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CHICAGO — Oral health can be a concern for people who are sheltering at home.
Dentistry is defined by close contact with patients, and distancing in the era of COVID-19 poses new challenges.
From the air down to the water, a local doctor is bringing high tech infection control to his neighborhood office.
When news of the virus shutting down China made its way to the U.S, Dr. Michael Czarkowski sunk his teeth deep into research.
“We’ve got to come up with a plan and I’m a pro-active person so I tried to figure out what do I have to do in my practice to protect my patients, my team and my family,” he said.
The dentist who typically sees 80 to 100 patients a week now sees about five for emergency procedures only.
And with worries about COVID-19, the phone isn’t exactly ringing off the hook.
“I can just tell some people are nervous,” he said. “But once they see what we’ve done, I can see their anxiety level diminish.”
Air filtration system bathed in UV light cleans particles from the air. The office has its own heating and cooling system.
“We can control the air coming in so we have kind of a positive pressure system you’d see in a hospital operating room,” Czarkowski said.
In the dental chair, droplets are an occupational hazard.
“We have to deal with patients as far as aerosols,” he said. “When we prepare teeth we drill, we create an aerosol. How are we going to control that? What’s the best thing we can do?”
Czarkowski said they use a unit that “takes the aerosol we create when we prepare a tooth for a filling, a crown or a bridge, and sucks it through the machine and runs it through a series of filters.”
Any aerosolized droplets are filtered through a medical grade system that eliminates virus bacteria and mold particles and vented out of the building.
“These units we can rotate the air and clean the air 16 times per hour,” Czarkowski said.
With all the new tools in place, Czarkowski hopes the high tech will ease some of the pain when it comes to a visit to the dentist.
“They know me. They trust me. They expect me to provide and take care of them,” he said. “I take that responsibility seriously.”
All the new technology and the necessary PPE adds up. Czarkowski said he will have to consider an infection control fee to cover the added costs.
“Notable increases” in deaths were seen in March and early April, the team led by the Yale School of Public Health found. This was especially true in New York and New Jersey, states hard-hit by the pandemic.
The study was first reported by the Washington Post.
Using data from the Centers for Disease Control and Prevention, the team found about 15,000 excess deaths from March 1 to April 4. During the same time, states reported 8,000 deaths from Covid-19. “That is close to double,” Dan Weinberger, who studies the epidemiology of infectious diseases at Yale, told CNN.
The team could not show whether the increased deaths were due to coronavirus, Weinberger said. But there are strong indications that they were. For instance, the team also looked at data on doctor visits.
“What we see is that in many states, you see an increase in influenza-like illnesses, and then a week or two later, you see an increase in deaths due to pneumonia and influenza,” Weinberger said. “It provides some confirmation that what we are seeing is related to coronavirus.”
Plus, in especially hard-hit states such as New York and New Jersey, where coronavirus is known to have spread widely and infected many people, overall deaths were far in excess in what would normally have been expected in March.
“In New York City, this discrepancy was even more stark, with three to four times as many excess all-cause deaths as pneumonia and influenza deaths,” the team wrote.
Some states, such as New York, seemed to keep up with the Covid-19 deaths. The state reporting of deaths in the pandemic closely tracked what the Yale team found. But others did not.
The new coronavirus causes respiratory disease, and deaths would presumably be listed among the regular reports of deaths and illness from pneumonia and influenza. But doctors are increasingly reporting other, sometimes fatal, symptoms from Covid-19, including strokes, kidney failure and heart damage.
Patients already weakened by pre-existing conditions such as diabetes, cancer and heart disease may have had a death listed as being due to one of those causes, rather than coronavirus.
Plus, it’s possible that coronavirus lockdowns would have led to a lower-than-average death rate. For instance, if fewer people were driving, traffic deaths could be expected to fall, Weinberger said.
So Weinberger’s team looked at both deaths from pneumonia and influenza, and deaths from all causes.
“We decided to look at all deaths from pneumonia, or all deaths overall, and see how those numbers were changing,” Weinberger said.
The CDC tracks deaths from pneumonia and influenza by the week, and compares them to a baseline of deaths to keep tabs on the annual epidemic of seasonal flu. Separately, the National Center for Health Statistics, part of the CDC, keeps data on all reported deaths.
The Yale-led team subtracted the
SARS-CoV-2, the causative agent of COVID-19, spreads efficiently, with a basic reproductive number of 2.2 to 2.5 determined in Wuhan1,2. The effectiveness of control measures depends on several key epidemiological parameters (Fig. 1a), including the serial interval (duration between symptom onsets of successive cases in a transmission chain) and the incubation period (time between infection and onset of symptoms). Variation between individuals and transmission chains is summarized by the incubation period distribution and the serial interval distribution, respectively. If the observed mean serial interval is shorter than the observed mean incubation period, this indicates that a significant portion of transmission may have occurred before infected persons have developed symptoms. Significant presymptomatic transmission would probably reduce the effectiveness of control measures that are initiated by symptom onset, such as isolation, contact tracing and enhanced hygiene or use of face masks for symptomatic persons.
