Volume 7 • 2020 • Issue 6

The most important thing is staying informed about what is happening locally in your community. Screening is your main defense, so knowing who the people who come into your office are, and where they have been, is very important. The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. presence of COVID in Canada. It is a critical tool for cluster outbreaks when individuals may have been exposed and we need to determine who actually got infected. Q How about Canadian-made PPE? AB: The government is shoring up investment in Canadian-made N95s, however, they will likely not appear in the Canadian market until 2021, or maybe even 2022. I expect there will continue to be shortages. Many of the companies that initially engaged with creating N95s have abandoned that work or haven’t been successful. It is more difficult than we expected to create a respirator of such high quality and the raw materials come from a small number of suppliers globally. Prototypes have either been uncomfortable, hard to breath in, or haven’t met standards. Some companies have pivoted to manufacturing Level-3 masks, but Canadian production has not been established. The concern will be that as foreign suppliers of respirators or other PPE start to export again, the viability to create production capacity in Canada will decrease. Q Vaccines—are there any encouraging developments? AB: There are a couple hundred vaccines in development and a few of them are in the midst of large clinical trials of approximately 30,000 people. There will be vaccines for COVID-19. The big question is: how safe and how effective will they be? An effective vaccine could change the situation a great deal; a less effective one, not so much. There are also questions about manufacturing and distributing a sufficient amount of vaccine. Vaccines require specialized manufacturing plants and there isn’t excess capacity just sitting idly by waiting for COVID-19 vaccines to be approved for manufacture! Disrupted supply chains have been a big problem during the pandemic, so that is another concern. Then it has to be decided who gets vaccines first and how to distribute them equitably and effectively. Q As restrictions have been loosened and dentists have returned to providing more of their regular services, what have you heard about the challenges of the new normal? AB: I think the biggest struggle is how labour intensive dentistry is right now. Pre-screening, social distancing, new protocols—these all take up time and energy on a day-to-day basis. I personally am exhausted after my day in the clinic. It’s also difficult emotionally to be so distanced from staff and other people. I’m longing for a world that isn’t so stringent on protocols when I can spend more of my time and energy connecting with my patients and the people that are part of my life. Q Many fear a second wave or resurgence of COVID in the autumn or winter. Do you have any advice on how dentists can prepare? AB: The most important thing is staying informed about what is happening locally in your community. Screening is your main defense, so knowing who the people who come into your office are, and where they have been, is very important so you can assess risk appropriately. Largely asymptomatic people have a lower probability of infecting others based on emerging information. The people we should be most concerned about are those that are pre-symptomatic, those who have a little tickle in their throat or other symptoms that should preclude them from a dental visit. The protocols that we use in the dental office are very effective in preventing disease transmission. Very few medical personnel have contracted the virus, even those primarily treating COVID patients. Dental office concerns have related to staff-to-staff transmission, particularly where community transmissions were clearly confirmed. We must stay vigilant about what is happening outside our offices, when we are socializing with others in non-medical environments. 14 | 2020 | Issue 6 CDA at W ork