A Message for CDA Corporate Member Provincial Dental Associations

Below is a snapshot of the Canadian Dental Association’s (CDA) pandemic-related work for the week ending April 23, 2021. CDA’s next update is slated for May 20, 2021.

Fast Facts: Current COVID-19 Situational Report

Dr. Aaron Burry, CDA’s COVID-19 Team Lead and Deputy CEO - Professional Affairs, provides a video update on the COVID-19 pandemic. Highlights include:

• April 2020 vs. April 2021: What a difference a year makes in case growth and vaccines administered.
• Concerns about the increases in hospitalizations across Canada – a province-by-province comparison.
• Canada’s vaccine supply is increasing over the next few weeks, which should start shifting the number of severe cases/hospitalizations in the right direction.
• A global comparison of the number of cases per day per 100k and the latest 14-day trends.
• Trends from other countries after attaining certain levels of vaccination. Canada is also closely watching the United Kingdom (UK) and other European countries, where cases have steadily declined after vaccinations administered increased and additional public health measures were implemented.
• Canada is following approximately six weeks behind the UK and many European countries and will hopefully experience a similar downward trend as more vaccine becomes available to the general population.
• Canada could see harder lockdowns/public health measures coming into effect to help control the spread of new variants. In some areas of Canada, workplaces with five or more employees have had to temporarily close for ten days after a COVID-positive case has been determined. This may be a risk for dental offices.

Key Takeaways for Dentistry:

• Dental office staff must remain hyper vigilant; in their personal lives, when presenting to the office for work, and when in non-clinical/common areas inside the office.
• Be aware of your local trends. Keep up with screening protocols and/or adapt screening questions as the local situation evolves.
• Dentists and dental teams are infection control experts and have always followed strict protocols and procedures to protect patients and staff. With added COVID-19 provincial guidelines, dentists are already doing everything possible to put additional levels of protection in place to create a safe environment for their patients and the dental team.
• The good news is that to date, dentistry has demonstrated that dental offices can offer care safely and that infection prevention and control practices are effective, allowing oral health care provision during the pandemic. Keep up the good work, but don’t let your guard down.

Video Length: 7 minutes. Recorded: April 20, 2021.

CDA Advocacy and Federal Government Announcements

Update: 2021 Federal Budget. On April 19, Deputy Prime Minister and Minister of Finance, Chrystia Freeland, tabled the federal budget. There is no specific mention of dental care or oral health care; however, there are several measures and commitments related to the profession of dentistry. Some highlights include:

Providing Access to Vaccines: Canada is on track to meet the commitment that every Canadian who wants to will be fully vaccinated by September. As a result of the federal government's ongoing efforts to accelerate the delivery of COVID-19 vaccines, Canada received a total of 9.5 million doses by the end of March 2021, 3.5 million more than the initial target of 6 million doses.

Extension of Federal Funding Programs:

• Extending the Canada Emergency Wage Subsidy (CEWS): Budget 2021 proposes to extend the wage subsidy until September 25, 2021. It also proposes to gradually decrease the subsidy rate, beginning July 4, 2021, to ensure an orderly phase-out of the program as vaccinations are completed and the economy reopens.
• Extending the Canada Emergency Rent Subsidy (CERS) and Lockdown Support: Budget 2021 proposes to extend CERS and Lockdown Support until September 25, 2021. It also proposes to gradually decrease the rate of the rent subsidy, beginning July 4, 2021, to ensure an orderly phase-out of this program as vaccinations are completed and the economy reopens.
• Extending the Canada Emergency Business Account (CEBA): The government recently extended the application deadline for CEBA to June 30, 2021.

Maintaining Flexible Access to Employment Insurance (EI) Benefits: Budget 2021 announces forthcoming consultations on future, long-term reforms to EI. To support this effort, the government proposes to provide $5 million over two years, starting in 2021-22, to Employment and Social Development Canada to conduct targeted consultations with Canadians, employers, and other stakeholders from across the country. Consultations will examine systemic gaps exposed by COVID-19.

Towards a New Disability Benefit: Budget 2021 proposes to provide $11.9 million over three years, starting in 2021-22, to Employment and Social Development Canada to undertake consultations to reform the eligibility process for federal disability programs and benefits. This will help maximize the reach of these programs and improve the lives of Canadians living with disabilities. This work would feed directly into the design of a new federal disability benefit.

