I bet many of us feel like we are living in a movie these days. I’m sure you have compared this pandemic to any number of movies. One of the biggest questions we all have on our minds is when will it be safe to go back to work, and what will it be like? The first movie that comes to mind is Jaws. In that movie everyone wanted to know when it will be safe to go back into the water. And now, forty five years later, people are still asking a similar question: whether it’s safe to go back to work.
Let’s explore the parallels.
The year Jaws came out, 1975, I was serving as a Captain in the Dental Corps at Ft. Dix N.J. During my time there I came down with Hepatitis B. I became infected from working on a patient…without gloves. Remember kiddies, this was 1975…there were no rules. It was the Wild Wild West in health care. As we all know, hepatitis is caused by a blood borne pathogen. I became quite jaundiced and severely ill. I spent two weeks in the hospital. I started feeling better after one month.
I felt good enough to go back to work, but the U.S. Army had other plans. I couldn’t go back into the clinic until my liver enzymes were back to normal. I was tested frequently not only by the military, but also by the county Board of Health. I remember how diligent they were about the testing. They were serious…I couldn’t go back to work until I was cleared. That was mostly to protect anyone I would come into contact with. I was a known carrier, unlike the infamous Typhoid Mary who carried her disease covertly. I’m sure the public was grateful that the government was acting so responsibly. That was their job.
Like today, the public health department’s job is to protect the public. That trust must exist for us to function as a society.
Fast forward to 1981. I was practicing full-time in my own private practice when the AIDs epidemic arrived in the U.S. By then I had learned my lesson and I was one of a small number of dentists who wore gloves on a routine basis. But I was in the minority. AIDs changed our entire profession. By the time it was over (if it ever truly was over) the life of every dentist changed forever. This time around I learned how serious government could be in enforcing public health regulations. They meant what they said (for those who are interested look up the case of Kimberly Bergalis). This was a classic example of the combination of blood borne pathogens and dentistry.
One thing I noticed during that period was the public awareness of dental practices and sterilization techniques. AIDS changed everything. It wasn’t the isolated patient who wanted to see how instruments were being sterilized. Many people stayed away during the height of the crisis. Yet in time the fear eased up. But not before more stringent rules and regulations were enforced. And once again the public was grateful.
Safety is a big concern for most humans.
Behavioral psychologist Abraham Maslow formulated the Hierarchy of Needs. At the very base of the Hierarchy are physiologic needs like food and sleep followed by safety and security needs. His theory stated that people would not seek satisfaction of higher needs (love, belonging, self-actualization), until the basic needs were met. Modern dentistry has been focusing on the higher needs for some time by developing more and more elective procedures. Patients will be demanding safety when practices reopen. Patients have been deciding on the essential nature of dentistry forever.
As long as it is safe…then elective procedures become essential to fulfill their higher needs.
Now…almost 40 years after AIDS we have a new pathogen – the corona virus– Covid-19. The biggest difference is that this one is an airborne pathogen. And that makes all the difference in the world. Fear is ubiquitous. There is a new shark in the water. It does not show its fin. Like Typhoid Mary. In the movie Jaws there were people who went back in the water and defied the local police even though the beaches were closed. The small New England town was divided by those who didn’t believe the shark was a threat. Martial law was imposed to keep every safe.
Today’s pandemic presents similar issues. People demanding to get back to work. People not wearing masks in public. People congregating on open public beaches. Protests.
This post is not about the biology or epidemiology of Covid-19. It is about human behavior and public trust. As long as the fear remains and people do not have the absolute certainty of safety, they will not return to dental offices except for essential services (pain based). The other part of this is that it is the job of governments to protect the public—no matter what. Until they know it is safe, dental practices will have to operate under new rules.
Forty five years after Jaws roamed the ocean it is safe to go back into the water, but rest assured we do know one thing…there will always be new and more dangerous sharks to worry about.