May/June 2020 | Page 7

Impressions “It was the best of times, it was the worst of times...” by Dr. Stephen T. Radack III, Editor Coronavirus, COVID-19, Wuhan, global pandemic, N-95, social distancing, flatten the curve, national state of emergency, shelter in place, stay at home order, essential or non-essential, hydroxychloroquine and chloroquine, work from home, PPE shortage, postponed, CANCELLED! When I sat at my desk at the office writing my editorial for the March/April issue of the PDJ, I had not heard much about those words above, or maybe only in passing. Now I sit at my desk at home writing because the office is closed, and has been for weeks due Governor Tom Wolf’s order on March19. This is the longest time span I have not done dentistry without being on a vacation or away at a dental meeting. I am not sure how we got here, but like the falling row of dominos, it seemed once the first one was tipped, it didn’t take long for the rest to start falling fast. Right now, there doesn’t seem to be an end in sight. Early in the New Year, we would occasionally hear about the coronavirus, which seemed to be in China. Then it started spreading outside of China and into Europe. People were not only getting sick, but they were dying from this “flu.” I still remember the first time I felt the impact of the fast-moving virus. I received an email from the Commission of Dental Competency Assessments (CDCA) on February 24, noting a worldwide shortage of personal protective equipment (PPE), due to COVID-19 (as it was being referred to more and more), and that it was possible that some of the upcoming spring licensing exams may be cancelled by the dental schools. That email was sent at 2:50 p.m. I was scheduled to exam at two upcoming exams – Case on February 28-29 and Maryland on March 12-13. At 4:59 p.m. I received a second email cancelling the Maryland exam. At this point, as far as we knew the virus was not in the U.S….or was it? The Case exam went off without any issues, except to guard your mask with your life. They had plenty, but wanted to preserve them. The first week and half of March seemed fairly uneventful. I traveled to King of Prussia for the Greater Philadelphia Valley Forge Dental Conference on March 4-6, and the noticeable changes were more use of hand sanitizer and some folks preferring not to shake hands when greeting one another. Close proximity and making contact with hands were thought to be part of the reason the virus was spreading so fast in Europe and other places. The real changes came the following week, as the far away pandemic hit home. Mary and I planned to go to Maryland even though the CDCA exam was cancelled since we both had the time off. Any chance to see one of our daughters, and especially our grandson, was one we could not pass up. During that six-hour trip the NBA and NHL both postponed their seasons. The next day the governor of Maryland sent his employees home until further notice. Schools were cancelled as well for the next two weeks. By the time we headed home on Sunday afternoon, March was truly mad, as the NCAA cancelled – not postponed – the men’s basketball tournament. Wow! During the ride home my phone was blowing up with alerts from PDA Go. When I took the passenger seat I started reading these, and there was much confusion and misinformation being spread about what dentists should do going forward. Folks wanted PDA to tell them what to do. During the next 24 hours both ADA and PDA boards were busy coming up with science-based recommendations for the members. After a confusing Monday (March16) at the office, ADA released its guidelines and recommended dentists suspend elective procedures and only treat emergencies. The same day Governor Wolf ordered the state stores would close Tuesday and all bars and restaurants would close immediately until further notice. The confusion on what to do at the office continued the next three days. Should we start cancelling all patients and only be available for emergencies? Our hygienists wanted to keep treating patients. I decided to clear my schedule of all elective procedures Thursday (March 19) and the following week. By Thursday evening it all became irrelevant as the governor ordered all “non-essential” and “non-life sustaining business” be closed until at least April 6. Wait a minute, aren’t dentists essential? I guess only if someone had an emergency! In a week, everything had changed. Everything in life was now cancelled or postponed and most businesses were closed. The stock market tumbled, losing almost a third of its value in a few days. Soon we were ordered to stay at home except for going to the grocery store and told don’t gather with anyone other than who you live with. The virus was spreading like wildfire and we needed to stay at home to “flatten the curve.” In Erie County we had one known case of COVID-19. I woke up Friday morning, and for the first time in almost 34 years was not able to work and wouldn’t for the next 3 weeks at the earliest. Things got worse and more confusing for dentists on Sunday March 22 when the governor ordered no treatment in our offices unless we had N95 masks and a negative pressure room to work in. Everyone was to be treated as an infected patient. If you didn’t have either then you would need to refer your patients to the emergency room. What? What can the ER do for a fractured tooth or lost crown or temporary? We were also MAY/JUNE 2020 | PENNSYLVANIA DENTAL JOURNAL 5