Supporting Long-Term Care: Budget 2021 proposes to provide $3 billion over five years, starting in 2022-23, to Health Canada to support provinces and territories in ensuring standards for long-term care are applied and permanent changes are made. To keep seniors safe and improve their quality of life, the federal government will work collaboratively with provinces and territories, while respecting their jurisdiction over health care, including long-term care. This work would ensure seniors and those in care live in safe and dignified conditions. Budget 2021 proposes to provide $41.3 million over six years, and $7.7 million ongoing, starting in 2021-22, for Statistics Canada to improve data infrastructure and data collection on supportive care, primary care, and pharmaceuticals.

Helping Our Health Care Systems Recover: As announced in March 2021, the federal government is proposing to provide provinces and territories with $4 billion through a one-time top-up to the Canada Health Transfer. This will help health systems ensure Canadians get the procedures and treatments they need to stay healthy and clear through the backlog of delayed procedures.

Renewing the Territorial Health Investment Fund: Budget 2021 proposes to provide $54 million over two years, starting in 2021-22, to renew the Territorial Health Investment Fund. Of this amount, $27 million would be allocated to Nunavut, $12.8 million would be allocated to Yukon, and $14.2 million would be allocated to the Northwest Territories. Note: This is in addition to the $4 billion one-time Canada Health Transfer top-up announced in March. The details of how exactly the funds added to the Territorial Health Investment Fund will be distributed are not articulated in the Federal Budget. However, currently the Territorial Health Investment Fund does allocate a portion of the envelope received from the federal government specifically to oral health.

Moving Forward on National Universal Pharmacare: The case for national universal pharmacare is well-established. The government is committed to work with provinces, territories and stakeholders to build on the foundational elements that are already in progress, like the national strategy on high-cost drugs for rare diseases, toward the goal of a universal national program. To maintain momentum, the government will proceed with its announced plan to provide ongoing funding of $500 million for the program for high-cost drugs for rare diseases. The government will also directly engage with willing partners on national universal pharmacare, alongside other important health priorities, that can be advanced at the provincial and territorial level. Note: The Act to Enact the Pharmacare Act that was proposed and defeated earlier this year was a Private Member’s Bill brought forward by NDP member, Peter Julian. The Liberal government is signalling its intent to find a solution to accessible drug coverage for all Canadians, though was not in agreement with the proposed NDP plan.

Improving Health Outcomes in Indigenous Communities: Budget 2021 proposes to invest $1.4 billion over five years, beginning in 2021-22, and $40.6 million ongoing, to maintain essential health care services for First Nations and Inuit, continue work to transform First Nations health systems, and respond to the health impacts of climate change, including:

• $774.6 million over five years, beginning in 2021-22, to ensure continued high-quality care through the Non-Insured Health Benefits Program, which supports First Nations and Inuit people with medically necessary services not otherwise covered, such as mental health services, medical travel, medications, and more.
• $354 million over five years, beginning in 2021-22, to increase the number of nurses and other medical professionals in remote and isolated First Nations communities.
• $107.1 million over three years, beginning in 2021-22, to continue efforts to transform how health care services are designed and delivered by First Nations communities, building on the government’s commitment to improve access to high-quality and culturally relevant health care for Indigenous peoples.
• $125.2 million over four years, beginning in 2022-23, to continue to support First Nations communities’ reliable access to clean water and help ensure the safe delivery of health and social services on reserve.

CDA will continue to monitor the situation and provide further updates, as new information becomes available.

COVID-19 Practice Recovery Task Force (“The Task Force”):

This group includes representatives from all Corporate Member provincial dental associations (PDAs). The Task Force continues to work together to discuss deliverables for:

1. information exchange on return-to-practice status across the country;
2. strategies for obtaining and securing PPEs; and
3. communications to the public on dentists returning to practice.

Ongoing: Mental Health in the Workplace. Safeguarding your mental health and overall wellness is important, especially during the COVID-19 pandemic. The Task Force continues to coordinate the evaluation of a short course on mental health in the workplace from the Mental Health Commission of Canada (called The Working Mind) to see if there is value in adapting or customizing this for dentistry. More information to follow as this work progresses.

