Dental team member compliance with personal protective equipment and aerosol generating procedure recommendations during the COVID-19 pandemic in Israel - An observational study.

INTRODUCTION: Coronaviruses which have been responsible for numerous epidemics worldwide, share common transmission modalities and pose a risk within dental clinics. Updated, COVID-19 specific infection control and personal protective equipment (PPE) guidelines for dental settings, including minimizing aerosol generating procedures (AGPs), were issued by the Israeli Ministry of Health (MoH) in spring 2020. This study investigated dental team members (dentists, dental assistants and hygienists) compliance with MoH recommendations exposed to asymptomatic COVID-19 positive patients. METHODS: The MoH analyzed exposure reports from dental clinics to asymptomatic SARS-CoV-2 positive patients following their reopening (April 2020). Exposure reports were verified against a COVID-19 national database. A cumulative transmission rate was calculated and compared to the rate in the population. RESULTS: 1323 exposure reports were received (May 1st - December 31st 2020) regarding dental team members who treated asymptomatic SARS-CoV-2 positive patients: 525 (39.7%) were dentists, 656 (49.6%) dental assistants, and 126 (9.5%) hygienists. Practitioner type was not reported in 16 (1.2%) cases. Most dental team members reported full PPE use and performance of short/non-aerosol generating procedures. Dentists and hygienists reported higher compliance compared with dental assistants. 8 (0.6%) dental team members (4 dentists, 4 dental assistants) were positive post-exposure, with an average of 5.4 days (median 5 days, SD = 4.8) from dental treatment to a positive COVID-19 test. PRINCIPAL CONCLUSIONS: Most dental team members complied fully with the MoH recommendations. Differences were found between the dental team members (hygienists being most adherent). Further efforts are required to encourage full compliance.

Effect of a national policy of universal masking and uniform criteria for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) exposure on hospital staff infection and quarantine.

OBJECTIVE: To determine the effect of 2 regulations issued by the Israel Ministry of Health on coronavirus disease 2019 (COVID-19) infections and quarantine among healthcare workers (HCWs) in general hospitals. DESIGN: Before-and-after intervention study without a control group (interrupted time-series analysis). SETTING: All 29 Israeli general hospitals. PARTICIPANTS: All HCWs. INTERVENTIONS: Two national regulations were issued on March 25, 2020: one required universal masking of HCWs, patients, and visitors in general hospitals and the second defined what constitutes HCW exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and when quarantine is required. RESULTS: Overall, 283 HCWs were infected at work or from an unknown source. Before the intervention, the number of HCWs infected at work increased by 0.5 per day (95% confidence interval [CI], 0.2-0.7; P < .001), peaking at 16. After the intervention, new infections declined by 0.2 per day (95% CI, -0.3 to -0.1; P < .001). Before the intervention, the number of HCWs in quarantine or isolation increased by 97 per day (95% CI, 90-104; P < .001), peaking at 2,444. After the intervention, prevalence decreased by 59 per day (95% CI, -72 to -46; P < .001). Epidemiological investigations determined that the most common source of HCW infection (58%) was a coworker. CONCLUSIONS: Universal masking in general hospitals reduced the risk of hospital-acquired COVID-19 among HCWs. Universal masking combined with uniform definitions of HCW exposure and criteria for quarantine limited the absence of HCWs from the workforce.