Executive Summary of UPenn OMFS Covid-19

Response Conference on 4/9/2020 By Shyam Indrakanti

Introduction by organizers and moderators of this conference: Drs. Neeraj Panchal and Anh Le (UPenn) – Brief history
of the pandemic spread from Wuhan China to the remainder of the world. Acknowledged the various entities supporting
this endeavor – UPenn, AAOMS, ACOMS, Women in OMFS,
Set the stage for the conference – 15 minute blocks with questions at the end of each block. Going over clinical, academic
and personal ramifications of this pandemic in the field of OMFS

Dr. Shahid Aziz (Rutgers) – as NJSOMS chair did a survey of 232 practitioners during feb (pandemic start in NJ) and March
20 (when NJ suggested closure of clinics)
- ~30% continued business as usual in early March, ~60% became emergencies only
- A significant portion of clinics did not have N95 masks but 42% were willing to treat patients regardless
o Indication of OMFS dedication to patient care despite not being fully prepared
- Clinics screened patients with temperature and symptoms
- 68% had to lay off staff
- 29% thought media had overblown the discussion

Dr. Lee Carrasco (UPenn) – Risk mitigation for residents and providers. Goals: minimize exposure and risks of cross
contaminations. Standardize treatment throughout departments –Negative pressure rooms for aerosolized procedures
and proper PPE (PAPR, N95)
- Minimize clinics to emergencies and transition to
telemedicine, split service into teams (see below), weekly
service wide teleconference
- Have aerosolized procedures discussed with the team to
follow. Allow for teams to have enough time off service and
should anyone be exposed or need to be quarantined, easy
to transition to fewer teams
- - Video visits for most patients, Email for new lesions
(pictures), Made a “Decision Tree” of what needs to be seen
or rescheduled based on categories of conditions
- Dr. Panchal and the trauma committee came up with
guidance for residents on how to handle trauma and
emergent consults
o Increased scope of what to do in ED and increased
attending participation for timely care delivery and reducing
time of exposure to residents
- Change the mindset of the practitioner to “pandemic
mode” prioritize protection over an innate desire to help.

Dr. Robert Glickman (NYU) – Snapshot of the NY experience. Demographic information. March 13th was a turning point –
PPE, resources, healthcare worker concerns and lack of beds. Redirected most things to Bellvue Hospital (their most
prepared facility), teledentistry screeners up 24/7 who direct to Staff – 50% on Rx therapy (smoldering problem per Dr.
Glickman) and 5% get sent to Bellvue.
- To minimize PPE use and aerosolization, treated the 5 fractures with bone screws (mostly interpersonal violence)
- 35 pts over last 3 weeks in ED, Lacerations, I&D, no extractions in ED (come to clinic). ORs and clinics shut down
- Though no N95 masks in clinic, they donated their anesthesia machines, PCR machine, masks gowns etc. to their
affiliates who needed.
- Recommend testing for covid and treatment for +ve patients in negative air pressure
- Overall problem is of resource limits (PPE) and realizing that waiting 18 months for a cure/vaccine is not realistic
Dr. Sidney Eisig (Columbia) – Encompass an area that includes Queens neighborhood (true epicenter in NYC). Entire
system had 4000 beds before this started. Helped treat New Rochelle cluster in their system. Their hospitals bulked up on
PPE around Dec/Jan but still the PPE usage skyrocketed (4000 masks per day -> 40,000 masks per day in March).
- Challenges in PPE acquisition – Rhetoric from White House, Limited materials being sent to 3M, most
manufacturing is outside USA.
- Also donated their PPE to the hospital once the dental school etc. was closed down.
- Task force made in Columbia to keep safety, prioritized negative pressure rooms for immediate use (GPR
residents only). Triage patients, do rapid covid tests if extractions need to be done
- Resident education is via Zoom lectures, reviewed OR logs and resident logs for graduating class
- Dental student education – allow 3 way tele visits so students can learn how to do so.
o School revenue severely reduced (clinic and faculty practice)
- 3 OR cases in the last month (2 infections and one possible malignancy case

