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UPDATES on COVID-19

Healthcare Guidelines – updated June 11, 2021

As society continues to climb out of the grip of COVID-19, the Board would just like to encourage its community of licensees to follow the guidelines of the CDC. Additionally, the Board would like to encourage you to read Governor Ducey's Executive Order 2021-08 titled Lifting Restrictions on Healthcare Institutions. 

Holiday Safety – updated December 21, 2020

When getting ready to celebrate, it is important to acknowledge the risk of holiday gatherings during this time and help slow the spread of COVID-19. The safest way to celebrate this winter is at home with the people you live with. Please follow the following link to access a Winter Holiday Safety Fact Sheet.

Governor Ducey Announces COVID-19 Vaccine has Arrived in Arizona - updated December 14, 2020

Arizona received the first shipment of COVID-19 vaccine doses, today Monday, December 14, 2020. This week, distribution of the vaccine will begin in the state’s largest population centers, Maricopa and Pima Counties. 

For Maricopa County:

The Maricopa County Department of Public Health (MCDPH) is in the final planning stages for providing COVID-19 vaccine to people who are at highest risk of contracting COVID-19 based on their occupational and individual risk factors. This includes many of you, who provide direct care and services to people who are or could be COVID-positive. 

Because supply will be limited at the outset and to ensure equitable distribution of those limited doses,(MCDPH) is following the guidance of the CDC’s Advisory Council on Immunization Practices (ACIP) and the Arizona Department of Health Services Vaccine and Antiviral Prioritization Advisory Committee (ADHS VAPAC).  

The first allocation of vaccine doses will be prioritized to individuals that ACIP has recommended to be in Phase 1A: those working in a healthcare setting, especially those with the most potential exposure to COVID-19, as well as residents and staff of long-term care facilities.  

To determine your eligibility, please complete this pre-screen survey as the first step to scheduling an appointment. Your response will help MCDPH determine your eligibility and connect you with your assigned regional vaccine provider, based on the location of your primary worksite.   

Things to know about the pre-screening:  

COVID-19 vaccine will be available to Phase 1A individuals by appointment only, and completing this pre-screening survey is required to make your appointment. 

  • Long term care residents/staff are mostly being vaccinated through a federal pharmacy vaccine program. 
  • You will be asked to provide your employee ID or other ID (such as a driver's license number) as part of the screening process. This will be used for identification purposes only. 
  • COVID-19 vaccines are free, however, insurance information will be requested during appointment scheduling so that an administration fee can be billed to insurance if you are insured. There will be no out-of-pocket costs requested during your appointment time and you should not receive a bill.
  • Priority will be given to those who meet exposure and risk thresholds. You will be notified when vaccine is available to you. The process may take several days, so please be patient while you await your notification. 
  • Any healthcare provider who provides direct patient care of any type (including environmental services and laboratory workers) will be included in Phase 1A. If you are determined to be eligible for vaccine in Phase 1A, you will receive a notification with details on where and how to set up an appointment.
  • Healthcare providers who do not provide in-person, direct patient care (administrators and telemedicine providers) will be included as essential workers early in Phase 1B but are not eligible for vaccine in 1A since they are not at increased risk of exposure in their work.
  • The information collected in this screening tool will only be accessed by MCDPH and will not be shared outside of public health.   
  • Vaccination sites for healthcare workers will not be open for an extended period of time, so we encourage you to sign up today or you may have to wait until later phases.

If you have any questions regarding COVID-19 vaccine pre-screening or need help filling out this form, please email [email protected]maricopa.gov 

Still deciding if you want to get the vaccine? Take a look at Maricopa.gov/COVID19vaccine1A and please complete the prescreening survey. The survey does not commit you to getting the vaccine, and after you complete it, you will receive more information about how and when you can get the vaccine.

 

For Pima County:

Pima County and area hospital partners will prioritize front-line health care workers treating COVID-19 patients, and residents and staff of long-term care facilities in initial distribution of the COVID-19 vaccine.

Pima County is expecting more than 50,000 doses in the first distribution of the Pfizer vaccine, including about 11,000 doses this week, followed by 17,000 about a week later.

