DR OSCAR SUM - SHANGAI
|
My name is Oscar Sum and I was born in a small town in the UK just outside of London and went to school there. My parents move to UK more than 50 years ago to enter the F&B industry like many Hong Kongnese.
After finishing 6th form college in Oxford I went to study Dentistry at King’s College London and graduated in 2011. I worked in a lovely general dental practice in Brighton and went on to do my residency in oral surgery also in the area before moving to Shanghai in 2013. |
Charity work in the poorest region of China
|
The experience working in China has been very eventful and positive and broadens your perspective greatly on the world as well as well as clinically.
|
THE DAY AFTER
Haztmat : the new dental scrub?
|
Dear Citizens of the world, I never expected to see that a picture I uploaded of me wearing a hazmat suit would go viral. Furthermore be used as a political statement from having adequate PPE in western countries to the pricing of dentistry in Europe. I was asked by Alpha Omega International Dental Society to write an article about my experiences in China since the picture was challenged as being fake or a piece propaganda of eastern media outlets so allow me to share my experiences from my heart. I plan also to make a short video next week of my life in china from buying groceries to working in the clinic. |
THE COVID-19 PANDEMIC
When did the quarantine hit?
I was on my way back from UK after attending a course at the end of January 2020 and made a stop in Hong Kong. We decided as a family that it would be best if my wife travelled from Shanghai to Hong Kong since she was pregnant and we had always planned to have the delivery in Hong Kong. After some technicalities however my wife was not allowed to stay in Hong Kong since we had missed the time frame for obtaining a certificate to give birth in Hong Kong since the hospital did not allow her to enter the hospital since she had completed a 14 day quarantine despite her visa allowing her 90 days had been cut short to 7 days.
Disappointed, we had to travel back to Shanghai instantly (given a matter of a few hours) as per regulations, I wasn’t even allowed to pick up my son. Since I am introverted I didn’t find the quarantine too challenging but it was not nice being away from my son, especially when he is too young to understand why the family has to be split apart. Thankfully to my mother and father they have taken good care of him.
What is happening now?
Right now citizens are still very cautious and wear masks, your temperature is measured regularly when you enter any building whether it’s an office block, restaurant or supermarket. The Chinese government has undoubtedly done a great job in controlling this virus, whatever your politics are this is an undeniable fact especially given the rapid unexpected outbreak in Wuhan.
Quarantine is well controlled by strict measures. When I was under quarantine the community officer around the compound I live in would come to check on us daily. We were not allowed to leave the compound as guards would ask for your quarantine status. We had to self report on a WeChat group (similar to Whatsapp in the west) our temperature twice a day. Once our quarantine was finished we were given a certificate. Furthermore there is a code that appears on the Alipay app that shows you have completed quarantine. In the last few days I understand now there are new restrictions to foreigners. People may look at this and think that these measures were over the top, but actually it’s necessary to employ such measures to ensure the control of such a situation.
What happened to dentistry?
Dental clinics were shut since Chinese new year and opened started to open the beginning of march. So that was at least 2 months of shut dental clinics. As dental clinics are slowly opening we are given restrictions. During this time I tried to promote my platform www.Aidencare.com too for a digital form of triage to help patients who needed advice.
In fact I feel very safe given the measures that have been put in. I have the correct PPE, The government has set up an excellent protocol which in theory means an covid-19 patient is highly unlikely to attend a dental clinic since they would have to slip through many holes including quarantine and temperature checks. Regarding the PPE, the regulations state that I can wear a surgical gown to do a check up, however the hazmat suit is available if we feel necessary. For example I still take impressions with my hazmat suit. We are not allowed to use rotary instruments or ultrasonic scaler yet. Other restrictions include seeing only a limited number of patients a day and allowing 30 minutes between every patient to sterilise the room with UV light (something I am aware the west sees limited evidence for). I think it should be emphasised that PPE on its own may be meaningless. It is in fact the surrounding protocols and measures in place around the country to make me feel extremely safe. The PPE is a bonus on top.
What the future holds:
It is strange times we live in now and I can only take things week by week. I just hope my son and the rest of my family including my brother’s family, mum and dad can be with me soon so we can sit on the couch together as a family and play the new final fantasy VII remake game on PS4! I have no affiliation to any political organisation. I think whether you are a democrat, republican, conservative, labour or CCP we have to realise we are in this fight against the virus together. I hope my second son will be born in a united world rather than a divided one. FREQUENT ASKED QUESTIONS
What is your take on the public wearing masks?
