4. What if staff members test positive for COVID?
The guidance on `Managing healthcare staff with symptoms of a respiratory infection or a positive COVID-19 test result` for practices in
England changed on 31 March 2023.
The main changes are:
- Most healthcare staff who have symptoms of a respiratory infection are no longer asked to test for COVID-19. They should stay at home until they no longer have a high temperature (if they had one) or until they no longer feel unwell
- Healthcare staff who test positive for COVID-19 are no longer required to have 2 negative lateral flow device (LFD) tests for COVID-19 before they return to work. They should follow the
guidelines for the general public who have a positive test result. Line managers should undertake a risk assessment before patient-facing healthcare staff return to work in line with normal return to work processes.
5. What if a staff member has contact with a COVID-19 case?
People who live in the same household as someone with COVID are at the highest risk of becoming infected due to having prolonged close contact. The same applies to people who have stayed overnight in such an environment.
It can take up to 10 days for any infection to develop and it is possible to pass on COVID to others, even if that person has no symptoms. Routine asymptomatic testing was paused from 31 August but continues for symptomatic NHS staff and staff in symptomatic NHS-commissioned independent healthcare providers (including return to work testing) which will involve taking an LFT at home. The change has been made because the prevalence in the community has fallen and remains at a comparatively low level.
The practice should have a conversation about people in "household or overnight contact" to discuss ways to minimise risk of onwards transmission and these may include considering the possible redeployment to lower risk areas for patient-facing healthcare staff and/or limiting close contact with others, especially in crowded, enclosed or poorly ventilated spaces.
In addition, whilst they are attending work, staff must continue to comply rigorously with all relevant infection control precautions.
In Wales, if a staff member has been in contact with a confirmed COVID case, they must follow a testing process to continue to work in a patient-facing environment. If staff do not agree, they should be redeployed or not attend work for 7 days. Before entering the practice, staff members should:
- Be asymptomatic
- Use lateral flow tests each day before coming to work for 7 days
- Take a PCR test as soon as possible if the confirmed COVID case is in their household. It is advised that employers request staff members receive a negative PCR result before coming into work.
In Northern Ireland, if someone in the dental team comes into contact with a confirmed COVID case and
is fully vaccinated, they are advised to isolate and take an LFD as soon as possible.
If the LFD is negative, they should stop isolating and take daily lateral flow tests before leaving the house until the tenth day after the last date of contact with the positive case. If the LFD is positive, they should isolate immediately. If the LFD results are negative, but they develop symptoms, they should book a PCR test and isolate immediately.
Staff who are
not fully vaccinated must continue to self-isolate for 10 days and should not end self-isolation early.
In Scotland, any
fully vaccinated close contacts of a case should take an LFD, if this test is negative, they are asymptomatic and have been risk assessed by their line manager they may return to work. To safeguard patients and other staff they will need to take an LFD for each of the ten days following the positive case and report the results to their line manager.
Unvaccinated staff should immediately isolate for ten days and have a PCR test as soon as possible. They should not exit self-isolation early.
6. Should I get a COVID-19 booster jab?
Yes. Healthcare workers are being advised to get a booster vaccination if they haven’t already received one. To do this, you can book an appointment online or attend a walk-in vaccination centre.
The Joint Committee on Vaccination and Immunisation (JCVI) has announced that COVID boosters will be made available for frontline healthcare workers, as well as for more vulnerable groups, this autumn. The aim of the booster programme is to increase population immunity and protection against COVID-19 over the winter period.
Boosters will be offered to residents in care homes, frontline health and social care workers, all those aged 65+ and those aged 16 to 64 years who are in a clinical risk group. The JCVI is reviewing the scientific data and further updates on the delivery dates will follow.
7. What about pregnant staff?
If the practice undertakes
risk assessments and acts on outcomes, we understand that the dental environment is a safe one and the pregnant members of the dental team can continue to work safely.
A common-sense approach
As would be expected, managers and other team members must be mindful of colleagues who are pregnant. If you are pregnant and working in a dental practice, it seems right that you wear a mask and follow infection control procedures at all times, no matter your gestation.
Contracting COVID-19 just before or at the time of birth, would obviously bring substantial challenges to all involved and is best avoided, so the closer the pregnancy gets to the due date, the more the practice should be prepared to show flexibility over the parental leave arrangements. See
government guidance for further information.
There should also be careful risk assessments for pregnant team members in a patient-facing role with appropriate arrangements to sufficiently minimise their exposure to the virus, taking into account individual risk factors.
Practice risk assessment (updated June 2022)
Pregnant - in patient-facing clinical role
Pregnant - in patient-facing administrative role
Pregnant - in non-patient-facing administrative role
Pregnant - in non-patient-facing decontamination/cleaning role
Self-employed
Pregnant self-employed members of the dental team are free to make their own decision as to whether they work or not; that said, we urge members to work together constructively to ensure that risks are kept to a minimum.
Vaccination and pregnancy
Pregnant members of the dental team are advised to speak to their doctor before receiving the vaccine. You may wish to review the advice produced by the Royal College of Obstetrics and Gynaecology (RCOG) and the Royal College of Midwives (RCM), on
pregnancy and vaccination. You may also wish to consult this
explainer on COVID-19 and fertility, compiled by Victoria Male, Lecturer in Reproductive Immunology at Imperial College London. It provides evidence-based answers to questions you might have regarding the COVID-19 vaccine, pregnancy, breastfeeding and fertility.
8. How can I support ethnic minority staff?
Emerging evidence shows that ethnic minority communities may be disproportionately affected by COVID-19. Organisations should ensure that line managers are supported to have sensitive and comprehensive conversations with their ethnic minority staff. They should identify any underlying health conditions that may increase the risks for them in undertaking their roles. These conversations should also, on an ongoing basis, consider the feelings of affected colleagues, particularly regarding their physical safety and mental health.
We've recently conducted a significant piece of research into dentists' experiences of racism, as a joint project with the Faculty of General Dental Practice. Informed by the racism focus group led by BDA President Russ Ladwa, this survey has provided us with a rich vein of data on the reality of racism in dentistry.
It's clear that we still face a significant problem with racism within dentistry. BDA Chair Eddie Crouch has encouraged us all to
recognise the reality of this, rather deny its existence. This would be the important step towards progress for our profession. For our part, we're continuing our work and research in this area and will update you when we have more information.