mental and physical health during the COVID-19 pandemic
• Canadian Mental Health Association: five mental health tips amid COVID-19 concerns
• CDSPI: self-care tips during COVID-19

CDA Help Desk:

CDA’s Help Desk continues to assist dentists and dental office employees on how to navigate and access federal government support programs.

For assistance, please call 1-866-232-0385, M-F, 7:30 A.M. – 8:00 p.m. EDT.

CDA COVID-19 Repository at a Glance:

New resources added!

CDA serves as a COVID-19 Repository for Corporate Member PDAs by collecting advice and available COVID-19 resources from external organizations and any sources that PDAs wish to share. The information is placed in the Repository and is exclusively available for use by the PDAs, for onward transmission to their respective dentist members, as deemed appropriate.

For quick reference, the following materials have been added to the Repository this week. For the complete resource listing, please log in to view them all. Login details on how to access the Repository are below.

International Resources:

American Dental Association:

• HPI polling shows robust, sustained rebound in dental care (Jun 8)
• Webinar: How Will COVID-19 Impact Access to Dental Care for Vulnerable Populations? Topics covered include non-dental work being performed by dental professionals in public health settings; the use of teledentistry in public health vs. private practice settings; challenges in caring for FQHC patient populations during COVID-19; how to create more cross-collaboration in private practices; and how COVID-19 may accelerate inequalities in dental care. (Jun 8)

FDI World Dental Federation

• FDI statement on dentistry and oral health - (guidance to members, health authorities and dental teams in response to COVID-19. (Jun 2)

OSAP / DentaQuest Partnership

• Best Practices for Infection Control in Dental Clinics During the COVID-19 Pandemic (Jun 17)

National Resources:

Canadian Dental Association Oasis Discussions:

• Dental Industry Initiatives During COVID-19
  We host a Q & A with three key dental industry professionals to hear how they have adapted in the face of the COVID-19 crisis, and ask what initiatives they have introduced to help support dentists in Canada and across the globe. (June 16)

Canadian Mental Health Association

• A range of helpful resources on the following:
  • Anxiety Disorders;
  • Care for the Caregiver;
  • Children, Youth and Anxiety;
  • Children, Youth and Depression;
  • Concurrent Mental Illness and Substance Use Problems;
  • Coping with Loneliness;
  • Depression and Bipolar Disorder;
  • Eating Disorders;
  • Feeling Angry; and
  • Getting Help.

Canadian Health Policy:

• Abstract to COVID-19 Policy Paper: COVID-19 Economic Costs and the Implicit Value of a Life-Year in Canada.

CDSPI:

• Navigating the Pandemic: Update from CDSPI President (Jun 10)

Provincial Dental Association / Regulatory Body Resources:

British Columbia Dental Association

• June 18, 2020 Member Update: Clarification on Coverage of New PPE Codes
• June 17, 2020 Member Update: 2020 BCDA Suggested Fee Guide Addendum: PPE Surcharge; Fillable Patient Screening Form; 2020 Economic Survey Reminder
• June 16, 2020 Member Update: PDC update; CERB & CEBA update; BCDA office reopening; and more.
• June 12, 2020 Member Update: BCDA Presentation to Provincial Finance Committee; CDA Presentation to Federal Health Committee; Potential changes coming to CERB & CEWS; and more.

Newfoundland & Labrador Dental Association

• COVID-19 Update: PPE Code; Pandemic Plan - COVID-19 for Return to Dental Practice; Guideline Differences; and more.

Nova Scotia Dental Association:

• NSDA News Brief - June 18, 2020: President’s Letter #14
• NSDA News Brief - June 17, 2020: Small Business Reopening and Support Grant; Update: Return-to-Practice Patient Communications for Members; NSDA Supply Hub; and more.

Ontario Dental Association

• Your Weekly COVID-19 Update: New Procedure Codes for PPE Costs Added to 2020 Suggested Fee Guide; Clarity on Stage 2 Reopening; ODA Requests PPE Prioritization from Chief Medical Officer of Health; Update on the Minister’s Order and Direction on PPE Data Collection; Federal Supply Hub; and more.

Access to COVID-19 Repository: PDA Executive Directors, Corporate Member Presidents and select staff, and CDA Board Members have access to the CDA COVID-19 Repository via the CDA Board Resource Website.

The link to access the CDA COVID-19 Repository: https://boardresources.ca/covid/.

Log-in: Please use your existing CDA Board Resources login credentials to access the COVID-19 Repository.

If you have trouble logging in, or require a login for someone in your organization who would like access, please email Dean Smith, CDA Manager of Information Technology, dsmith@cda-adc.ca.

Share: To include your organization’s resources in the COVID-19 Repository, please email Zelda Burt, CDA Communications Manager, zburt@cda-adc.ca.

The CDA COVID-19 Response Team works diligently on a range of fronts to help minimize and mitigate the impacts of COVID-19 on the dental profession. CDA is working to address scientific, clinical, economic and business-related matters impacting dentistry, including efforts to increase awareness about the mental health and wellness of dentists, their families and dental office employees during these challenging times. CDA will communicate regular updates as new information becomes available.