Reminder! Resources on Vaccine Hesitancy. Canada’s vaccine supply will be increasing over the coming weeks. CDA has produced a package of resources to help dentists facilitate the discussion with their teams around the importance of immunization. The suite of materials includes the following resources, and has been provided to Corporate Members, via the Dental Communications Group, to use and adapt, as deemed appropriate:

1. Huddle notes for dentists: Let’s Talk About … COVID-19 Vaccines: A conversation guide for dentists with their teams
2. Electronic handout: COVID-19 Resource Listing
3. Printable handout: Top 20 Frequently Asked Questions about COVID-19 Vaccines
4. Printable handout: Fast Facts about COVID-19 Vaccines
5. Printable handout: Top 10 Myths about COVID-19 Vaccines
6. Printable dental office posters: Sleeve-up series
7. Social media: Sleeve-up series
8. Website content (may be repurposed or PDAs can link back to this CDA webpage)
9. Social video (Top Ten List with Dr. Aaron Burry - COVID-19 Vaccine Myths)

Please visit the COVID-19 vaccine section on the CDA website: www.cda-adc.ca/covid19vaccine

A preview of one of the new posters included in CDA’s resource package called Sleeve Up: Addressing COVID-19 Vaccine Hesitancy. Colours and text may vary as PDAs may adapt the materials for use by their member dentists.

Reminder: The Task Force continues to review and prioritize its list of deliverables. Any specific expectations or special requests of the Task Force should be fed forward by Corporate Member PDAs to their PDA member Task Force representative.

A Message from Public Health Agency of Canada: Information Bulletin on VITT for Health Care Providers

Since it began, the COVID-19 pandemic has been a highly dynamic situation. New developments in the pandemic have led to new evidence, which, in turn, have informed new or refined public health guidance.

As you may know, Canadian public health guidance around the AstraZeneca COVID-19 vaccine has evolved in recent weeks, in part due to concerns around vaccine-induced immune thrombotic thrombocytopenia (VITT, also known as vaccine-induced prothrombotic immune thrombocytopenia/VIPIT), which has been reported following post-licensure use of the vaccine in several countries. We understand that the evolving guidance has implications for you, as a health care provider, and particularly those who administer COVID-19 vaccines or provide education or advice to patients on vaccination.

The Public Health Agency of Canada is committed to addressing the evolving COVID-19 vaccine-related knowledge and training needs of health care providers. We will continue to offer webinars, and other training opportunities, to health care providers, to share the latest evidence and guidance with you on authorized COVID-19 vaccines, vaccine safety and related topics.

In the meantime, we have prepared a short information bulletin on AstraZeneca and VITT (attached). The bulletin compiles statements and guidance documents on these topics from a number of federal and provincial sources.

We will keep you informed of additional vaccine-related information and training opportunities as soon as we are able.

Knowledge and Information Broker:

CDA Oasis is CDA’s primary channel of communication for delivering urgent information to the dental community during the COVID-19 pandemic. The following discussions have been recorded since CDA’s last COVID-19 update. Be sure to check these out:

• Aerosols in the Dental Office:
  Dr. David French reviews the key strategies and protocols implemented so far in practices across Canada, and brings a particular focus to the application of UV light in removing airborne contaminants. (April 6, 2021)
• How Do You Manage Refusal to Wear a Mask?
  Dr. Clive Friedman highlights the importance of first giving the individual the space and opportunity to explain their position. He addresses the notion of "reasonable accommodation" and breaks down this tricky situation into actionable steps that ensure both a respectful approach to the patient/caregiver and due consideration to the safe management of your practice. (April 20, 2021)

This week’s CDA Oasis Bulletin collated relevant and timely “news that you can use” related to COVID-19.

New! CDA Essentials, Issue 2 is available online. Here are some of the edition’s highlights pertaining to the pandemic:

• President’s Column, Lessons Learned from the Pandemic
• Your COVID-19 Questions Answered
• Let’s Talk About Vaccine Hesitancy

CDA Help Desk:

CDA’s Help Desk continues to assist dentists and dental office employees on how to navigate and access federal government support programs.

For assistance on how to navigate these support programs for Canadians and businesses, please call 1-866-232-0385, M-F, 7:30 A.M. – 8:00 p.m. EDT.

