Technical care guidelines for procedures with sedation during the confinement stage and afterwards declared by COVID-19 to be a pandemic

Abstract

From the World Health Organization, a global speech was made by the Director General, Dr Tedros Adhanom, on 11 March 2020, in which he declared the situation of the coronavirus pandemic. Due to the rapid spread of the disease in all countries around the world, there are more than 6.5 million people infected and almost 400,000 deaths worldwide. As of June, the epicentre of the pandemic is in countries such as the United States and Latin America, where Brazil represents the country with the highest number of cases in the region.1,2 This situation is a matter of concern not only for the world health organization but also for all governments in the region because of the devastating effect that the pandemic can have on Latin America due to the evident limitation of health resources, which can collapse health systems and significantly increase the number of people killed by the virus.2

In response to the increasing number of cases of VIDOC-19 during the 2020 pandemic, many governments in Latin America have declared a state of emergency, which has led to the imposition of quarantine and restrictions on the normal movement of citizens as the main measure.

These measures are intended to isolate inhabitants, to avoid close contact between communities in order to slow down the speed of infection and to safeguard the health of the most vulnerable people. This limitation in the normal activity of citizens implies the suspension of school and university activities, the suspension of massive events and shows, the closure of commercial activities, the limitation to public transport, among other measures.

The restrictions also include a reduction in the provision of outpatient or elective health services, treatment carried out in dental surgeries, and only urgent or non-postponable treatment is permitted (provided that the delay in treatment could be detrimental to the patient's health). In this context, governments call for not exposing the health of patients, nor the health personnel working in the offices, as well as for responsible action respecting the measures established by the health secretariats and government authorities of each country.3,4

However, it is necessary to prepare in parallel for the period following the crisis created by the pandemic. Specific official protocols are currently being developed to clearly implement how dental and paediatric dentistry care should be initiated in daily practice, after confinement, in order to work with the best guarantees of protection for patients and the health team. 5,6

Based on this context, this document was written, which presents a plan of care with a series of guidelines that can be useful when treating patients in the dental office. Due to the great uncertainty represented by the high percentage of infected asymptomatic patients in Latin America, there must be very clear guidelines that provide effective care strategies in order to avoid the spread of coronavirus in clinical care areas where patients are attended. It is important to emphasise that this document is dynamic and should be regularly updated as more relevant scientific information is published.