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| How’s the Economy Doing? Watch the Dentists | How’s the Economy Doing? Watch the Dentists |
| (7 days later) | |
| If not for coronavirus, you’d expect your local dentist office to be doing just fine. | If not for coronavirus, you’d expect your local dentist office to be doing just fine. |
| Dentist offices tend to be stable businesses that stick around for decades, unlike restaurants that open and close frequently. Dentists earn a healthy salary — a median of $159,000 — and offer services with no clear substitute. If you need your teeth cleaned or a cavity filled, the dentist is the only option. | Dentist offices tend to be stable businesses that stick around for decades, unlike restaurants that open and close frequently. Dentists earn a healthy salary — a median of $159,000 — and offer services with no clear substitute. If you need your teeth cleaned or a cavity filled, the dentist is the only option. |
| This makes them, in the eyes of some economists, the perfect barometer for gauging the country’s recovery from the shock of the pandemic. | This makes them, in the eyes of some economists, the perfect barometer for gauging the country’s recovery from the shock of the pandemic. |
| “If you look at your typical dentist office, nothing went wrong with their business model,” said Betsey Stevenson, an economics professor at the University of Michigan. “It’s just coronavirus that happened.” | “If you look at your typical dentist office, nothing went wrong with their business model,” said Betsey Stevenson, an economics professor at the University of Michigan. “It’s just coronavirus that happened.” |
| The dental industry has weathered an exaggerated version of the pandemic’s economic impact, experiencing both a steeper decline and a faster recovery than other sectors. Half of all dental workers lost their jobs in March and April as states closed businesses to slow the virus’s spread. The industry accounted for a staggering 35 percent of all health care jobs lost in those months, even though its workers make up just 6 percent of the industry, according to analysis of federal data by the nonprofit Altarum Institute. | The dental industry has weathered an exaggerated version of the pandemic’s economic impact, experiencing both a steeper decline and a faster recovery than other sectors. Half of all dental workers lost their jobs in March and April as states closed businesses to slow the virus’s spread. The industry accounted for a staggering 35 percent of all health care jobs lost in those months, even though its workers make up just 6 percent of the industry, according to analysis of federal data by the nonprofit Altarum Institute. |
| How long it takes those jobs to come back entirely will be a crucial indicator of whether Americans feel safe returning to normal activities, and if they have the economic means to do so. | How long it takes those jobs to come back entirely will be a crucial indicator of whether Americans feel safe returning to normal activities, and if they have the economic means to do so. |
| “I’m obsessed with dentists because, if the only thing we’re doing is putting the economy on pause, and then going back to normal, all of them should be coming back,” Ms. Stevenson said. “We’re not really recovered until all the dentists are back to work.” | “I’m obsessed with dentists because, if the only thing we’re doing is putting the economy on pause, and then going back to normal, all of them should be coming back,” Ms. Stevenson said. “We’re not really recovered until all the dentists are back to work.” |
| The dental industry halted much of its work on March 16, when the Centers for Disease Control and Prevention and the American Dental Association issued joint guidance against elective care. Some dentists say they closed even earlier as protective equipment became in short supply. | The dental industry halted much of its work on March 16, when the Centers for Disease Control and Prevention and the American Dental Association issued joint guidance against elective care. Some dentists say they closed even earlier as protective equipment became in short supply. |
| By mid-April, 45 percent of dentists had laid off their entire staffs, according to data collected by the dental association. Only 13 percent remained fully open, with the remaining offices keeping a skeleton staff. Patient visits fell to 7 percent of normal rates. | By mid-April, 45 percent of dentists had laid off their entire staffs, according to data collected by the dental association. Only 13 percent remained fully open, with the remaining offices keeping a skeleton staff. Patient visits fell to 7 percent of normal rates. |
| Marko Vujicic, the chief economist at the dental association, expected a slow return of workers into dentist offices. But regular surveys, sent out to 12,000 dental practices every two weeks, showed a relatively fast recovery. | Marko Vujicic, the chief economist at the dental association, expected a slow return of workers into dentist offices. But regular surveys, sent out to 12,000 dental practices every two weeks, showed a relatively fast recovery. |
| “My initial predictions were we’d have an elevator ride down and an escalator ride up,” he said. “But we’re actually seeing a pretty sharp acceleration of the jobs coming back.” | “My initial predictions were we’d have an elevator ride down and an escalator ride up,” he said. “But we’re actually seeing a pretty sharp acceleration of the jobs coming back.” |
| By early May, 33 percent of dental offices had hired their full staffs back. The number rose to 58 percent by mid-May and, most recently, hit 77 percent the first week of June. | By early May, 33 percent of dental offices had hired their full staffs back. The number rose to 58 percent by mid-May and, most recently, hit 77 percent the first week of June. |
| New federal data released last week tells a similar story. The dental industry gained a quarter-million jobs in May, accounting for a full 10 percent of the net jobs added across the American economy. | New federal data released last week tells a similar story. The dental industry gained a quarter-million jobs in May, accounting for a full 10 percent of the net jobs added across the American economy. |
