It is unbelievable that almost 19 years have passed since the twin towers collapsed. September 11, 2001, my first meeting as President of the Nashville Dental Society – a day that none of us will forget. And now as President of the TDA, the surreal COVID-19 pandemic that has impacted our economy, our daily lives, our health, our social mores, our offices, family and staff, our livelihoods, income with lasting effects it will leave behind. We will recover with time. The TDA and ADA have worked tirelessly to provide the most up-to-date information for our members and have worked around the clock to keep you well informed. The challenges have been that the date to return to work and the information regarding financial assistance are a moving target. If there was ever a time to be a member of the Tripartite system, it is now. The ADA is fiercely advocating for its members who are caught in the conundrum and the alphabet soup of the SBA, EIDL and PPP loans to enable dentists to make the best use of these funds. The TDA is also doing its part to advocate for our members to return to a safe practice environment.
The TDA has received many communications from our members. These communications include admonishment for not advocating to keep dentists in their offices providing routine dental care for their patients. We have received calls, emails and notes of praise for advocating to keep our members, our staff, our families and ourselves safe from transmission of COVID-19. We have received messages of hope, fear and despair, but all have been voices of concern for staff and for patients, for the best possible outcome from the chaos of the past few weeks.
It is challenging to be a leader in a time where there are no good answers to questions like: When can I return to work? Where can I secure N-95 masks? Will there be new guidelines regarding PPE as a result of COVID-19? If I only have 60 days to use my EIDL funds, but I receive them while I am mandated to be closed, how will that work? If I plan to be back to work and the Governor issues an extended mandate, how can I survive having my practice closed? Can I get the rapid COVID tests to screen patients when they arrive at my office? Why was dentistry considered a non- essential business, when other businesses could stay open?
All GOOD questions with no GOOD answers. Our members look to the TDA to help them with these challenges and unknowns. The problem is that no one has the answers, because policy is being developed in the moment and decisions are being made day-by-day. We are in unchartered waters and there is no right answer – we are in survival mode, making decisions based on scientific evidence that changes by the day. Although we are stabilizing and headed towards recovery. It is in our sights to emerge from this unprecedented threat to return to the lives that we knew.
I have been asked by many colleagues if the TDA advocated for the Governor to close dental offices? The answer is that the TDA advocated for the safety of patients, dentists, and their staff. The recommendation of the ADA was supported by the TDA Board of Trustees and passed on to the Tennessee Department of Health. Executive Order 18 & 25 apply to elective procedures by both physicians and dentists. The “shelter at home” mandate and social distancing were ordered for containment of the spread of the virus. It is true that dentists have always practiced according to OSHA guidelines, using universal precautions, but few offices had access to N-95 masks. While our OSHA guidelines are adequate for bloodborne pathogens, not so much for a hostile, sticky virus-like COVID-19 with the ability to replicate so quickly, that it overwhelms the immune response and transmitted via droplet inhalation or fomite, any inanimate object that when contaminated can then transfer the disease to a host.
As we contemplate returning to work, the ADA is developing guidelines for safer practice. We will post those all for all of our members once they are issued. In the meantime, now is the time to access PPE that will be required to safely return to practice. Practicing defensively will be the norm and new protocols will be suggested. Fear of what tomorrow brings and how our practice and personal lives will change causes anxiety. If there is any calm to this storm, it is that we are resilient, and we will survive this, but with a new appreciation of what may be.
The TDA has been vocal and visible during this pandemic to the governmental and regulatory agencies in our State. The responsibility of leadership in a time of crisis can be challenging. We see it clearly on the national, state and local levels and within our professional associations. We are anxious for friends and colleagues to return to work, knowing they will continue to practice with guidelines for infection control that will protect those who have entrusted us with their care and those who look to us as their employer. We adhere to the Hippocratic oath to “first do no harm” and we have always subscribed to the fact that prevention is preferable to cure of disease. Dentists have endured the assignment of mitigating the spread of this virus and have been valiant. It is time to resume our work.
We have survived the initial panic brought on by the virus and have experienced the shelter in place mandated by our Governor. We have managed furloughing and are managing emergencies. We have negotiated applications for PPE and EIDL. Now is the time to create a strategic plan to begin the process of returning to work, restarting our practices and welcoming our patients. The ADA has yet to announce updated infection control guidelines for returning to our practices, but enhanced infection control will be on the minds of our patients and they will trust that we will provide that for them, as we always have.
We are stronger together and our dental families will return to normalcy and do what we do best, providing expertise in dentistry, in a safe environment with the care and professionalism that we have always exhibited. The TDA stands with our members and dental families.
COVID-19 will forever be in our memories.
Terryl Propper, DDS