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South African Dental Journal

On-line version ISSN 0375-1562
Print version ISSN 0011-8516

S. Afr. dent. j. vol.75 n.4 Johannesburg May. 2020




Personal protective equipment under and after COVID-19 need a rethink



KC Makhubele




Today as I write this article, it is with the backdrop of the speech On Thursday, the 23 April wherein President Cyril Ramaphosa announced that the country would resume economic activity in a phased approach from 1 May.

He said "...We have developed an approach that determines the measures we should have in place based on the direction of the pandemic in our country. As part of this approach, there will be Ave coronavirus level (1-5). What we are facing is a pandemic, all countries affected have approached it differently. We applaud the Government of SA in the timely and considered manner in which they are managing the pandemic."

But one has to ask - or at least this question has crossed many people's mind - what will the world look like when it emerges from the life of lockdowns, quarantine and isolation and the rampant ravages of COVID-19? What will South Africa look like? Close to our heart, how will dentistry look like?

The choices that are being made now and the political outcomes that will follow are critical to determining South Africa's future. Therefore, predicting what will happen after the pandemic is difficult, not least because we have little information about how long the outbreak and restrictions will last.

As a rare event, we have limited historical evidence even with the learning from the Spanish flue; as an unexpected event, little thought has been given to how to deal with it - when our Minister of Finance made his budget recently, he had no idea what would hit South Africa. We have to all readjust our contribution to life in the "new" and "reconfigured "country.

The pandemic will last longer and its effects felt long after it has disappeared. The issue of high-level hygiene is amongst the issues that will be high on the mind of dentistry more than any other health care sectors. It is in this light that I am urging third-party funders to alter their fees without delays and unnecessary long-drawn discussions, to account for the increasing cost of personal protective equipment that dentists are using to protect themselves, their staff and patients.

These organisations should adjust their benefit programs either the maximum allowable fees for all procedures or allow a standard fee per date of service per patient to accommodate the rising costs of PPE. SADA is currently working on guidelines that should have been published at the publication of this article.



To step up the protection of patients, staff and themselves, and the new SADA guidelines, dentists will have to procure a huge amount of PPE and these requirements will without a doubt increase the overhead for every dental practice. These anticipated increases in overhead were not taken into account in the fees in place before the pandemic. I also feel very strongly that third-party funders should not bundle the fee for temporary procedures performed or extraoral imaging conducted during the pandemic with the payment for the permanent procedure that may be submitted in the future. It will be inappropriate for any third-party benefit program to unfairly place the cost burden on dentists by disallowing or bundling charges for PPE on the pretext that the payment for additional required PPE is included in the payment for any other procedure billed for the visit.

The above factors may create an environment that may be unsustainable for dental practices. I, therefore, call upon our partners to pay special attention to these consequences and support payment for PPE as we all strive to keep our patients and communities of South Africa healthy. There is also discussion underway for dentists to join the public national fight against the Coronavirus and there is a chance that some of the dental practices may be converted into COVID-19 testing centres. This adds more weight to have this discussion and a solution sooner than later.

This is not a fight that one profession can fight alone, it requires joint efforts, it requires all stakeholders, it requires foresight and it requires us to put the health of the communities above all else.



Notice of Amendment: 20th Annual General Meeting (AGM) of The South African Dental Association NPC (SADA)

Amended Notice is hereby given that the 20th Annual General Meeting (AGM) of the South African Dental Association (SADA) will be held on Wednesday, 17 June 2020 at 18h00 at the SADA Head Office, 31 Princess of Wales Terrace, Parktown, Johannesburg (opp. Sunnyside Hotel) pending the lifting by that date of the lockdown restrictions and prohibition of gatherings due to COVID-19. If these restrictions are not lifted, the meeting will be conducted entirely by electronic communication due to the COVID-19 pandemic and requirements of social distancing, which will be facilitated from the SADA head office above or contracted providers.

In the event that SADA is required to conduct the AGM entirely by electronic communication due to restrictions of movement and gatherings, we will provide necessary information in order to enable members, or their proxies, to access the available medium or means of electronic communication (link to join the electronic meeting).

Members are advised that they must have access to a computer or smart device or dial up facility in order to join the online meeting. In view of extraordinary circumstances and to ensure maximum participation of voting members on resolutions tabled at an AGM, we call for early return of proxies from members who are unable to attend.

Questions from members: We are also encouraging members to raise questions prior to the AGM, thereby allowing those not in attendance, the opportunity to raise issues which can then be dealt with at the AGM or referred to National Council meeting. The questions and answers covered in the AGM will, following the meeting, be published on the Association's website.

The full Agenda and supporting document for the meeting will be sent to members and posted on the SADA website in due course.

SADA is your Association and your voice counts.

P Govan

Head Legal & Corporate

20 April 2020

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