2 News addressed We have the challenge from 8 perspectives and tried to ensure that every vulnerable area from our staff to our systems have been thoroughly upgraded to deal with this invisible enemy and others of this nature. We can’t live in fear and we must apply science and the information to combat the disease as we have successfully done in every case. This pattern always repeats with every disease. As we understand the disease better now we can control and limit its spread thereby pandemic proofing. Do you think once we come out of the pandemic the future of dentistry will change for India? If so, how? If we let it be a positive change there’s much to gain here. Since the pandemic was global our best practices are globally accepted. It is a common misconception that Indian dental practices may follow standardized practice recommendations to their own discretion. This seems like the perfect opportunity to ensure that we upgrade our practices to global standards of contactless appointments with teledentistry & online bookings, sterilization with Class B autoclaves, air purification with HEPA filters and aerosol limitation with optimal suctioning units. These measures will not only reduce our risk to the pandemic but also create a safe and impressive practice for our patients to return to. How should one best use the book? The book must be a ready reckoner that you can go back to when you have questions or doubts about different aspects of practice. It is designed to safeguard all dimensions of your practise from your patients to your premises. The ideal way is to give it a speed read to familiarize yourself with it. Then approach each chapter from an implementation standpoint reading times, sharing it with your colleagues, discussing the it, watching it multiple online content, downloading the relevant resources till you have implemented that section and then moving to the next The book for dentists only and is this for practice owner or even someone who is working at a dental office? It’s meant to be for everyone owner, associate, assistant or even a health care worker the rules remain the same and the knowledge something we all need to have to safeguard ourselves. is What are your future plans? Any books coming up? from We have all been talking about survival so far. In one of my live interviews with an imminent leader the management world I realized the conversation must move from mere survival to success -- surviving this pandemic to actually resuming a new way of life is something we should adapt to and start demanding success from ourselves. We all need encouragement and strategies so my next book is on success skills. I had been working on its since before the pandemic but felt it important to address the pandemic first. The message of this book has been pandemic proofing with technical skills and safety measures. The next one addresses the skills and mindset that one must have against all challenges pandemic and beyond. Author: Dr Diksha Batra Dr Diksha Batra is a dentist with over a decade of experience. She the Owner of Smile is 12/20 Essentials - a 3-time winner of the Times All India Healthcare Award brand. During COVID, she has been establishing instrumental in safety protocols form of videos for dentists across the nation under the aegis of the prestigious Indian dental association. the in • She has been lecturing virtually across the country over the last few months advising dentists on COVID preparedness and getting back to work. • Extensive research and planning have led her to develop training systems and protocols for the dental industry called Dentistry 2.0. • She continues to sharpen her training and solutions for safeguarding clinics and spaces from the pandemic. • She has authored a book called “Let’s Reset - Pandemic Proofing Your Dental Practice”. The book is available as hard copy and soft copy. New ICMR study: Rapid Antigen Test can detect COVID-19 patients within the first 5 days of illness by Rajeev Chitguppi, Dental Tribune South Asia Rapid Antigen Test (RAT) showed an excellent specificity to ‚rule-in‘ COVID-19 patients within the first 5 days of illness and had a moderate sensitivity. Therefore, patients showing positive results need to be immediately triaged and those with negative tests should be reconfirmed by an rRT-PCR. reverse The problem with the real- time transcription- polymerase chain reaction (rRT- PCR) testing is that it requires a sophisticated Biosafety level (BSL)-2/BSL3 laboratory setup, and also trained technicians to run the test and interpret results. It takes a minimum of 8-10 h for the rRT-PCR from swab collection until the results are reported. This duration can increase further in resource-limited and high-burden settings, eg. in small towns and cities, where molecular diagnostic laboratories are non- existent, and where they find it difficult to procure the reagents/ viral transport medium (VTM) and other resources. Therefore, the need of the hour is to rapidly detect and isolate positive cases New ICMR study says with an excellent specificity and moderate sensitivity, this RAT may be used to ‚rule in‘ COVID-19 in patients with a duration of illness ≤5 days. (Photo: PIXNIO) quickly to contain the disease spread, to triage patients with severe acute respiratory illness in emergency departments (EDs) and to ramp up testing facilities. (SARI) Many Rapid Antigen Test (RAT) - kits and devices are available/ being developed to facilitate point-of-care testing. However, there is very limited data on the performance and potential utility rapid chromatographic of a immunoassay-based antigen test for SARS-CoV-2 in suspected patients. diagnostic A cross-sectional, single- blinded study was conducted at (reference a tertiary care teaching hospital in north India. Paired samples were taken for RAT and rRT- PCR standard) from consecutive participants screened to for COVID-19 calculate the sensitivity and specificity of the RAT. Further sub-group analysis was done based on the duration of illness and cycle threshold values. Results: 1. Of the 330 participants, 77 were rRT-PCR positive for SARS-CoV-2. 64 out of these 77 patients also tested positive for SARS- CoV-2 by RAT. The overall sensitivity and specificity were 81.8 and 99.6 per cent, respectively. 2. Overall, among the positive test results, with respect to the reference standard, the RAT detected 63 true-positives (19%) and gave one false-positive result. Among the negative test results, 252 (76.3%) were true- negatives and 14 (4.2%) were false-negatives. What is significant in this study? 1. 2. The overall sensitivity of the test was 81.8% and specificity was 99.6 %. The test accuracy was 95.4 %. But the sensitivity of RAT was higher (85.9%) in participants with a duration of illness ≤5 days. The RAT in the present study showed a high positive Likelihood Ratio (LR) of 207.0, which 207-fold increase in the odds of having infection with SARS-CoV-2 in participants with positive RDT results. indicates a 3. Likewise, the negative LR for the RAT was 0.18, which means that the odds of having SARS-CoV-2 had decreased by 5.5-fold after a negative RDT result. infection Conclusion: With an excellent specificity and moderate sensitivity, this RAT may be used to ‚rule in‘ COVID-19 in patients with a duration of illness ≤5 days. Large- scale testing based on this RAT across the country would result in quick detection, isolation and treatment of COVID-19 patients. Reference: Gupta A, Khurana S, Das R, Srigyan D, Singh A, Mittal A, Singh P, Soneja M, Kumar A, Singh AK, Soni KD, Meena S, Aggarwal R, Sharad N, Aggarwal A, Kadnur H, George N, Singh K, Desai D, Trilangi P, Khan AR, Kiro VV, Naik S, Arunan B, Goel S, Patidar D, Lathwal A, Dar L, Trikha A, Pandey RM, Malhotra R, Guleria R, Mathur P, Wig N. Rapid chromatographic immunoassay-based evaluation of COVID-19: A cross-sectional, diagnostic test accuracy study & its implications for COVID-19 management in India. Indian J Med Res. 2020 Oct 31. doi:10.4103/ijmr.IJMR_3305_20. Epub ahead of print. PMID: 33146157.