Dealing with the Coronavirus Pandemic

Monday, 16 March 2020 10:07
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Is your area free from Coronavirus cases?  Have you taken the proper precautions to protect your patients?  Have you taken the proper precautions to protect your team?  If not, maybe this pearl can help.


The Coronavirus infects both animals and people and can cause a wide range of illnesses from the common cold to lung lesions and pneumonia.  It seems to spread easily from person to person, especially in homes, hospitals and other confined spaces such as professional offices. The pathogen can travel through the air, enveloped in tiny respiratory droplets that are produced when a sick person breathes, talks, coughs or sneezes.  Hundreds of thousands of cases exist throughout the world with thousands of deaths.  As of this writing the US has about 4,000 known cases with about 70 deaths.  To slow down the course of this virus, the federal and state governments have declared that gatherings of more than 50 people are illegal; it may become less than 50.  This pandemic is a serious matter and your practice must take certain precautions.


Scheduling:  In the USA human gatherings are limited to 50 or less people.  In other countries there are other limits, but these suggestions still apply.  The maximum 50 count includes both patients and staff, so if you have 5 to 10 staff, you can have 45 to 40 patients at one time.  Most practices see between 30 and 80 patients spread out over an 8-hour day.  The most crowded times are in the early morning and late afternoon.  After reviewing many busy client schedules it seems that between 10 and 20 patients are seen within any one-hour period for a single doctor Tx day and between 15 and 25 on a two-doctor Tx day.  Bottom line, almost all practices meet the less-than-50 gathering criteria.  Should there be more, you might want to thin it out with more weeks between appointments or by expending the afternoon rush over a longer treatment day.


Distancing:  Keeping your staff more than 6 feet from your patients is impossible, but can be safe if you take the proper precautions.  Keeping your chairs more than 6 feet apart is also difficult, but if you have many chairs use every other chair if possible.  Spread out your “on deck” chairs or limit the amount of patients on deck.  Remove some of your reception area chairs and spread the remaining chairs about three feet apart.  Important, do not allow parents/friends of patients to be in the operatory.  For ultimate distancing, have the patient/family wait in their car and call the patient by text/phone when ready to seat him/her in the clinic.


Precautions:  Following all of the usual OSHA guidelines is important to protecting your patients and team from infecting each other.

  • Don’t use a handpiece, it spreads saliva many feet from the patient’s mouth and is hard to clean up on floors, walls, vertical surfaces, you, etc.
  • Place a breathable napkin/cloth over the patient’s mouth when not working in that open mouth.
  • Sterilization of instruments, supplies, etc. is important and is probably under control, but should be checked out.
  • Store supplies (archwires, etc.) away from the chair where they can become contaminated.
  • Wipe the entire chair, counter, light and keyboard surfaces with disinfectant after every patient.
  • Use facemasks (mainly to protect your patients from you spreading the virus) and use protective eyewear.
  • Use personal protective clothing (PPC).  Wear uniforms while in the office and change into personal clothing before going home.  Wear disposable protective coveralls if desired and discard them at the end of the day.
  • Have ALL staff wear gloves, especially the receptionist and TC.
  • Carefully handle any across toe counter payments and put them in a zip-lock envelope to be sprayed before posting later on.


Screening each patient:

  • If possible, measure every patient and family member for a fever when they arrive at the office.  Ask everybody if they have had a fever, a dry cough, fatigue and difficulty breathing or shortness of breath within the past two weeks.
  • Do the same for your team at the start of the day.
  • If not at the door, measure the patient for a fever when they are seated at the chair.  Ask every patient if they have had a fever, a dry cough, fatigue and difficulty breathing or shortness of breath within the past two weeks.
  • If there is an obvious problem, call the patient’s MD for a Coronavirus test and maybe call the patient’s parent/spouse.


Do whatever realistically needs to be done in your special situation to protect your team and patients from infection; this might include canceling patients for a few weeks.


Frankly, maybe the ideal solution is to just shut down for 2-3 weeks and get short term funding to deal with staff salaries if needed!


Dealing with a practice Financial Downturn:

This message is directed to practices who have been mandated to close or are voluntarily closing for many weeks and are having a financial setback in cash flow.  If so, consider the following:

Get a 90-day extension on your April 15th estimated taxes and/or possibly skip/reduce your June quarterly payment if a drop in income.

Have your team members go on unemployment and only pay the difference between their unemployment pay and usual weekly pay.

Loans help spread out the financial burden over many months instead of weeks ("flatten the curve").

Get a loan from your P&PS, 401K, etc. and pay it back over better times.


I hope that this simple advice helps you to get through this pandemic safely.

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