Valued friends and patients.
We've entered a new phase on the world stage and the dental theater, specifically. My practice, originally under Drs Yeoman and Williams, has safely treated patients for almost 70 years and we in this for the long haul, though we find ourselves hauling down a new and uncertain road! We are taking the steps necessary to safely treat our patients, following guidance from the Public Health Departments and the State of California, as well as observing standards in excess of those recommended by the CDC, which are, IMHO, politicized and inadequate. Overall, we expect to prioritize necessary treatment until further notice. We have put in place systems for patient care, like rotation of treatment rooms, 50-60 minute room disinfection & sterilization downtime between patient visits, specialized vacuum systems and HEPA filtration throughout the office. There are barriers in place, every treatment room has open windows, so it makes it a bit noisy.
I have hired additional employees for patient screening, and Juli does coronal polishing for all patients prior to Carrie's hygiene/perio maintenance visit. If you call the office you should have an employee answer your questions, get a recording or even get me (lucky you!). Regardless, you can text me directly at my cell # 403-9103 in the 805. Feel free to leave a message!HOW WE WILL CONDUCT YOUR APPOINTMENT:
1. Take the ADA self assessment query: Click Here.
Please do not come in if you feel unwell! This includes possibly sick with cold, coughing, fever, recent loss of taste/smell, runny nose, sneezing, headache, diarrhea, or have traveled by plane in the past 2 weeks. We are happy to reschedule with 48 hrs notice.
At the Alamar Dental Center Parking Lot:
1. PLEASE ARRIVE 10 MINUTES EARLY. Call our office from your car, give us your car's description and we may come out to your car for a screening. Alternately you can come to the front door. At the front door you can use the hand sanitizer and a staff member will screen you. Please wear a facemask. We will take your temperature and review your paperwork.
2. We will escort you into our office directly to your treatment room and review your conditions before we start.
4. You will remove your mask and Dr. Mintzer or his hygienist will don PPE before beginning.
FOR ALL APPOINTMENTS:
For patients seen in our office, we will allow 50-60 minutes for individual room turnover (air filtration and disinfection) before another patient is seen. The CDC recently relaxed their guidelines from 15 minutes to zero, nationally, which I believe inadequate.
HOW HELPFUL IS COVID-19 TESTING?
We all want to find out if we, or our patients, are now or have had contact with the COVID-19 virus and can transmit this disease. The tests that are being used are somewhat helpful, unfortunately, but are worth taking anyway. There are two basic types of tests, one (the antigen) looking for parts of the virus itself from nasal swabs (Q-tips) and one from the blood (serous/antibody) looking for antibodies against the disease. The former is more accurate, and can show if you're "shedding" virus from your respiratory tract, but only if the swab is a good sample. If it's not, this may lead to a false negative result. There aren't many "false positives," however, if you get a positive result then you're contagious and may know it! Likewise, you could be asymptomatic and capable of transmitting the virus. The second test type requires a small amount of blood to see if you've had contact with the disease over the past weeks to months but not within the last week or two, when you could be contagious. Again, more false negatives can be produced. Testing really tells us who is already sick/contagious and should be
quarantined but has not been used effectively to locate the asymptomatic
"super spreaders" who are most responsible for infecting others. The
idealized, best way is to have 330,000,000 tests given to everyone in
the country, on the same day, with results given that day, and actions
taken afterwards to quarantine or treat those affected. Unfortunately
NOT a possibility.
INTERESTING FEATURES OF COVID-19
- Facial coverings are crucial and may be more important than hand washing.
- Re-Infection: This is a rare phenomena that has been documented in some 22 cases world-wide, but subsequent disease appears "lighter" than the initial disease. This follows textbook experience with past viral infections, but there is no guarantee that the novel coronavirus will follow the textbook, however, as a case 10/11/2020 in NV illustrates.
- The coronavirus is very large for it's class and contains "proofreading" instructions to maintain the fidelity of its copies. This makes it a generally more stable virus over time and easier to target a vaccine against. By 9/21/2020 a point mutation was observed that led to the substitution of one amino acid in the spike protein for another, making the virus easier to spread, but should not affect the targeting by vaccines, as of yet. The initial report was not peer-reviewed as of 9/25/2020.
- The amount of virus you become exposed to may be very important in that a more massive/extensive exposure may lead to a more severe outcome, all other things being equal.
- Many researchers assume that, given enough time, we will all get either the virus itself or the vaccination, until some point herd immunity is established, at whatever percentage of the population that stabilizes at. A vaccine, if demonstrated to be both safe and effective, doesn't have to protect us completely from this disease, just enough to diminish its worst effects. There is expected to be much confusion arising from competitive vaccine efficacy, as all have been tested against a placebo, rather than each other.
- Predicting how you will respond if you get sick from this virus is evolving and critical. There are the "usual" risk factors but a recent paper from a highly respected journal claimed to show that genes left over from our intermingling with Neanderthals may increase our susceptibility! Zeberg, H. et al. The major genetic risk factor for severe COVID-19 is inherited from Neanderthals. Nature https://doi.org/10.1038/s41586-020-2818-3(2020).
THE POLITICS BEHIND IT ALL?
In multiple reports the CDC has, under the Trump Administration, suppressed or altered staff epidemiologists recommendations , apparently for political gain. This is beyond sad, IMHO, and absent a national set of standards, states are left up to their own devices when it comes to the public health guidance. California appears to have done a pretty good job. Santa Barbara public health seems OK, but there are many data points missing from the records and little guidance regarding management of COVID-19 symptoms and what recovery actually looks like.
Until we meet, be well; these times will pass!
Roy Mintzer, DDS
HELPFUL COVID-19 LINKS:
Santa Barbara Public Health Department
Country & State Comparisons
US - Overall Mortality Rates & COVID Animation
Map - Johns Hopkins Coronavirus Resource Center