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How Dentists on the Frontline Can Reduce Coronavirus Infection Rates
Experts have warned the UK government that COVID-19 antibody tests lack “adequate assessment” to be rolled out nationwide. The tests could also reportedly create an unnecessary burden on the UK’s National Health Service (NHS).
Bad Timing
This comes during a pivotal period in the country, as lockdown restrictions are being lifted. Despite these warnings, the government has rolled out millions of tests to NHS Trusts nationwide. They have also rolled out the tests around care homes, whose primary patients are the elderly.
What’s more, the UK is set to lift even more lockdown restrictions on July 4. However, it must take precautions to ensure that, unlike the United States, reopening efforts do not cause higher reinfection rates.
Why Dentists?
Healthcare workers on the frontline are at the highest collective risk of exposure to the virus. This is according to statistics curated by the US Department of Labor. In particular, dentists are at the greatest risk in both exposure to the disease and physical proximity to others.
Dr David Denning is a Professor of Infectious Diseases in Global Health at the University of Manchester. He believes that dentists can be a great asset in the fight against the virus transmission.
Furthermore, he explains, the many unanswered questions of the SARS CoV2 infection are an “intrinsic problem”. Yet, “many individual patients do want to know if they have had COVID-19 or not.”
Can Antibody Testing Reduce Coronavirus Transmission?
Some scientists have argued that testing dental patients for COVID-19 transmissibiity could be a great way to reduce reinfection rates.
Co-founder of DenScreen, Dr. David Denning states that this new system will “assist dentists in getting back to work safely.”
“If only IgG (immunogloblulin test) results from symptomatic SARS CoV2 PCR positive patients obtained at least 2 weeks after infection are taken into account, the sensitivity of the best fingerprick and some of the ELISA methods is 95-97% and specific approximately 99%,” he wrote in a letter in the peer-reviewed, British Medical Journal.
The letter was in response to criticisms against the scientific inadequacies of “rapid roll out of SARS-CoV-2 antibody testing.” Indeed, the novelty of the virus has created scientific dispute about the proper methods for testing the British population.
“While not perfect, this is a high level of performance and much higher than many of the routine tests we currently do and substantially better sensitivity that SARS CoV2 PCR approximately 70%,” he continued.
“There are now some data indicating that asymptomatic SARS CoV2 infection usually generates an IgG antibody response, but sensitivity is lower. Also antibody levels fall over time, and so repeat testing many be indicated,” Denning argued.
He added that “we are missing data from children, many immunocompromised groups and those of different ethnic backgrounds.
“Without prospective studies these data are unlikely to be generated in the UK, because of the necessary linkage with medical records required for analysis, which requires explicit consent and is unattainable for a devolved laboratory system as the PHE (Public Health Emergency) is currently structured without substantial resource put into gaining consent.
“The UK’s tight rules on consent for this sort of linkage data is an impediment to data generation for public health benefit, as in the current crisis,” the letter reads.
Using Dentists to Collect Valuable Data
Although dentists face the highest risk of exposure to the virus, millions of people visit dentists every year. For example, in the UK, about 20 million people visit a dentist annually. In other words, dentists make a great addition to frontline workers who can test a significant part of the population
For Denning, the plan is “to collect all the data antibody data and basic demography to better understand the background infection rates in dental workers and in patients.”
To illustrate, Dr. Gareth Elgan Rees, a dentist in England, has introduced the system in practice.
“As our dental practices open their doors to patients again, we have to prepare and protect both our staff and patients from an invisible enemy,” he asserted.
“Dentists can now screen patients to see who is high or low risk and do a ten minute antibody test to see who has already had COVID-19 and is non-infectious,” he added.
“Everyone’s risk of carrying the coronavirus can be checked – whether low, medium or high. Dentistry can be very safe for patients with good systems in place.”