Dr. Tom Dodson (UW) – Current Covid Stats, OMFS management and risk of exposure
- Washington peak utilization was 4/2/2020, supposing past the peak of the crisis
- Limited care to Urgent/emergent (bleeding, fx, space infections) – all get preop covid testing
o If +ve cancel case. If -ve, standard OR PPE (conserve on N95). Standard level mask will protect adequately
against 95% of 6um respiratory droplets and 0.1um viral
particles. 5% remaining risk
- 2/240 asymptomatic patients tested here were +ve.
Upper limit of 95% CI = 3%.
- Rough estimate of risk exposure among asymptomatic
patients 3% x 5% = 0.0015. Furthermore, symptoms and infection
is a function of viral inoculum during the exposure. With a
symptomatic patient this risk is 0.0076.
o Risk increase with close contact (10-30 min), mucosal
manipulation and aerosolization
- Limit OR personnel and office staff to a minimum

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Question session #1 with Drs. Carrasco, Glickman, Eisig and Dodson

- Precautions for surgical extractions during the pandemic?
o Dr. Dodson – if asx and -ve for covid standard precautions
o Drs. Glickman, Eisig and Carrasco – use N95 mask/ face shield avoid rotary instruments, use testing and
negative clinical findings, but when limited take all precautions (different institutions have different testing
standards)
o Dr. Eisig – there is also the issue of false negatives up to 20-21% for testing.
- IV sedations during pandemic?
o Dr. Dodson – if urgent, asymptomatic & negative covid – standard precautions.
o Dr. Glickman – lower rate of conversion in Washington but be more cautious in NYC where the prevalence
and conversion is higher. Also points out our clinic staff might not be well trained in proper donning/doffing
of PPE
- Reuse of N95 mask for up to 1 week?
o Dr. Carrasco – considers this acceptable but states they become loose over time and will no longer be as
efficacious in sealing “when you feel the cold air on your cheek”
o Dr. Glickman – some hospitals dissuade use of a surgical mask over N95 since it may compromise the seal
of the N95. Another consideration: long term use of N95 without sterilization may lead to it being
contaminated or removing them becomes a risk.
- Negative pressure rooms being built in non hospital settings?
o Most speakers explained the procedures in place at their hospitals and how these facilities were established
and acquired
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Dr. Rania Habib (UPenn) – Dentoalveolar emergency management
- SARS-CoV 2 is the virus, COVID-19 is the diseases. Zoonotic origin is Chinese horseshoe bats. Duration of
incubation is 5-6 days but can be 14+, vertical transmission
unknown. Droplets are small hence 6 feet
- Transmission in clinic – patient cough/sneeze, rotary
instuments/aerosolization, contaminated instruments (puncture or
via mucous membranes being touched)
- Clinic vs
Hospital setting
for various
specific
conditions

- Patients being treated via

BlueJeans (video based, protects patient data) or Doximity (phone based with
protecting personal data).
- Medicaid will not cover audio only in certain states, coding is D9995 or Time
based service reporting (GT is the modifier for audio and video, GTX is audio only)
- Resident use is unclear, some variability by area for coding
 Covid questionnaire
- PPE – double glove to allow manipulation of mask without contamination
- Stagger breaks, single serving food, seal the scrubs used in a bag, remove
supplies from rooms - virus lasts up to 2-3 days on plastic and cardboard and few
other surfaces
- Negative pressure room for any aerosolized
procedures. (- 2.5 Pascal with 12 air changes per hour.)

Dr. Vincent Ziccardi (Rutgers) – Impact on the training program. Severe cutback of cases in mid-march with ORs reduced
by 2/3 in the last week. Reduction in outpatient visits is significant, elective cases are cancelled to conserve PPE but Time
sensitive procedures like CNV Microsurgery were allowed to continue.
- Currently doing Trauma, H&N infections, Malignant Path, Benign Path that cannot be postponed (ameloblastoma
with 2o infection)
- Residents into 2 teams, full time faculty working 2-3 days per week. Significant reduction in number of cases
- Surgery rotations are limited to emergencies, anesthesia experience - limited cases, pediatric anesthesia paused
- Student considerations – manakin for N2O competency, cadaver extractions for competency.
- Nerve microsurgery – Delay unless there is clear foreign body or observed injury, but 6-9 months is the window of
opportunity. Ideally 2-3 months per Dr. Ziccardi.
o If having improving sensory function patients can be followed for up to 6 months