Mental Health and Wellness:

It is important to safeguard your mental health and wellness. Individuals can access mental health and wellness support by calling CDSPI’s Members’ Assistance Program (MAP) at 1.844.578.4040 or visiting www.workhealthlife.com

MAP provides a variety of resources to help individuals deal with life's challenges. It is a confidential counselling, referral and information service for individuals who are dealing with mental health challenges or need advice on topics such as physical fitness, nutrition or parenting. MAP services and resources are offered through Shepell, Canada’s largest provider of Employee and Family Assistance Programs.

Reminder: Check out this wellness discussion featured in CDA Oasis:

• Healthy Workplace Matters Resources on CDA Oasis:
  We are pleased to announce the launch of the Healthy Workplace Matters initiative on CDA Oasis. The website brings together a range of helpful resources and tools to help the dental team contribute to creating and maintaining a healthy workplace. This initiative was made possible by the collaborative efforts of members of the Healthy Workplace Working Group, which consists of representatives from CDA, CDAA and CDHA. (April 19, 2021)

CDA COVID-19 Repository at a Glance:

CDA serves as a COVID-19 Repository for Corporate Member PDAs by collecting advice and available COVID-19 resources from external organizations and any sources that PDAs wish to share. The information is placed in the Repository and is exclusively available for use by the PDAs, for onward transmission to their respective dentist members, as deemed appropriate.

For quick reference, the following materials have been added to the Repository since CDA’s last COVID-19 update. As of November 2020, resources listed below and posted in the repository appear in the language it was created in. For the complete resource listing, please log in to view them all. Login details on how to access the Repository are below.

Dental Schools, Research, Journal Articles and Continuing Education Resources

American Dental Association

• HPI New Data Series on Oral Health Equity in the U.S.: Health equity is taking center stage in health policy, particularly as the COVID-19 pandemic exposes systemic inequities in the U.S. health care system. Check out the latest data on racial disparities in dental care use, cost barriers to dental care, the dental workforce, and the dental student pipeline:
  • Racial and Ethnic Mix of the Dentist Workforce in the U.S.
  • Racial and Ethnic Mix of Dental Students in the U.S.
  • Cost Barriers to Dental Care Among the U.S. Population, by Race and Ethnicity
  • Dental Care Utilization Among the U.S. Population, by Race and Ethnicity

National Resources:

Canadian Dental Association

• How Do You Manage Refusal to Wear a Mask?
  Dr. Clive Friedman highlights the importance of first giving the individual the space and opportunity to explain their position. He addresses the notion of "reasonable accommodation" and breaks down this tricky situation into actionable steps that ensure both a respectful approach to the patient/caregiver and due consideration to the safe management of your practice. (April 20, 2021)
• Healthy Workplace Matters Resources on CDA Oasis:
  We are pleased to announce the launch of the Healthy Workplace Matters initiative on CDA Oasis. The website brings together a range of helpful resources and tools to help the dental team contribute to creating and maintaining a healthy workplace. This initiative was made possible by the collaborative efforts of members of the Healthy Workplace Working Group, which consists of representatives from CDA, CDAA and CDHA. (April 19, 2021)
• Aerosols in the Dental Office:
  Dr. David French reviews the key strategies and protocols implemented so far in practices across Canada, and brings a particular focus to the application of UV light in removing airborne contaminants. (April 6, 2021)

Public Health Agency of Canada

• Government of Canada products and fact sheets (April 22, 2021)
• Health Care Provider Vaccine Tool Kit (April 21, 2021)
• COVID-19 Awareness Toolkit (April 14, 2021)
• Information Bulletin on VITT for Health Care Providers (April 13, 2021)

Provincial Dental Association / Regulatory Body Resources:

British Columbia Dental Association

• Member Update (April 22, 2021): BC Budget Highlights, VCH Vaccine Hesitancy Resources, Dentists Billing MSP
• Member Update (April 20, 2021): Highlights of Federal Budget, Extension of Provincial Health Orders, Upcoming BCDA Webinar
• Member Update (April 15, 2021): Report to the Profession, Amended BCDA Career Opportunity, HPV Vaccine Survey
• Member Update (April 13, 2021): Dental Office COVID-19 Exposures, Vaccinations for New Staff
• Member Update (April 8, 2021): FAQ on Vaccination Status Issues, PST Rebates for Capital Investments
• Member Update (April 1, 2021): Dentists & HPV Vaccinations Survey, Register for Next Week’s TMD Webinar
• Member Update (March 30, 2021): Be Vigilant with New Restrictions, Webinar Completion Certificates
• Member Update (March 25, 2021): Reduction in Training for Dentists Giving Vaccines, Vaccination Hesitancy Resources, Upcoming TMD Webinar
• Member Update (March 23, 2021): Dentists in NHA Eligible for Vaccine, CEBA Extension, Tonight’s Webinar on COVID-19 Variants