The first vaccinations are scheduled for Dec. 17.

This initial Phase 1A distribution, announced at a joint press conference of officials from the Pima County Health Department, Tucson Medical Center and Banner – University Medicine, follows recommendations from the Centers for Disease Control and Prevention (CDC).

The CDC says on its website:

“Healthcare personnel are defined as paid and unpaid people serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials. Long-term care facility residents are defined as adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently.”

Banner and TMC will serve as initial vaccinators and will be distributing vaccines to health care workers across all Pima County providers who meet the criteria. Other hospitals and health care partners are expected to receive the Moderna vaccine before the end of the month for distribution to their employees.

Health care workers are advised to look for communication from their employer about which priority groups they fall under and when they can begin scheduling their vaccine appointments.

Vaccinations are voluntary but are encouraged by health officials in order to protect those on the front line from becoming sick while helping us control the pandemic and ensure the community has continued access to necessary health care services.

The initial Phase 1A rollout will include two distribution sites – one each at TMC and Banner. According to Crystal Rambaud, the Pima County Health Department Manager for Vaccine Preventable Diseases, a partnership between Walgreens, CVS and long-term care facilities in the County will allow staff and residents to receive direct vaccination.

For the 1C group and later, there will be much broader distribution, most notably at doctor’s offices and clinics.

A chart for the overview of the vaccine prioritization, including the general population in Phase 2, can be found here.

The timeline for the rollout of vaccinations to the priority groups is in flux, with the amount of vaccine made available to the County one of several variables. Dr. Theresa Cullen, the Pima County Health Director, said the period of vaccination for all of the priority groups identified in Phase 1 (A, B and C) could take at least five months.

“The caveat to all this is availability of vaccines, as well as what vaccines have been reviewed and endorsed by the FDA and CDC,” Cullen said. “It is possible this timeline could accelerate.”

The vaccine is the newest tool in the toolbox to slow the spread of COVID-19. Cullen says the other mitigation tools in the toolbox – wear a face mask, wash your hands, stay at least 6 feet apart, stay at home when you can – remain essential.

“We need every resident of the County to continue to adhere to the recommendations,” Cullen said. “We are in an accelerated transmission phase. Despite the fact that the vaccine will be here this week, the impact of the vaccine will take months to achieve in terms of a community-based response.

“Obviously the individuals who receive the vaccine will get protection after the second shot. In the meantime, we encourage and really plead with the community to stay committed to the activities we know will help mitigate the transmission we are currently seeing.”

For more and updated information about vaccine distribution/safety and FAQs, visit www.pima.gov/covid19vaccine

To watch Monday’s press conference, use this link from the Pima County Facebook page.

Media Contact: Pima County Communications, [email protected]

To download photos and B-roll video from TMC’s mock vaccine drive-thru, use this link: https://pimacounty.widencollective.com/c/zaeudsb3

Vaccine phases

The CDC updated the Guidance for Dental Settings During the COVID-19 Response - updated August 28, 2020 

 

This updated guidance helps give clarification to the previous interim guidance.   The updated guidance offers the following:

 

  • Provides a section for routine delivery of care during the pandemic and a second section for delivery of care recommendations for patients suspected or known COVID-19
  • Reminder for DHCP of transmission risks outside of patient care areas.
  • Clarification on engineering controls for open bay operatories, reprocessing treatment areas between patients, and alternative disinfection methods.

New Guidance from the CDC in Dental Settings - updated August 4, 2020

The CDC Guidance for Dental Settings During the COVID-19 Response has been updated. Most recommendations in the updated guidance have been rearranged for clarity and are not new. Recent updates include:

  • How to respond to SARS-CoV-2 exposures among dental healthcare personnel (DHCP) and patients, and guidance on physical distancing.
  • The definition of fever changed to either a measured temperature ≥100.0°F or subjective fever to align with CDC’s Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.
  • In areas with moderate to substantial community transmission, during encounters with patients not suspected of SARS-CoV-2 infection, CDC recommends that DHCP:
    • Wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from exposure to respiratory secretions, including those where splashes and sprays are not anticipated.
    • Use an N95 respirator or a respirator that offers an equivalent or higher level of protection during aerosol generating procedures.
  • Added language that protective eyewear (e.g., safety glasses, trauma glasses) with gaps between glasses and the face likely do not protect eyes from all splashes and sprays.