| Federal stimulus programs may have played a key role in bringing dentists back to work. An estimated 37 percent of dental offices received funding through the Paycheck Protection Program, meant to help small businesses keep workers on payroll. Dentist practices that participated in the program were more likely to remain open than those that didn’t. | Federal stimulus programs may have played a key role in bringing dentists back to work. An estimated 37 percent of dental offices received funding through the Paycheck Protection Program, meant to help small businesses keep workers on payroll. Dentist practices that participated in the program were more likely to remain open than those that didn’t. |
| As dentists head back to work, it’s unclear whether patients will follow. While most states have given dentist offices the go-ahead to reopen, patient volumes remain half of what they were before the pandemic. | As dentists head back to work, it’s unclear whether patients will follow. While most states have given dentist offices the go-ahead to reopen, patient volumes remain half of what they were before the pandemic. |
| That suggests it isn’t just stay-at-home orders that have caused patients to cancel appointments. Some may have lost the dental insurance they used to get at work. Others may fear contracting the virus; they may feel safer putting off preventive care that has already waited months. Or they may question the value of regular cleanings altogether. | That suggests it isn’t just stay-at-home orders that have caused patients to cancel appointments. Some may have lost the dental insurance they used to get at work. Others may fear contracting the virus; they may feel safer putting off preventive care that has already waited months. Or they may question the value of regular cleanings altogether. |
| Dentists understand why coming into their offices — even with the extra protective equipment they’ve invested in — may not be an appealing proposition. | Dentists understand why coming into their offices — even with the extra protective equipment they’ve invested in — may not be an appealing proposition. |
| Updated June 30, 2020 | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| “You have to have someone right in your face,” said Jason Bastida, who practices primarily in Elmhurst, a neighborhood in Queens that was hard hit by coronavirus. “I get to wear an N95 mask, but you have to make yourself vulnerable by taking your mask off.” | “You have to have someone right in your face,” said Jason Bastida, who practices primarily in Elmhurst, a neighborhood in Queens that was hard hit by coronavirus. “I get to wear an N95 mask, but you have to make yourself vulnerable by taking your mask off.” |
| He returned to work last week and has about a quarter of his regular patient volume. He graduated from dental school in 2017, and worries about how he’ll pay off his $330,000 in outstanding student debt if his caseload doesn’t pick up soon. | He returned to work last week and has about a quarter of his regular patient volume. He graduated from dental school in 2017, and worries about how he’ll pay off his $330,000 in outstanding student debt if his caseload doesn’t pick up soon. |
| Even after last month’s job gains, the dental industry still has 289,000 fewer workers than it did before the pandemic. That suggests to Ms. Stevenson, the economist, that the industry — and the rest of the American economy — is far from recovered. | Even after last month’s job gains, the dental industry still has 289,000 fewer workers than it did before the pandemic. That suggests to Ms. Stevenson, the economist, that the industry — and the rest of the American economy — is far from recovered. |
| “The fact that dentistry employment is down 30 percent tells us that there is income loss, and there is fear,” she said. “We might not see employment in a retail store get back to the levels it had last year. But we should see dental employment get all the way back to where it was.” | “The fact that dentistry employment is down 30 percent tells us that there is income loss, and there is fear,” she said. “We might not see employment in a retail store get back to the levels it had last year. But we should see dental employment get all the way back to where it was.” |
| Employment in the dental industry — and the rest of the economy — is likely to remain constrained by other areas of the economy that don’t reopen as quickly. This is especially true for day cares and schools, many of which will not reopen full time in the fall. | Employment in the dental industry — and the rest of the economy — is likely to remain constrained by other areas of the economy that don’t reopen as quickly. This is especially true for day cares and schools, many of which will not reopen full time in the fall. |
| Abi Adeyeye, a 31-year-old pediatric dentist in Plano, Tex., was among those who returned to work in May. Over the past five weeks, she has been excited to see patient volume rebound to pre-coronavirus levels. | Abi Adeyeye, a 31-year-old pediatric dentist in Plano, Tex., was among those who returned to work in May. Over the past five weeks, she has been excited to see patient volume rebound to pre-coronavirus levels. |
| “Before coronavirus, I had a cancellation rate around 30 percent,” she said. “Now nobody cancels. It seems like people are wanting to get out of the house and need something to do.” | “Before coronavirus, I had a cancellation rate around 30 percent,” she said. “Now nobody cancels. It seems like people are wanting to get out of the house and need something to do.” |
| Even with a full patient schedule, her office is not at full employment. She used to have six dental assistants, but only four have come back to work. One was pregnant, and one couldn’t secure child care. | Even with a full patient schedule, her office is not at full employment. She used to have six dental assistants, but only four have come back to work. One was pregnant, and one couldn’t secure child care. |
| The work of dentistry, at the same time, has only become more challenging. Dr. Adeyeye now wears an N95 respirator mask, a surgical mask, a face shield and a surgical cap. | The work of dentistry, at the same time, has only become more challenging. Dr. Adeyeye now wears an N95 respirator mask, a surgical mask, a face shield and a surgical cap. |
| “The first two weeks I had these massive migraines,” she said. “Not only am I hot, I also can’t breathe.” She’s slowly adjusting to the new dentistry: “My headaches have gone down to once a week.” | “The first two weeks I had these massive migraines,” she said. “Not only am I hot, I also can’t breathe.” She’s slowly adjusting to the new dentistry: “My headaches have gone down to once a week.” |