Tagged CDC

Some Ivory Towers Are Ideal For A Pandemic. Most Aren’t.

Saint Mary’s College in Moraga, California, is open for business this fall — but to get there, you really have to want it. Tucked amid verdant hills 23 miles east of San Francisco, accessible by a single road and a single entrance, the small, private Roman Catholic school receives almost no visitors by accident.

This, in the age of a pandemic, is good news indeed for its administrators.

“We can control who comes in or out in a way that larger, urban campuses perhaps can’t do,” said William Mullen, the school’s vice provost for enrollment. “Those campuses are in many cases more permeable.”

As colleges and universities across the country juggle student and staff safety, loss of opportunities and loss of revenue during the COVID-19 pandemic, even seemingly secondary considerations — how many entrances a school has, how close it sits to community foot traffic, how food is served — loom large.

And while officials are loath to make broad guarantees about safety, they can’t ignore public health advice and thus are immersed in an effort to at least minimize the potential for harm. What that looks like will vary wildly from campus to campus, but in almost every case it will include attempts to limit close contact with others — a difficult job for educational institutions.

The stakes are enormous. Some universities are already projecting financial losses in the tens of millions due to declining enrollment and the uncertainty ahead. But at its core, this is a health problem that remains both simple and vexing: How do you open up a campus without inviting mass infection?

One preliminary answer: Don’t let too many people hang around at the same time.

“I would never use the term ‘make it safe,’” said Dr. Sarah Van Orman, who oversees student health services at the University of Southern California, a private school in the heart of Los Angeles. “I would say we’re going to reduce the risk to the degree possible to have everything in place.”

On many campuses, that means reducing class size (even if it requires adding new sections), making large survey courses online-only, cutting dorm residencies by as much as 50%, limiting or eliminating common-area food service, and perhaps even alternating students’ in-person attendance according to class level (freshman, sophomore, etc.) by quarters or semesters.

That’s in addition to the protocols recommended by the American College Health Association. The ACHA, to which more than 800 institutions belong, has called for a phased reopening of campuses “based on local public health conditions as well as [school] capacity.” Its guidelines include widespread testing, contact tracing, and isolation or quarantine of both ill and exposed individuals.

The Centers for Disease Control and Prevention laid out even more daunting instructions for what a campus should do in the event of a positive test, calling for potential short-term closures of buildings and classrooms that might extend into weeks in the middle of a semester. Among other things, the CDC said, the scenario could include having to move some on-campus residents into short-term alternative housing in the surrounding community.

Van Orman is a past president of the ACHA, but her school has yet to announce a definitive plan for the fall. That puts USC in good company. Although a rolling survey by the Chronicle of Higher Education suggests that nearly 70% of schools are planning for on-campus education, almost every institution directly contacted by Kaiser Health News was actually planning for all contingencies, with fully or partly opened campuses simply being the best-case and most publicly touted scenarios.

Making a campus virus-ready could take all summer, according to officials at several schools. Most of them don’t yet know how many students will return, and about half the schools contacted by KHN said they’ve pushed back the decision deadline for incoming freshmen to June 1, a month later than usual.

Those decisions have huge ramifications for university budgets. Ben Kennedy, whose Kennedy & Co. consults higher education institutions, said most are planning for an enrollment drop of 5% to 10%. “They’ll experience the big financial hit this fall,” Kennedy said.

At Georgetown University in Washington, D.C., a projected $50 million shortfall prompted voluntary furloughs, suspended retirement contributions and construction stops. The Massachusetts Institute of Technology reported $50 million in unexpected costs, while Janet Napolitano, president of the University of California’s 10-campus system, estimated combined losses of $1.2 billion from mid-March through April in announcing salary cuts and some freezes.

At the same time, large-scale restructuring will be required at bigger campuses in response to the pandemic. Converting some multiperson dorm rooms to singles will become the norm at many schools, although not every campus — or community — is prepared to handle a surge of students needing to find other housing as a result. Solutions are still being studied to address those who will be in close quarters in shared dining halls, bathrooms and common rooms. Some schools plan to set aside dorms for students who test positive and need to be isolated or quarantined.

“Students with existing health issues will have priority for single occupancy,” said Debbie Beck, executive director of health services for the University of South Carolina’s 33,000-student Columbia campus. “Testing in the residence halls will be critical.”