 

It is unknown at this time how COVID-19 may permanently change infection control practices in dental health care settings. CDC continually assesses emerging scientific evidence for developing policies, guidelines, and recommendations. You can find the most up-to-date information about infection prevention and control practices on CDC’s COVID-19 page. This is an emerging, rapidly changing situation, and CDC will update this guidance as additional information becomes available.  

American Dental Association Provides a Patient Communication Resource Center to Help Welcome Patients - updated July 7, 2020

The American Dental Association launched a customizable patient return resource center July 7, designed to help its member dentists communicate changes with their patients amid reopening.

The 10-page guide consists of:

  • A comprehensive visual guide to show patients what the new care process will look like
  • A detailed FAQ to address common patient concerns
  • Social media post templates
  • Four office signage templates
  • Email and text message templates to communicate the office's infection control procedures before patients' appointments

 

Dental School Graduates and the Issuance of Provisional Licenses - updated July 1, 2020

If I am a dental school graduate, or soon to be graduate, may I apply for and be issued a license without taking the required national examinations, including the clinical examinations? While Governor Ducey's 2020-17 initially allowed for licensing agencies to issue provisional licenses without taking the required national examinations, it also stated that graduates would be required to take and pass the national examinations when testing centers re-open. Now that testing centers have re-opened and have even made allowances for examinations using manikin based tests, the Arizona State Board of Dental Examiners ("Board") will no longer be issuing provisional licenses - beginning July 1, 2020.

Applications must complete all requirements under Arizona Law, including the national and clinical exams. Please note that the Board is still waiving all required application fees thru December 31, 2020. 

 

The tests are for health care workers and first responders and are being funded by the State of Arizona. According to their guidance, an individual licensed by Arizona Board of Dental Examiners is included in their list of health care workers.

 

Governor Ducey Issues Executive Order Directing Employers to Create Policies - updated May 12, 2020

In an effort to limit and mitigate the spread of COVID-19, Governor Ducey issued Executive Order 2020-36 directing employers to develop, establish and implement policies based on guidance from the CDC, Department of Labor, Occupational Safety and Health Administration (OSHA) and ADHS. The policies should include the following: 

a. Promoting healthy hygiene practices;

b. Intensifying cleaning, disinfection and ventilation practices;

c. Monitoring for sickness;

d. Ensuring physical distancing;

e. Providing necessary protective equipment;

f. Allowing for and encouraging teleworking where feasible;

g. Providing plans, where possible, to return to work in phases; and

h. Limiting the congregation of groups of no more than 10 persons when feasible and in relation to the size of the location.

 

FREE Continuing Education RE: PPE - updated May 12, 2020

Increasing healthcare worker safety is essential in our new unknowns regarding COVID-19. Dental workers (including dentists, hygienists, dental assistants, and other office staff) are at risk of infectious disease through patient contact and contact with the patient care environment. Employers are required to train workers about the necessity of PPE, including how to use it, put it on, remove it, and safely dispose of it. For a free, OSHA funded online training that focuses on the safety of the worker and addresses the Centers for Disease Control and Prevention’s recommended donning and doffing procedures for PPE, please see https://ppetraining.org/. Proper techniques are crucial to prevent the spread of infectious disease to workers on the front-lines of patient care. The training includes strategies and techniques so that workers can protect themselves against these serious workplace safety hazards.

 

 Recycling PPE - updated May 5, 2020

The Arizona Department of Health Services (AZDHS) is excited to announce the pending arrival of the Battelle Critical Care Decontamination System™ (Battelle CCDS™) to aid frontline workers in Arizona in extending the use of disposable respirators and PPE. AZDHS and the Board appreciate your participation. 