SARS (severe acute respiratory syndrome) was notable, because infectiousness increased around 7–10 days after symptom onset3,4. Onward transmission can be substantially reduced by containment measures such as isolation and quarantine (Fig. 1a)5. In contrast, influenza is characterized by increased infectiousness shortly around or even before symptom onset6.
In this study, we compared clinical data on virus shedding with separate epidemiologic data on incubation periods and serial intervals between cases in transmission chains, to draw inferences on infectiousness profiles.
Among 94 patients with laboratory-confirmed COVID-19 admitted to Guangzhou Eighth People’s Hospital, 47/94 (50%) were male, the median age was 47 years and 61/93 (66%) were moderately ill (with fever and/or respiratory symptoms and radiographic evidence of pneumonia), but none were classified as ‘severe’ or ‘critical’ on hospital admission (Supplementary Table 1).
A total of 414 throat swabs were collected from these 94 patients, from symptom onset up to 32 days after onset. We detected high viral loads soon after symptom onset, which then gradually decreased towards the detection limit at about day 21. There was no obvious difference in viral loads across sex, age groups and disease severity (Fig. 2).
San Antonio – A Northwest Side dentist said he welcomed Monday’s news from Gov. Greg Abbott about allowing dentists and doctors to reopen, but he admits it’s going to be a little bit of a process to open back up.
Dr. Willie Cantu, who owns Smile Solutions in the 13100 block of Northwest Military Drive, said he will probably will start seeing patients Monday.
Cantu said he and his staff will review their supply of personal protection equipment to make sure they have everything they need.
Texas Gov. Greg Abbott has released his plans to reopen Texas. Here’s what we know
He also said they will probably use their parking lot as a virtual waiting room to make sure social distancing is practiced.
“Today was welcome news, but we’ll have to certainly take baby steps to kind of get back started again because it’s been a bit,” Cantu said. “And, we got to get a lot of folks in, and hopefully everybody remains patient and understanding that we’re trying to work through, you know, some real difficult times with keeping everybody safe while still trying to treat patients.”
Cantu said he understands there will be some patients and staff members who may not be comfortable coming back but he said he’s ready to go back to work and his office will be operating in a way to keep his patients and staff safe.
COVID-19, the respiratory disease caused by the new virus, stands for coronavirus disease 2019. The disease first appeared in late December 2019 in Wuhan, China, but spread around the world in early 2020, causing the World Health Organization to declare a pandemic in March. The first case confirmed in the U.S. was in mid-January and the first case confirmed in San Antonio was in mid-February.
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WASHINGTON, April 14, 2020 /PRNewswire/ — The Emergency Medicine Foundation, a 501(c)(3) nonprofit organization founded by the American College of Emergency Physicians (ACEP) to advance research and education in emergency medicine, has recently announced that it will award up to $100,000 in new research grants to further the medical community’s understanding of and response to the novel coronavirus, COVID-19.
“Emergency Medicine Foundation sponsored research has been defining and refining the practice of emergency medicine for almost 50 years, and it is imperative that we act immediately as new threats, like COVID-19, arise,” said David Wilcox, MD, FACEP, Chair of the EMF Board of Trustees.
Through these funds, the Emergency Medicine Foundation and ACEP seek to effect quick and meaningful change by advancing emergency patient care, improving how our health care system responds and ensuring that our health care workers are protected during this and future pandemics.
Proposals are due June 5, 2020 and eligible applicants must be a United States-based emergency physician as principal or co-principal investigator with a project active and in place by July 1, 2020. Proposal topics may include, but are not limited to, the following:
Click here to read the request for proposals.
The American College of Emergency Physicians (ACEP) is the national medical society representing emergency medicine. Through continuing education, research, public education and advocacy, ACEP advances emergency care on behalf of its 39,000 emergency physician members, and the more than 150 million Americans they treat on an annual basis. For more information, visit www.acep.org and www.emergencyphysicians.org.
The Emergency Medicine Foundation (EMF) is a 501(c)(3) nonprofit organization founded in 1972 by visionary leaders of the American College of Emergency Physicians (ACEP). EMF supports scientifically rigorous research and education that improves the care of the acutely ill and injured. To date, EMF has awarded more than $17 million in research grants to advance emergency medicine science and health policy. For more information visit www.emfoundation.org. Companies or individuals interested in contributing to support emergency medicine research can contact Peggy Brock, EMF Executive Director, at [email protected].