Several schools are considering ending their fall semesters before Thanksgiving, which Beck said “would further reduce risks and control the spread of COVID” as students are sent home until January. Stanford University, meanwhile, is pondering a range of possibilities that include permitting only a couple of class years on campus, perhaps alternating by quarters.

A common misperception, several officials said, is that college campuses have been “closed” since the outbreak of the coronavirus. Although student life has been restricted, other parts of many campuses have remained in operation, particularly at research institutions.

“We have research departments and laboratories that really don’t work if you’re not there,” said Dr. Jorge Nieva of USC’s Keck School of Medicine. “It’s difficult to do mouse experiments with cancer if you’re not doing mouse experiments with cancer.”

California’s two massive public university systems embody that dichotomy. California State University Chancellor Timothy White said the 23-campus CSU system, primarily instruction-focused, will mostly conduct remote learning. Napolitano expects the research-heavy University of California campuses to be open “in some kind of hybrid mode,” which many other schools likely will adopt.

“These kids are digital natives,” said Nieva, whose son was a freshman living on campus at USC before students were sent home. “A lot of what they’re experiencing, they’re perhaps better equipped to handle than another generation might be.”

Back in Moraga, Saint Mary’s will reduce dorm capacity, record lectures for online retrieval and institute strict guidelines to prevent the spread of illness — but it plans to continue a 150-plus-year tradition of close, personal education for its 2,500 undergraduates. In its case, being small is the biggest advantage.

“If we already only have 15 or 18 students in a classroom that can hold 30, then it becomes much easier to adapt to the new guidelines and protocols,” said Dr. Margaret Kasimatis, the school’s provost. “That’s a pretty good start.”

This KHN story first published on California Healthline, a service of the California Health Care Foundation.

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Must-Reads Of The Week

The news this week did seem dominated a bit by President Donald Trump. And most of it was trivial: Do we believe he is really taking hydroxychloroquine? (Who knows?) How obese is he? (Not as obese as Nancy Pelosi said he was.) Would he wear a mask at the Ford plant he was touring? (He did when he wasn’t in public view.)

It should not go unnoticed that Jacinda Ardern, who has led New Zealand through the coronavirus pandemic with but a few deaths (21, per the tally by Johns Hopkins University researchers), is that country’s most popular prime minister in 100 years.

I’m Damon Darlin, your guest writer for this edition of the Friday Breeze. We will have a rotating cast of writers for a few weeks to give you a breezy rundown of the week’s health care news.

You know, there were other things happening this week that mattered a bit more. People are still dying of COVID-19. The toll is approaching 100,000 deaths in the United States. Many of the deceased aren’t being counted among the COVID-19 casualties, according to a number of analyses.

The New York Times reported, in one of the most attention-getting pieces this week, that 36,000 fewer people in the United States would have died if only the country had locked down just one week earlier. If the U.S. had done it two weeks earlier, on March 1, “the vast majority of the nation’s deaths — about 83 percent — would have been avoided,” it reported.

Science magazine looked at the so-called superspreaders of the coronavirus. They examined a number of studies done across the globe in an attempt to understand how, if most people don’t transmit the virus, it spreads so much. It’s those circumstances in which it spreads massively that most intrigue the scientists.

The race for a vaccine to prevent further infections accelerated. So far, the results were mostly seen in the stock market. Moderna, a little-known drug company, announced preliminary results of its vaccine testing and its stock price soared. The federal government’s Biomedical Advanced Research and Development Authority (BARDA), the agency overseeing the rapid production of a vaccine, gave Moderna $438 million. (One of its board members, Moncef Slaoui, was appointed the nation’s new “vaccine czar,” and his financial ties to the industry are being questioned. The New York Times called them “vast.”)

Such publicity over vaccine development has raised the question of “science by press release.” KHN’s Jay Hancock took a look at how the pharmaceutical companies are trying to use publicity about their search for a vaccine to improve their damaged reputations.

The Centers for Disease Control and Prevention, which has faced withering criticism throughout this epidemic, came under fire again this week. This time, it was for messing up a pretty basic rule of epidemiology, supposedly its specialty. The federal agency was combining the results of two different kinds of tests for the coronavirus, viral and antibody, which would mess up crucial metrics needed to determine if it is safe to reopen a state. Virginia was doing this same thing. The Atlantic said Georgia, Texas and Pennsylvania were also misreporting data.

By the way, the head of the CDC, Robert Redfield, said he wasn’t being muzzled by the White House.