Dr. Rabie Shanti (UPenn) – H&N cancer management during Covid Pandemic. Highlighting HPV (fastest rising cancer in
men in USA) and oropharyngeal cancer will keep increasing past 2060 despite HPV vaccine
- During 2009 H1N1 pandemic – 9.5% of all solid tumor patients died of respiratory failure secondary to H1N1. In
perdiatric population, chemo was temporarily withdrawn in 54% of cases in a 62 patient study, 2 of those children
died of progressive cancer
- Delay of cancer therapy vs managing resources etc. during the pandemic
- Cancer survivors and patients currently with cancer have higher ICU needs etc. if infected with Covid.
- 2016 Journal of Clincal Oncology – 1 in 4 patients normally has some treatment delay. Data shows time to
initiation of treatment is more sensitive for for oral SCC (delay leads to more risk of cervical node metastasis)
 o Oropharyngeal cancer (negative P16) more susceptible to this
compared to oral tongue, pharynx and hypopharynx
- Treatment modalities – Surgery and primary RT are more
sensitive to delay. Primary chemoradiotherapy is less sensitive to delays.
Important to stick to standardized NCCN guidelines (aim for curative
treatments). Non standard treatment has similar outcomes to no
treatment (see graph)
- 95% of oral SCC is treated via primary surgery (best outcomes),
5% primary radiotherapy. 60% of cancer patients and a significant portion
of their care-takers will develop anxiety or PTSD like symptoms. They
need care!
o If recent biopsy done, review all pics, path reports etc, obtain staging imaging as needed, telehealth video
consult – request photos for posterior oral cavity lesions if referral did not have any. Finally in person
consultation to do physical exam including neck. Avoid nasopharyngeal laryngoscopy, do direcy
laryngoscopy on day of surgery
o If no biopsy – get a photo, telehealth consult for histories and comorbidities, consider getting biopsy if
consultation warrants it. Rest same as above
- High risk is aerosolization and manipulation of oral/nasal mucosa, lower risk procedures include neck dissections
- Surgical considerations – Avoid tracheostomies or modify to reduce exposure. Pedicled flaps where possible to
reduce surgical time needed for free flaps. In post op care, remove all drains and decannulate trach as needed.
- Consider prepping mucosal surfaces with povidine Iodine solutions 1-7.5% for 15s. Known to eradicate 99.9% of
virus particles including closely related SARS–CoV–1

Dr. G.E. Ghali (LSU Shreveport) – Surge planning as chancellor of the LSU system, removed 1st and 2nd year med students
out of class. Suspended 3rd and 4th year rotations. Graduation was preponed to April to allow more healthcare providers
locally and elsewhere. Allowed Webex meetings to communicate with various student groups
- Began to move non-urgent cases. Began inventories of PPE and contacted virology department to have their own
in house RT-PCR testing for covid. Dismissed non essentials. Made a hospital in conjunction with the governor’s
office.
- OMFS issues – covid testing is a must, currently there is a 24 hour turnaround but Dr. Ghali recommended the
newer test with 5-15 min turn around to the American College of Surgeons

Dr. David Yates (El Paso Children’s Hospital) – Craniofacial management & COVID-19. Reviewing literature for urgent and
emergent needs in craniofacial cases
- Delay all cleft lip and palate (not urgent). Nasoalveolar molding should be delayed if possible
- In micrognathia/retrognathia – distraction is better than tracheostomy. Reserve
only if severe and compromising airway. Defer orthognathics for later and treat sleep
apnea non surgically.
- No lit recommendations for craniosynostosis – If endoscopic, its time sensitive.
Avoid open procedures since they often need transfusions
- Pathology – Biopsy for questionable lesions. Resect and treat if threatening vital structures (orbit/vision)

