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A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Science Versus Economic Demand

Universally and individually, we are trapped between the proponents of reopening society for economic reasons and those who say we must wait for answers about how best to reduce mortality and morbidity from COVID-19.

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May you live in interesting times” goes the old curse — and these are certainly interesting times. While normal has changed, none of us know what this means for the future, except this: What emerges will be determined to great extent by the competition between science and economics. Universally and individually, we are trapped between the proponents of reopening society for economic reasons and those who say we must wait for answers about how best to reduce mortality and morbidity from COVID-19.

There are strong arguments on both sides. Without jobs, individuals and companies, as well as national, state and local governments, face economic disaster. On the other hand, opening too quickly — and without proper testing, medications and vaccines — may increase the pandemic’s toll.

Federal authorities have shifted much of the responsibility of how to reopen to state and local governments. This will allow local authorities to make judgments based on community needs. Of course, this also makes state and local authorities responsible for any resulting problems. The situation has become a political football, and with an election on the horizon this political gamesmanship is not likely to change soon. After all, reopening society will improve the economic outlook, which benefits those in power. At the same time, any new outbreaks will be laid squarely at their doorstep.

WE ARE TRAPPED BETWEEN THE PROPONENTS OF REOPENING SOCIETY FOR ECONOMIC REASONS AND THOSE WHO SAY WE MUST WAIT FOR ANSWERS

On the other side of the argument is the scientific community, whose concerns can be summarized by former secretary of defense Donald Rumsfeld, who said, “We know the known unknowns, but not the unknown unknowns.” This has led to a call to move forward slowly. Safety amidst the pandemic is found in universal testing, new medications and vaccines — all backed by randomized clinical trials before being applied universally.

As of this writing, the economic side is prevailing. As a result, we will have a period in which there will not be adequate testing, and medications will be used with trial and error.

How will this impact dentistry? There will be practice restrictions in place, including recommendations from the U.S. Centers for Disease Control and Prevention and World Health Organization. Exactly what these will be is unknown, but it can be assumed it will radically transform practice. The vast majority of oral health professionals generate aerosols, so we will need to develop strategies to deal with this issue. One possibility is point-of-care testing prior to treatment, as this will address aerosol concerns. Other possibilities include more efficient use of personal protective equipment (and even respirators), staff training, and reworking our offices and schedules to fit new guidelines. The economic consequences will be significant.

Even with so many uncertainties ahead, there is cause for optimism. While the future will be shaped by this economic/scientific battle, let’s hope the scientific community is heard, and that practice modifications will ensure both economic viability and safe treatment.

Thomas G. Wilson Jr., DDS

Editor in Chief
[email protected]

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