In other fiddling-with-the-data news, a data analyst working for the Florida state government said she was fired because, the South Florida Sun-Sentinel reported, “her bosses told her to remove the raw data from the website, meaning that users could no longer download it for analysis.”

Meanwhile, an assistant professor at the University of North Carolina in Wilmington said on Twitter that that state isn’t manipulating the data, just the graphic representation of it, so the results looked better.

We aren’t done yet with the data category. An article that broke late last Friday night said that the Stanford University study you undoubtedly read about suggesting the coronavirus was not as deadly as was thought was sponsored by David Neeleman, the JetBlue Airways founder who has been saying the pandemic isn’t deadly enough to justify lockdowns. Stanford didn’t disclose the financial ties, according to BuzzFeed, or that scientists were concerned about the accuracy of the antibody tests the study was based on.

This report from NBC was intriguing. It casts strong doubts on the much-touted technology for washing and reusing face masks that health care workers use. The federal government contracted with an Ohio research company to be the nation’s laundromat. NBC said the potential cost to taxpayers is $413 million.

Finally, because it’s a national holiday on Monday — no, really, check your calendar, it’s Memorial Day — I leave you with a host of things to worry about as the country struggles to reopen.

Enjoy your long weekend. The ultraviolet light in sunshine is useful.

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KHN’s ‘What The Health?’: When It Comes To COVID-19, States Are On Their Own

Can’t see the audio player? Click here to listen on SoundCloud.

At least so far, states that reopened their economies are not seeing a major spike in cases of COVID-19. But it remains unclear if that is because the coronavirus is not spreading, because the data is lagging or because the data is being manipulated.

Meanwhile, President Donald Trump said he’s taking the controversial antimalarial drug hydroxychloroquine as a preventive measure after he was exposed to a White House valet who tested positive for the coronavirus. Despite the fact that there is no data to suggest the drug works to prevent infection, the president’s endorsement has apparently led to new shortages for patients who take the medication for approved purposes.

This week’s panelists are Julie Rovner of Kaiser Health News, Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times and Kimberly Leonard of Business Insider.

Among the takeaways from this week’s podcast:

  • As federal and state officials push to reopen the economy, there have been questions about the coronavirus data they are using. Sometimes they combine the number of diagnostic tests — which show if someone is currently infected with the virus — with the number of antibody tests — which show if a person once had the virus.
  • The Centers for Disease Control and Prevention, which has been the lead federal agency in other serious disease outbreaks, is relegated to a backup role on the coronavirus. That points to the difference in trust levels between the public and the White House, which has emphasized the reopening of the economy rather than public health.
  • So much attention is focused on the race to get a successful vaccine. But even if researchers are able to produce one, distribution to millions of Americans will be a logistical problem.
  • Public health officials are pushing hard for Americans to wear face coverings in public, but certain groups are resisting. Polling finds that most Americans don’t object to wearing a mask, but it is a significant change in the U.S. culture and also a key change in public health recommendations. That shift has added to the confusion and may have led to some of the resistance.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: Kaiser Health News’ and The Guardian’s “Lost on the Frontline,” by the staffs of KHN and The Guardian

Kimberly Leonard: Business Insider’s “How Coronavirus Will Permanently Change Healthcare, According to 26 Top Industry Leaders,” by Lydia Ramsey, Kimberly Leonard and Blake Dodge

Margot Sanger-Katz: The Atlantic’s “Why the Coronavirus Is So Confusing,” by Ed Yong

Alice Miranda Ollstein: Politico’s “Politics Could Dictate Who Gets a Coronavirus Vaccine,” by Sarah Owermohle

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcherGoogle PlaySpotify, or Pocket Casts.

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En medio de la pandemia, dentistas vuelven a ofrecer atención de rutina con miedos y dudas

Tom Peeling quería una limpieza dental y no iba a dejar que la pandemia de coronavirus se lo impidiera.

Afortunadamente, la cita que tiene cada seis meses estaba programada para principios de mayo, cuando a los dentistas de Florida se les permitió reabrir para servicios de rutina.

A finales de marzo, el estado había ordenado a los dentistas tratar sólo los casos de emergencia para mantener a los residentes en sus casas y controlar así los limitados suministros médicos, como las mascarillas N95, que podrían ser necesarias para tratar a los pacientes de COVID-19.

