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20 September 2020

Safety in the context of COVID-19

Experts predict the second wave of coronavirus (COVID-19), accompanied by seasonal respiratory viral infections and influenza in autumn. The doctors are required to strengthen safety measures in clinics. We would like to bring to your attention additional preventive measures recommended by WHO to protect the personnel and patients of dental clinics.


 

PROTECTION OF PATIENTS

If previously a visit to a clinic started from a coatstand, today it starts with a sanitizer. These devices, which contain hand sanitizer, have proven to be one of the most reliable barriers to virus transmission. So reliable that they will most likely remain in our daily life even after the pandemic is defeated.
In the clinic, it is recommended to place a sanitizer immediately at the entrance, in front of the wardrobe and the shoe cover stand. A poster indicating that first you need to use a sanitizer and then take off your outerwear and put on shoe covers, and then use the sanitizer again, will help the patient not to spread the virus around the clinic.
A sanitizer and the instructions on how to use it should also be placed in the toilet. Often people are unaware of an efficient use of a sanitizer and soap.


And finally, it is recommended to put sanitizers in all offices, right at the door. The poster should encourage patients to sanitize their hands before and after visiting the doctor’s office.
All patients should be considered as potential carriers of infection. In order to prevent carriers of infection from entering the clinic, all patients should have their temperature measured with a non-contact infrared thermometer at the entrance. It is also advisable to undertake a pulse oximetry procedure for patients.
When scheduling an appointment or reminding of it, the administrator should telephone screen all patients for their health, any suspicious symptoms and visits to high-risk countries, and also invite the patients to take the temperature. If it is higher than normal, suggest rescheduling the visit to the clinic. This should be done in such a way that patients perceive these requests not as an obstacle, but as a concern about their health.
The patient should wear a medical face mask outside the doctor's office. To make sure that the patient’s facemask meets all the necessary requirements, and he is not wearing one and the same mask for the third day in a row, the clinics should better purchase the masks and give them to patients at the entrance. The same applies to gloves.
It is necessary to schedule appointments to minimize the number of patients in the waiting room. This can be achieved through a regimented scheduling of appointments. The administrator must explain to the patient that it is unacceptable to arrive late, due to health care reasons.
During the epidemic, it is highly probable that a patient may get sick or go into self-isolation — as a contact person. In this case, he will not be able to attend the next medical appointment. Therefore, it is necessary to offer people such format of treatment when all the manipulations can be completed during one visit or when it is possible to discontinue/ postpone the next medical appointment. To make it easier for the doctor to keep to a “treatment per one appointment” pattern, it is recommended to extend the appointment time and the intervals between patients when scheduling.

PROTECTION OF PERSONNEL

The personnel of the clinic should maintain strict personal hygiene. It is necessary to wash hands with soap, hot or warm water for 20 to 60 seconds, treating the skin between the fingers, thumbs, and inner surfaces. It is recommended to use a sanitizer after washing hands.
Since antiseptics can dry out the skin, cause cracks and reduce skin protective functions, it is necessary to actively use hand care products to moisturize skin.
Until the threat is over, we need to follow simple but effective rules: regularly measure the temperature of all employees of the clinic, conduct Covid-19 tests and antibody tests. Strictly warn the staff not to go to work at the slightest hint of acute respiratory viral infection or allergy symptoms and immediately consult a doctor.
Among all the specialists it is the dentist who works in the closest contact with the patient, one of the safety precautions for a doctor is to work in a medical face mask, goggles, or a face shield. Hair also needs to be covered. It is necessary to change the mask every 2−3 hours or as soon as it becomes wet.

If feasible, ensure that necessary conditions are in place for the personnel to take a shower at the end of the working day. If not, recommend them to take shower immediately after they get home.
Employees are not recommended to travel long distances during an unfavorable epidemiological situation. If such a trip did take place, the employee must self-isolate and take a coronavirus test.

PROTECTION OF PREMISES

Infectious agents concentrate on doorknobs, telephone cases, and the front desk.
It is recommended to regularly wipe these surfaces with liquids with an alcohol content of
 70 %

Wet mopping of premises should be carried out at least twice a day, and a full-scale cleaning — at least once a week. During cleaning, it is necessary to thoroughly rinse floors, furniture, equipment, window sills and doors using detergents and disinfectants.
Door handles, telephone surfaces, check-in counters, computer keyboards should be cleaned with particular care. As a rule, these are the main places where infectious agents are concentrated. It is recommended to regularly wipe displays, keyboards, phone cases and equipment with liquids with an alcohol content of 70% or more.
It is necessary to maintain the highest level of hygiene in the doctor’s office  — the place of direct contact between a doctor and a patient.


The boundaries of the treatment area: the surface of the manipulation table, arm boards, dental treatment unit, microscope, chip blowers, individual glasses, dental spatulas and cups for mixing the impression material — must be cleaned and disinfected after each patient, at the end of the shift and as it gets dirty.
In addition to standard procedures, during the pandemic, is required to use bactericidal air irradiators of open and closed type for room disinfection after each patient.
Manufacturers of air conditioners do not recommend using them in public places during epidemics. If there is a carrier of infection in the clinic, the air currents created by air conditioner will accelerate the spread of the virus and help it spread over a larger area than it can do on its own. Instead of an air conditioner, it is better to regularly air out the room and turn on the air extraction system.


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