A Message for CDA Corporate Member Provincial Dental Associations

Below is a status update from the Canadian Dental Association (CDA) about the COVID-19 pandemic for the week ending September 17, 2021. CDA’s next COVID-19 update is slated for October 22, 2021.

Quick Facts: Current COVID-19 Situational Report

Dr. Aaron Burry, CDA’s COVID-19 Team Lead and Deputy CEO - Professional Affairs, provides a video update on the COVID-19 pandemic to the Presidents and CEOs of CDA’s Corporate Member provincial dental associations.

Video Length: 23 minutes. Recorded: September 14, 2021.

Video highlights include:

• The current context since June 2021, including worldwide trends: Lower than needed vaccination rates are not containing the spread of the COVID-19 virus. Trends show that we will likely not achieve a state of herd immunity as rapidly as originally anticipated. COVID-19 will likely be around for some time yet. Through media pushes, the federal and provincial governments continue to encourage more individuals to get fully vaccinated (2 doses).
• A snapshot of worldwide case levels since July: There are trends of hot spots and tremendous case growth across the globe. Although North America has good vaccination rates, we remain in the early stages of world-wide vaccination against COVID-19. Low vaccination rates in other countries mean that the virus will continue to circulate and can put Canada at risk because any new variants will make its way in through travel.
• Different countries have different approaches. Dr. Burry discusses what drives government policy and explains the difference between a “zero case strategy;” an endemic strategy; and a combination strategy. A combination strategy has largely been employed in Canada, which includes measures such as mandating vaccinations for certain groups; implementing a range of public health measures such as masking and limiting indoor activities; and introducing vaccination certifications, etc.
• Hospital trends and deaths: Since vaccination is more widespread, case counts are a less important marker for the severity of Canadian epidemic. Canada is beginning to see significant increase hospitalizations again.
• Delta variant: Dr. Burry discusses “what we think we know;” “what may be true;” and “what we don’t know” about the Delta variant. Currently, it is unclear how long vaccines are effective for and if variants, such as the MU variant, can evade vaccine immunity.
• The next wave: The current dominant strain (Delta) has followed similar wave patterns as previous versions. Public health measures tend to bring down the height of the curve, but don’t necessarily change the duration of the wave or eliminate the full impact on the health care system. Vaccination is highly effective, but it is not 100% guaranteed to prevent the spread or illness. Based on hospitalizations data from various parts of the world with similar vaccinations rates, approximately 70% of hospitalizations are among non-vaccinated individuals. About 90% of individuals who land in ICU are not vaccinated and have other underlying health conditions. At this point in time, we don’t know when governments can safely transition to a more endemic strategy.

Areas of focus for dentists:

• Wave 4 is here: Canada is currently in a fourth wave, which is expected to last approximately 90 days based on previous patterns. Case growth is being driven by the Delta variant.
• Avoid travel to sun destinations: As an added cautionary measure, Canadians should avoid travel to sun destinations, which poses a risk for dentists and office staff. Continue to watch for travel advisories and high-risk countries.
• Think locally: Take extra precautionary measures in places where there are low vaccination uptakes or where cluster outbreaks begin to be reported, such as schools, day cares, and other areas in the community.
• Elevated infection prevention and control protocols (IPAC) will likely remain in effect over the next year. To date, dentistry has demonstrated that dental offices can offer care safely and that IPAC practices are effective, allowing oral health care provision during the pandemic. Considerations for dentistry, based on the current patterns of infections and assumptions of the current variant includes:
  • Eye protection should be worn by all staff, at all times, while in the dental office.
  • Surgical masks should be worn by all staff, at all times, while in the dental office.
  • Cloth masks should be avoided outside of the operatory since they may not be as effective against the spread of infection.
  • Dental office staff must remain hyper vigilant both in their personal lives, when presenting to the office for work, and when in non-clinical/common areas inside the office.
• COVID-19-related oral and overall health trends in patients: More research is becoming available that show trends in patients oral and overall health. For example, patients who have had significant COVID-19 illness have symptoms such as dry mouth, which continue to linger for months. Additional case reports of many individuals who test positive with no symptoms but are later experiencing an onset of severe fatigue and other symptoms are appearing. This demonstrates that COVID-19 seems to have lingering health effects on individuals and their health beyond the initial illness. Lastly, more studies are emerging that initially looked at patients who were asymptomatic but after intense follow-up, diagnostic tests showed indications of unexplainable lesions and damage to other organs such as the liver, pancreas or even salivary glands.