Dr. Paul Tiwana (University of Oklahoma) – Maxillofacial Trauma Management. There is a large respiratory component
and use of povidine iodine preparation of these mucosal surfaces is highly recommended
- Called COVID by WHO to reduce the negative connotations with SARS in Southeast Asia.
- AOCMF Executive summary of risks and PPE
recommendations. Do Covid testing if possible
- No clear definitions in OMFS for what is
emergent. But large lacs, airway compromise and
trauma should be operated on with Proper PPE
- If nasal intubation is necessary pass the tube
through the nose attached to a red rubber catheter to minimize mucosal trauma, reduce aerosolization and risk
of contamination. Opt for submental over tracheostomy
 - Preop, consider betadine rinses to protect anesthesia. Use a knife over a bovie to minimize vaporization.
- Dentoalveolar trauma – disinfect the mouth, drape the nose, closed treatment and splints > archbar placement.
Avoid using cautery, use suture ligation where possible. Extract teeth with periotome/chisel instead of handpiece
- Lacerations and avulsions – drape out the mouth/nose if possible or disinfect the area before repair
- Mandible trauma – MMF where possible, use lingual splints. Avoid screwretained archbars, prefer mono-cortical
fixations with self drilling screws or bi-cortical screws at low speeds. Consider and prefer extra-oral approaches
where appropriate to avoid instrumentation and disruption of oral mucosa
- ZMC Trauma – Prefer Gillies approach for isolated arch, minimize oral incisions and utilize them only when plating
the ZM buttress is needed. Semi-closed Carroll-Girard screw is another option if appropriate
- Orbit Trauma – Disinfect conjunctiva (5% povidine, 10cc) Disinfect the sinus/ethmoids through floor/medial wall
defect. If possible avoid conjunctival incisions, opt for subtarsal/midlid. Prefer self drilling scews
- Maxillary Trauma – Oral rinse and prep! Consider closed treatment and wire fixation. Irrigate the maxillary
sinuses, prefer self drilling screws and established trauma principles
- Nasal and NOE Trauma – Disinfect mucosa/conjunctiva. Minimize conjunctival incisions. Closed treatment for
nasal fractures, self drilling screws if needed. Despite higher risk due to nasal cavity/sinus exposure, high risk if not
appropriately corrected for the patient.
- Frontal Bone Trauma – delay minimally/moderately displaced anterior table fracture. For obliteration procedures,
disinfect before instrumentation. For posterior table fractures needing cranialization, bi-frontal craniotomy just
above the height of the sinus, disinfecting irrigation prior to instrumentation. Use self drilling scews.
- Reduce the time in the OR by sticking to known techniques. Do a good prep and do open procedures when closed
treatment just isn’t an option.
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Question session #2 with Drs. Habib, Ziccardi, Shanti, Ghali, Yates, Tiwana
- Neurosurgery at UPenn doesn’t want to do any frontal sinus procedures can they be done delayed?
o Dr. Tiwana – Possible to delay but if large, consider the risk of CSF leak or meningitis
- What are some tracheostomy alterations you suggest and what can be done if a patient cannot be decannulated for
a rehab facility?
o Dr. Ghali – If possible delay trach, but if they need it Head and Neck society has some guidelines for that.
PAPR is very important. Shut internal flows off when cutting into trachea, avoid using stay suture. PPE and
proper technique are best. Secondary hospitals or LTACs are preferred destinations if they cannot be
decannulated
o Dr. Shanti – Agreed with Dr. Ghali’s statements and added that continuity of PPE between the various
members of the team including RTs is important when dealing with any trach patient.
- What betadine dilution is best? Are there other solutions that can work to disinfect
o Dr. Tiwana – 5% povidone Iodine, used for approximately 2 minutes. H2O2 at 15% is appropriate
o Dr. Habib – In UPenn clinic chlorhexidine rinse is currently being used but soon to transition to povidone
- The number of trauma cases coming in?
o Dr. Tiwana – Stay in place and other measures have reduced trauma numbers
o Drs. Ghali and Ziccardi – Curfews and other social distancing measures have reduced the number of cases
- How are you following nerve injury paients
o Dr. Ziccardi - Deferring them for 1 month but doing phone follow ups when possible. No testing
- How are cancer patients being operated on? Is there a covid panel they are presented to?
o Dr. Shanti – covid discussion is incorporated in to monthly tumor board. Avoiding surgery as much as
possible but targeting cases where surgery now could avoid a free flap down the road etc.
- Are you getting approval for elective surgery?
o Dr. Ghali – “surgery, for the most part, very few procedures we do are purely elective” as an administrator he
wants to limit the number of “non-urgent” cases giving the example of a knee arthroscopy as something
worth delaying. However at his Level I trauma center, he advocates for surgery in necessary cases. For 2.5
weeks cancer surgeries had been stopped and he is currently slowly regaining capacity to do so. Expecting
June to be the earliest for him to start orthognathic procedures
o Dr. Yates – Texas Medical Board and Gov. Abbott in TX mandates surgeons to sign paperwork indicating “if
not performed, will threaten vital bodily structures or function” and suggests reporting violators of this policy
to the board.
o Drs. Ziccardi and Tiwana – the chairman of the Department of surgery goes over cases being approved
 - Regarding staff and surgeon liability for the program chairs?
o Dr. Tiwana – no precedent has been set, no issues if the cases are appropriate and PPE is
o Dr. Ghali – “I have 38 who have tested positive in my hospital … the big thing is going to be testing for
antibodies”
- Negative pressure room will become necessary for OMFS private offices?
o Dr. Tiwana – Unlikely to have these built and maintained without institutional resources
__________________________________________________________________________________________________

