Dr. Carter: You served on the American Dental Hygienists Association's task force to develop the ADHA interim guidance on returning to work in April 2020. As we continue to learn more about SARS-CoV-2 and as the virus keeps changing, is the guidance document a living document, and how so?
Kathy Eklund: Yes, it is a living document, and the task force is still meeting through ADHA, and we've done several webinars. Every time there is guidance from CDC or OSHA or any change in regulations, it's continually being updated. It's managed by staff working with the task force to ensure that it's the most up-to-date information. Reopening guidance really is intended to marry very closely with the guidances from CDC and OSHA, so any time there's a change, those are updated. ADHA is also managing many emails and questions coming from hygienists.
Dr. Carter: What is the current status of dental practices' ability to acquire PPE? Are there particular items that in your travels you have listened to dentists and hygienists speaking about their problems, with their practice's ability to acquire PPE? Are there particular items you would forecast as being in short supply, and are these national limitations in the supply chain, or do they seem more regional?
Kathy Eklund: I don't know that I can give a real accurate answer to that. I have had people contact me and Forsyth about our situation in terms of accessing PPE, and we've worked very hard to ensure that we can provide adequate personal protective equipment, and following the CDC guidance, in terms of donning, doffing, and disposable PPE being disposed after each patient. In terms of the overall shortages, I think it was far worse early on, particularly with N95 respirators and some face masks and gowns, because many of these were being manufactured overseas. Many companies, interestingly, stepped up, including clothing companies, some toy companies and others, who started to manufacture particularly face shields, some gowns, and isolation gowns, and that has significantly helped.
But I think the supply chain is always going to be a problem until we really have the ability to do as much manufacturing as possible here in the United States. Many of the raw materials, however, do have to come from outside the United States for things like disinfectant wipes, the substrate. There are manufacturing challenges, supply chain challenges, and I think it just varies across the country.
It's ensuring you have that on-the-ground, in-the-practice leadership and people are working together. Having an infection control coordinator is very important, because they can continue to monitor many things, including the local epidemiology of COVID-19 in the community and in the population that you're serving, because that's part of that whole framework. Ensuring people are up-to-date in terms of any changes in CDC guidance, state Departments of Public Health guidance, and OSHA guidance as well. I'm very active with the Organization for Safety Asepsis and Procedures (OSAP), and we have many learning tools. We have a certificate program for infection control education, and we also worked with DentaQuest, who helped with a project where OSAP, with an entire team, developed a checklist that's free and downloadable from the OSAP website. It also is a living document, and it reflects CDC guidance, OSHA guidance, ADA, as well as ADHA. Any time any of those guidances are updated, the toolkit and the checklist itself are updated. So, you can go to that often.
Dr. Carter: Kathy Eklund, I'd like to thank you very much for your insights today on the topic of infection prevention and control in the era of COVID-19. Thank you very much.
Kathy Eklund: Thank you for having me.