COVID-19 Update
May 5, 2020
Greetings!

We want to remind members that SFDS is not a regulatory agency – we cannot order members to practice or not to practice. Our responsibility is to provide our members reliable information as soon as we have it so that you can make the best decisions for your practice and your patients. The current information that we have, and that we expect to be amended sometime this week or early next week, is that routine care is not yet appropriate in San Francisco. This, of course, is subject to change and when we learn otherwise, we will immediately share those changes with you.

At the start of our COVID-19 UPDATES and Messages from President Nogueiro we qualified everything with “what is true today, may not be true an hour from now, a day from now, or a week from now.” All one needs to do is listen to the different news conferences from our Governor and our Mayor, and read the many variations on stay at home orders, business resumption orders, essential business provider restrictions, etc., from various county health departments to understand how true this is.

The CDA Board of Trustee’s started meeting weekly throughout this crisis. As a result, we will begin bringing you weekly reports from your trustees, Drs. Duffala and Fitzpatrick.  
CDA Board of Trustee’s Report 5/1/2020

The CDA Board of Trustees met virtually on Friday May 1 st . Both of your SFDS Trustees, Gail Duffala DDS and Courtney Fitzpatrick DDS, were in attendance.

  • The Board of Trustees approved an extension to the delinquency date of membership dues from May 31 to June 30, 2020. The current pandemic is impacting dental practices in many ways, including the ability to pay dues by the previously approved May 31 deadline. This deadline extension aligns with the ADA’s delinquency date and TDIC’s requirement of membership renewal by June 30 to maintain insurance coverage.

  • On the legislative front, the proponents of the MICRA (Medical Injury Compensation Reform Act) initiative have decided to delay submitting their measure until the 2022 ballot.

  • The California Department of Public Health released guidelines on Monday April 27, 2020. Dr. Kumar, our state dental director, is working closely with all the parties involved to create clear language and guidance that dentists may rely on as they begin to reopen their dental practices.

  • The City and County of San Francisco Department of Public Health released an Order of the Health Officer. This 32-page document was released on April 29, 2020 and extends the order to Shelter in Place another 28 days until May 31, 2020, and this order also extends several previous orders including order C19-08 prohibiting most routine appointments and elective surgeries (p 19). 

Generally, the recommendations and guidelines that are provided by the State of California are what we should follow including the State of California recommendations from March 19 th that are still in effect. Only when the local orders and guidelines are more restrictive do they supersede the state mandate.

Currently, we must rely strongly on the CDC and Cal OSHA guidelines regarding our Personal Protective Equipment (i.e. N95s, face shields, etc.). There are still restrictions on aerosol generating procedures. CDA and TDSC are addressing the critical shortages dentists are facing when trying to acquire PPE.

Please do not hesitate to contact your two Trustees with any questions or concerns regarding this report or other issues. Thank you. 
CDA’s Back to Practice Resources , which complements ADA’s Toolkit , is designed to help members prepare for a return to routine care, once PPE becomes more readily available. The resources include: Preparing your Practice, Patient Care, and Practice Management.  
Personal Protective Equipment Shortages

One of the bigger concerns raised by members, in addition to “when can we return to routine care," is the lack of PPE - not just N95s, but also gowns, shields and more. This is a topic of conversation in each of our weekly meetings with CDA and ADA. ADA has been conversing regularly with FEMA regarding PPE supplies for dentistry and TDSC has been chasing down source after source, most of which are not reputable.

Mr. Jim Wiggett, TDCS CEO, reported on a new feature for members: a “wait list” feature. You no longer have to place and pay for an order only to find it backordered. Instead you can mark items to be placed on a “wait list," and when the supplies hit the warehouse, TDSC will reach out to you to confirm if you still need the items before the order and payment are completed. TDSC encourages members to continue to check the TDSC Website for PPE inventory updates and to sign up for product waiting lists.

