Managing the ODA during the coronavirus pandemic state of emergency
At the time I am writing this we are about two weeks into the state’s order directing all health care providers to delay all elective procedures. I give you that timeframe because by the time you read this undoubtedly even more changes and challenges will have emerged than what I am writing about today. Things seem to change daily, sometimes hourly during this crisis.
Just over a month ago (but it seems like years), ODA leaders were faced with a decision about canceling the ODA Leadership Institute. We had over 250 member dentists registered for the event to be held here in Columbus at the end of March and the programming was outstanding with informative and entertaining speakers lined up and wonderful networking opportunities planned. As anyone who has ever attended the ODA’s annual spring leadership retreat can attest, this program is one of the premier leadership development/CE events for dentists in the Midwest.
At the time, many organizations were still holding events. However, the state of Ohio and the city of Columbus had just canceled “The Arnold” – an annual sports festival in Columbus that attracts tens of thousands of athletes and spectators from around the world. It was a shock to many when the Arnold was cancelled and it got the attention of all meeting planners.
While the decision to cancel the ODA Leadership Institute seems like a no-brainer today, this was in the days before daily press conferences about the number of infections, hospitalizations and deaths due to the coronavirus in Ohio. Ultimately, the ODA Executive Committee made the difficult decision to cancel the 2020 Leadership Institute (just days later the state of Ohio would issue an order prohibiting any meeting with 100 or more attendees). That was a particularly low point for me as the ODA staff had worked so hard to put a first class event together for our members. At that time, I had no idea that things would get much worse.
On March 13, Ohio Gov. Mike DeWine, Ohio Department of Health Director Dr. Amy Acton, and other state officials held their regular press conference providing updates related to the coronavirus situation. They specifically mentioned that they were reaching out to health care providers, including hospitals, physicians, ambulatory surgical facilities, dentists and veterinarians, because they were planning to order that all elective health care procedures be delayed.
The very next day, on the morning of March 14, ODA President Dr. Sharon Parsons, who is a general dentist on the east side of Columbus, and I had a call with Gov. DeWine, Dr. Acton and other state officials. They explained the extreme need the health care system in Ohio will have for personal protective equipment (PPE) to treat the expected surge in coronavirus patients. Accordingly, they indicated that the state of Ohio would issue an order directing all health care providers to delay elective procedures in order to preserve PPE.
Dr. Parsons and I explained the extreme hardship this decision would have on dental practices and employees in dental practices. The state officials indicated that they understood our concerns but felt they had no choice but to take drastic action in order to fight the pandemic. They also indicated that they would be working with other state officials and the federal government to provide assistance to businesses and employees who are hurt by this crisis.
We also discussed that dentists should still be allowed to provide emergency services in order to keep patients from presenting at hospital emergency rooms for oral health issues at a time when hospitals will be focusing on addressing the coronavirus crisis and other emergency care. The state officials asked the ODA to work with representatives of the Ohio State Dental Board to develop guidelines for the dental profession in order to comply with the coming order to delay non-emergency care.
After the call, Dr. Parsons and I discussed the surreal nature of the call and the current situation. She said “never in a million years did I think I would have to address something like this during my year as ODA president.” Not surprisingly though, for any of you who know Dr. Parsons, she jumped into this situation with both feet – ready to represent and lead the dental profession and ODA during this crisis.
The next day, on Sunday, March 15, ODA leaders met with representatives of the Ohio State Dental Board to try to develop guidance for Ohio’s dentists in light of the upcoming order to delay all elective care. Some dental leaders came to the ODA offices in Columbus for the meeting held in our Mercer Boardroom, while others who were from other parts of the state called into the meeting. This was before the ADA developed its guidance on defining what urgent and emergency care was. After several hours of research, discussion, and some debate, the group came to a general consensus. That same day, the governor issued an Order closing all restaurants, except for takeout and delivery. I remember driving home from the office that night and noticing that the parking lots of the bars and restaurants were eerily empty.
On Monday, March 15, the Ohio State Dental Board issued a directive from the governor to all licensed dentists, which you likely have already read (a summary of which you can find on the front page of this issue of the “ODA Today” and the entire order is posted on the OSDB’s website). It provided guidance as to what procedures are permissible and what should be delayed. The OSDB’s statement also provided tips on limiting patients’ potential exposure to coronavirus (e.g., cell phone triage, etc.). The OSDB’s message also encouraged dentists to review inventories and consider donating “any surplus protective equipment and supplies” to local hospitals and medical clinics to assist in the fight against the coronavirus.