Sin embargo, para Peeling, de 62 años, de Lantana, Florida, la visita al dentista no fue exactamente rutinaria. Le tomaron la temperatura al llegar y le pidieron que se enjuagara con una solución de peróxido de hidrógeno para reducir los gérmenes antes que el dentista y la asistente examinaran su boca. El dentista y sus asistentes usaron máscaras.

Otra novedad: era el único paciente.

Florida es uno de los 40 estados que ha permitido a los consultorios dentales reanudar servicios de rutina tras el cierre, en marzo, de negocios no esenciales en gran parte de los Estados Unidos, a causa de COVID-19.

La American Dental Association (ADA) apoya la reapertura de los consultorios dentales, con precauciones adicionales, en los estados donde disminuyen los casos de COVID-19. La ADA asegura que los pacientes necesitan servicios dentales regulares. Además, la organización señala que los consultorios se resienten económicamente al no poder atender a sus pacientes regulares.

Pero muchos expertos en salud opinan que los estados están precipitando la reapertura.

Los Centros para el Control y Prevención de Enfermedades (CDC) siguen aconsejando limitar las visitas al dentista a las emergencias. Los CDC aún no tienen datos sobre la posibilidad de que el coronavirus “se transmita durante la práctica odontológica o para determinar si los proveedores están adecuadamente protegidos al brindar tratamiento dental”.

Matt Crespin, higienista de Milwaukee y presidente de la American Dental Hygienists’ Association, también piensa que no es el momento. Su asociación cree que los dentistas deberían posponer la atención no urgente hasta que los consultorios tengan suficiente equipo, y se hagan más pruebas para medir la propagación de la enfermedad.

“Algunos higienistas están listos para volver al trabajo y seguir las directrices para protegerse a ellos mismos y a sus pacientes”, explicó Crespin. “Pero a otros les preocupa regresar porque no existen las protecciones adecuadas” o el suministro es limitado.

Los expertos en control de infecciones señalan que los pacientes, los dentistas y su personal deben sopesar sus riesgos, que varían según el lugar donde viven, su edad y otros factores.

“Sólo porque puedas volver al dentista no significa que debas ir”, dijo Pia MacDonald, experta en enfermedades infecciosas de RTI International, un instituto de investigación sin fines de lucro en Carolina del Norte. Señaló que los pacientes deberían hablar con sus dentistas sobre las precauciones que están tomando.

Para los consultorios dentales, como para muchas otras pequeñas empresas, el cierre ha sido financieramente devastador. Una encuesta de la ADA realizada a 17,000 dentistas reveló que, a principios de abril, más de 9 de cada 10 indicó que su volumen de pacientes se había reducido un 10%, y poco menos de la mitad había dejado de pagar a sus empleados.

Según la encuesta, un 20% de los dentistas no sabía si podrían mantener su consulta si las restricciones actuales seguían hasta finales de junio.

“Vamos a ver a más dentistas declararse en bancarrota si las restricciones se mantienen hasta junio”, aseguró Margaret Gingrich, presidenta de la Asociación Dental de Michigan. Como muchos dentistas, Gingrich recibió un préstamo de la Administración de Pequeños Negocios para el pago del alquiler, los servicios públicos y la nómina.

Incluso cuando a los dentistas se les permite reanudar las visitas regulares, no se sabe con certeza cuántos pacientes las pospondrán por temor al coronavirus. Una encuesta realizada en abril por el North American Dental Group, que agrupa a 230 consultorios dentales en todo el país, indicó que el 71% de los encuestados se sentía incómodo al acudir al dentista para someterse a un procedimiento odontológico no urgente.

“No estoy cómoda en la silla con la boca abierta durante largo tiempo”, dijo Marian Hollingsworth, de 66 años, residente de San Diego, California.

Muchos dentistas planean ver menos pacientes por día para reducir el número de personas en la sala de espera y dar al personal más tiempo para desinfectar las áreas entre consultas, lo que aumentará sus problemas financieros.

Matthew Roberts, dentista de Crockett, Texas, que reabrió su consulta a los pacientes habituales la semana pasada, dijo que los dentistas están acostumbrados a controlar los gérmenes que pueden causar infecciones.

“Aunque no estamos familiarizados con este nuevo virus, tratamos con infecciones todo el tiempo”, señaló. “Los pacientes no deberían tener reparos en volver”.

Además de usar máscaras N95 y batas, él y sus higienistas ahora usan protectores faciales.

