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Do You have Your “COVID Card?” Welcome to the new normal. Living and practicing during a pandemic.
Sharon Pollick, D.D.S.
It’s the question we may be asked in the course of everyday exchanges in the future. And we may be requesting the same from our patients once normal commerce has returned. The coronavirus pandemic has brought new challenges around the world, including for healthcare workers everywhere. Healthcare workers have the innate capacity to adapt and use the knowledge we have gathered through evidence-based medicine. We do this to change the way we analyze and treat a patient’s disease, all for the betterment of the public and their health. During this pandemic, experts1 from around the world and in all specialties are leading the way in educating the rest of us who will be following in their footsteps.2 We are using evidence-based dentistry, because that’s what we have been taught. It is the new buzz phrase, synonymous with “Tell/ Show/Do.”3 Proof and Importance of Immunity Americans may one day be asked to show their immunity certificate4 for access to public activities. By, essentially, declaring “I have COVID-19 immunity,” they will be allowed entrance to shopping malls, theaters, cruise ships and into our offices. Such a measure would, at least for the short term, attenuate transmission. The most vulnerable population—those with co-morbidities and over age 65—have accounted for 8 out of 10 deaths in the United States.5 Freeop.org reports that, according to the Centers for Disease Control and Prevention, 2.1 million people live in nursing homes or residential care facilities, representing 0.6% of
the U.S. population. And, yet, residents in such facilities account for 42 percent of all deaths from COVID-19, in states that report such statistics.”6 Countries like Sweden, with a large nursing home population, have weathered the high mortality rate associated with this virus in the elderly,7 while avoiding a stay-at-home order and quarantine8 like what was implemented in New York and many other states. New York State has seen a high mortality rate,9 with at least 5,596 confirmed and presumed COVID-19 nursing home deaths,10 which excludes those who were transferred to hospitals and died. Conversely, Florida, with a high elderly population, has had a much lower mortality rate, comparatively speaking, and their nursing home population has had 1,230 deaths.11 This difference may be attributed to state policies enacted during the pandemic. On the other hand, Swedish epidemiologists predicted that their approach would propel them over the top of the curve to, ultimately, achieve herd immunity in the near future,12 a status no other country has achieved. As of reports from early June, Sweden continues to maintain its plateau. It’s important to understand that in the absence of personal and herd immunity, infection can’t be prevented; quarantining just delays it. This is what many have called “flattening the curve,” or postponing infection and deaths into the future, a measure that would potentially prevent a large spike of cases all at once, which would overwhelm our hospitals and result in higher mortality. Sweden avoided a stay-at-home measure and kept schools and busi-
The New York State Dental Journal
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JUNE/JULY 2020 11
