Covid Info

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WILEY ONLINE LIBRARY -COVID‐19: its impact on dental schools in

Italy, clinical problems in endodontic therapy and general considerations

The prevention protocol being adopted in Italy includes:

1. Triaging patients to detect by the history any with respiratory infection, flu, acute
respiratory illness, conjunctivitis and cardiovascular abnormalities;
2. Separation of patients with respiratory symptoms to limit their contact with dental
staff, students and patients;
3. Avoiding dental treatment if at all possible;
4. Regular, meticulous and effective hand washing with no touching of face, eyes etc;
use of face masks;
5. Decontamination of all surfaces within clinics with 0.1% sodium hypochlorite or 70%
ethanol or 0.5% hydrogen peroxide, which are disinfectants already available in
dental clinics (Kampf et al. 2020);
6. Respiratory hygiene/cough etiquette – use of tissues (Catch, Bin,
Kill; https://www.england.nhs.uk/south/wp‐content/uploads/sites/6/2017/09/catch‐bin‐
kill.pdf);
7. Special precautions by dentists and assistants to prevent contamination from air
droplets:
a. Wear a disposable surgical mask and isolate the patient in a dedicated single‐
patient room (with closed door) separated from other staff/patients;
b. When possible, use a rubber dam that must cover the nose of patient during
the entire endodontic procedure;
c. Application of powerful air/water surgical suction pump (aspirator) close to the
tooth and a second suction close to the nose to prevent aerosol and saliva
droplet diffusion;
d. If possible, use high‐speed handpiece with no exhaust;
e. Decontamination of equipment, surgeries/operatories after reach patient.

General advice issued by many national authorities includes staying aware of the latest
information on the COVID‐19 outbreak. Take care of your health and protect others by doing
the following:

 Regularly wash your hands with soap and water – for at least 20 s;
 Always wash your hands when you get home or into work;
 Use hand alcohol‐based sanitizer gel if soap and water are not available;
 Cover your mouth and nose with a tissue or your sleeve (not your hands) when you
cough or sneeze;
 Put used tissues in the bin straight away and wash your hands afterwards;
 Try to avoid close contact with people who are unwell;
 Do not touch your eyes, nose or mouth if your hands are not clean;
 If you have fever, cough and difficulty breathing, seek medical care early;
 Stay informed and follow advice given by your healthcare provider.

In conclusion:
1. The risk for dental personnel, dental nursing staff and for dental students is high and
must be managed;
2. University students are a population with a substantial number of ‘potential contacts’
that must be limited;
3. Universities in high‐risk areas should consider using online web‐based teaching;
4. The development of a simple laboratory test to detect and monitor COVID‐19 in
Medical and Dental personal is necessary;
5. The role of the dentist in the prevention and monitoring of viral infections should be
redefined.

WORLD HEALTH ORGANIZATION

Practicing hand and respiratory hygiene is important at ALL times and is the best way to
protect others and yourself.

When possible maintain at least a 1 metre (3 feet) distance between yourself and others.
This is especially important if you are standing by someone who is coughing or sneezing.
Since some infected persons may not yet be exhibiting symptoms or their symptoms may be
mild, maintaining a physical distance with everyone is a good idea if you are in an area
where COVID-19 is circulating.

Stay aware of the latest information on the COVID-19 outbreak, available on the WHO
website and through your national and local public health authority. Most countries around
the world have seen cases of COVID-19 and many are experiencing outbreaks. Authorities
in China and some other countries have succeeded in slowing their outbreaks. However, the
situation is unpredictable so check regularly for the latest news.

You can reduce your chances of being infected or spreading COVID-19 by taking some
simple precautions:

 Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash
them with soap and water. Why? Washing your hands with soap and water or using
alcohol-based hand rub kills viruses that may be on your hands.
 Maintain at least 1 metre (3 feet) distance between yourself and others. Why? When
someone coughs, sneezes, or speaks they spray small liquid droplets from their nose
or mouth which may contain virus. If you are too close, you can breathe in the
droplets, including the COVID-19 virus if the person has the disease.
 Avoid going to crowded places. Why? Where people come together in crowds, you
are more likely to come into close contact with someone that has COIVD-19 and it is
more difficult to maintain physical distance of 1 metre (3 feet).
 Avoid touching eyes, nose and mouth. Why? Hands touch many surfaces and can
pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose
or mouth. From there, the virus can enter your body and infect you.
 Make sure you, and the people around you, follow good respiratory hygiene. This
means covering your mouth and nose with your bent elbow or tissue when you cough
or sneeze. Then dispose of the used tissue immediately and wash your hands. Why?
Droplets spread virus. By following good respiratory hygiene, you protect the people
around you from viruses such as cold, flu and COVID-19.
 Stay home and self-isolate even with minor symptoms such as cough, headache,
mild fever, until you recover. Have someone bring you supplies. If you need to leave
your house, wear a mask to avoid infecting others. Why? Avoiding contact with
others will protect them from possible COVID-19 and other viruses.
 If you have a fever, cough and difficulty breathing, seek medical attention, but call by
telephone in advance if possible and follow the directions of your local health
authority. Why? National and local authorities will have the most up to date
information on the situation in your area. Calling in advance will allow your health
care provider to quickly direct you to the right health facility. This will also protect you
and help prevent spread of viruses and other infections.
 Keep up to date on the latest information from trusted sources, such as WHO or your
local and national health authorities. Why? Local and national authorities are best
placed to advise on what people in your area should be doing to protect themselves

The most important thing to know about coronavirus on surfaces is that they can
easily be cleaned with common household disinfectants that will kill the virus. Studies
have shown that the COVID-19 virus can survive for up to 72 hours on plastic and
stainless steel, less than 4 hours on copper and less than 24 hours on cardboard.As,
always clean your hands with an alcohol-based hand rub or wash them with soap and
water. Avoid touching your eyes, mouth, or nose.

