Updated May 29, 2020 10:30 PM
During this critical time, the main objective for businesses is to keep people physically separated to reduce the risk of person-to-person transmission of COVID-19.
- Create a plan to increase social distancing between workers, between workers and customers, and between customers
- This might include modifying workspaces such as cubicles, office areas, waiting areas, checkout lines, and other areas where close contact with others is likely
- Designate 6-foot distances. Designating with signage, tape, or by other means 6-foot spacing for employees and customers in line to maintain appropriate distance
- If not possible, consider if the particular job or task could be discontinued for a time
- If job function is essential, have employees wear goggles, gloves, and a mask, if possible
- Modify workplaces to create physical barriers between people (workers and the public)
- Windows, plexi-glass, or physical distance
- Implement new administrative operations for employees, including telecommuting as much as possible and temperature checks.
- Purchase thermometers for daily temperature checks
- Encourage telecommuting and meeting via webinar, if possible
- Discourage in-person group meetings, travel, and large gatherings
- Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other areas where they are likely to be seen.
- Implement new plans to incorporate Personal Protective Equipment (PPE). Educate employees on the proper use of various levels of PPE
- Cloth masks (face coverings) worn by employees are encouraged. They protect customers and other workers
- Avoid surgical masks or N95 respirators as they are needed by healthcare workers
- Increase cleaning protocols and processes as part of your infection control plan, making sure to use appropriate disinfectants.
- Appropriate disinfectants can be found HERE
- Set up a cleaning schedule and clean common and frequently used areas such as doorknobs
- Stock hand sanitizer and sanitizing products. Have anti-microbial soap and water or hand sanitizer and sanitizing products readily available for employees and customers
- Increase support for employees to remain at home if they are unwell or have been in close contact with those who are sick.
- Evaluate if you can provide employees more sick leave or family medical leave if necessary
- Limit punitive actions for individuals that need to be absent from work
Partner with the Health Deparment by implementing measures to prevent the spread of disease
- Tell employees to dial 2-1-1 United Way of the Plains if they have COVID-19 questions or if they have any COVID-19 symptoms and want to be tested at no cost at the Sedgwick County Health Department drive-through sampling site.
- Employers with questions or concerns can dial 2-1-1 United Way of the Plains or 316-660-7300 Sedgwick County.
- The Health Department receives COVID-19 laboratory results and:
- Contacts people who are close contacts of a person who is COVID-19 positive, ensures they are tested, and places them on quarantine. People can request a return to work letter.
- Contacts people who test positive for the coronavirus and places them in isolation until 72 hours after symptoms stop or seven days after symptoms start, whichever is longer. People can request a return to work letter.
- Contacts employers if a person who has COVID-19 was contagious while at the business or if there is reason to believe the person became infected while at the business.
What Steps Can We Take to Protect our Dental Providers, staff and patients?
- Front office staff and any other staff not providing direct patient (or times between providing patient care) should wear a face covering during work hours. All infection control best practices recommended by OSHA and CDC during the pandemic should be followed.
- 16.20 OSHA created interim guidance for dental health care workers including the addition of a Respiratory Protection protocol (29 CFR 1910.132) and how to implement the protocol. https://www.osha.gov/SLTC/covid-19/dentistry.html
- Respirator Protection Flexibilities can be found in the “Control and Prevention” page of https://www.osha.gov/SLTC/covid-19/controlprevention.html#ppe_considerations
- 1.20 The CDC recommends limiting services to emergency visits only during the time of the pandemic-no elective procedures, surgeries, and non-urgent dental care. This action helps offices to preserve PPE and keep staff and patients safe.
- “There are currently no data available to assess the risk of SARS-CoV-2 transmission during dental practice or to determine whether DHCP are adequately protected when providing dental treatment using Standard Precautions. To date in the United States, clusters of healthcare workers positive for COVID-19 have been identified in hospital settings and long-term care facilities, but no clusters have yet been reported in dental settings or personnel.”- https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html
- 4.20 Kansas dental offices are allowed to reopen and start practicing dentistry per Phase 1 of Governor Kelly’s recovery plan. (Industry standards are recommended to be followed and can be found on the Governor’s website.)
- 7.20 ADA released toolkit for opening dental offices during the pandemic for non-emergent dental treatment.
- 11.20 Kansas Dental Board sends letter to all Kansas dentists stating the Governor’s Office has changed their FEMA level to a level 7, allowing for dental offices to request PPE through local emergency management departments.
- 12.20 KDHE and KDEM released a statement that only face shields can be supplied to dental offices due to limited PPE stock pile in the state.
Infection Control During Check-In
- Post signs at the entrance asking people not to enter if they have symptoms of respiratory infection. Reschedule appointments after the patient recovers. A patient should be fever free for at least 24 hours without using any fever reducing medications.
- Evaluate patients with detailed questions prior to treatment about flu-like symptoms, travel abroad for self and family/friends, and use a thermometer to take their temperature. Check KDHE self-quarantine guidelines to determine which patients/staff without symptoms should be rescheduled.
- Post signs throughout the facility, encouraging hand hygiene, respiratory etiquette (cover your cough and sneeze), and avoiding touching your face with unwashed hands. Post materials in the languages used by the populations you serve. Print materials are available here on the CDC website or from the Sedgwick County Health Department
- Have fact sheets available for patients.
