Dental practices are high-risk during the pandemic. Here’s what to know before making an appointment.

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Photo: Oscar Del Pozo/Getty Images

In the early days of the Covid-19 pandemic, when almost all U.S. dentists had temporarily closed their doors, Ravina Kullar’s mother shut down her dental practice for good. At 70 years old, she was ready to stop practicing — but as it became clear that both her age and profession placed her at particularly high risk, the pandemic “kind of pushed her into retirement,” says Kullar, PharmD, a Los Angeles, California-based infectious disease specialist, epidemiologist, and Infectious Diseases Society of America spokesperson.

To date, no cases of Covid-19 have been attributed to any dental practices in the U.S., according to Kullar and the American Dental Association (ADA). But the practice of modern dentistry places oral health care practitioners and their patients in a uniquely dangerous position — and as practices reopen, people are facing decisions about whether and when to see a dentist. …

Unused tech tools and a coordination vacuum between state and local health departments can help explain why contact tracing is not going well

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Photo: Xinhua News Agency/Getty Images

In mid-June, the latest study to model the effects of public health interventions on the ebb and flow of Covid-19 infections affirmed what public health experts have long suspected: Contact tracing is central to controlling this pandemic. Using a model based on real-world social contact data from the United Kingdom, the study’s authors found that even if people socially distanced themselves to only a moderate degree, a vigorous contact tracing effort could reduce viral spread by two-thirds and ultimately snuff out transmission.

The United States has been providing federal funding for contact tracing since the Department of Health and Human Services announced its first wave of financial support for the strategy in late April. But the implementation of contact tracing programs has unfolded in wildly uneven ways across the nation: In some states, such as Washington, California, and Massachusetts, massive programs employing thousands of workers are reaching enormous numbers of Covid-19-infected people and their contacts, while in others, public health leaders are still dithering over such a program’s best design. And the size of states’ contact tracing efforts do not always track with slowdowns in their infection rates. …

A vaccine will be necessary to help the country’s economy

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Photo illustration. Sources: alexey_ds/Getty Images, daboost/Getty Images

In late April, New Zealand’s public health officials announced that the spread of Covid-19 had ceased within its borders. The world cheered, and headlines trumpeted the strength and compassion of the country’s political leadership and its science-first policies as an important cause of its success.

These factors certainly helped New Zealand crush its epidemic curve, says John Crump, MD, a global health epidemiologist at the University of Otago in Auckland, but they don’t exist in a vacuum: New Zealand also has innate characteristics that both enabled and incentivized the approach its leaders took to eliminating Covid-19, he says — and it’s impossible to fully understand the success of its approach without acknowledging them. …

Lack of coordination and trust caused trouble for the country’s response to the pandemic

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Photo illustration. Sources: alexey_ds, Lepusinensis/Getty Images

As any aficionado of the “Italian grandmothers making pasta” video genre might infer, Italy’s population has the world’s second-highest proportion of older adults. Twenty-three percent of the country’s residents are older than 65, and 20% of older Italians live with at least one child.

Italy’s age-diverse culture of multigenerational, high-density living has been blamed, in part, for the way the coronavirus spread through parts of the country like wildfire, resulting in what is to date one of the highest per capita death rates due to the virus worldwide. …

A rising mortality rate suggests the more lax model means more death

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Photo illustration. Photos (Getty Images): alexey_ds; daboost

A funny thing happened in late April: Sweden — 70% marginal tax rate, safety net replete Sweden — briefly became the darling of the American right wing.

The cause of the fandom was the country’s approach to mitigating the coronavirus pandemic’s effects on its population: Unlike most nations, including its Scandinavian counterparts, Sweden did not shut down its economy or schools. …

The country learned tough lessons from the MERS pandemic, and it’s paying off now

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Photo illustration. Photos: alexey_ds; daboost/Getty Images

South Korea and the United States identified their first cases of Covid-19 around the same time, in mid-to-late January. But while case counts exploded and are still high in many parts of the U.S., South Korea quickly stanched the infection’s spread without forcible lockdowns or an economic shutdown. The country is still seeing hotspots of infection, including recent outbreaks at a nightclub and an industrial warehouse, but its per-capita deaths and its economic contraction have been among the world’s lowest.

Preparedness

Some have suggested luck has a lot to do with South Korea’s comparatively successful coronavirus response: Less than a month before the country identified its first case of Covid-19, it had completed a tabletop exercise on emergency preparedness for a viral pneumonia, and its first cluster of cases was among young, relatively invulnerable attendees of a single church. …

Anosmia, ‘happy hypoxia,’ and blood clots: What scientists know and don’t know

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Photo: Chip Somodevilla/Getty Images

The Covid-19 pandemic is an unprecedented event in modern medical practice, and health care providers are seeing extraordinary numbers of severely ill people. Many providers think the novel coronavirus is causing the human body to behave in weird ways. In some cases, they may be right — but not in all of them.

Some of the side effects associated with Covid-19 are unusual symptoms for a respiratory infection while others are simply being observed by doctors more often because of the sheer number of people infected. …

Technology may play a role, but human contact tracers will likely be at the heart of the process

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Photo: Catherine Lai/Getty Images

In the next few months, it’s going to happen to a whole lot of us: We’ll get a phone call from a number we don’t recognize, and on the other end of the line will be a person employed by a state or local health department to inform us we’ve been exposed to Covid-19. These calls, and any follow-up testing and subsequent check-ins, are part of the process of contact tracing, a public health strategy seen as critical to epidemic control.

Contact tracing is usually part of an effort to contain an epidemic in its early days and has historically been used to trace diseases spread by very close or intimate contact, like sexually transmitted infections, bacterial meningitis, and tuberculosis. But the experts creating the strategy for reopening American society think it will likely play an important role in guiding decisions after the coronavirus epidemic has crested. …

“Such an important rite of passage for queer and trans kids coming out is going out.”

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Image by akshardave_ for Pexels.com

Jason Rosenberg is finding little joy these days, even though he’s seeing people care for each other. Rosenberg is a member of New York City’s COVID-19 Working Group, an alliance for community-based responses to the pandemic that includes, among others, HIV treatment advocacy groups (like PrEP4All Collaboration and Treatment Action Network) and the Callen-Lorde Community Health Center, which serves the city’s LGBTQ population. …

Here’s how to proceed safely

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Photo: MediaNews Group/Reading Eagle/Getty Images

It’s not easy to get yourself tested for Covid-19 right now, but if you’ve done so and received a positive result — whether you got tested as part of a surveillance program, because you were a contact of someone who tested positive, or because you were feeling sick — know that most people who contract Covid-19 have a pretty mild case, ranging from no symptoms at all to flu-like symptoms including fever, cough, congestion, and stomach upset. …

About

Keren Landman, MD

Infectious disease doctor | Epidemiologist | Journalist | Health disparities, HIV/STDs, LGBTQ care, et al. | kerenlandman.com.

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