4. Should I screen staff for COVID-19?
We recommend you consider implementing a daily health screening check point and log for all employees entering the workplace. Our daily screening log can be used to document this. Dental staff should pay special attention to their own symptoms and stay home or be sent home immediately with symptoms of COVID-19 (fever, cough, sore throat, headache and muscle soreness, which may be accompanied by nasal symptoms).
This is one of the many steps we recommend practices take to ensure they are operating as safety as possible for staff and patients. Members should see our toolkit on returning to face-to-face care for a comprehensive overview of the practical steps we recommend.
5. What about staff returning from abroad?
The government has said that no travel is “risk-free” during the pandemic and that people returning from some countries should self-isolate for two weeks.
People arriving from exempt countries do not need to self-isolate. There is a
list of exempt countries on the gov.uk website . Please note, this list changes regularly.
Our advice is to check whether you are returning from one of the
countries which are exempt from the quarantine guidelines . If you are in Scotland, please refer to the
specific advice from the Scottish Government (Northern Ireland
and Wales currently follow the same guidelines as England). If the country is not on the exempt list, you will need to self-isolate for 14 days.
Please note, SSP is not payable for staff self-isolating after returning from holiday.
Staff in these circumstances who have to isolate should either be on paid holiday (if the member of staff has paid holiday to take) or unpaid leave. Whether it is paid or unpaid leave should be subject to agreement between the parties.
6. Who should self-isolate and what should they do?
Dentists and their teams will be providing emergency care should follow government guidance on whether it's safe for them to do so .
We believe members of the dental team over 70 years of age should stay at home.
Members of the dental team under the age of 70, but with an underlying health condition (such as asthma, diabetes, heart disease), are at increased risk. Guidance says people in this category can go to work, but they should stay at home as much as possible. People in this category should not be forced to return to work in a dental practice. The risks should be assessed in each case. The risks can be reduced if there is space in the practice to maintain social distancing and/or if people with increased risk can avoid taking part in AGPs.
Advice has been published for
pregnant women who are working in the NHS and other work settings. Women who are less than 28 weeks pregnant should practise social distancing but can continue working in a patient-facing role, provided the necessary precautions are taken. Women who are more than 28 weeks pregnant, or have underlying health conditions, should avoid direct patient contact. It has also recommended that pregnant women, regardless of gestation, should be
offered the choice of whether to work in patient-facing roles during the pandemic.
Staff should also stay at home if they, or a member of their family, have coronavirus symptoms (the latter group should self-isolate for 14 days following the family member's diagnosis). Others will also have been advised to self-isolate. Staff staying at home for these reasons should be treated as if they are on sick leave.
The UK Government has said that statutory sick pay (SSP) should be payable from the first day of the sickness period. Employers with fewer than 250 employees will be eligible to reclaim two weeks' SSP for each employee who has been affected by COVID-19. This has not yet been formalised in emergency legislation, but it may include a clause allowing it to be backdated. Ensure you keep records of any absence due to COVID-19 to be able to claim this back from the government.
We recommend that you communicate with staff in an open and cooperative manner at this difficult time. Members can download our toolkit on returning to face-to-face care for support and advice.
7. What if I'm pregnant?
We have been gathering and reviewing published guidance from various sources, UK and international, including
Royal College of Obstetricians and Gynaecologists (RCOG).
Unfortunately, it is still a relatively new airborne virus and the world-wide medical profession does not have the evidence it would like to have in order to understand the virus and all its effect – however, this is the best advice we can give with the information available at the time of writing.
Firstly, it should be noted that the advice that others, such as RCOG, and we are giving has changed; this is because of a better understanding of the effects of coronavirus and because of the change in the number of people infected: the number of hospital admissions and the number of deaths are substantially lower than they were during the height of the pandemic in March and April 2020.
Suffice to say that the evidence is that pregnant people of any gestation with no underlying health issues are at no more risk of contracting the virus than any other non-pregnant person who is in similar health.
If staff follow correct procedures and wear appropriate PPE, we believe that the dental environment is a relatively safe one and that pregnant members of the dental team can continue to work safely. We now have established Standard Operating Procedures and a good supply of PPE which gives members of the dental team substantial protection against catching coronavirus.
As you know, health and safety regulations require employers to remove additional risks particular to pregnant colleagues, such as exposure to x-ray radiation; these regulations also require employers to remove risks of catching communicable diseases, such as coronavirus, where these risks are higher in the workplace.
