I’ll give Dutch prime minister Mark Rutte the benefit of the doubt. Here is a man under pressure because his entire liberal, easy-going vision of the world is being deep-frozen by a virus that’s even smaller than the smallest of viruses. In answer to a question on whether dentists could open their practices, Rutte patronizingly replied that dental practices had always been allowed to remain open, and that dentists had themselves decided to close.
The way he brushed off, in condescending fashion, the fact that over 90% of Dutch dentists had decided to open their practices for only for emergency treatment of non-infected patients, since 15th March, is nothing but an insult to our profession. Rutte is right in saying that we took it upon ourselves to close our practices. This was not only an act of solidarity – we are all in this together, and every gesture helps – but also one of wisdom based on scientific and medical knowledge.
It was a wise decision on two counts. Firstly, at the time of closure, the pandemic was growing exponentially, and the number of infected people was rising steeply by the day. Had dental practices remained opened, it was just a question of time before, somewhere, a member of a dental team got infected and passed the infection onto, on average, three others. In the dental setting, the chances of cross-infection are minimal, of course, especially if the strict infection prevention protocol is adhered to. But that is not the same as saying that the chance of infection is non-existent. We are all human, and accidents do happen. So, why take a risk, then?
But there is another reason why the dental profession acted the way it did. The COVID-19 pandemic puts us all in exceptional circumstances that require exceptional responses. Rutte’s apparent surprise that dental practices closed at all, is a sign that, despite his plea for caution and patience, there is a part of him that doesn’t want to come to terms with the exceptionalism of the situation. It is a reaction comparable to the freeze-reaction observed in rape victims, whose psyches just don’t come to terms with what has happened. In this way, Rutte only closed schools because public opinion asked him to. Reason would have it that, in exceptional circumstances, it is an exceptional but justified measure to take. An exaggerated measure? Maybe. A safe measure? Yes. We should always play on the side of safety.
The realization of how urgent the situation was, should have come a long time ago, as soon as the first cases were reported in China and, certainly, as soon as cases were reported in Europe. Instead, the complacency shown by politicians and decision makers, was nothing short of pandemic in its own right. The COVID-19 virus was first seen as a virus only capable of living in China. When it did appear in Europe, the initial response was to say that everything was under control and that, in any case, it was just a flu. Now, we are all faced with a pandemic that, like it or not, is here to stay. We may manage to control the COVID-19 virus, but we will never get rid of it.
I sincerely hope that Mark Rutte’s comment is, a slip of the tongue at best, or, at worst, a misjudgment. Truth be said, I think that it is neither. It is the symptom of a man whose responsibility towards a nation has outgrown him. he felt uncomfortable at the press conference and, truth be said, who can blame him. He not only has to decide over the lives of millions of people, but also over their way of life. In a way, his “intelligent lockdown,” is being outwitted by a stupid virus whose only goal in life, is to multiply.
In the meantime, dentists are going about their business differently. We are asking our patients difficult questions about their health. We have a representation of what someone could have when he/she sneezes or coughs – and it unsettles many, and even scares a few. We are asking personal questions about who our patients have been with, and when. We are telling them we know what they might have by the people they mingle with.
As I finish my first afternoon back in my practice, it is probably not fortuitous that, just before the lockdown – self-imposed as Rutte would have it – I had invested in a new stool and a new floor covering. A new beginning, I thought, the final furlong before I sink into the anonymity of retirement, and at last have all the time in the world to read and write.
But something wasn’t quite right. It was the sound of my assistant’s voice asking questions to patients, in order to confirm the appointment they already have. “Triage,” the Dutch call it. One of the few Dutch words I can pronounce effortlessly. Not surprising because it’s French. In a medical context, it is defined as, “the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.” For us, it just means whether we feel comfortable giving an appointment to someone who has been attending our practice for over twenty years.
There was something else, too. A weightless piece of plastic that was hanging on my nose. Dentists are so used to wearing surgical masks and disposable gloves, that it has become second nature. But this was different. For the first time in my life, my assistant and I are wearing a face shield. It’s weightlessness was only matched by the magnitude of its significance. It protects those who trust us, and protects us from those we don’t.