Coming up:

• CDA continues to stress the importance of full vaccination for all dentists and dental office staff in Canada, and promotes the importance of getting vaccinated to the general public via social media.
• Early next week, CDA plans to issue a public statement calling on provincial and territorial governments to mandate COVID-19 vaccination for all health care workers, including oral health care professionals. CDA intends to publish the statement on its website and promote it via social media. Stay tuned for more information.

Advocacy

CDA liaises directly with a range of federal government departments, working diligently to ensure that oral health remains a recognizable and significant public health issue.

CDA’s Preparation for the Election:

Over recent weeks, CDA has engaged in staff-level meetings with the Liberals, Conservatives and NDP prior to the election to discuss platform development and issued letters to these parties to outline our top recommendations to support the dental profession and help Canadians achieve and maintain optimal oral health, which include:

• Recommending that Parliament conduct a detailed study on improving dental coverage for Canadians, within the first 12 months following the election. However, in the interim, CDA recommends an investment of $600 million over the next 5 years to maintain and expanding existing dental care programs delivered by provincial and territorial governments, particularly those targeting vulnerable populations.
• Given the unique oral health challenges faced by seniors in long-term care (LTC) facilities and the importance of oral health on overall health, CDA recommends that any new national standards developed for LTC facilities include a standard relating to oral health.
• Supporting dental offices and access to dental care as Canada transitions to life post-COVID, which will help ensure that cost-effective dental care can remain accessible to Canadians. This includes:
  • Continuing efforts to provide dental offices with cost-effective access to N95 respirators and nitrile gloves;
  • Implementing the provisions in Budget 2021 to support dental offices that incurred significant additional costs adapting their offices for COVID-19 health and safety measures. These provisions should be modified so that they are retroactive to the start of the pandemic, and accessible to all dental offices; and
  • Maintaining support programs for small businesses still suffering from the economic impact of the pandemic, such as some dental offices.
• CDA has a focus on promoting healthy eating since sugar is one of the main causes of dental problems, such as dental decay, particularly in children. Dental decay itself is the most common childhood disease in Canada. CDA’s recommendation is that front-of-package labelling regulations should be put in place without delay, making it easier for the public to identify foods that are high in sugar. CDA also recommends that legislation be put in place to restrict food and beverage marketing to children.

CDA has supplied Corporate Member PDAs and CDA Affiliate Members who wish to follow a similar grassroots approach in their advocacy efforts with an election kit of documents, which includes a handout outlining the CDA’s platform and policy recommendations for this election, and other helpful information.

COVID-19 Practice Recovery Task Force (“The Task Force”):

This group includes representatives from all Corporate Member provincial dental associations (PDAs). The Task Force continues to work together to discuss deliverables for:

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

Update: Mental Health in the Workplace. Safeguarding your mental health and overall wellness is important, especially during the COVID-19 pandemic.

The Task Force has been focused on The Working Mind, a short course on mental health in the workplace, from the Mental Health Commission of Canada. The Working Mind is an evidence-based program designed to promote mental health and reduce the stigma around mental illness in the workplace. By reducing stigma and discrimination, the course helps organizations create a culture that fosters greater awareness and support for mental health among employees, managers, and employers.

The Task Force has been working to adapt the content for dentistry. CDA is approaching the last phases of customizing this pilot course, which will be called, The Working Mind: Workplace Mental Health & Wellness for Oral Health Care Professionals. CDA is working closely with Corporate Member provincial dental associations to determine how this course could potentially be integrated into their membership offerings. It is anticipated that this course will become available in 2022. CDA will provide more details as this project moves ahead.

CDA Knowledge Products:

CDA Oasis is an online community for clinical support and the latest information on issues and technology impacting the dental profession. The following discussions have been recorded since CDA’s last COVID-19 update in June 2021. Be sure to check these out:

• Staying Well and Healthy Despite Pandemic Fatigue:
  Dentistry is a tough profession at the best of times, but given the events of the last 18 months many people in the dental profession are experiencing pandemic fatigue. Dr. Uche Odiatu, general practitioner and wellness coach from Toronto, gives his practical insights into how dentists can stay fit and healthy during these difficult times. (September 2, 2021)
• Is There an Association Between Periodontitis and the Severity of COVID-19 Infection?:
  Dr. Faleh Tamimi coauthored a recent article titled Association between periodontitis and severity of COVID-19 infection: A case–control study. Dr. Tamimi talks about why it was important to carry out the study, its purpose, how the study was conducted, and about the study findings and their implications. (June 14, 2021)

New: CDA Essentials, Issue 4 is available online. Below are some of the edition’s highlights pertaining to the pandemic. Issue 5 will be available in October 2021.