As such, the level of risk of catching coronavirus at work must be viewed in relation to the level to which pregnant team members may be exposed outside the workplace; we believe the risk of catching coronavirus whilst working in the dental practice with good procedures and PPE is no greater than the risk of catching it in the wider environment.
That said, managers and other team members must be mindful of colleagues who are pregnant and follow all practice policies (such as wearing the correct PPE, hand washing and social distancing) to avoid transmission of the virus between team members.
We’ve produced a series of risk assessments for members, to support dentists and their teams to keep safe during this challenging time:
Pregnant - in patient-facing clinical role
Pregnant - in patient-facing administrative role
Pregnant - in non-patient-facing administrative role
Pregnant - in non-patient-facing decontamination/cleaning role
In addition, it also stands to reason that team members who have symptoms of coronavirus, such as a high temperature, a new, continuous cough or a loss or change to sense of smell or taste, should not go to work.
First two trimesters
In relation to the first two trimesters, we could find little evidence that those who caught coronavirus in first two trimesters (or their babies) were at any increased risk as a result of the pregnancy.
As such, the advice in relation to anyone in the first two trimesters is that they can continue to work subject to conducting careful risk assessment and having correct PPE.
As far as the third trimester is concerned, for those who are 28 weeks pregnant and beyond, there is an increased risk of becoming ill should they contract COVID-19 (this is true of any viral illness contracted, such as ‘flu). It should be noted, however, they are just as likely to recover as people who are not pregnant.
That said, guidance states that contracting COVID-19 just before or at the time of birth, would bring substantial challenges to all involved and is best avoided, so the closer the pregnancy gets to the due date, the more the practice should be prepared to show flexibility over the parental leave arrangements.
There should be careful risk assessments for pregnant team members in a patient-facing roles with appropriate arrangements to sufficiently minimise their exposure to the virus, taking into account individual risk factors.
Pregnant self-employed members of the dental team, they do not have the same level of protection and are free to make their own decision as to whether they work or not; that said, we urge members to work together constructively to ensure that risks are kept to a minimum.
8. How can I support BAME staff?
Emerging evidence shows that black, Asian and minority ethnic (BME) communities may be disproportionately affected by COVID-19. Organisations should ensure that line managers are supported to have sensitive and comprehensive conversations with their BME staff. They should identify any underlying health conditions that may increase the risks for them in undertaking their roles. These conversations should also, on an ongoing basis, consider the feelings of BME colleagues, particularly regarding their physical safety and mental health.
It is also important to note in this context, that PPE fit-testing requires men to shave their beards. Men who do not wish to shave their facial hair for religious reasons are currently being advised to wear a PPE hood instead and tuck it into their gown.
9. What if a staff member has COVID-19?
If a member of staff has coronavirus, they should
follow government advice. Staff who have COVID-19 symptoms or a positive test result should self-isolate for 10 days, or for 14 days if they are admitted to hospital.
Standard sickness procedures should also be followed. Staff should contact the practice and update them on when they will be able to return. They will either be entitled to sick pay or, depending on the terms of their contract of employment, statutory sick pay. Check your contracts of employment and the practice's policy on sick pay.
Please note, the Coronavirus Job Retention Scheme is not intended for short-term absences from work due to sickness.
10. What if a patient has coronavirus?
A recent update to COVID-19 guidance on the management of health and social care settings and the Test and Trace programme, has clarified the position of dentists with regards patients who are later found to have COVID-19.
We now know that if dentists are providing direct care to a patient with COVID-19 and are wearing the correct PPE in accordance with the current IPC guidance, they are not considered a contact for the purposes of contact tracing and isolation, and are not required to self-isolate for 14 days.
11. What do I need to know about redeployment?
Many dentists and dental staff are volunteering for redeployment. Many others are working in urgent care settings, or providing remote advice. Some dentists are taking the opportunity to work in different arenas and learn new skills.
We recommend that you read our
financial impact page for more information and use our
Redeployed Duties and Training Log on a daily basis to keep track of your work, as you may need these records later. We also urge members to contact
BDA Health Assured if you find your mental wellbeing is under stress during this challenging time.
As practices reopen, they will want associates and other members of the team to return to work. Those who are volunteering should therefore make arrangements to return to work at their practice. We recommend you discuss the situation with your practice and reach an agreement. Though it should be noted that we are still waiting to find out the contract terms on which the NHS will pay dental practices to reopen and start providing NHS dentistry.