SOURCE Emergency Medicine Foundation
Dr. Denis Vincent was in the business of smiles.
His patients say he was a talented dentist, but remember him most vividly for his gift of making others feel good.
“You knew he had competency, but he was also a people person. He made you feel at ease,” said longtime patient Anne Bethune. “You know when people have that extra gift with their chosen profession? I didn’t spend a lot of time in his chair, but in that time, he nailed personal connection.”
Bethune, whose three sons also saw Vincent, first learned of his death when a friend she had referred to his Vancouver, British Columbia, practice texted that he was believed to be the province’s first COVID-19-related death. He was 62 and had no known pre-existing conditions.
A father of two sons, Vincent was also an avid skier and sailor.
“He gave me hope. This is a tragic loss for our community.”
Bethune occasionally spoke with him in the chairlift line at Whistler Blackcomb, a mountain resort about two hours north of Vancouver.
“He had a gifted memory. He genuinely took an interest asking about my boys,” Bethune said.
Linda Galasso, another of Vincent’s patients, says she was as charmed by him as she was pleased by his talent as a dental surgeon.
Also see: Testing for COVID-19 antibodies could be a ‘game-changer’ for the economy but it’s still too early to tell
“He was the most caring doctor I’ve ever had,” Galasso said. “He became a facilitator of my health. He said: ‘I know I can help you get better.’ And he did. He gave me hope. This is a tragic loss for our community.”
Galasso, who saw Vincent about three times a year, was surprised to discover during one visit that her patient file contained a detailed and beautiful hand drawing of her bite.
“The care he put into his work was amazing,” she said.
In conversation with office staff, Galasso learned that Vincent drew the bite of each patient and that his approach had inspired many others in his profession.
Vincent also seemed to have an innate sense of what makes any office a great place to work, Bethune said.
“It was him. The staff was lovely and loyal to him. He chose well, they were each personable, positive, upbeat personalities. They were happy to be there and made going to the dentist a reasonable experience.”
Vincent, who died at home on March 22, was among about 15,000 dentists who had recently attended the Pacific Dental Conference.
Read more stories of the lives lost to COVID-19
After his death, friends observed to the media that he was self-isolating, as directed, and that he had avoided going to a hospital for fear of burdening the health care system as a pandemic was unfolding.
Family lawyer, Bettyann Brownlee, reflected on her longtime client’s legacy: “[he will] be greatly missed. In addition to being a gifted dentist, he had a
Philadelphia Eagles owner Jeffrey Lurie today announced a $1 million contribution to Penn Medicine to establish the COVID-19 Immunology Defense Fund, laying the foundation for the world’s foremost experts to fight the novel coronavirus pandemic.
The funds will support both an emerging research program to test front-line health care workers for potential immunity to COVID-19, as well as provide flexibility for Penn Medicine’s researchers–who have overseen the world’s most seminal advances harnessing the power of the immune system to fight disease–to develop real-time research protocols to battle the disease.
The contribution provided by Lurie offers the opportunity for Penn’s leaders to address critically emerging needs as the pandemic evolves. Top priorities range from developing rapid diagnostic testing, to finding drugs that work against the virus, to developing potential vaccines. In the coming days, serology tests will be deployed across multiple research studies, including for health care workers and recovered COVID-19 patients, helping scientists to determine if a person has antibodies against the virus, which could help to enhance hospitals’ knowledge about which staff may be immune to the disease. These critical projects will enhance understanding of how to protect frontline health care workers, and drive knowledge to advance options for treatments and vaccines in the crucial months ahead.
We are in the midst of a humanitarian crisis that is affecting all of us in so many ways. Every passing day brings new stories of heartbreaking tragedy, inspirational courage, and hopeful innovation. We can and will get through this, but only if we work together, care for each other, and focus our attention and resources towards sustainable strategies. There are so many individuals and organizations who are making daily sacrifices, and we are incredibly thankful for their dedication and bravery. We must continue to support these efforts in every way that we can, while also seeking a solution that will help us move forward.
We have reached a critical point in our fight against COVID-19 in which testing for antibodies is absolutely essential both to protect our front-line workers in the short term and to develop treatments and vaccines that will save lives and help defeat the virus. With that in mind, I am proud to offer my support to Penn Medicine’s research efforts by establishing the COVID-19 Immunology Defense Fund. This fund will aid Penn’s multi-disciplinary approach in immunology, merging research in diagnostics, therapeutics and vaccine development. Researchers from those three areas will work hand- in- hand and rely upon one another to create an immediate and lasting impact both locally and worldwide.”
