Dentists say mandating COVID-19 tests for patients before procedures will ‘shut down’ dentistry

(Creative Commons photo by Allan Foster)

When Gov. Mike Dunleavy and state health officials said elective health care procedures could restart in a phased approach, many of Alaska’s dentists were hoping to take non-emergency patients again.

But they said a state mandate largely prevents that from happening. 

State officials said they want to work with the dentists, but point to federal guidelines that dentists are at very high risk of being exposed to the virus.

Find more stories about coronavirus and the economy in Alaska.

The mandate said patients must have a negative result of a test for the coronavirus within 48 hours of a procedure that generates aerosols — tiny, floating airborne particles that can carry the virus. Aerosols are produced by many dental tools, from drills to the ultrasonic scalers used to remove plaque.

Dr. David Nielson is the president of the Alaska Board of Dental Examiners, which licenses dentists. In a meeting with the state, he told state Chief Medical Officer Dr. Anne Zink that it’s a challenge for patients to get test results within 48 hours of an appointment.

“Basically, what that means is, in your view, dentistry is just shut down indefinitely,” Nielson told Zink.

“That’s not true. That’s not what I feel at all,” Zink said.

“Well, that’s what it says to most of us,” Nielson said.

Nielson said dentists can ensure that patients are safe without testing for the virus.

“We do believe that waiting for the availability of testing to ramp up to the levels that would be necessary will jeopardize the oral health of the public,” he said.  

Nielson also said dentists are already taking steps to practice safely and could start taking more patients if they didn’t have to follow the testing mandate. 

“Based on everything that we’re doing with all our, you know, really, really intense screening protocols and all the different PPE requirements and stuff like that, that we’re basically good to go, as long as we do all of the things that we’ve already recommended,” he said.

Zink said Alaska is among the first states to reopen non-urgent health care. She says the state’s testing capacity is increasing, and that other groups affected by the mandate are working to have patients tested. 

“We are seeing numerous groups, including surgeons, stand up ways to be able to get testing available,” she said. 

The state mandate is less restrictive than what’s currently recommended by the federal Centers for Disease Control and Prevention. The CDC said all non-urgent dental appointments should be postponed. The CDC is revising the recommendation, but it’s not clear when there will be new recommendations. 

The dental board would like to replace the mandate with guidelines that require that every patient be screened, including answering questions about their travel, symptoms and contacts before an appointment, as well as to be checked for whether they have a fever before an appointment. 

Zink noted a problem with relying on screening. 

“It’s increasingly challenging to identify COVID patients,” she said. “This is an incredibly sneaky disease that appears to be most contagious in the presymptomatic or early symptomatic people with symptoms that can look almost like anything else.”

The draft framework proposed by the dental board also differs from CDC recommendations on personal protective equipment. The CDC recommends both an N95 respirator and either goggles or a full face shield. The framework said that if goggles or face shields aren’t available, dentists should understand there is a higher risk for infection and should use their professional judgment. 

Dentists working to start seeing more patients say they already take precautions against infectious diseases. 

Dr. Paul Anderson of Timbercrest Dental in Delta Junction said it would be challenging to have timely tests done for patients who live far from an urban center. 

Anderson said dentists have been working to prevent the spread of infectious diseases since at least HIV/AIDS in the 1980s. 

“We’ve been following these protocols, and it just seems odd to me that all of a sudden the government feels that it’s necessary to add all of these additional regulations,” he said. 

Anderson said screening patients — including checking their temperatures — is a significant safety measure dentists can take.

Zink said the state is open to working with the dental board to revise the mandate, or to issue a new mandate specific to dentistry. It’s not clear if the issue can be resolved before Monday, when the state will begin allowing elective procedures under the mandate. 

This content was originally published here.

Pennsylvania teen who tortured dying deer avoids prison sentence; case highlights need for mental health evaluations in animal cruelty instances

This case has set a precedent in Pennsylvania for future wildlife cruelty cases to be charged under Libre’s Law. Photo by Maura Flaherty

A Pennsylvania court this week allowed an 18-year-old to avoid prison time for a crime that shocked Americans when a viral video of it surfaced earlier this year: in the video, the young man and his friend were seen torturing a dying deer, kicking him in the head and even ripping off his antler as the frightened animal cried in pain and tried to escape.

The two young men were charged soon after with felony animal cruelty under Libre’s Law, a landmark 2017 Pennsylvania law that increased penalties for egregious animal cruelty. This was a heartening development, because we often find that in most animal cruelty cases the punishment doesn’t fit the crime, and the new law finally gave Pennsylvania a strong tool to ensure that those who commit such terrible animal cruelty are held accountable. It also set a precedent in Pennsylvania for future wildlife cruelty cases to be charged under Libre’s Law.

This week, the older teen was sentenced to two years of probation and 200 hours of community service after pleading guilty to a misdemeanor charge of cruelty to animals and summary counts of violating state hunting regulations. His hunting license was also revoked for 15 years. The more serious charges, including a felony count of aggravated cruelty to animals that carried a penalty of up to seven years in prison, were withdrawn. (The other teen, who is 17, has been charged as a juvenile).

However one may feel about the outcome, one thing is clear: there is a lot more that remains to be done to ensure that animal cruelty crimes are treated with the seriousness that they deserve.

One of the most disturbing aspects of this case was the apparent apathy of the young men to the pain and suffering of a dying animal: they could be seen laughing as they videotaped themselves on their phones hurting the terrified deer in his final moments.

Research has drawn a clear link time and again between animal cruelty and acts of human violence. It is a link we ourselves have often reported, including in the case of the high school shooter who boasted of killing animals before he shot and killed 17 people in Parkland, Florida. Just last week, we heard of this case in South Carolina where a dog was found shot inside the home of a man facing multiple charges after a domestic violence investigation.

That’s why the Humane Society of the United States is now asking prosecutors in Pennsylvania to consider mental health evaluations and counseling for cases involving such egregious animal cruelty. We are working closely with state organizations, including the State’s Center for Children’s Justice, the Pennsylvania Coalition Against Domestic Violence and the Pennsylvania Coalition Against Rape, to develop a free seminar for law enforcement and social service professionals centered around the important relationship between animal cruelty and family violence.

We are also supporting a state bill, the Animal Welfare Cooperation Act, HB 1655, which will encourage cross-agency partnerships and collaboration that will be particularly helpful with complicated cases under Libre’s Law or investigations that cover multiple jurisdictions. The bill would, among other provisions, allow the office of the attorney general to provide free training for district attorneys and humane police officers on handling complicated animal abuse investigations. In one year alone there are more than 18,000 animal abuse offenses reported in Pennsylvania, and this law would better equip law enforcement agencies to address them.

We need your support to get this bill passed so if you live in Pennsylvania, please call your state lawmakers and ask them to support H.B. 1655. This case also highlights the importance for each one of us to be vigilant and report animal cruelty when we see it happening, so those who cause such intense animal suffering do not have a chance to repeat it.

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This content was originally published here.