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 May 29, 2020.

This Week’s Fast Facts: Current COVID-19 Situation

• There are nearly 6 million COVID-19 cases worldwide, with a current mortality rate of 6.1%. There continues to be a 12 to 15% increase in new cases worldwide weekly with significant hot spots including Russia, the United States and Brazil.
• Germany, a reference country for Canada in terms of approach to COVID-19, has seen an increase in new COVID-19 cases as restrictions have been lifted. There is evidence of similar problem in Canada and interprovincial travel poses potential increased risk.
• To date, the mortality rate for the U.S. is 5.8%.
• In Canada, the mortality rate to date is 7.8% and stems largely from the high percentage of cases in long-term care facilities and among the elderly. At this point in time, the significant “hot spots” with active outbreaks continue to be Ontario (especially the GTA) and Quebec (Greater Montreal).
• The Chief Public Health Officer of Canada is recommending non-medical masks for the general population in situations where maintaining a two-metre social distancing is difficult and similar recommendations that patients wear masks while in the dental office are being recommend.

Reminder! Case finding follow-up shows that even in places where stringent infection prevention and social distancing protocols exist, there have been transmission of COVID-19.

This is primarily being traced back to interactions that happen between individuals in common areas, such as lunchrooms, washrooms, etc. It’s important not to let your guard down. Individuals, including at workplaces that are gradually resuming routine service provision, should continue to take all necessary precautions, including disinfecting common area surfaces, such as counters, door handles, faucets, sinks and toilets, and respect the need to socially distance to avoid the spread of the virus.

Personal Protective Equipment (PPE):

Update: Federal Government PPE Supply
The Public Works and Government Services Canada’s new webpage provides information on the availability of government-procured PPE. It shows that additional shipments have been received; however, the gaps between orders and deliveries remain significant. Reports from industry informants indicate that it will likely take months for supplies to catch up with demand.

The Logistics Advisory Committee, set up under the Federal/Provincial/Territorial Public Health Response Plan for Biological Events, reports that appropriate stock is available for hospitals, long-term care facilities and home care. Availability of stock for hospices, pharmacy, dentistry and other allied health care providers remains problematic and varies between jurisdictions. Coverage of the costs also varies by jurisdictions. They are working on refining the specifics by jurisdiction.

Ongoing: PPE Price-gouging
There are instances of dentists experiencing “price-gouging” of N95 respirators from sellers. CDA is investigating potential recourse through Health Canada and the Public Health Agency of Canada to force these resellers to bring prices down to a more reasonable level.

It is important to remember that unless a respirator is properly fitted and fit tested, it is only a mask and does not provide the level of protection the wearer may need.

CDA will provide further updates on these issues as new information becomes available.

Update: Claims for Extra Charges for PPE
CDA has heard that many dentists feel the need to add a PPE charge to their patients’ bills.

To minimize the impact of these extra costs on the ability of Canadians to access oral health care, CDA, in collaboration with the Canadian Life and Health Insurance Association (CLHIA) and the provincial and territorial dental associations that use the USC&LS for their fee guide, has defined a new code for the description of that charge.

Once these codes are formally adopted, they will be available for inclusion in provincial fee guides. Claims that include them will be transmittable with CDAnet and insurance companies will be able to adjudicate those claims.

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 is currently focusing its efforts on the facilitation of claims related to the cost of additional PPE. The extra cost of PPE issue is tangible and relatively easy to explain, and are negatively impacting the cost of oral health care. Further increases can be expected in the coming months as the time to provide treatments has increased substantially under the provincial return to work protocols. CDA will continue to support Corporate Member PDAs as they work to include these additional costs in their fee guides.

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

The Task Force includes representatives from all Corporate Member PDAs, and meets 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.

As provinces begin to lift restrictions on dental practice, the task force is looking at how to help dentists with both practice and economic changes that the pandemic has caused.

Ongoing: Return-to-Practice Office Manual
The French version of Version 1 of the manual is now available, as well as Version 2 of the English manual. Both a “tracked changes” and clean version of the English manual have been provided to Corporate Member PDAs on Friday, May 29, 2020.

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.

CDA’s Infection Control Working Group:

This Working Group is responsible for collecting and assessing information on infection protection and control to support the Return to Practice Task Force. The Working Group will meet every Thursday until its tasks are completed. The Working Group has organized their work into four key areas, including:

1. minimizing the emission of infectant particles;
2. controlling infectant particles’ dispersion to other surrounding areas;
3. protecting staff and patients in the dental office, including PPE requirements; and
4. contamination and disinfection protocols.

In collaboration with the Return to Practice Task Force, the Working Group has compiled information about all the return to work protocols published by the provinces, at this point in time. This information will be updated as protocols evolve.

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 videos were published this week:

• CARDP Roundtable – Applying Silver Diamine Fluoride:
  In this edition of CARDP Roundtable, Dr. Les Ennis shares his experience of using with Silver Diamine Fluoride in his practice, and fields questions on its uses and benefits from Dr. Deb Schwartz, Dr. Shammick Kotecha and Dr. John O’Keefe. (May 26)

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

Reminder: CDA Essentials Issue 3 now is available online.

Mental Health and Wellness:

With the COVID-19 pandemic placing significant strain on individuals and families across the country, it’s more important than ever to safeguard your mental health and overall wellness.

New! Two wellness posts featured in the Mental Health Corner of CDA Oasis:

• Mind Your Business – Building a Resilient Work team
  If you’re looking to grow a team that can tackle adversity with greater confidence, try some of these simple leadership measures. (May 27)
• Mind Your Business – Removing Stigma – Workplace Mental Health:
  Take an active role in contributing to better mental health for yourself and others. Removing stigma is one of the 5 Rs of workplace mental health. Read on to learn more about how removing stigma can make a difference. (May 25)

Reminder! Please visit the Centre for Addiction and Mental Health’s website for mental health resources and support. The site offers help for health care professionals; coping strategies and personal assessment tools to help manage stress and anxiety; and a range of other helpful resources.