CDA was quoted in a recent Sacramento Bee feature on Monday, Why CA Dentists Can't Fix Your Teeth Right Now , about the lack of PPE for California Dentists.
ADA Issues Alert

Congress Plans Next COVID-19 Relief Legislations

The ADA issues alert hitting members in-boxes this afternoon asks for members to support their efforts to act on your behalf. As many states begin the reopening process, Congress will also be returning to Washington, D.C. to deliberate on the next legislative package in response to the COVID-19 pandemic. Our 163,000 members came together to ensure that Congress included our dental concerns in the previous package, the Coronavirus Aid, Relief and Economic Security (CARES) Act, and now the ADA needs your help once again!

The ADA is asking Congress to include the following provisions in the next phase of economic stimulus and COVID-19 relief legislation:

  • Give small businesses increased flexibility within the Paycheck Protection Program (PPP) for which they seek forgiveness for the PPP loans. This will allow small businesses to make more appropriate decisions about staffing and payroll based on when they plan to fully reopen.
  • Ensure adequate oversight over the distribution and loan forgiveness provisions in the CARES Act for PPP loans. This will guarantee that only those small businesses that were economically distressed as a result of the pandemic receive the funds and forgiveness.
  • Intensify the production of personal protective equipment (PPE) and focus its distribution to dentists and health care providers who are treating emergency cases or near-emergency cases now and in the future without an adequate supply of N95 masks and face shields. This will help the dental team to continue to practice in a safe environment for themselves and their patients.
  • Provide tax credits or allow PPP funds to be used for the purchase of additional PPE and safety improvements to the office. This will assist financially stressed practices in providing an additional layer of safety and protection.
  • Extend the Department of Health and Human Services’ discretionary authority during public health emergencies to provide targeted liability protections for providers who administer FDA-authorized COVID-19 diagnostic tests within their scope of practice until the end of 2020. This will expand the nation’s capacity to screen patients for COVID-19 outside of already burdened hospital emergency departments.
  • Permit nonprofit dental and medical organizations to utilize the PPP or future small business loan programs. This will ensure that non-profit medical and dental associations can continue to serve as a trusted resource for their health care professionals and patients.

Please click here to let your members of Congress know how important these provisions are for your dental practice, patients and our profession as a whole.
SFDPH Recommending Testing for Asymptomatic Essential Workers

As local COVID-19 diagnostic testing capacity has increased, the San Francisco Department of Public Health (SFDPH) is recommending that SF asymptomatic frontline or essential workers be tested. Click here to read the SFDPH Health Advisory.

N95 Fit Testing Requirements Resource Now Available
 
The N95 fit testing requirements resource, which summarizes the Cal/OSHA requirements, is now available on cda.org .
Delta Dental of CA Announces Financial Relief Program for Dentists
 
The ADA News reports Delta Dental of California “ announced April 27 the details of a $200 million loan program that will provide economic assistance and post-COVID-19 pandemic relief for its independent provider network in 15 states and the District of Columbia." For more information from Delta Dental, click here .  
Viva Online CE - Free for Active SFDS Members
 
  • No charge for Viva webinars for qualified SFDS members
  • Infection control and CA Dental Practice Act courses available
  • Earn live interactive CEU
  • On-demand CE
  • Dental Podcasts
  • Clinical and Practice Management Courses
  • Learn from the comfort of your home
  • World class speakers and clinicians
  • Approved ADA CERP Provider
  • Seats for live webinars are limited
 
If you would like to utilize this useful option and need login credentials, contact the SFDS at 415-928-7337 or membership@sfds.org
What are YOU doing?

CORRECTION : Last week we shared some PowerPoint slides which Dr. Sandy Shih is using to update her infection control training protocols at her office. These slides initially came from Dr. Nicole Rasmussen with modifications from Dr. Shih for her office.
What are YOU doing that is interesting, fun or different during this Shelter in Place?  Have you read an interesting book that your colleagues would enjoy? Give us a quick 4-5 sentence highlight, the title and author. What about a gardening or sewing project? Send us a picture. A favorite or interesting blog post? Share the link.
Quick-links from the SFDS COVID-19 News Page