Pandemic ponders

Is the COVID-19 pandemic over? Not sure. It may seem like it is in the UK but officially the pandemic is 'far from over' according to The Lancet.¹ Whatever the technical definition, the immediate effects do seem to have passed even if the lasting health and social legacies remain very present.

What I find so extraordinary is that it is three years ago this month that we had the first UK lockdown. Did that really happen? Yes, of course it did and, yes we were all very fearful of this new virus variant and the way it was ripping through the population, compromising and taking members of our families, friends and colleagues. But time passes and we forget. There was no vaccine either and the media hype suggested that it could be one, two or more years until an effective one was developed. In theory we could still be waiting - how much chaos would that have precipitated? In fact it was in December 2020 that the first wave of vaccinations was rolled out - and how grateful we all are that the skill and enterprise of the scientific and pharmaceutical world prevailed. The alternative would have been very different by now.

In forgetting, or at least consciously bypassing the memory of how we really felt those 36 months ago, we are also in danger of conveniently overlooking, or minimising, the disruptive longer-lasting effects that combatting the virus are having on us and our daily lives. The cover story of this issue of BDJ In Practice while focussing on the effect of the cost of living crisis on child oral health also acknowledges the backlog of treatment caused by the necessary but restrictive measures throughout the pandemic, especially on general anaesthetic sessions. Similarly, in terms of compounding the reasons, the brooding, parlous state of NHS dentistry pre-pandemic has only been accelerated, or heightened as a result of our coronavirus adversary.

There is a line of thinking which states that often something bad has to happen before something good can transpire, comparable I suppose to the saying that every cloud has a silver lining. Humans can be very creative, especially during times when their security or wellbeing is challenged. Finding alternatives and modifying existing procedures are features of both individual and collective behaviour and these in turn lead to new and sometimes unexpected consequences. Who, for example, could have predicted the huge upsurge in online communication prompted by the stay-at-home circumstances? Concomitantly, who foresaw this as a spur for users to seek cosmetic dentistry, as a result of having their teeth and smiles brought into closer and more prolonger personal scrutiny? Logically, this must be based on personal assessment since no one in any of the online calls in which I have participated has ever criticised the look of another participant's facial appearance.

A further change, and one which may be considered as a positive or a negative depending perhaps on enthusiasm of IT adoption or phobia, is the rise in acceptance of what is dubbed 'teledentistry' as a form of telemedicine. We are all aware that dentistry is a hands-on activity but there are ways in which some functions of dental practice can be facilitated by distant communication such as medical history taking, triage and so forth. There will certainly be further developments and refinements in this area which will improve the use of this technology. Nevertheless, the essential change is the awareness of it as a tool and the acceptance of it as a legitimate alternative in some circumstances. In itself it also has the positives of reduced travel time and costs as well as the measurable associated ecological benefits.

Other legacy effects include spikes in the use of antibiotics, some prescriptions of which may or may not have been appropriate but which were provided a time of great uncertainty, and some remaining confusions over additional cross-infection control and personal protective equipment protocols. In a further three years we will probably have selectively forgotten these matters in the same way that our senses of bewilderment and danger have faded these three years on from the fateful March days of 2020. What is not in doubt is our ability as a profession to learn to cope and to provide as good a service as possible to the patients for whose welfare we are responsible. ◆

David Westgarth will be back next month