I appreciate that western evidence points to the fact that masks have no functional value particularly after a day of use. However I think the evidence can be reviewed particularly when it comes to a pandemic situation. I also appreciate there may be political, economical or resource reasons as to why there is not a strong push for public to wear masks. Although I can only quote for anecdotal evidence my hypothesis is that a mass population wearing masks will see lower rates of viral transmission as the mask can create a conscious awareness of the pandemic situation and reduced touching to their face. I appreciate people can still touch around the mask, however when wearing the mask you are less likely to touch around the face.
What is the screening process to ascertain who is positive?
There are designated fever clinics which people can report to or are sent to if they display any symptoms displayed by people. Here, the testing is done and if positive then they have to undergo treatment and quarantine in the centre. Testing is an important part of the process to contain the virus.
Which rotary instruments can you not use? so how do you work?
Unfortunately no rotary instruments are allowed; fast, slow or ultrasonic scaler. This means that is very challenging to work. I am limited to doing orthodontic adjustments and taking impressions for invisalign. For bonding brackets or anything for that matter; I etch as normal, clean off the etch with alcohol cotton pleggits, then ask the patient to rinse out. I use good isolation technique and wait for the tooth to true in combination to using dry cotton to dry the surface. I have managed to achieve good frosted appearance using this method.
Are your patient afraid to come to the dentist?
So far I do not see this as there is great trust in the system and general belief that there is extremely low risk of contracting covid-19. When patients see the measures that we have gone through, patients are very understanding and display confidence in us.
Less patients means loss in revenue right?
For sure I have seen a sharp decrease in revenue, many organisations has. We have to work towards rebuilding the city and remain positive as things pick up. As dentists we have a responsibility to reduce the likelihood of covid-19 spreading in dental clinics. In fact I have lowered by fee’s considerably since many people have lost their jobs and have been in discomfort for a long period of time. I stay positive by saying I believe this is only temporary and jobs demand will increase again.
How does the UV light work?
This is another thing that I believe is unique to China, Russia and some part of eastern Europe.
Unfortunately I have no hard evidence to this either however the regulations stipulate that this much be carried out. The decontamination process is the same is otherwise the same as the UK (where we trained)
Do you change suits in every patient?
Yes - bear in mind that I use a surgical gown for procedures I consider low risk such as check up/consultation regarding abscess or pain. With increased exposure to fluids I wear the hazmat suit. Since we have a limited number of these suits we have to decide when to use them. Since we are not seeing that many patients a day this is not really an issue.
You talk about a Covid-19 positive patient would have to slip through many holes to enter a dental clinic, what do you mean by this?
Right now there are no domestic cases of Covid-19, Only imported cases, This means people entering China from other countries. Upon entering the country, everyone is required to register and have their temperature check. People have to undergo supervised quarantine (different to quarantining at home) as these are specified government buildings. People are also tested in these centres. Furthermore, patients before entering our dental clinic have to be screened. They must show their certificate to show they have finished quarantine and sign a declaration saying they have no symptoms of Covid-19 including fever, sore throat or coughing. They must declare they have not travelled outside of Shanghai in the last 14 days and not been in contact with anyone that has travelled out of Shanghai in the last 14 days. Furthermore their temperature is checked again.
I was on my way back from UK after attending a course at the end of January 2020 and made a stop in Hong Kong. We decided as a family that it would be best if my wife travelled from Shanghai to Hong Kong since she was pregnant and we had always planned to have the delivery in Hong Kong. After some technicalities however my wife was not allowed to stay in Hong Kong since we had missed the time frame for obtaining a certificate to give birth in Hong Kong since the hospital did not allow her to enter the hospital since she had completed a 14 day quarantine despite her visa allowing her 90 days had been cut short to 7 days.
Disappointed, we had to travel back to Shanghai instantly (given a matter of a few hours) as per regulations, I wasn’t even allowed to pick up my son. Since I am introverted I didn’t find the quarantine too challenging but it was not nice being away from my son, especially when he is too young to understand why the family has to be split apart. Thankfully to my mother and father they have taken good care of him.
What is happening now?
Right now citizens are still very cautious and wear masks, your temperature is measured regularly when you enter any building whether it’s an office block, restaurant or supermarket. The Chinese government has undoubtedly done a great job in controlling this virus, whatever your politics are this is an undeniable fact especially given the rapid unexpected outbreak in Wuhan.
Quarantine is well controlled by strict measures. When I was under quarantine the community officer around the compound I live in would come to check on us daily. We were not allowed to leave the compound as guards would ask for your quarantine status. We had to self report on a WeChat group (similar to Whatsapp in the west) our temperature twice a day. Once our quarantine was finished we were given a certificate. Furthermore there is a code that appears on the Alipay app that shows you have completed quarantine. In the last few days I understand now there are new restrictions to foreigners. People may look at this and think that these measures were over the top, but actually it’s necessary to employ such measures to ensure the control of such a situation.
What happened to dentistry?
