Page 9 - RADC 2020

the world, we had no complaints when directed not to travel outside of the province. With Banff, Jasper and Waterton all on our doorstep we were able to explore these places without the usual swarms of tourists; a small silver lining to the Canadian COVID experience.
CYPRUS
It quickly became apparent in Cyprus that the pandemic presented not so much a ‘learning curve’ but a ‘learning cliff’ that needed scaling and time was definitely
not on our side. The first problem any Overseas Dental Centre faces is that they do not have access to the NHS safety net and the (Urgent Dental Care Clinics) UDCCs that would be set up to enable F2F treatments. In Cyprus there is very limited national health primary dental care and private dentists were directed to close, thus denying all access to host nation care. We were on our own and our patients had only us! But this is the essence of being Army Dental! Whether faced with bullets, bombs or in this case a biological threat; we train to deliver dentistry in all conditions.
In the early days, the atmosphere of
fear that surrounded this pandemic very much resembled the script of many a well-known Hollywood pandemic film. This was not helped by the mixed messaging from governments and heavily embellished reporting of the world’s media. But we
were not deterred and drafted contingency plans in conjunction with the local medical and environmental health teams based
on the need to see and treat a potential COVID-19 positive patient. With a regional ‘Dirty Team’ that would have access to the few sets of enhanced PPE, surgeries
with adequate assisted ventilation, and very controlled ingress and egress protocols, we were confident that we could minimise the risk of transmission.
We then patiently waited and implemented our care as best we could by remote triage,
advice and prescriptions, for the most part. During lockdown the region were faced with only a handful of acute patients that required physical treatments. It was apparent that we did not need all our staff to be ‘on standby’ during this time so once regional emergency rosters were arranged the remaining
staff were rebrigaded to assist with wider efforts. Dental nurses were tasked with case tracking, hygienists worked in Medical Centre receptions, and a civilian dental practitioner turned her hand to the pharmacy technician role. This admirably demonstrates the remarkable adaptability and can-do spirit of our people. The RSDO found himself as ‘SO1 COVID response J1/J4 Med’ which was a rambling portfolio encompassing everything from procurement of PPE, establishing bedding down facilities and training a volunteer workforce.
It was an immense relief when we were able to dispense with the telephone triage system, and rehang our ‘we are open’ signs. Any empathetic clinician naturally despises this remote management system as it denies them the opportunity to help patients physically. After all, most of the time, in
order to heal our patients we must be
able to lay hands on them. The immediate aftermath priority was seeing to the backlog of patients that had built up over lockdown.
The key to success in managing our patients during the lockdown and the following period of restricted services was communicating effectively and widely, and setting clear expectations of what we could and should be delivering. By keeping our populations well informed and supported, and at the very least always able to talk to a dental officer by phone 24/7, we ensured that our patients remained serviced and cared for throughout.
BRUNEI
Like everywhere else in the world, Brunei has not escaped the effects of COVID-19 in 2020. Brunei being a relatively small country
with a population of approx. 430,000, the potential for COVID-19 pandemic to cause a lot of disruption to normal life was high which initially made it a stressful time for all the military personnel and their families based out here.
It was around the middle of March that Brunei got its first cases and the country went into lockdown with all borders shut and all schools and public facilities closed. This was a worrying time for all with lockdown restricting a lot of people’s freedoms e.g.
no socialising with anyone outside of your immediate family, the wearing of masks in public places, etc. This lasted until around the middle of May before restrictions started to be relaxed as the number of cases stopped rising and no further domestic cases were recorded. Due to the quick response by Brunei’s MOH to the pandemic we have been very fortunate, and the number of cases has been kept relatively low with there being currently only 146 cases with 3 deaths.
From May onwards restrictions relaxed, and life is now almost back to normal in Brunei. However, the borders remain shut and only essential travel is allowed in and out of the country and if you do leave
the country you have to do 14 days in quarantine on your return in a hotel room. So, unfortunately, I don’t think we will be leaving Brunei on holiday anytime soon. We have tried to turn this into a positive and have explored and seen more of Brunei these last few months than we have over the last two years. Nevertheless, we are still very isolated out here and it has been hard for everyone not to be able to return to the UK or Nepal to see their family and friends whenever needed.
Dentistry wise we started seeing routine patients again in the middle of June for Non- AGP and Low-Risk AGP procedures. With restrictions being further relaxed in July and no new domestic cases for over two months we started carrying out High-Risk AGPs with
Cyprus – Before and after: Pandemic changes to dental practice, Dr K Hitchcock and Cpl S McCourt
RADC BULLETIN 2020 7