• From the President: Making a Difference by Sharing Good Science
• Your COVID-19 Questions Answered
• COVID Vaccines: How Can Practice Owners Promote Vaccination Among Staff?
• Ask a Clinical Pharmacy Specialist: How Effective are COVID Vaccines?

Mental Health and Wellness:

COVID-19 continues to create stress and anxiety for many Canadians, including health care workers, primary care providers and oral health care professionals who are on the front lines of the pandemic.

Prioritize your well-being and take time to check in with how you are feeling. Wellness Together Canada offers free and confidential online mental health and substance use supports available 24/7, including 1 to 1 counselling. For more information, check out this factsheet, Wellness Together Canada – At a Glance.

This tip sheet also provides 10 things you can do right now to reduce anxiety, stress, worry related to COVID-19.

The Members’ Assistance Program (MAP) is available: Individuals can access mental health and wellness support by calling CDSPI’s Members’ Assistance Program (MAP) at 1.844.578.4040 or visiting www.workhealthlife.com. MAP provides a variety of resources to help individuals deal with life's challenges. It is a confidential counselling, referral and information service for individuals who are dealing with mental health challenges or need advice on topics such as physical fitness, nutrition or parenting. MAP services and resources are offered through Shepell, Canada’s largest provider of Employee and Family Assistance Programs.

CDA COVID-19 Repository at a Glance:

CDA serves as a COVID-19 Repository for Corporate Member PDAs by collecting advice and available COVID-19 resources. As of September 2021, CDA is collecting resources from external national and international organizations only. 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 since CDA’s last COVID-19 update. Resources listed below and posted in the repository appear in the language it was created in. For the complete resource listing, please log in to view them all. Login details on how to access the Repository are below.

Dental Schools, Research, Journal Articles and Continuing Education Resources

McGill University

• Second Update, prepared for the Chief Dental Officer of Canada: Evidence to support safe return to clinical practice by oral health professionals in Canada during the COVID-19 pandemic: A report prepared for the Office of the Chief Dental Officer of Canada (March 2021)

Federal Government Resources

Health Canada

• Recalls and Safety Alerts: Health Canada updates Pfizer-BioNTech COVID-19 vaccine label to reflect very rare reports of Bell's Palsy (August 6, 2021)

National Resources:

Canadian Dental Association

• JCDA.ca: How Often Are Dental Care Workers Exposed to Occupational Characteristics that Put Them at Higher Risk of Exposure and Transmission of COVID-19?
  A Comparative Analysis (Dr. Sonica Singhal, Christine Warren, Dr. Erin Hobin, Dr. Brendan Smith; Dental care workers’ high risk of occupational exposure to disease points to the need for guidance to reduce transmission and ensure the well-being of this workforce. (August 19, 2021)
• JCDA.ca: Characteristics of Emergent and Essential Dental Services in University and Hospital-based Settings During COVID-19 Pandemic in Vancouver, Canada:
  Drs. Nicholas R. Tong, Jennifer Park, Suzanne Carlisle, Catherine F. Poh. This descriptive data on urgent and essential dental care will help with planning for future limitations secondary to a pandemic. (July 12, 2021)
• CDA Oasis: Staying Well and Healthy Despite Pandemic Fatigue:
  Dentistry is a tough profession at the best of times, but given the events of the last 18 months many people in the dental profession are experiencing pandemic fatigue. Dr. Uche Odiatu, general practitioner and wellness coach from Toronto, gives his practical insights into how dentists can stay fit and healthy during these difficult times. (September 2, 2021)
• CDA Oasis: Is There an Association Between Periodontitis and the Severity of COVID-19 Infection?:
  Dr. Faleh Tamimi coauthored a recent article titled Association between periodontitis and severity of COVID-19 infection: A case–control study. Dr. Tamimi talks about why it was important to carry out the study, its purpose, how the study was conducted, and about the study findings and their implications. (June 14, 2021)

The Society of Obstetricians and Gynaecologists of Canada

• Frequently Asked Questions for Health Care Providers: COVID-19 Vaccination in Pregnancy (revised version from May 27, 2021) Click here for English and French

Mental Health and Wellness

Wellness Together Canada

• Factsheet: Wellness Together Canada, At a Glance. A free, online mental health resource For Healthcare Workers and Primary Care Providers (July 25, 2021)

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.