Cuando los pacientes llegan a su oficina, les toman la temperatura para asegurarse de que no tienen fiebre, lo que podría indicar una infección por COVID, y deben llenar un cuestionario sobre su salud.

Roberts dijo que le ha sorprendido gratamente que muchos de sus pacientes hicieran sus citas en cuanto reabrió. Lo atribuyó a que su condado tiene pocos casos de COVID y los pacientes desean volver a la normalidad. Después de estar cerrado por seis semanas, Roberts aseguró que tiene un atraso de 300 citas que cumplir. Está programando pacientes hasta septiembre.

Matthew Messina, portavoz de la ADA y dentista en Columbus, Ohio, expresó que, con precauciones adicionales como que los pacientes esperen en sus automóviles y que los dentistas usen protectores faciales, los pacientes deberían sentirse seguros en el dentista incluso si son mayores y personas de riesgo.

“El consultorio dental es un lugar seguro para los pacientes”, enfatizó.

MacDonald, el experto en enfermedades infecciosas, recomendó, sin embargo, que las personas mayores consulten con su médico sobre si vale la pena arriesgarse a una consulta dental de rutina.

“Los dentistas están bien equipados para manejar la situación”, comentó Thomas Paumier, dentista de Canton, Ohio, que reabrió la semana del 11 de mayo. Por la escasez de mascarillas N95, dijo, usa mascarillas quirúrgicas de alta calidad y un protector facial.

“Desde la experiencia con el VIH en la década de los ‘80, tratamos a cada paciente como potencialmente infeccioso”, señaló Paumier.

Al igual que muchos otros dentistas, donó máscaras y guantes a los hospitales del área. Pero se los acaban de devolver porque no se necesitaron.

Aún así, a otros dentistas les preocupa el suministro del material adecuado. Michael Hoffmann, dentista y tesorero de Greater St. Louis Dental Society, dijo que muchos consultorios allí “no están abiertos a plena capacidad, porque no hay suficiente equipo de protección personal”.

Dijo que a su consultorio le queda un mes de suministros. “Una vez que se agoten, tendremos que cerrar hasta que podamos conseguir más”, dijo.

La entidad contactó a un vendedor, con el que Hoffmann había trabajado anteriormente, para encargar 100,000 máscaras KN95 —la versión europea de las N95— a un proveedor en China. Pero las máscaras llegaron en cajas con un sello que las calificaba de material “no médico”.

“Al probarlas vimos que no filtraban”, explicó Hoffmann. “No había manera de sellarlas y nos dimos cuenta de que eran falsas”.

Le devolvieron el dinero al grupo, y Hoffmann dijo que reembolsará a los dentistas que las habían ordenado.

La corresponsal de KHN, Lauren Weber, colaboró con esta historia.

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Reopening Dental Offices For Routine Care Amid Pandemic Touches A Nerve

Tom Peeling wanted his teeth cleaned and wasn’t going to let the coronavirus pandemic get in the way.

Luckily, his six-month regular appointment was scheduled for earlier this month, just days after dental offices were allowed to reopen in Florida for routine services. In late March the state ordered dentists to treat only emergency cases as part of its efforts to keep residents at home and to preserve limited medical supplies, such as N95 masks, that might be needed to treat COVID-19 patients.

Yet for Peeling, 62, of Lantana, Florida, the dental visit was anything but routine. He had his temperature taken upon arrival and was asked to rinse with a hydrogen peroxide solution to reduce germs before the dentist or hygienist looked into his mouth. The dentist and his assistants all wore masks.

Another change: He was the only patient in the office.

Florida is one of 40 states that have allowed dental offices to resume providing routine services following the March shutdown of nonessential businesses in much of the United States when the COVID-19 pandemic began.

The American Dental Association supports dental offices reopening — with added precautions — in states where COVID-19 cases are declining. It notes that patients are better off if they have their regular dental services. The dental group says many dental practices are being hit hard financially because most of their regular patients aren’t coming in for routine care.

But many health experts question whether states are moving too fast.

The federal Centers for Disease Control and Prevention continues to advise patients to limit dental visits to emergencies. The CDC said it has no data yet about the possibility of coronavirus “transmission during dental practice or to determine whether [dental health care providers] are adequately protected when providing dental treatment using standard precautions.”

