Lessons Learned from Contact Tracing COVID-19 cases in Dental Settings in East Scotland.

INTRODUCTION: Dental settings were considered high risk settings for COVID-19. A Dental Public Health Team in East Scotland worked to risk assess each situation timeously to break chains of transmission. AIM: To present learning from routine data collected from contact tracing COVID-19 cases in the dental setting. DESIGN: Retrospective analysis of a routine data set of COVID-19 cases associated with a dental setting reported via the national contact tracing system for two health board areas in the East of Scotland. METHODS: Descriptive statistics summarise the data collected over a 13-month period (Oct 2020-Dec 2021) during which all included COVID-19 cases were confirmed by PCR. A narrative presents output from contact tracing of all cases and includes themes identified during contact tracing that led to transmission within a dental setting. A case study illustrates impact of transmission. RESULTS: 752 cases are included. No evidence of staff to patient transmission or vice versa was found in this study. Staff to staff transmission occurred in non-clinical areas contributing to 33% of total staff cases with the remainder assessed to result from community transmission. CONCLUSION: Transmission of COVID-19 in a dental setting, in the context of this study, appears to be confined to non-clinical areas with the majority of staff cases resulting from community transmission. Future pandemic plans should include tools to aid with implementation of guidance in non-clinical areas.

Lessons Learned from Contact Tracing COVID-19 cases in Dental Settings in East Scotland.

INTRODUCTION: Dental settings were considered high risk settings for COVID-19. A Dental Public Health Team in East Scotland worked to risk assess each situation timeously to break chains of transmission. AIM: To present learning from routine data collected from contact tracing COVID-19 cases in the dental setting. DESIGN: Retrospective analysis of a routine data set of COVID-19 cases associated with a dental setting reported via the national contact tracing system for two health board areas in the East of Scotland. METHODS: Descriptive statistics summarise the data collected over a 13-month period (Oct 2020-Dec 2021) during which all included COVID-19 cases were confirmed by PCR. A narrative presents output from contact tracing of all cases and includes themes identified during contact tracing that led to transmission within a dental setting. A case study illustrates impact of transmission. RESULTS: 752 cases are included. No evidence of staff to patient transmission or vice versa was found in this study. Staff to staff transmission occurred in non-clinical areas contributing to 33% of total staff cases with the remainder assessed to result from community transmission. CONCLUSION: Transmission of COVID-19 in a dental setting, in the context of this study, appears to be confined to non-clinical areas with the majority of staff cases resulting from community transmission. Future pandemic plans should include tools to aid with implementation of guidance in non-clinical areas.

A Health Inequalities Impact Assessment of the surveillance of COVID-19 in asymptomatic patients attending dental settings in Scotland.

INTRODUCTION: A key aspect of the public health response to COVID-19 in Scotland was enhanced community surveillance, including testing in dental settings. Across Scotland, dental settings offered patients over 5-years-old the opportunity to participate in community surveillance of COVID-19. METHODS: A Health Inequalities Impact Assessment (HIIA) was conducted to understand the differential impacts the programme would have on the population and to improve the accessibility of the programme. HIIA is a tool to allow the assessment, understanding, and mitigation of impacts on people of a proposed policy or practice. It fulfils an organisational duty to meet the requirements of the Equality Act and Fairer Scotland Duty. The HIIA was conducted rapidly in parallel with the programme development. An action research approach included an online workshop, consultation, review of population data and a literature search. RESULTS: Adjustments were required to improve the programme's accessibility. Stakeholders, including dental teams from across Scotland were involved in the consultation and brought their front-line experience in different settings. Common issues identified included digital literacy and access, language and cultural barriers to participation, and issues relating to the implications of a positive COVID-19 result. Literature indicated limited evidence on the acceptability, accessibility, and equity of asymptomatic COVID-19 surveillance. CONCLUSION: This HIIA was conducted during the COVID-19 pandemic. As an example of good practice in tackling inequalities in access to programmes it should represent the benchmark for other similar initiatives.

Spontaneous sublingual haematoma in acquired haemophilia: case report.

Acquired haemophilia is a rare disease in which bleeding is more severe than in hereditary haemophilia and usually occurs in the soft tissues, the gastrointestinal tract, or the mucous membranes. There have been only a few presentations of spontaneous sublingual haematoma in acquired haemophilia, but prompt management of the airway and identification of the underlying cause was crucial in all.