- Regularly clean and disinfect counters, waiting areas, and other high-touch surfaces in public areas with an EPA-approved disinfectant. Wipe all areas patients or staff have come into contact with after the patient or staff member has finished his/her business in the areas(s).
- Place alcohol-based hand sanitizer next to the checkout window so people can sanitize their hands before and after using common items, like the pens used to sign-in.
- Keep pens for clients separate from your own and clean them daily or give new pen to each patient to keep after use.
- Remove magazines, toys, etc. from waiting area and treatment rooms to prevent contamination.
- Place alcohol-based hand sanitizer at all entry points and key points in the dental office.
- Consider ways to limit waiting room time by staggering appointments or asking patients to wait in cars until called.
Infection Control during Dental Treatment
- Ensure all staff members are using personal protective equipment properly; i.e. face shield, eye protection, correct N95 respirator/ASTM level 3 surgical mask, gown, and hair covering, and gloves
- N95 respirator are recommended and will require a fit test to determine size and brand of respirator dental staff will need to safely provide treatment to patients
- KN95 masks are not encouraged for use due to many are counterfeit and have been removed from the FDA list of approved masks.
- If an N95 respirator is not available, please follow OSHA and CDC guidelines for safely providing dental treatment
- Follow OSHA and CDC guidance for donning and doffing PPE for patient treatment
- Ensure dental staff is practicing best practices for hand hygiene throughout the day
- Use rubber dam isolation and high volume suction when possible to limit aerosols during procedures.
- Use a 1% hydrogen peroxide rinse prior to examination of the oral cavity by the patient to reduce microbial load.
- Ensure proper sterilization practices for all equipment and dental instruments per industry standards. (Cold sterile is not encouraged or recommended for infection control practices.)
Business Continuity of Operations Plans
- The American Dental Association recommends dentists postpone elective appointments for three weeks as soon as logistically possible. Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.
- Develop or review business continuity plans for how to keep critical services going if staffing levels drop due to illness or taking care of ill family members or friends or children that may be temporarily out of child care or school settings.
- Be prepared to change your practices as needed to maintain critical operations (e.g., prioritize clients or temporarily suspend some services if needed).
- Ensure you have adequate supplies of soap, paper towels, tissues, hand sanitizers, cleaning supplies, and garbage bags. If possible, a supply of disposable gloves and paper facemasks may be useful if persons become ill while at your facility.
- You can find more information on organizational preparedness on the CDC website
Prepare Staff, Volunteers, and Clients
- Ensure sick leave and other polices are in place to support staff to stay home if needed. Do not require a healthcare provider’s note as this will put more stress on the providers’ offices.
- Share information on continuity planning with staff and volunteers.
- Create a cleaning schedule so staff are regularly disinfecting touched surfaces such as doorknobs, handrails, bathroom fixtures, countertops, work stations, tables, and chairs.
- Staff should monitor Sedgwick County Health Department and KDHE websites (see online resources below) to understand COVID – 19 activity in their community.
- Sign up for Clinical Outreach and Communication Activity Updates from the Centers for Disease Control and Prevention (CDC) with upcoming guidelines for dental practices.
- Report unusual patient and staff complaints, surges in symptoms of fever, cough, or respiratory distress to the Sedgwick County Health Department at 316-660-7300.
- Call United Way at 2-1-1 for COVID-19 testing. Health care workers may be tested with no symptoms present at no cost to the individual if tested at the Sedgwick County Health Dept.
Suggested COVID-19 Preparedness Checklist for Businesses
Adapted from the Lear Safe Work Playbook
Dated Completed/ Reviewed
Create an internal response team to review operations and coordinate response. Include diverse employees with different trainings and educational backgrounds, if possible.
Create a plan for when employees are quarantined because they are a close contact of a person who is COVID-19 positive and also for employees that need to be isolated because they have tested positive. The plan should include contact with the health department and how to manage multiple workers out of the office.
Provide open and transparent communication with all customers and employees.
Create a social distancing protocol for customers and employees.
Review sick leave policies. Determine if incentives or flexible options are available to encourage employees to stay home when they are sick.
Identify possible work-related exposures and health risks to employees. OSHA has more information on how to protect workers from potential exposures to coronavirus.
Create policies and procedures for using and stocking preventative materials such as cleaning supplies, thermometers, and cloth masks and gloves.
Create an on-site pre-shift health screening procedure for employees to monitor for illness, including fever, recent travel, and any contact with a COVID-19 case.
Create a protocol for visitors and contractors to self-screen prior to entry.
If applicable, create a protocol for safe transportation of employees or customers.
American Dental Association: https://www.ada.org/en
Sedgwick County Health Department: https://www.sedgwickcounty.org/health/coronavirus-disease-2019-covid-19/
Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/index.html
Kansas Department of Health and Environment: http://www.kdheks.gov/coronavirus/index.htm
Kansas Dental Association: https://www.ksdental.org/
Kansas Gov. Kelly Ad Astra: A Plan to Reopen Kansas: https://covid.ks.gov/ad-astra-a-plan-to-reopen-kansas/
- Industry Guidance document: https://covid.ks.gov/wp-content/uploads/2020/04/Business-Guidance.pdf
Lear Safe Work Playbook: https://www.lear.com/Site/Company/Safe-Work-Playbook.aspx
OSHA COVID-19 Guidance: https://www.osha.gov/SLTC/covid-19/