REPORTED BY NORMAN J CLEMENT RPH., DDS
“Rapid and accurate SARS-CoV-2 diagnostic testing is essential for controlling the ongoing COVID-19 pandemic. The current gold standard for COVID-19 diagnosis is real-time RT-PCR detection of SARS-CoV-2 from nasopharyngeal swabs……..saliva has exhibited comparable sensitivity to nasopharyngeal swabs in the detection of other respiratory pathogens, including endemic human coronaviruses, in previous studies.”
SALIVA IS MORE SENSITIVE FOR SARS-CoV-2 DETECTION IN COVID PATIENTS THAN NASOPHARYNGEAL SWABS, YALE UNIVERSITY REPORT SAYS
Saliva sampling is an appealing alternative to nasopharyngeal swab, since collecting saliva is non-invasive and easy self-administered, states a Yale University study, which supports You’re Within The Norms (YWTN) earlier conclusions. Clearly, COVID-19, is and Oral pharyngeal disease, detectable in the mouth and there is a need for Oral Healthcare Armed Intervention, before it expresses itself as a Systemic Pulmonary disease with horrific deathly outcomes.(1)(3)
In a study conducted at Yale University School of Public Health, Yale School of Medicine, abstract published April 22, 2020, reported:
“Our (The Yale University) study demonstrates that saliva is a viable and preferable alternative to nasopharyngeal swabs for SARS-CoV-2 detection. We (Yale) found that the sensitivity of SARS-CoV-2 detection from saliva is comparable, if not superior, to nasopharyngeal swabs in early hospitalization and is more consistent during extended hospitalization and recovery. Moreover, the detection of SARS-CoV-2 from the saliva of two asymptomatic healthcare workers despite negative matched nasopharyngeal swabs suggests that saliva may also be a viable alternative for identifying mild or subclinical infections. With further validation, widespread implementation of saliva sampling could be transformative for public health efforts: saliva self-collection negates the need for direct healthcare worker-patient interaction, a source of 14–16 several major testing bottlenecks and overall nosocomial infection risk , and alleviates supply demands on swabs and personal protective equipment.”
YALE SCHOOL OF PUBLIC HEALTH AND YALE UNIVERSITY SCHOOL OF MEDICINE STUDY SUPPORTS DENTAL HEALTHCARE INVOLVEMENT
“As SARS-CoV-2 viral loads differ between mild and severe cases, a limitation of our (Yale)study is the primary focus on COVID-19 inpatients, many with severe disease. While more data are required to more rigorously compare the efficacy of saliva in the hospital setting to earlier in the course of infection, findings from two recent studies support its potential for detecting SARS-CoV-2 from both asymptomatic individuals and outpatients. As the infectious virus has been detected from the saliva of COVID-19 patients , ascertaining the relationship between virus genome copies and infectious virus particles in the saliva of pre-symptomatic individuals will play a key role in understanding the dynamics of asymptomatic transmission .”
“Stemming from the promising results for SARS-CoV-2 detection in asymptomatic individuals, a saliva SARS-CoV-2 detection assay has already gained approval through the U.S. Food and Drug Administration emergency use authorization. To meet the growing testing demands, however, our findings support the need for immediate validation and implementation of saliva for SARS-CoV-2 diagnostics in certified clinical laboratories.“
WHAT AND WHY IS DENTISTRY SITTING ON THE SIDELINES?
My Letter to the Dean, University of Michigan School of Dentistry
Dr. McCauley:
The Field of Dentistry, including its specialties, can ill-afford to sit at home and must change their roles as providers of oral dental health to “a covered person” during this SAR-COV-2 pandemic. We cannot permit those most knowledgeable in Oral Health and Oral Pathology to be sidelined. The failure to implement Oral Health protocols will result in unnecessary deaths and destruction of the Worlds Economy. We are at war. Dentistry has a role in our Healthcare Armed Forces and will primarily be:
a) Oral and nasal testing to identify the presence or non-presence of COVID-19 Virus
b) Intervention and Prevention
c) Adopting an Oral-Healthcare Guideline.(4)
COVID-19 is an oral pharyngeal disease before it becomes a pulmonary and systemic disease.(id.) Once this virus gets past your hands and into your mouth and nose, your dentist, the dental office, Dental schools must be brought on board and utilized for testing and identification of preventive, intervention procedures.(2)
Dr. McCauley, please, if you can, USE YOUR MIGHTY POWERS to help publish these articles in the Michigan Dental Journal, University of Detroit Dental Journal, America Dental Association Journal, Yale University School Medicine Journal, National Dental Association Journal, Yale University School of Public Health Journal, because your authority in Dentistry may mean life existence to the World.
THE JOURNAL OF THE AMERICAN DENTAL ASSOCIATION
The Journal of the American Dental Association, Vol 135, issue April 4, 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D.;(2)
” The saliva and nasopharyngeal secretions also may contain other pathogenic organisms. These may include common cold and influenza viruses, herpes viruses, pathogenic streptococci and staphylococci, and the SARS virus. The use of universal precautions with all patients initially was based on the assumption that all patients may have an infectious bloodborne infection, such as with hepatitis B virus, hepatitis C virus, and HIV. It also should be assumed that all patients may have an infectious disease that has the potential to be spread by dental aerosols; thus, universal precautions to limit aerosols also should be in place.”
THE AMERICAN DENTAL ASSOCIATION POSITION ON COVID-19 TESTING
In the letter to Adm. Brett P. Giroir, M.D., HHS assistant secretary for health, the ADA explained that administering these types of tests falls under licensed dentists’ scope of practice. The Association said by issuing federal recognition; dentists would qualify as “covered persons” under the Public Readiness and Emergency Preparedness Act, which may extend protection from liability associated with the administration or use of FDA-authorized COVID-19 tests.
NORMAN J CLLEMENT RPH., DDS
Living in the Spirt of Sankofa
FOR NOW:
YOU ARE WITHIN THE NORMS
ENDNOTES
- MedRxiv preprint doi: https://doi.org/10.1101/2020.04.16.20067835.this version posted April 22, 2020.
- The Journal of the American Dental Association, Vol 135, issue April 4 2004, Pages 429-437, Aerosols and Splatter in Dentistry: A Brief Review of the Literature and Infection Control Implications, by Stephen K. Harreld, DDS., John Molinari, Ph.D
3. Sample collection Inpatients, Nasopharyngeal, and saliva samples were obtained every three days throughout their clinical course. Nasopharyngeal samples were taken by registered nurses using the BD universal viral transport (UVT) system. The flexible, mini-tip swab was passed through the patient’s nostril until the posterior nasopharynx was reached, left in place for several seconds to absorb secretions then slowly removed while rotating. The swab was placed in the sterile viral transport media (total volume 3 mL) and sealed securely. Saliva samples were self-collected by the patient. Upon waking, patients were asked to avoid food, water, and brushing of teeth until the sample was collected. Patients were asked to repeatedly spit into a sterile urine cup until roughly a third full of liquid (excluding bubbles), before securely closing it. All samples were stored at room temperature and transported to the research lab at the Yale School of Public Health within 5 hours of sample collection.
