Is Now the Right Time to Get Your Annual Physical or Dental Cleaning?
By Joni Sweet
Should you skip your annual checkup? The answer would have been a resounding "no" if you asked most doctors before the pandemic.
But with the risk of COVID-19, the answer isn't so clear anymore.
Many states banned nonessential medical procedures in an effort to stop the spread of the disease. Patients have also put off routine care out of fear that they could be exposed to the new coronavirus at hospitals and doctors' offices.
With states starting to open up, you might be wondering whether you can finally get that checkup, dental cleaning, or cancer screening you've been pushing off.
Here's what you need to know about scheduling preventive care appointments during the pandemic
Are States Allowing Preventive Care Visits?
First things first: If you're experiencing a medical emergency, don't delay treatment.
While there's the potential that you could be exposed to infections at the emergency room, the health risks of avoiding urgent medical care could be far more severe.
Hospitals have also implemented precautionary measures, like distributing masks to patients, that help cut down the risk of viral exposure.
Now that that's out of the way, is it possible to start catching up on routine healthcare appointments, like physicals and dental cleanings?
"Different places are in different stages of opening up," said Dr. Arvind Ankireddypalli, primary care physician and geriatrician at Methodist Le Bonheur Healthcare. "Preventative services might not even be available in some communities, [and in others] medical appointments may be on a case-by-case basis."
Like medical care, dental appointments fall under similar guidelines.
"Dental cleanings are nonessential treatments, and the department of health in most states only allowed emergency dental treatments to be completed during COVID-related shutdowns," said Dr. John Nelson of Midtown Dental Miami.
"As states begin to slowly reopen and restrictions begin to relax, dental cleaning services are starting to be provided again. I expect [that within the next few weeks], barring any setback, your local dental office will begin providing cleanings," he said.
Check with your local and state health departments for the most up-to-date guidelines.
Is it Safe to Go to the Doctor?
If your state is open (or will end its lockdown soon), you may be able to start booking preventive care appointments, like Pap smears, cancer screenings, checkups, and dental cleanings.
But is it worth the risk of possible exposure to the new coronavirus?
Opinions vary among healthcare providers and the conditions of their patients, as well as the infection rate in their communities and availability of personal protective equipment.
Dr. Len Horovitz, internist, pulmonary specialist, and director of Carnegie Medical, recommends that patients avoid delaying their annual physical or other types of preventive care.
"You will encounter problems that are best seen earlier rather than later," he said. "It is possible to provide a safe environment for a patient in the doctor's office. There's no reason for people to put off an annual exam; these are important appointments that help keep problems from getting out of control."
In an effort to curb the spread of infection, Horovitz has been following a strict set of procedures at his office, including allowing just one patient in at a time, requiring patients to wear masks and gloves, and disinfecting the examination room between every patient.
Other physicians, like Ankireddypalli, conduct a risk-benefit analysis for every patient before agreeing to see them in person.
"It is probably not appropriate to keep delaying visits for high-risk patients, like older adults or people with chronic conditions," he explained.
Role of Telehealth Visits
Telemedicine visits, where doctors connect with patients via phone or video chat, can be an option if in-person appointments are risky or prohibited.
The Centers for Medicare & Medicaid Services and some private insurance companies have expanded coverage for telehealth services during the pandemic. As a result, some practices have seen the use of telemedicine services soar over the last few months.
"Telemedicine is a way that patients can be seen, evaluated, counseled, and informed about their healthcare without being exposed to the dangers of going into lobbies and offices," said Dr. Steve Ommen, cardiologist and associate dean of the Mayo Clinic Center for Connected Care, which offers telemedicine services.
"It is particularly relevant for patients who already have a relationship with a provider, the appointment is for an ongoing care episode, and the patient doesn't need to be touched," he said.
A virtual doctor's visit can't be a substitute for all routine care, though. Cancer screenings, blood draws, evaluations of lumps, Pap smears, and other services still need to be done in person.
But even if you do have to go to the doctor's office, telehealth services can help cut down on the amount of time you spend there, thus potentially reducing your exposure to the new coronavirus and other germs.
"Patients often come to the Mayo Clinic for a major evaluation and then sit with us to go over the results, but we can go over the results through telemedicine when they're at home, rather than having them stay another day," Ommen explained.
He adds that telemedicine services generally won't suffice for patients who are unwell or experiencing any new symptoms.
"That's a different level of acuity than a health maintenance visit," he said.
With so much uncertainty, the best thing you can do is keep an open line of communication with your doctor, dentist, and the rest of your healthcare team.
Don't just push off your routine services indefinitely, doctors say.