Matt Crespin, president of the American Dental Hygienists’ Association and a Milwaukee hygienist, also said it’s not time yet. His association believes dentists should postpone all elective and nonemergency care until dental offices have enough equipment such as masks to safeguard all employees and there is more testing to gauge the spread of the disease.

“We have some hygienists who are ready to go back to work and follow the guidance to keep themselves safe and their patients safe,” Crespin said. “But we are hearing from other hygienists worried about going back because appropriate protections are not being put in place” and offices have limited supplies of protective gear.

Infection control experts said patients, dentists and their staffs need to weigh their risks — which vary by where they live, their age and other factors.

“Just because you can be going back to the dentist doesn’t mean you should automatically go,” said Pia MacDonald, an infectious disease expert with RTI International, a nonprofit research institute in North Carolina. She said patients should talk to their dentists about what precautions they are putting in place.

For dental practices, like many other small businesses, the shutdown has been financially devastating. An ADA survey of 17,000 dentists found that by early April more than 9 of 10 dentists said their patient volume was 10% or less of normal, and just under half had stopped paying their employees. Nearly 20% of dentists said they had concerns about sustaining their dental practice if current restrictions are kept in place until the end of June, according to the survey.

“We are going to see more dentists file for bankruptcy if the restrictions go into June,” said Margaret Gingrich, president of the Michigan Dental Association. Like many dentists, Gingrich received a Small Business Administration loan to help her pay rent, utilities and payroll.

Even when dentists get clearance to resume regular visits, it’s uncertain how many patients will postpone out of fear of coronavirus infection. An April survey by the North American Dental Group, which operates 230 dental offices nationwide, found 71% of respondents were uncomfortable going to the dentist for a “non-time sensitive” dental procedure.

“I don’t feel comfortable being in the chair with my mouth open for an extended period of time,” said Marian Hollingsworth, 66, of San Diego.

Adding to their financial woes, many dentists plan to see fewer patients per day to reduce the number of people in their waiting rooms and give staff more time to disinfect areas between cases.

Matthew Roberts, a dentist in Crockett, Texas, who reopened his practice to routine patients last week, said dentists are accustomed to handling germs that can cause infections.

“While we are not used to this novel virus, we deal with infections all the time,” he said. “Patients should have no qualms” about returning.

In addition to wearing N95 masks and gowns, he and his hygienists now use face shields.

When patients arrive at his office, staff members take their temperature to make sure they don’t have a fever, which could signal a COVID infection, and screen them by asking questions about their health.

Roberts said he has been pleasantly surprised that many of his patients have chosen to book appointments once he reopened. He attributed that to his rural county having few COVID cases and patients wanting a return to normal. After being closed for six weeks, Roberts said, he has a backlog of 300 appointments to get through. He’s scheduling patients into September.

Matthew Messina, a spokesperson for the ADA and a dentist in Columbus, Ohio, said that, with added precautions such as having patients wait in their cars instead of small waiting rooms and dentists wearing face shields, people should feel comfortable about going to the dentist even if they are elderly and at high risk for COVID complications.

“The dental office is a safe place for patients,” he said.

MacDonald, the infectious disease expert, recommended, however, that older people consult with their medical doctor about whether a routine dental visit is worth the risk.

“Dentists are uniquely positioned to handle this,” said Thomas Paumier, a Canton, Ohio, dentist who reopened last week. With a shortage of N95 masks, he said, he is using high-quality surgical masks and a face shield.

“Ever since the HIV experience in the 1980s, we treat every patient who walks in the door as potentially infectious,” Paumier said.

Like many other dentists, he donated masks and gloves to area hospitals. But recently, his were returned because they were not needed.

Still, other dentists are concerned about getting adequate supplies. Michael Hoffmann, a dentist and treasurer for the Greater St. Louis Dental Society, said many practices there are “not opening to full capacity — because there’s not enough personal protective equipment.”

He said his own practice has about a month’s worth of supplies. “Once we run out, we’ll have to close our doors until we can get more,” he said.

The society recently used a salesperson Hoffmann had previously worked with to order 100,000 KN95 masks — the European version of N95s — from a supplier in China. But the masks arrived in boxes stamped “nonmedical.”

“When we were trying to fit-check them, they leaked horribly,” Hoffmann said. “Nobody was able to get any kind of seal, and we knew they were fraudulent.”

The group received its money back, and Hoffmann said they will refund the dentists that preordered.

KHN Midwest correspondent Lauren Weber contributed to this story.

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