 

"Re-Opening" - Dentistry Guidance - updated April 27, 2020

Following the guidance from our state leadership, which comes at a crucial time for our community, and given the latest Executive Order 2020-32, the Governor's Office, in collaboration with the Arizona Department of Health Services, developed an FAQ page for dentists and hygienists to follow to "re-open" on May 1. Please reference the FAQ link beginning on page 5 for specific direction regarding dental providers. The Board appreciates and recognizes all the efforts of the Governor's Office and AZDHS for providing this direction and allowing for the re-opening of dentistry on May 1. 

What Next? What can you do now to prepare your business, employees, etc.? Click here for help.

 

Governor Ducey Announces New Guidance on "Elective Surgeries" - updated April 22, 2020

Governor Ducey announces and issues a new Executive Order to allow for elective surgeries. Under the new order, hospitals, dental offices and other health facilities can resume conducting elective surgeries on May 1 if they can show they have implemented measures intended to keep health care workers and patients safe. These include:

  • Demonstrating greater than a 14 day supply of PPE; 

  • Ensuring adequate staffing and beds;

  • Testing patients prior to surgery and all at-risk health care workers;

  • Ensuring appropriate discharge plans for patients being transferred to nursing care facilities, including diagnostic testing for COVID-19;

  • Implementing a universal symptom screening process for staff, patients, and visitors; 

  • Establishing an enhanced cleaning process for waiting areas; 

  • And prioritizing the restart of elective surgeries based on urgency.

Facilities that meet the specified standards will need to complete and exemption request and receive approval from the Arizona Department of Health Services before resuming elective surgeries. The order shall be considered for repeal or revision every two weeks. 

 

Frequently Asked Questions - updated April 10, 2020

The Board met on April 10, 2020 and among other things discussed the economic impact of COVID-19/Coronavirus on the dental community. As such, and to coincide with Governor Ducey's 2020-17 Executive Order, the Board voted to waive many of its fees through the remainder of the 2020 calendar year. Please review this FAQs document for more information respective to your fee concern(s). Additionally, the FAQs also addresses other matters, such as renewal extensions, examinations for initial licensure, provisional licenses and more. The granting of a provisional license may help in obtaining employment, but the Board makes no assurances that a provisional license will guarantee employment, the receipt of insurance from an insurance carrier or a DEA Certificate of Registration to dispense drugs and/or devices.  

 

Report a COVID-19 Related Concern

Please use this link to report a concern related to the practice of dentistry during the COVID-19 pandemic. Once submitted, the concern will be raised, with the compliance team, to determine whether or not the licensee is committing any conduct or practice that constitutes a danger to the health, welfare or safety of the patient or the public in spite of the Governor's Executive Orders. Please note that not all complaints will merit an investigation and not all investigations warrant discipline even though the complainant's perception is that it should. 

 

Register as a Volunteer Health Professional for a Public Health Emergency

The Board staff has fielded numerous phone calls and emails from our healthcare professionals who are interested in volunteering for the COVID-19 Response. The Arizona Department of Health Services (ADHS)  has recently responded and needs emergency response volunteers to call upon during a time of need. The knowledge and skills you have can help make a difference during this or any disaster. The first step in volunteering is to register with the Arizona Emergency System for the Advance Registration of Volunteer Health Professionals (AZ-ESAR-VHP or https://esar-vhp.health.azdhs.gov/). Once registered, request membership into the COVID-19 Response or other categories of interest. You can also get involved with opportunities by connecting with your local medical reserve corps by visiting https://mrc.hhs.gov/FindMRC.

Additionally, if a healthcare professional wishes to donate any medical supplies, including PPE, all items can be donated directly to their local county health departments or healthcare facilities. 

Specifically, if you wish to donate to the Maricopa County Department of Public Health (MCDPH), who depends on the generosity of community members like you, they have implemented a donation management program to allow for individuals and/or organizations to donate. Follow this link for donation drop off location and times, and help spread the word.

 

Governor Ducey Announces Latest COVID-19 Actions 

Governor Ducey announces and issues an Executive Order that halts all elective surgeries in the state of Arizona to free up medical resources and maintain the capacity for hospitals and providers to continue offering vital services. The Executive Order includes dental surgeries. 

