Should a vaccine mean a return to life ‘Before-COVID’?
2020 is a year that will live in infamy. The calamity ofCOVID-19 and its effects — both from a public health perspective and an economic perspective -— will linger for years to come. Almost every aspect of our society has been touched by the pandemic — from the way we purchase goods, undertake study, or even meet one another; all have been radically changed. A simple shaking of hands seems destined to be retired from our habits forever. From an oral health viewpoint, what long lasting changes will we see here in Ireland? And how will these changes unfold against the backdrop of Brexit, high unemployment, and continued uncertainty of public health?
To predict the future is always foolhardy, and 2020 handed us a refresher course! However, as COVID-19 research brings news of vaccines, successful clinical trials and high degrees of efficacy, the hope is that a vaccination is just a matter of time. At the beginning of December; the UK approved the use of the PfizerBioNTeeh vaccine. European Union member states are coordinating through the European Medicines Agency, whose scientific committee for human medicines published its assessment on 29 December.
EU countries had the same option as the UK; so-called ‘batch approval’, as opposed to the more overarching ‘market authorisation’ the EU has chosen to pursue – and eyebrows were raised among European regulators at the UK’s jingoistic celebrations (Pfizer is a US company and BioNTech was founded by a German couple of Turkish descent). But, politics aside, long-term immunity, always the goal, appears wlthin our reach — just nine months after this virus wreaked havoc throughout Europe. In thinking about general dental practice in particular, access to dental senrices, the role ofthe dentist, and reaching a nearly normal phase seem worth exploration.
With the restrictions and protocols in place, attendance at the dentist has become very much tied to appointment times. Reduced space in waiting rooms, increased disinfection/cleaning times, augmented cross-infection measures (with PPE) have meant that routine dentistry continued, albeit with lower patient numbers. This concept of ‘block treatment’, where an increased number of scheduled procedures are performed in one sitting has lead to higher productivity per patient visit. The downside here is that patients face a higher per visit spend which, for many; is challenging, particularly as the economy is still very fragile. Despite this, the methodology of higher spend per visit is both financially and clinically prudent. Many dentists plan to continue this practice even when restrictions lift.
The role of the dentist is one which is also worth examining. Do we have a role to play in charting the COVID-19 course? And, in the roll out of any proposed vaccination programme, will private dentists be sequestered to help in the effort? Given the long standing success of pharmacists in administering the routine winter flu vaccine, there is merit in exploring this option — particularly if rapid deployment is of the essence. The meaning of the phrase ‘role ofthe dentist’ can also be thought of in its broader sense too. We are all data processors, cross-infection policymakers and radiological undertakings, to name but a few of the many hats we wear in general practice. We somehow are meant to extract the odd tooth, place a filling and fit a denture along the way too!
In some respects, if this era of COVID-19 is being seen as some kind of reset, then perhaps thought should be given to re-examining these roles also. Each aspect mentioned above, is critical to safe patient care and treatment delivery. Isn’t it time we closely examined how we are absorbing or passing on the associated costs with this critical aspect of treatment provision?
And finally, the nearly normal phase is worth looking at too. All things going well, a safe, dependable vaccine administered to the vast majority of the population should see things return to how life was before March 2020. But will it really? Will the lessons we learned from this dark chapter of our recent history be quickly brushed aside or will we embrace a modified version of life in the years BC (Before-COVID)? Will we continue to embrace Zoom or Microsoft Teams? Will large multinationals abandon office space in Dublin/Cork/ Limerick/Galway forever? How will this affect urban footfall and patient numbers in larger towns and cities? Will online CPD learning replace the usual face-to-face lectures and workshops? Only time will tell the long-lasting impacts and legacy of this pandemic.