The COVID-19 situation is changing quickly and the Minister of Health, Adrian Dix, and Provincial Health Officer, Dr. Bonnie Henry, are making regular joint statements on this topic.
The joint statements about COVID-19 from the Provincial Health Officer and the Minister of Health are available here.
You can hear audio recordings of the joint press conferences on the BC Government’s SoundCloud Account.
The provincial government has created a dedicated phone service to provide British Columbians non-medical information about COVID-19. This includes the latest information on travel recommendations and social distancing, as well as access to support and resources from the provincial and federal governments.
Minister Dix advised that British Columbians can reach service representatives seven days a week, from 7:30 a.m. to 8 p.m., by calling 1 888 COVID19. Information is available in more than 110 languages.
Managing the risk of transmission of infection is a significant challenge in all healthcare settings including dentistry. In dentistry, there is specific concern related to the potential for infection as a result of airborne transmission from people with pre-symptomatic or asymptomatic COVID-19 given the frequency with which aerosol generating procedures (AGPs) are performed and the duration of those AGPs. These AGPs are important to the delivery of dental services, and so it is critical to recognize that the risk of exposure to potentially infectious aerosols from a person with unrecognized COVID-19 is dependent on the extent of community transmission of COVID-19. As BC moves into phase 2 of the government’s restart plan, there is evidence that community transmission has fallen to a significantly lower level based on number of new cases detected per day through current testing pathways. There is a lack of evidence that AGPs represent a significant risk in this context of controlled community transmission. There is not a clear evidence base for a general restriction on use of AGPs or for requiring routine use of airborne precautions (N95 masks) when AGPs are performed on people where there is no fever, no other symptoms suggestive of COVID-19 and no recent contact with a known case of COVID-19. Key elements in managing the risk are active surveillance for fever or respiratory symptoms before attendance and on arrival at the healthcare setting and the application of Standard Precautions (Routine Practices) when caring for all people in all settings at all times. In effect, key elements of contact and droplet precautions (use of gloves and a surgical mask) are routinely applied in dental practice.
In phase 2 of the BC government’s restart plan, oral health care providers are free to return to their full scope of practice as long as risk assessment informs their decision-making around the provision of care.
On March 23, 2020, Provincial Health Officer Dr. Bonnie Henry issued an update addressed to all regulated health professionals in BC. Health professionals were asked to limit delivery of in-person services in community settings and this message remains current, despite the recent discussion of lifting some of these measures at a future date. To be clear, the message from the Provincial Health Office continues to be that “all non-essential and elective services involving direct physical contact with patients and clients should be reduced to minimal levels, subject to allowable exceptions, until further notice.” Regulated health professionals are encouraged to provide services via telephone/video where possible. Timelines of when non-urgent in-person care can resume remain unknown and this direction will be provided by the Provincial Health Officer at the appropriate time. In the meantime, stay the course, limit in-person services to patients who require urgent care that cannot be delivered via telephone/video, and continue to consult the CDSBC website for up-to-date information. We are all looking forward to being able to receive healthcare services again. But as Dr. Henry and Minister Dix said on April 22: “We have been clear from the outset, we are taking a whole-province approach and we need every individual, every business and every community to do that same. We cannot afford to have any weakness in our firewall that will result in a surge in new cases. To ease restrictions, we need a continued decline in both the number of new cases and the number of outbreaks. Until we clear that important hurdle, we can’t begin to make changes.” The College has struck an expert COVID-19 Response working group to develop practice guidance for registrants should restrictions on physical distancing be lessened over the next few months.