Professional Courtesy Testing—1, 2, 3 ... by Dr. Thomas Giacobbi

by Thomas Giacobbi, DDS, FAGD, editorial director

Seven coronaviruses can infect humans: Four produce mild symptoms and represent 15% of common colds each year (the other 85% from rhinovirus), and the other three can cause serious illness—MERS, SARS and COVID-19. The spread of COVID-19, in both speed and numbers, has blown the doors off the other two by a mile. Right now, you’re closer to someone who’s been a victim of COVID-19 than you are to Kevin Bacon.

Testing continues to be a critical issue that will remain long after the drive-thru testing tents have been packed away. Even when case numbers begin their steady decline, the thought of a single sick team member can be enough to keep you up at night; having one or two members of your team sidelined for an extended period will have a major impact on the practice.

Rapid testing will be a critical piece of your practice moving forward. For example, a dentist gets a weekend call from a team member who has a fever and doesn’t feel well. She tells him to get tested and stay home until he knows he tests negative for COVID-19 or is healthy. Nine days later, the test results come back positive.

By now that’s old news, because the team member has gone through the litany of common symptoms and is already getting better. If someone he encountered during that contagious, asymptomatic period wants to get tested and is waiting more than five days to get a result, it is meaningless. During the isolation time waiting for test results, they’d know they were sick long before they get test results.

The real value from testing is finding people who have COVID-19 before they have symptoms.

One example of a portable, rapid, point-of-care test is Abbott’s ID Now. The toaster-sized machine can provide results in less than 15 minutes. A small number of false negatives have been reported, but it’s not clear if that was because of poor sample collection or the timing of the test relative to virus exposure.

I fully expect someone to get this technology or something similar, pack it in a car and drive around all day, testing dental teams on a regular schedule. Would you pay for a service like this? I would in a heartbeat. We have many months ahead before a viable vaccine is available, who knows how many months after that before you can get vaccinated, and even more months before we know how well it worked. Dental offices need to have rapid testing in place for employees when it becomes available. I say “when” because it’s very difficult to find access to this technology unless you play professional sports.

Some have suggested that if testing can be done in our office, we should also offer it to our patients. While I could see the benefit if you had a clinical employee test positive, this option is a slippery slope. One, I am not equipped to bill patients’ medical insurance, and two, I don’t want my office to be a magnet for sick people in search of a diagnosis.

On the other hand, enterprising dentists could find a way to buy the equipment and make testing a profit center by offering tests on the weekends, followed by a deep clean of the area before returning to work on Monday.

Do you think testing your team members in the office will be a reality soon, or do you have any objections to this concept? How much would you pay for a service like this? Please share your comments below.

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