Jeffrey Lurie, Philadelphia Eagles owner
Armed with the largest single-institution immunology community in the country, Penn has notched a string of U.S. Food and Drug Administration approvals for immune-based therapies in the past three years. Penn’s best-in-class infrastructure — from well-established bench-to-bedside pipelines, to high-level biosafety facilities to test treatments with live virus– has led its immunologists to international renown for the discovery,
EDWARDSVILLE — When an email from the Illinois State Dental Society recommended for dental offices in the state to shut down for two weeks starting March 17, Glen Carbon dentist Dr. Briana Oller’s thoughts were on her patients at Simply Smiles.
“I was very scared. I was very nervous for my employees. I was nervous for my patients, who I wasn’t going to be able to serve. I was nervous for myself. How was I going to be able to make the bills of my business and the personal bills,” Oller said.
Those fears became secondary when Oller, 42 with no underlying issues, was diagnosed with coronavirus on March 30 after battling a headache, fever and loss of taste and smell. She was tested on March 26, nine days after a headache started.
“We don’t know where I got this. We have no clue,” said Oller, who hasn’t traveled outside the country. “We now know I’ve had my symptoms since March 17. We believe exposure occurred sometime around March 13 somewhere in the community because my mom is also positive for the coronavirus. She has followed a similar timeline but started a day later than me. The last time we were together was March 13. It is in our community and it has been this whole time.”
All of Oller’s patients and staff were made aware of the diagnosis and none have shown any symptoms. Her mom is also on the road to recovery.
Oller has been recovering from her home with her two daughters, who haven’t shown any symptoms.
All of Oller’s symptoms have subsided except the fever, which is hovering around 100.5 degrees. The highest it reached was 101.9 degrees.
“I’m getting stronger every day and it’s no longer up and down like it was. The breathing is so much better. I feel like the worst part is beyond me,” Oller said.
As of Sunday, Madison County was reporting 48 cases of coronavirus, including six females in their 40s, with 13 hospitalizations and 12 recoveries.
Late Thursday morning, Oller used a 10-minute Facebook video to share her emotions through the journey. As of Sunday afternoon, it has been viewed approximately 69,500 times and with over 2,800 shares.
“It actually was very hard for me to post because I’m a pretty private person, but I was
Good dental hygiene might not be in the front of your mind in the middle of the COVID-19 pandemic.
That could change quickly if you develop a painful cavity and can’t get in to see a dentist.
“I understand that this isn’t the most normal of times, but it’s very important to control the things we can right now,” H. Dieu Luong, DDS, a New Jersey-based dentist, told Healthline. “On a long list of things in these trying times is oral care.”
Generally speaking, dentists’ advice is to maintain a daily routine of brushing teeth and flossing to prevent tooth decay.
“The main objective is very simple: plaque control,” Daniel Rodda, DDS, owner of Oasis Dental Care in Flagstaff, Arizona, told Healthline.
He advises brushing teeth twice daily and flossing once per day.
“If you haven’t already, make the switch to an electric toothbrush — and brush your teeth for 2 minutes,” Faraj Edher, DDS, a prosthodontist in Vancouver, British Columbia, Canada, told Healthline. “This has shown to offer the highest levels of oral hygiene, which is crucial at a time when you aren’t seeing your dentist or hygienist for cleanings and checkups.”
Rinsing with a non-alcohol-based mouthwash twice a day also can help reduce plaque buildup leading to inflammation of the gums (gingivitis).
“The oral microbiome is a key component of the immune system,” Mark Burhenne, DDS, founder of AsktheDentist.com, told Healthline. “Mouthwashes high in alcohol or toothpastes with bactericidal components in them, like triclosan or other antibacterial ingredients, can greatly disrupt the health of the oral microbiome.”
“During this time, it’s best not to use any mouthwash or toothpaste that is meant to kill oral bacteria,” Burhenne said. “Your best bet is to use a hydroxyapatite toothpaste, which is less bactericidal than fluoride but rebuilds tooth enamel equally as well.”
Other dentists also recommend the use of fluoride-based toothpaste.
What you eat is also important.
Chris Strandburg, DDS, a spokesperson for Waterpik, advised avoiding excessive snacking — a habit that’s all too easy to adopt when dealing with the stress and boredom inherent in self-quarantining.
“Starchy foods or drinks lead to acid in our mouths, which dissolves tooth surfaces,” Strandburg told Healthline. “The more often our teeth are bathed in these acids, the weaker and softer they become.”
Burhenne also recommended avoiding non-fiber carbohydrates — “which act just like straight sugar and contribute to plaque buildup” — as well as adopting a Paleo-type diet and avoiding processed foods, if possible, to protect oral health.
Good hydration also is important for oral health, dentists agree.
“Resist turning to unhealthy habits to