Dental clinics were shut since Chinese new year and opened started to open the beginning of march. So that was at least 2 months of shut dental clinics. As dental clinics are slowly opening we are given restrictions. During this time I tried to promote my platform www.Aidencare.com too for a digital form of triage to help patients who needed advice.
In fact I feel very safe given the measures that have been put in. I have the correct PPE, The government has set up an excellent protocol which in theory means an covid-19 patient is highly unlikely to attend a dental clinic since they would have to slip through many holes including quarantine and temperature checks. Regarding the PPE, the regulations state that I can wear a surgical gown to do a check up, however the hazmat suit is available if we feel necessary. For example I still take impressions with my hazmat suit. We are not allowed to use rotary instruments or ultrasonic scaler yet. Other restrictions include seeing only a limited number of patients a day and allowing 30 minutes between every patient to sterilise the room with UV light (something I am aware the west sees limited evidence for). I think it should be emphasised that PPE on its own may be meaningless. It is in fact the surrounding protocols and measures in place around the country to make me feel extremely safe. The PPE is a bonus on top.
What the future holds:
It is strange times we live in now and I can only take things week by week. I just hope my son and the rest of my family including my brother’s family, mum and dad can be with me soon so we can sit on the couch together as a family and play the new final fantasy VII remake game on PS4! I have no affiliation to any political organisation. I think whether you are a democrat, republican, conservative, labour or CCP we have to realise we are in this fight against the virus together. I hope my second son will be born in a united world rather than a divided one. FREQUENT ASKED QUESTIONS
What is your take on the public wearing masks?
I appreciate that western evidence points to the fact that masks have no functional value particularly after a day of use. However I think the evidence can be reviewed particularly when it comes to a pandemic situation. I also appreciate there may be political, economical or resource reasons as to why there is not a strong push for public to wear masks. Although I can only quote for anecdotal evidence my hypothesis is that a mass population wearing masks will see lower rates of viral transmission as the mask can create a conscious awareness of the pandemic situation and reduced touching to their face. I appreciate people can still touch around the mask, however when wearing the mask you are less likely to touch around the face.
What is the screening process to ascertain who is positive?
There are designated fever clinics which people can report to or are sent to if they display any symptoms displayed by people. Here, the testing is done and if positive then they have to undergo treatment and quarantine in the centre. Testing is an important part of the process to contain the virus.
Which rotary instruments can you not use? so how do you work?
Unfortunately no rotary instruments are allowed; fast, slow or ultrasonic scaler. This means that is very challenging to work. I am limited to doing orthodontic adjustments and taking impressions for invisalign. For bonding brackets or anything for that matter; I etch as normal, clean off the etch with alcohol cotton pleggits, then ask the patient to rinse out. I use good isolation technique and wait for the tooth to true in combination to using dry cotton to dry the surface. I have managed to achieve good frosted appearance using this method.
Are your patient afraid to come to the dentist?
So far I do not see this as there is great trust in the system and general belief that there is extremely low risk of contracting covid-19. When patients see the measures that we have gone through, patients are very understanding and display confidence in us.
Less patients means loss in revenue right?
For sure I have seen a sharp decrease in revenue, many organisations has. We have to work towards rebuilding the city and remain positive as things pick up. As dentists we have a responsibility to reduce the likelihood of covid-19 spreading in dental clinics. In fact I have lowered by fee’s considerably since many people have lost their jobs and have been in discomfort for a long period of time. I stay positive by saying I believe this is only temporary and jobs demand will increase again.
How does the UV light work?
This is another thing that I believe is unique to China, Russia and some part of eastern Europe.
Unfortunately I have no hard evidence to this either however the regulations stipulate that this much be carried out. The decontamination process is the same is otherwise the same as the UK (where we trained)
Do you change suits in every patient?
Yes - bear in mind that I use a surgical gown for procedures I consider low risk such as check up/consultation regarding abscess or pain. With increased exposure to fluids I wear the hazmat suit. Since we have a limited number of these suits we have to decide when to use them. Since we are not seeing that many patients a day this is not really an issue.
You talk about a Covid-19 positive patient would have to slip through many holes to enter a dental clinic, what do you mean by this?
Right now there are no domestic cases of Covid-19, Only imported cases, This means people entering China from other countries. Upon entering the country, everyone is required to register and have their temperature check. People have to undergo supervised quarantine (different to quarantining at home) as these are specified government buildings. People are also tested in these centres. Furthermore, patients before entering our dental clinic have to be screened. They must show their certificate to show they have finished quarantine and sign a declaration saying they have no symptoms of Covid-19 including fever, sore throat or coughing. They must declare they have not travelled outside of Shanghai in the last 14 days and not been in contact with anyone that has travelled out of Shanghai in the last 14 days. Furthermore their temperature is checked again.
The UV Light