CDA Help Desk:

CDA’s Help Desk assists 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.

Advocacy Updates

Update: CDA Invited to Present to Federal Health Committee
CDA has formally been invited to present to the House of Commons Standing Committee on Health as part of its ongoing study on the impacts of COVID-19. CDA will present to the committee on Wednesday, June 10, at 4:30 p.m.

Update: Canada Emergency Commercial Rent Assistance (CECRA) and Canada Emergency Wage Subsidy (CEWS):
CDA has reached out to the office of Finance Minister Bill Morneau this week 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. Additionally, CDA has underlined some concerns with the administration of the CEWS, especially in how the CRA has stated it views cost-sharing agreements and partnerships. CDA continues to collaborate with other groups on these specific issues, including the Canadian Medical Association and other health professional organizations.

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.

Mental Health and Wellness Resources:

Canadian Dental Association:

• Mind Your Business – Building a Resilient Work team
  If you’re looking to grow a team that can tackle adversity with greater confidence, try some of these simple leadership measures. (May 27)
• Mind Your Business – Removing Stigma – Workplace Mental Health:
  Take an active role in contributing to better mental health for yourself and others. Removing stigma is one of the 5 Rs of workplace mental health. Read on to learn more about how removing stigma can make a difference. (May 25)

Conference Board of Canada

• COVID-19's Impact on Mental Health and Returning to the Workplace Article (May 28)

National Resources:

Canadian Dental Association

• CARDP Roundtable – Applying Silver Diamine Fluoride:
  In this edition of CARDP Roundtable, Dr. Les Ennis shares his experience of using with Silver Diamine Fluoride in his practice, and fields questions on its uses and benefits from Dr. Deb Schwartz, Dr. Shammick Kotecha and Dr. John O’Keefe. (May 26)

Office of the Chief Dental Officer

• National status of the re-opening of oral health care in Canada (May 22)

The Canadian Dentist Podcast

• May 21 Podcast. Summary: How protected are you as a dentist? Do you have someone who can support you when the challenges start to pile up? Features Ontario-based dentist, Dr. Kal Khaled.

Provincial Dental Association / Regulatory Body Resources:

British Columbia Dental Association

• May 28 Member Update: Joint webinar; Daily BCDA Member Update emails to be reduced Jun 1; Reputation Management with COVID-19: Effective Communication
• May 27 Member Update: BCDHA/BCDA Returning to Work Forum, updates on the BCDA Return-to-Practice Office Manual Webinar, Dentist Wellness Program Peer Support Sessions updates and more.
• May 26 Member Update: BC Government COVID-19 Survey; Dentist Wellness Program Peer Support Sessions, and more.
• May 25 Member Update: Canada Emergency Commercial Rent Assistance (CECRA) Applications Open Today, COVID-19 Office Safety Plan, Dentist Wellness Program Peer Support Sessions and more.
• May 22 Member Update: Return-to-Practice Office Manual, Public Listing of Emergency Dental Clinics Ending, BCDA Supply Hub Clarification and more.

Dental Association of PEI

• Member Update (May 22): Matter of Perspective on Protocols offers some perspective on DAPEI’s protocols and they were developed.
• DAPEI 2020 Annual Report (June 2020)

New Brunswick Dental Society

• Member update (May 25): NBDS secured a quantity of N95 respirators from the Government NB’s inventory

Newfoundland & Labrador Dental Association

• NLDA COVID-19 Update (May 27): Highlights include Afternoon Briefings, N95 Mask Supplier updates and details to reserve your spot at this year’s AGM that will be held virtually through Zoom.
• NLDA COVID-19 Update (May 25): Highlights include updates to the Canadian Emergency Commercial Rent Assistance Program (CECRA), a plan for returning to dental practice and more.
• NLDA COVID-19 Update (May 22): Highlights include guidelines for a return to dental practice, information on the upcoming virtual AGM and an NLDA Webinar.

Nova Scotia Dental Association:

• Daily COVID-19 Update (May 28): Upcoming webinar for return to practice; update on pandemic insurance claims in NS; NS government announcement on COVID-19: Small Business Reopening & Support Grant program
• NSDA President’s Message to Members #11 (May 28)
• Daily COVID-19 Update (May 27): Update on return to practice; pandemic insurance; and more.
• NSDA Return-to-Practice Office Manual (May 27)
• Daily COVID-19 Update (May 26): Update on return to practice; pandemic insurance; and more.
• Daily COVID-19 Update (May 25): Pandemic Insurance updates, information regarding Return to Practice, NSDA advocacy updates and more.
• Daily COVID-19 Update (May 22): Pandemic Insurance updates, information regarding Return to Practice, NSDA advocacy updates and more.

Ontario Dental Association

• Message from ODA President (May 28): How to Get to a Safe, Sustainable Future for Dentistry
• Planning for the Return to Non-Essential and Elective Health-Care Services (May 27)
• Weekly COVID-19 Update (May 26): An update on returning to practice; ODA advocacy on PPE and employment issues; face shields are now available on ODA Supply Hub, and more.
• Return to Practice Toolkit Launched (May 22): Link to download toolkit. The Toolkit is meant to complement the guidelines of the Royal College of Dental Surgeons of Ontario.

Royal College of Dental Surgeons of Ontario (RCDSO)

• COVID-19: Managing Infection Risks During In-Person Dental Care (May 25)

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.