WHO recognizes that there are many questions about the use of face masks to prevent the
transmission of COVID-19 in the community, and that many countries are recommending
that people wear them. Wearing a medical mask can limit the spread of certain respiratory
viral diseases, including COVID-19. However, the use of a mask alone is not sufficient to
provide an adequate level of protection. Other measures such as physical distancing and
hand hygiene should be adopted.

WHO aims to provide the most scientifically sound yet practical recommendations for the
safety and wellbeing of individuals in all settings.

At present, WHO recommends a risk-based approach to be considered by decision makers


when deciding in which settings and circumstances non-medical masks could be used in the
community.

No, WHO does not recommend the regular use of gloves by people in the community. The
wearing of gloves may increase risks, since it can lead to self-infection or transmission to
others through touching contaminated surfaces which is not followed by removal of gloves
and hand hygiene.

Therefore, in public places such as supermarkets, in addition to physical distancing, WHO


recommends the installation of public hand hygiene stations at the entrance and exit.
By widely improving hand hygiene practices, countries can help prevent the spread of the
COVID-19 virus

What types of masks are used against the spread of COVID-19?

Medical masks (also known as surgical masks): these are made from a minimum of three
layers of synthetic nonwoven materials, and configured to have filtration layers sandwiched
in the middle. These masks are available in different thicknesses, have various levels of
fluid-resistance and two levels of filtration. These medical masks reduce the transfer of
saliva or respiratory droplets from the wearer to others and to the environment. They also
decrease the likelihood of potentially infectious droplets from others reaching the mouth and
nose of the mask wearer.

Hand hygiene should be performed before putting on a clean mask and after removing the
mask. These masks should be worn tightly around the chin and top of the nose. The wearer
should avoid touching the mask while it is on the face and the mask should be immediately
discarded if it becomes moist. Importantly, wearing a mask must be combined with other
preventive measures including performing frequent and appropriate hand hygiene and
physical distancing of at least 1 metre (3 feet).

Respirators (also known as filtering facepiece respirators --FFR) and available at


different performance levels such as FFP2, FFP3, N95, N99): these are specifically
designed for healthcare workers who provide care to COVID-19 patients in settings and
areas where special medical procedures are undertaken. Respirators are intended to protect
the wearer when these medical procedures aerosolize smaller particles than normal droplets
into the air in the health treatment area. Healthcare workers should be fit tested before using
a respirator to ensure that the respirator is sealed tightly on the wearer’s face and is properly
fitted. Respirators with valves should not be used as the purpose of source control.

Should wear a clean, non-sterile, long-sleeve gown, a medical mask, eye


protection (i.e., googles or face shield), and gloves. Procedure should be conducted in a
separate/isolation room, and during NP specimen collection health care workers should
request the patients to cover their mouth with a medical mask or tissue. Although
collection of NP and OP swabs have the potential to induce fits of coughing from the
patient undergoing the procedure, there is no currently available evidence that cough
generated via NP/OP specimen collection leads to increased risk of COVID-19
transmission via aerosols.

Does WHO recommend routine wearing masks for healthy people during the 2019
nCoV outbreak?

No. WHO does not recommend that asymptomatic individuals (i.e., who do not have
respiratory symptoms) in the community should wear medical masks, as currently there is no
evidence that routine use of medical masks by healthy individuals prevents 2019-nCoV
transmission. Masks are recommended to be used by symptomatic persons in the
community. Misuse and overuse of medical masks may cause serious issues of shortage of
stocks and lack of mask availability for those who actually need to wear them. 

In health care facilities where health care workers are directly taking care of suspect or
confirmed 2019-nCoV acute respiratory disease patients, masks are an important part of
containing 2019-nCoV spread between people, along with other PPE and hand hygiene. For
more information on medical mask use

What are the disinfectants recommended for environmental cleaning in healthcare


facilities or homes housing patients with suspected or confirmed 2019-nCoV
infection?

Environmental cleaning in healthcare facilities or homes housing patients with suspected or


confirmed 2019-nCoV infection should use disinfectants that are active against enveloped
viruses, such as 2019-nCoV and other coronaviruses. There are many disinfectants,
including commonly used hospital disinfectants, that are active against enveloped viruses.
Currently WHO recommendations include the use of:

 70% Ethyl alcohol to disinfect reusable dedicated equipment (e.g., thermometers)


between uses
 Sodium hypochlorite at 0.5% (equivalent 5000ppm) for disinfection of frequently
touched surfaces in homes or healthcare facilities

Click here for the guidance on clinical management of severe acute respiratory infection
when novel coronavirus (nCoV) infection is suspected.
Click here for the guidance on infection prevention and control during health care when
novel coronavirus (nCoV) infection is suspected.
More information about environmental cleaning can be found

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