COVID-19 and Dentisting
Well, life was quite a bit different the last time I wrote down anything here. Here we are, in the midst of the worst global pandemic since the Spanish Flu of 1918.
Forgive my poor writing, the parts of my brain that handle reading, writing, and higher order thinking have been exhausted. Here’s a synopsis…
As a part of my job, I take a drill spinning at 200,000 rpm and use it right next to the mucous membranes and oral tissue of patients. This whips up whatever bacteria and viruses are present into a large, invisible cloud. Doing this day in, day out, with many patients per day means I’m going to get exposed to high viral loads in the air. (Per recommendations from our national and state dental associations, I am not working right now.) So, when I return to work, the thing that worries me is this is precisely the kind of environment that hospital personnel are in right now, and it appears that this repeated exposure (when combined with immune systems depleted due to stress) causes a relatively high rate of symptomatic COVID-19 infections amongst them. But I am lucky to be young, here’s why:
This says it is highly unlikely I am going to die from COVID-19 caused by an infection with SARS-CoV-2. That’s good! But my lizard brain keeps telling me it is possible, so I bounce between thinking I’ll be fine for 50% of the time and worrying this will kill me for the other 50% of the time. That’s bad!
Another thing that bears repeating and repeating and repeating —- look up at that chart again, where its data originates. It’s not from the CDC. It’s not from the United States. It’s from China. And their neighbor, South Korea, is currently testing nearly as many people PER DAY as the United States has tested IN TOTAL. Here’s Derek Thompson writing at the Atlantic in a piece called “America Is Acting Like a Failed State”:
Finally, large nonprofit organizations are stepping up to fill the void left by the administration’s testing failure. Amazon and the Bill & Melinda Gates Foundation have offered to provide testing kits to people in Seattle with coronavirus symptoms. Yesterday, the Jack Ma Foundation, a charitable organization established by the founder of the Chinese retail company Alibaba, announced a donation of 500,000 testing kits to the United States. Acute state failure has reduced the richest nation in world history to a charitable cause.
Taking into account total population and time since outbreak, that means South Korea is testing people at a per-capita rate about 200 times that of the United States. Testing is so SO important because it helps us track the asymptomatic people who are infected! And with this virus, those asymptomatic people exhibit viral loads comparable to symptomatic infected individuals. We need to know where (and when!) the asymptomatic infected people are!
Without testing, we don’t know where this is spiking, we don’t know the true number of cases, and we don’t know when or where it is going to spike next. We can’t see trends. We can’t see curves. We do not have the public health data we desperately need to track this. Our best hope to contain the first spike (what everyone is, accurately, calling ‘flattening the curve’) is to try to do what Italy did (drastic isolation and quarantine measures) sooner than they did (before our hospital system is overwhelmed). The United States’ inability to test for this is a catastrophic failure.
At the same time, my grandfather Bup is dying in the hospital. He lived at home, the same home, since my mother was about five and of course for my entire life. He lived there until only a few days ago, when he was admitted to the hospital, with symptoms of dementia, delirium, and metastatic colon cancer in its most common form: multiple myeloma. He has a few days left. I can’t visit him because of the SARS-CoV-2 pandemic; hell, we may not even be able to have a timely funeral because the current recommendations are against a gathering of greater than ten people… and on the coasts that has evolved into a recommendation against leaving one’s house unless absolutely necessary. This is, without a doubt, the strangest, most extreme, most stressful constellation of uncontrollable, bad, tragic, scary things that has ever happened in my life. I’ve been at home, not working, for just two days and I literally can not believe how the British people mentally dealt with The Blitz for 8 goddamned months. Oy.
And on the other hand: Ess just blossoms when we pay her attention. She loves to share whatever she’s doing or imagining or watching with us. These moments, watching a silly show on Netflix, or playing an invented marble game in the basement, or taking a walk as a family — these are the ones I hope I remember from this time. But hearing your five-year-old say she’s “tired of everyone talking about coronavirus all the time” makes you realize how impressionable, sensitive, and attentive one’s child can be. But she is loved, and I think, I hope, she knows it.