1.
Since January 11, when the first 40 cases of infection by SARS‐Cov‐2 (COVID‐19 disease) were communicated from Wuhan, in the Chinese province of Hubei, about 4.5 million confirmed cases have been reported worldwide. During this 3‐month period, 80,000 new cases and 11,000 deaths were registered daily.
Spain holds the sad privilege of leading the European ranking of confirmed cases (>228,000) and deaths (>27,000) with no consensus on the actual figures.
An ad hoc population‐based, descriptive quantitative study undertaken by the Spanish General Dental Council (https://www.consejodentistas.es) between April 8 and 13, 2020, on a sample of 4,200 GDPs unveiled that 8 out of 10 dentists were unable to obtain the necessary protective equipment for clinical work due to lack of supply. About half of the participants reported to have experienced COVID‐19‐related symptoms, 14% had to be confined because of close contact with infected individuals, with 2% of them confirmed positive for SARS‐Cov‐2.
The most important preventive actions implemented so far to contain the virus have been social distancing and barrier and hygiene measures. In this vein, the Spanish Government decreed the state of alert since March 14 to May 24, 2020. This situation restricts mobility and work to strictly essential activities.
The combination of these three factors resulted in dentists treating only medical and dental emergencies selected under rigorous ethical and technical criteria, with just 0.5% of all dental clinics in Spain managing to keep routine dental care. Oral and Maxillofacial surgeons had also to constrain their activities to oncology, traumatology, and other urgent cases.
An Italian group recently warned about the diagnostic delay in oral cancer caused by the outbreak of COVID‐19 (Arduino, Conrotto, & Broccoletti, 2020). In this vein, proposals have been issued to learned societies for producing quality educative material to be available online for continuous education on this topic during the COVID‐19 lockdown (Da Cruz Perez, Passos, Machado, Martelli‐Junior, & Bonan, 2020).
Several studies have been disclosing gaps of knowledge and improvable attitudes toward oral cancer among Spanish GDPs for more than 20 years (López‐Jornet, Camacho‐Alonso, & Molina‐Miñano, 2010; Varela‐Centelles, Estany‐Gestal, Bugarín‐González, & Seoane‐Romero, 2018). Spanish general practitioners attending continuing education courses in oral cancer have proved an increased probability for adopting preventive attitudes, double the odds of giving alcohol advice to their patients and showed a tenfold increment in the odds for performing mucosal explorations on a routine basis. Also, they are 3.5 times more likely to undertake biopsy procedures for the diagnosis of suspicious lesions (Seoane et al., 2012).
In late 2018, the Spanish General Dental Council supported an educational intervention designed by university academics which consisted of a 20‐hr online course on early detection of oral cancer. This course was acknowledged by the National Commission for Continuing Education of the Healthcare Professions (#07‐AFOC‐06030.2/2018) and gathered 1,500 dentists.
During the current times of coronavirus, this course has been re‐activated and it is currently available from April 1 to May 31 and more than 800 GDPs are attending it. The possibility for new coronavirus waves suggests there may be a chance for producing high‐quality online information designed to improve dentists’ performance on oral cancer diagnosis during hypothetical future lockdowns (Cyranoski, 2020; Da Cruz Perez et al., 2020). In addition, and despite the heterogeneity of continuing education programs in oral cancer, stakeholders and professional organizations should promote collaborative efforts to elaborate and share these materials online. Such initiatives would result in a better diagnosis at the primary care level, particularly when oral cancer incidence is increasing, mortality retains high rates (Global Cancer Observatory 2018), and diagnosis continues to be made at advanced disease stages.
AUTHOR CONTRIBUTION
Pablo Varela‐Centelles: Conceptualization; Writing‐original draft; Writing‐review & editing. Pía López‐Jornet: Conceptualization; Writing‐original draft; Writing‐review & editing. Alicia Gonzalez‐Mourelle: Conceptualization; Writing‐original draft; Writing‐review & editing. Juan Seoane: Conceptualization; Writing‐original draft; Writing‐review & editing.
REFERENCES
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