Sir, I refer to the recent publication C1461 issued by the Chief Dental Officer entitled 'Standard operating procedure: transition to recovery (a phased transition for dental practices towards the resumption of the full range of dental provision)'.1
The document advises that dichotomous division of all clinic attendees into two pathways, respiratory and non-respiratory, should be conducted prior to their management based on the initial screening for COVID-19. Introducing such additional tiers of screening and further confusion, as well as logistical issues, to an already complex problem, rather than administration of simple point of care (POC) antigen screening, is probably questionable. This is particularly the case when rapid, sensitive POC diagnostic tests for COVID-19 are already available which yield results within 60 seconds(Ã la British Airways).2 These could be easily administered by the patient himself/herself prior to clinic attendance, particularly if exhibiting respiratory symptoms.
Another point of contention in the new document is the section on 'Staff at increased risk from COVID-19 and other respiratory infections' (pp 11) which states that 'staff, including Black, Asian and Minority Ethnic (BAME) staff [...] should be risk assessed so that appropriate measures are put in place to minimise exposure to risk and support safe working.' This is a sweeping statement which is pejorative and unlikely to be evidence-based as far as the UK is concerned. Although emerging evidence suggest that the long-term consequences of COVID-19 may be severe for BAME groups, there are no data, to my knowledge, that such minority groups 'as a whole' are a higher COVID-19 infectious risk to the community than non-BAME groups.3
Perhaps these points should be noted for future editions, although the rapidly evolving dynamics of the disease, as we are currently witnessing, may render them open for further debate.
References
NHS England and NHS Improvement. Dental standard operating procedure: Transition to recovery. Version 6. Updated 25 November 2021. Available at: https://www.england.nhs.uk/coronavirus/publication/dental-standard-operating-procedure-transition-to-recovery/ (accessed December 2021).
Samaranayake L, Kinariwala N. Point-of-Care (POC) diagnostics for coronavirus disease 2019 (COVID-19) and their potential impact on dentistry. Dent Update 2021; doi: 10.12968/denu.2021.48.7.585.
Nafilyan V, Islam N, Mathur R et al. Ethnic differences in COVID-19 mortality during the first two waves of the Coronavirus pandemic: a nationwide cohort study of 29 million adults in England. Eur J Epidemiol 2021; 36: 605-617.
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Samaranayake, L. SOP recovery transition. Br Dent J 231, 725 (2021). https://doi.org/10.1038/s41415-021-3783-4
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DOI: https://doi.org/10.1038/s41415-021-3783-4