"By delaying preventative care, we can miss the window of catching certain conditions early. Patients can work with their healthcare providers to put a plan in place and get their services back on track," Ankireddypalli said.
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Jean-Marc Neveu and Olivier Civil never expected to find themselves battling against disposable mask pollution.
When they founded their recycling start-up Plaxtil in 2017, it was textile waste they set their sights on. The project developed a process that turned fabrics into a new recyclable material they describe as "ecological plastic."
Mounting Piles of Waste<p>It is not only the streets of Chatellerault where pandemic pollution is piling-up, but also the world's beaches and oceans. Once there, they can take up to 450 years to degrade and disappear.</p><p>Esther Röling, co-organizer of the annual Adventure Clean Up Challenge held on Hong Kong Island, has seen this waste firsthand. In October the sports challenge pitted teams against one another in a competition to remove trash from 13 hard-to-reach coastal areas around the city.</p><p>They find tons of both disposable and reusable masks, said Röling. "You wonder how it ended up there. Was it just thrown on the ground? Or was it in a garbage bag that broke open?"</p><p>Almost 10,000 kilometers away in Antibes on the sunny French Riviera, it's a similar picture. For the past few months, divers and clean-up volunteers working with an ocean clean-up non-profit called Operation Mer Propre have been collecting an increasing number of masks found on land and in the sea.</p><p>"Since the beginning of the lockdown when we started to count, we've reached 800, 900, [and now in total] 1000 masks," said co-founder Joko Peltier. </p><p>According to <a href="https://unctad.org/news/growing-plastic-pollution-wake-covid-19-how-trade-policy-can-help" target="_blank">UN estimates</a>, up to 75% of all coronavirus-related plastic could end up as waste in oceans and landfills.</p>
The Limits of Recycling<p>Yet not all are convinced the recycling of this waste is possible on a global scale. </p><p>"What those citizen groups are doing is really beneficial but once they collect it, it should just go to a landfill or an incinerator. They shouldn't necessarily expect it to get recycled," said Jonathan Krones, an industrial ecologist and visiting assistant professor of environmental studies at Boston College.</p><p>That's because mask recycling programs like Plaxtil are few and far between and most don't have the benefit of a readily adaptable production process. </p><p>Even in countries with solid recycling infrastructure, he says, the system is designed to separate out specific types of waste like bottles or cardboard.</p><p>"I imagine that it would be technically feasible to develop a separation process to filter out masks, but there simply aren't enough of them to make that economical," he said.</p><p>Collection is a big hurdle, he adds. Since each mask only weighs a fraction of a gram and they're scattered on roads or mixed with other trash, it is difficult and costly. </p><p>"You need a lot of raw material of the right quality to make investing in the recycling technology and the recycling system worthwhile," he said.<span></span><br></p>
Hemp, Sugar Cane and Sustainable Alternatives<p>Some projects are instead addressing the material used to make masks.</p><p>French company Geochanvre have created a mask made primarily from hemp, while in Australia, researchers at the Queensland University of Technology are experimenting with a disposable product made from agricultural waste. </p><p>Biodegradable options are exciting alternatives to reduce the fossil fuels needed for the creation of plastic-based masks, said Krones, but they don't absolve the wearer from the responsibility of what happens afterwards. </p><p>Bio-based masks often need their own composing solutions, he explains, because in landfill they can produce high amounts of the greenhouse gas methane when anaerobic bacteria feeds on the organic material. Methane is known to be significantly more potent than carbon dioxide.</p><p>"I think as long as we have in our mind that we want to have disposability, we're going to have to wrestle with a variety of different sorts of environmental tradeoffs," he said, adding that reusable, fabric masks are the best option available to most people.</p><p>Precimask is developing a clear face covering with an optional visor made from hard plastic, designed to be long-lasting.<br></p><p>Air enters either side of the cheeks through a technology normally found in pool filters and car exhaust systems, said company spokeswoman Juliette Chambet.</p><p>"We wanted to make ceramic-based filters that would be washable and cleanable, which would allow them to be reused as many times as desired without having to buy a new consumable or produce waste," she said. </p><p>Ultimately, encouraging mask wearers to think about the entire lifecycle of a mask is key, explains Neveu. </p><p>"We want people who put on the masks to realize that they are also responsible for the waste, he said. "It's not inevitable that this [pandemic] will become an environmental catastrophe.</p><p><em>Reposted with permission from </em><em><a href="https://www.dw.com/en/covid-19-recycling-pollution-trash-pandemic/a-55707817" target="_blank">Deutsche Welle</a>.</em><a href="https://www.ecowatch.com/r/entryeditor/2649032193#/" target="_self"></a></p>
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