New Brunswick Dental Society

• CDA Federal Budget Update (April 23, 2021)
• President’s Message (April 15, 2021): AVDC – Conference; NBDS Supply Hub; Reminders; and more.
• Bi-Weekly Update (April 1, 2021): Atlantic Virtual Dental Convention; Vaccine Hesitancy; and more.
• Booking Your Vaccinations (March 22, 2021)

Nova Scotia Dental Association:

• NSDA Dispatch (April 20, 2021): Election in the wind? The NSDA is looking for MLA Contact Volunteers; Now available — Healthy Workplace Matters resources on CDA Oasis; Does your dental office software have the latest MSI fees?; and more.
• NSDA News Brief (March 31, 2021): Resources on vaccine hesitancy; Webinar recording: MSI Dental Programs webinar with Green Shield Canada; CDA COVID-19 Update: CDA and BCDA host a session on variants; and more.
• NSDA News Brief (March 25, 2021): Extension of the Canada Emergency Business Account (CEBA) – Small Business Loans; Business of dentistry feature on Nova Scotia-CDA Oasis community page; COVID-19 vaccination office policy; and more.

Ontario Dental Association

• Weekly COVID-19 Update (April 21, 2021): COVID-19 Directive #2 for Health-Care Providers; Emergency Child Care for Dentists and Their Teams; New! Resources to Address COVID-19 Vaccine Hesitancy; Justifying Travel During the Stay-at-Home Order; ASM21 Oral Health Strategy: Mental Health and Addictions and more.
• Weekly COVID-19 Update (April 14, 2021): Virtual Health Care; Just Three Weeks to Go – Register for ASM21 Today; and more.
• Weekly COVID-19 Update (April 7, 2021): Prioritization of Phase 2 Populations for COVID-19 Vaccination; Phase 1 Vaccine Access Achieved: Dentists Can Get Their First Doses; Ontario Government Issues Stay-at-Home Order; Register for the ASM21 Panel Discussion with the Pandemic Recovery Working Group; and more.
• Weekly COVID-19 Update (April 1, 2021): All 34 Public Health Unit Regions to Move into Shutdown; New and Updated Employment Resources; Oral Health Month Campaign Launches Today; Second Vaccination Dose Timing; and more.
• Weekly COVID-19 Update (March 24, 2021): Province Releases Spring Budget and Next Phase of COVID-19 Action Plan; Questions for the Pandemic Recovery Working Group?; Federal Government Proposes to Temporarily Lift Sales Tax from Some PPE; Extension of the Canada Emergency Business Account; CDA update; and more.

Royal College of Dental Surgeons of Ontario (RCDSO)

• COVID-19 Update: Province-wide Stay-at-Home order (April 7, 2021)

Access to COVID-19 Repository: PDA Executive Directors, Corporate Member Presidents and select staff, and CDA Board Members have access to the CDA COVID-19 Repository via the CDA Board Resource Website.

The link to access the CDA COVID-19 Repository: https://boardresources.ca/covid/.

Log-in: Please use your existing CDA Board Resources login credentials to access the COVID-19 Repository.

If you have trouble logging in, or require a login for someone in your organization who would like access, please email Dean Smith, CDA Manager of Information Technology, dsmith@cda-adc.ca.

Share: To include your organization’s resources in the COVID-19 Repository, please email Zelda Burt, CDA Communications Manager, zburt@cda-adc.ca.

The CDA COVID-19 Response Team works diligently on a range of fronts to help minimize and mitigate the impacts of COVID-19 on the dental profession. CDA is working to address scientific, clinical, economic and business-related matters impacting dentistry, including efforts to increase awareness about the mental health and wellness of dentists, their families and dental office employees during these challenging times. CDA will communicate regular updates as new information becomes available.