Our KO COVID-19 Response
An article was written by Dr. Bowman for Kalamazoo Orthodontic patients in the midst of the COVID-19 epidemic (May, 2020) as we anticipated reopening to see our patients once again. It details the significant changes that we made in logistics, air quality, aerosol mitigation, etc. to the benefit of both our patients who entrust their care to us and also for our team members. The changes we have made are also detailed in 2 published articles, several roundtable interviews, and other web-based interviews that Dr. Bowman participated in. Thankfully, we have subsequently also re-opened our satellite offices in Paw Paw and Kalamazoo.
Kalamazoo Orthodontics reopened on June 1, 2020, to begin to see our patients. Dr. Bowman made the decision to close our offices on Tuesday, March 16th, prior to the Governor’s Executive Orders. Our staff was laid-off. It has been nearly 3 months without seeing anyone, except just our patients with emergencies. We asked those folks to e-mail their photographs, we then triaged, and handled their issues (sometimes by Virtual Visit on-line and others required in person attention).
KO BOOT CAMP We are thrilled to have re-hired all of our Team KO staff members. We’ve stayed in touch during the lock-down with regular ZOOM virtual meetings. Prior to seeing our first patients, all of us will have completed 4 full days of training to include new COVID-era procedural changes, CDC and OSHA recommendations, new equipment instruction, re-assign staff roles, and conducted rehearsals to integrate it all for the optimum safety for our patients.
“For your health and safety, we have modified our store experience to meet or exceed public health requirements with cleaning, sanitization and social distancing.” – Starbucks
ENVIRONMENTAL CHANGES KO has gone above and beyond any suggestions from the CDC and OSHA for your safety. We began researching immediately when the pandemic broke. We brought in an HVAC engineer to advise and design the changes that we have subsequently made. Some folks are interested in the details of what we have done, so we are providing the low-down on the changes we have made:
Three Furnaces/AC units have been replaced with high efficiency units including: 3 Bryant Cor Air Purifier Systems – HEPA filtration
3 Second Wind 2000 Germicidal UV-C light units
3 Aprilaire humidifiers to maintain 40-60% humidity (the virus doesn’t like humidity)
Two “Air Isolation Rooms” Besides our new office HVAC constantly recirculating air filtration, we have also converted 2 private rooms to “air isolation units” that can be switched to “negative pressure” as necessary. Each room has its own Microcon EXC7UV hospital grade HEPA and UV-C light filtration units with Echophan blower. The air exchange rates can be varied from 6 > 14 air changes/ hour (ACH). These rooms will be used for specific procedures and filtration adjusted for complete air changes every 5 minutes. These two rooms are not mandated or required. However, in combination with the other filtration enhancements in the office, we believe we have likely reduced the potential transmission of most any type of airborne infectious diseases (e.g., colds, flu, strep, pneumonia, COVID, and it will help with allergies, too).
Two Jade Surgically-Clean Air Purifiers – self-contained standalone HEPA/UV light filters.
We now also have a 3rd M11 Autoclaves in our laboratory, along with a Lab Hood Vent Exhaust. We also ordered 2 UPang UV-C sterilizing cabinets.
Each operatory unit is equipped with Hu-Friedy Antimicrobial Agent Waterline Filters.
We have invested in a variety of brand-new options for aerosol mitigation at each of our operatory units. Some catch aerosols intraorally, others just at the edge of your lips, and others are mobile filtration units (e.g. HealthyAir Source Dental Aerosol Extractor) that also have self-contained HEPA/UV filtration and function as aerosol “scavengers” near your face.
We have converted 2 private orthodontic “records” rooms with new chairs for digital intraoral scanning using our iTero Element scanners. Scanning replaces most goopy impressions for fabricating Invisalign, retainers, and other appliances. We also added a chair to an alcove for simple, quick procedures, and instructions.
We ask that you contact us when you arrive, we’ll communicate with you before permitting entry. (We will ask medical history questions, does the patient have any broken braces that would necessitate a different appointment, confirm that the patient used the bathroom at home and also brushed thoroughly before coming to the office, that patient checked that their temperature and it is less than 100 degrees, and that they are wearing their own mask or face-covering, etc.
Only the patient will enter our Portage office. We will verify their temperature (we have 3 different methods to confirm) and if >100F, then we will re-appoint. Our office will be maintained MOVIE THEATRE–ICE COLD (we are all wearing HOT PPE), so please bring your own sweater or sweatshirt to keep warm.
Just so you know, our staff must go through the medical screening and temperature taking prior to donning their PPE. They also have specific protocols and new logistics and roles within the office. As you might imagine, you will notice many changes when you visit KO (and more that are behind the scenes) – all made to improve our environment for your safety. we have not added fees in response to all of the changes and added PPE costs.
Dr. Bowman began comparing notes with his colleague, Dr. Jason Cope, in Texas. They divvied-up their investigations, bouncing ideas off each other, and then ran their ideas by Jackie Dorst. This process resulted in Dr. Bowman being invited for interviews and publications, including a panel discussion webinar for the Journal of Clinical Orthodontics on “COVID-19: Returning to Our Practices.” This was followed by an Interview Podcast for Orthodontic Practice-US. The JCO then asked panelists to provide answers for a Roundtable Discussion to be published. Next, was a more in-depth interview with Dr. Bowman for Orthodontic Products on YouTube.
Dr. Bowman then began a collaboration with a group of orthodontists on a comprehensive article for the Journal of Clinical Orthodontics: “Orthodontics in the COVID-19 Era: The Way Forward.” This was pushed through peer-review for rapid dissemination. Since the pandemic started, he also has been in the middle of authoring a book chapter on Improving the Predictability of Clear Aligners (Invisalign) for The Moyers Symposium, taught the residents at The University of Michigan for the 19th year, and was invited to give webinars for a variety of groups around the world, such as the European and Eastern Angle Societies (including 300 different residency programs), and for groups based in Scotland, Italy, Mexico,
Brazil, India, Egypt, and later this Summer, Russia. Team KO certainly has not sat still.
We are EXCITED and GRATEFUL to see the return of our family of patients, get your treatments on-track, unveil some new smiles, and demonstrate what we’ve done to enhance a safe environment here for all of you.
Until we can see you in-person, if you have an emergency, please send photos to firstname.lastname@example.org so that we may take a look at the situation and offer suggestions.
As Janine in Ghostbusters said, “Yes, we’re back!”
Dr. Bowman and Team KO