 

Arizona State Board Dental Examiners’ COVID-19 Statement:

As the facts and situation around COVID-19 (Coronavirus) continue to evolve, the Arizona State Board of Dental Examiners is requesting the cooperation of all Arizona dental licensees and is issuing the following guidance below. This recommendation is being made after careful deliberation and in consultation with state and national public health experts[1], and in line with our mission to protect the public.

The Arizona State Board of Dental Examiners supports the American Dental Association’s (“ADA”) recommendation(s). To quote the ADA, “As healthcare professionals, it is up to dentists to make well-informed decisions about their patients and practices.” As always, the Board hopes and urges its licensees to continue to be available as needed for essential and/or emergency care and services, but to take appropriate and enhanced precautionary measures for patient safety, as well as the safety of their staffs and themselves.

The Board does not make this request lightly, but out of an abundance of caution during this historic public health emergency. As health care professionals, we all have a role to play in "flattening the curve" in order to follow sound, scientific public health advice to help limit infections and slow the spread of the virus.

Our collective actions now will determine the spread of COVID-19. We believe by taking these extraordinary precautions, dental practitioners can make a difference in helping to preserve the limited supply of personal protective equipment critical for emergency dental care and frontline health care personnel responding to the pandemic. We recognize the gravity of these extreme measures and are sensitive to the economic impact of such actions. Rest assured that the Board will advocate on behalf of all dental licensees in Arizona for economic relief packages.

We understand you will have questions about what to do next following this announcement. As licensed dental practitioners we urge you to do what is best for the communities you serve, including your staff and your patients. For the most up-to-date information and support, continue checking this webpage.

In addition, the Board Recommends the following protocols:

Patients should be screened for active disease prior to providing dental care in the office. Please take note of:

  • Any individual who exhibits or reports signs of acute respiratory illness such as coughing, fever and shortness of breath. Take temperature readings.
  • Recent travel to any locations designated by the CDC to have a Level 3 Travel Health Notice for COVID-19. Verify when the patient returned to the United States.
  • Close contact with an individual, such as a family member or co-worker, diagnosed with COVID-19 within the last two weeks.

To reduce the production of aerosols during dental treatment, which is also advised during this time of increased transmissibility:

  • Avoid or minimize operations that can produce droplets or aerosols; use rubber dams as much as possible.
  • Rinse the oral cavity slowly, avoiding unnecessary splatter.
  • Use high-speed evacuation for all dental procedures producing an aerosol.
  • Have patient use an antimicrobial rinse before starting a dental procedure; ADA suggests using 1% hydrogen peroxide.
  • Avoid or minimize procedures that may induce coughing, such as taking routine intraoral X-rays.

Interim CDC guidance for businesses and employers recommends that:

  • Employers encourage employees who report symptoms of acute respiratory illness to stay home and not return to work until they are free of symptoms for at least 24 hours without the use of fever relieving or symptom altering medications.
  • If an employee appears to be sick upon arrival to work, they should be separated from other employees and sent home immediately.
  • Employees cover a cough or sneeze with a tissue and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Employees wash hands often with soap and water for at least 20 seconds. If soap and water are not readily available, an alcohol-based hand sanitizer with at least 60% alcohol can be used.
  • Clean and disinfect public areas frequently, including door handles, chairs and bathrooms.

CDC recommends healthcare facilities, including dental offices, screen patients before

proceeding with an appointment. Information to take note of:

  • Any individual who exhibits or reports signs of acute respiratory illness such as coughing, fever and shortness of breath.
  • Recent travel to any locations that have a Level 3 Travel Health Notice for COVID-19. Verify when the patient returned to the United States. If the patient reports that at least two weeks have passed since their return from one of the identified regions and no symptoms have presented, the dental office can proceed with the appointment. When local, state or federal public health officials declare the disease is at the community level, screening for travel is not necessary.
  • Close contact with an individual diagnosed with COVID-19.

Lastly, and for some guidance in how your office(s) should protect the public exposure and its staff, you may want to consider requesting your patients to complete a Medical History Addendum. Click here for an example.