COVID-19 and dentistry: Australian and New Zealand embrace uncertain future
SYDNEY, Australia: For much of 2020 and 2021, Australia and New Zealand fared remarkably well in containing the spread of SARS-CoV-2—a function of factors including their geographic isolation and the near cessation of international travel. Recent months have seen both nations face outbreaks of the highly contagious delta variant, leading to widespread lockdowns and reduced access to dental services. Since leading governmental figures have admitted that elimination of this variant is impossible, state and regional governments have slowly begun to ease certain restrictions, including those placed on healthcare personnel.
In Australia, a temporary stay-at-home order that was issued for large parts of the state of New South Wales (NSW) on 26 June was lifted yesterday, since 70% of its adult population is now fully vaccinated against SARS-CoV-2. Hospitality businesses, including pubs, cafes and restaurants, as well as many retail businesses, are now able to reopen for vaccinated customers. Unvaccinated people are only able to access critical services like grocery stores and pharmacies.
Prior to yesterday, the NSW branch of the Australian Dental Association (ADA), in line with guidance from the Dental Council of NSW, advised dental practitioners to take a risk-based approach to providing dental care, recommending deferring non-essential treatments unless a delay would lead to adverse patient outcomes. Given the high vaccination across the state, ADA NSW now supports the safe provision of the full range of dental care by practitioners in the state provided they have undertaken appropriate risk-based screenings, a spokesperson told Dental Tribune International. Dental staff and patients are still required to wear appropriate personal protective equipment (PPE) when possible.
Victoria moves toward milestone
Though new daily COVID-19 cases in NSW have dropped significantly from the record 1,603 cases recorded on 11 September, case numbers in Victoria continue to hover just under 2,000 per day. Large parts of the state remain in lockdown and have a curfew in place between 9 p.m. and 5 a.m. Its capital, Melbourne, recently claimed the unenviable record of having spent the most days in lockdown since the pandemic began.
Currently, dental practitioners in Melbourne, Mitchell Shire and Mildura are only “permitted to provide dental services in management of patients with urgent needs or care where failure to do so in a clinically appropriate time frame will lead to adverse outcomes,” according to the Victorian branch of the ADA. Urgent treatment for confirmed or likely SARS-CoV-2-positive patients is required to be conducted in an acute care environment with an oral and maxillofacial surgery registrar present, these guidelines state.
It is not all doom and gloom for the southern state, however, as it is expected to have 70% of its adult population fully vaccinated by 26 October. At this milestone, restrictions on the provision of dental services will be lifted.
New Zealand anticipates rising COVID-19 numbers
An outbreak of COVID-19 in New Zealand that began with a single confirmed case on 17 August has failed to be completely halted in the weeks since, despite a nationwide lockdown with various levels of restriction. The country recorded 94 new cases last weekend, regarding which epidemiologist Prof. Michael Baker of the University of Otago told The Guardian that New Zealand’s COVID-19 numbers are “on the exponential growth curve”.
“If you look at the trend, it’s clearly going up in Auckland, and it’s not just the total cases but also the unexplained cases, which suggests transmission in the community is increasing,” Baker added.
Last week, New Zealand Prime Minister Jacinda Ardern announced that the country would no longer be aiming to eliminate SARS-CoV-2, but would instead look to increase vaccination rates and suppress the spread of the virus. The announcement has already proved to be a lightning rod for criticism, and commentators have noted that the reduced vaccination rates in Māori populations (compared with non-Māori populations) could make them particularly vulnerable.
Dental professionals working in Auckland, Northland and parts of Waikato are currently operating under alert Level 3 restrictions, while the rest of the country is at Level 2. At Level 3, all patients must be triaged via phone and only given treatment in low-risk situations, while Level 2 allows most patients to receive treatment as normal provided the appropriate PPE is used.