On Wednesday, March 17, a day normally reserved for St. Patrick’s Day celebrations, Gov. DeWine and Dr. Acton announced the issuance of an Order, set to go into effect the following day, directing that “all non-essential or elective surgeries and procedures that utilize PPE should not be conducted.”
On Thursday, March 18, Dr. Parsons issued an ODA President’s Message to assist dentists in complying with the order and to remind them of their obligations as community leaders and respected professionals “to put the welfare of patients and staff, as well as the citizens of Ohio above all else.”
By Friday, March 20, it became apparent that Gov. DeWine was considering a statewide stay-at-home order. The ODA reached out to the governor and his staff reminding them of the importance of designating dental offices as essential businesses so that dentists can still treat emergencies and keep patients from presenting to hospital emergency rooms for oral health issues during this public health crisis.
On Sunday, March 22, the state of Ohio issued an order, to take effect the following day, directing that “all persons stay at home unless engaged in essential work or activity.” Dental offices were designated as essential businesses in order to provide emergency care.
On Monday, March 23, Dr. Parsons and I hosted a Facebook live event providing the latest information on the coronavirus emergency to our members. To date, it is one of our most viewed videos ever. We know our members are thirsty for information but unfortunately not all sources are necessarily credible. In fact, we have been made aware of several coronavirus-related scams targeted at small businesses and dental offices. We are striving to be timely and accurate in all of our communications – demonstrating that organized dentistry (ODA, ADA, and local component dental societies) continues to be the source of credible information for dentists in this crisis, and always.
The above chain of events has sent shockwaves through the dental profession, the ODA, the health care system, the economy, businesses, workers and families. Every dentist and every dental office in Ohio has been impacted. Dentists who own their own practices struggle to maintain their businesses, figure out what to do about the staff, and make arrangements to treat patient emergencies. Other dentists are worried about their jobs while dental residents and graduating dental students are worried about their future prospects.
The ODA has scrambled to provide the most up-to-date information about all kinds of issues including unemployment benefits, Small Business Administration Loans, and new federal mandates for paid sick leave and expanded family and medical leave. In just the first two weeks after the order to delay elective procedures, the ODA staff has been working day and night to answer more than 500 calls, texts and emails on a slew of different issues. With the passage of every new piece of legislation in Washington the information related to disaster relief loans and other possible assistance changes. We work to keep our members up to date by posting the latest information on www.oda.org and the ODA Facebook page and Twitter feed.
In the days leading up to the state’s shutdown order, I had the ODA’s IT consultant scrambling to make sure ODA staff had the means to work from home so we could continue to provide valuable updates and guidance to our members and engage in important advocacy to make sure dentistry’s voice is being heard during this crisis. We also continue to provide assistance and answer our members’ questions related to various ODA programs. For example, we continue to work with our member dentists who have health benefits for themselves and/or their staff through the ODA Wellness Trust to make sure they continue to have the coverage they need.
As the days go by, the number of issues continues to grow. We have gotten questions about unemployment benefits, SBA loans, the CARES Act, cell phone triage, teledentistry, aerosols, infection control, PPE, loan options, staffing, CE, payroll taxes, and many others. We are here to answer your questions, direct you to available resources and help you through this!
We also have ODA staff members who have been impacted by the coronavirus emergency, and we worry about them and their families as they scramble for child care or to care for a loved one or a parent.
I have a daughter in high school and one in college. While all this was hitting, I received a message that my older daughter was required to move out of her dorm at The Ohio State University. My wife and I hurriedly loaded up the SUV and minivan to move our daughter back home. Since we are now all staying at home just about 24/7, it has brought us closer as a family even as we try social distancing. There are no school activities so we regularly eat dinners together for the first time in years. We are only a couple weeks in and it is all good so far. If this goes significantly longer as some predict, I am skeptical this family bliss will continue! We’ll see.
This crisis is a challenge for everyone – but especially the dental profession. The ODA continues to work on your behalf. And your leaders – especially the members of the ODA Executive Committee – have been particularly engaged to ensure that we are in position to provide assistance to all of our members in their time of need. We will all get through this. Together. Hang in there.