Dr. Peter Quinn (UPenn) – A look at Pennsylvania. 586 patients, 216 discharged alive. The UPenn system’s busiest site is
close to New Jersey. The daily census seems to be plateauing, however this is due to discharges, mortality etc.
- Currently 35% of Covid patients on ventillators, Covid cohort units in the hospitals
- OMFS’ main role is keeping patients out of the hospital and reducing resource consumption at hospital
- Problems with deferring and delaying care – will need strategies to generate incremental volume, large volumes
of challenging cases (like late stage cancer) and PTSD in the work force from the surge during covid and managing
increased need after covid.
- The Mutter Museum in Philadelphia recently had displays from the 1918 Pandemic. The health commissioner at
that time allowed a parade in Philadelphia and this lead to 60,000 people dying in Philadelphia – A cautionary tale

Dr. Joe Niamtu (Private Practice Cosmetics) – Cosmetic facial surgery is entirely elective. The main cosmetics office is
currently not operational since there are no cosmetic emergencies. 5 other dentoalveolar offices in the practices are open
for emergencies only. 50 employees have been furloughed in the practice already and this has been a challenging time for
cosmetic surgeons.
- Zoom meetings with staff, talk to patients frequently to maintain contact and optimism
- Good amount of time to learn with webinars etc. Currently he is working on a new edition of his textbook
o Give CE talks, lectures, pursue social media (youtube, profiles of partners in the practice etc)
- Virtual consults for free still per Dr. Niamtu. Not a good idea to charge.
- Cosmetics practice was wound down such that patients were waiting in their cars, waiting rooms were closed
- Post 9/11 guilt – patients feel guilty to seek out “vain” procedures. The economic effects causing disposable
income to plummet – cosmetics is an upper class luxury after all.
- Not advisable to give discounts or incentivize cases right now
- Its good form to refund deposits for procedures that people have put down without penalties due to the
circumstances right now.
o The full partners in this practice are going without paycheck but paying other staff members
- Planning for extended hours and days to make up for backlog generated in this pandemic.

Dr. Thomas Schlieive (Parkland) – Effect on residency training. UTSW medical school suspended as of 3/17. AAMC and
LCME advocate for reasonable changes as needed to requirements. Re-eval on 4/13.
- UTSW has returned OMFS residents back to the department.
- Prometric centers closed – Step exams delayed, OMSITE delayed, NBME Self Assessments are free (Step & Shelf)
o Might have a virtual NBME Shelf exams
- Good time to have educational lectures/didactics – ensure security of the sessions
- Per CODA – distance learning can be completed with online lectures, but take attendance
- Interruption of education clause – notify CODA by 5/15 and how accreditation reqs will be addressed. Site visits
suspended. ABOMS will look into when OMSITE could come back online
- ACGME – clear guidance for pandemic
- Parkland residency requirements that are impacted – Pediatric anesthesia (cancelled), other anesthesia
experience is also minimal during this pandemic. Surgery/Medicine – minimal disruption. OMFS – decreased case
volume (CODA Reqs - 175 required ORs, 300 general anesthetics, 150 sedations, 50 < 13yo)
- Delays in licensing, BLS/ACLS/PALS exams can delay incoming interns/residents
- Offsite rotations are fine but our of state rotations are not allowed at this time.
- Minimal exposure to residents, multiple teams in case there is exposure to one team
- $100 per day hospital stiped for covid unit treatment teams.
Dr. Bill Nelson (U Minnesota) – CODA accredits OMFS programs, evaluates the programs against the standards set.
Doesn’t assess the readiness of residents and doesn’t have any real part in licensure.
- Current focus is on residents/fellows completing this summer
- Impact on CODA operation/Site visits and interruption of education were the only 2 items.
o All currently accredited programs will retain accreditation
o All grads will be deemed to have graduated from the accredited program despite modifications
- All site visits through 2020 have been cancelled and rescheduled at 2021. Special focus site visits postponed for
the earliest opportunity. Any site visit fees paid will be refunded.
- CODA commissioned specific review committees to consider potential temporary flexibility in the discipline
specific accreditation standards for expected grads.
o OMS committee will look at each program and will be meeting on Monday and requests a brief report of
specific items.
- Recommendations and publications will be presented as appropriate by CODA.
- http://ada.org/coda has detailed section that is updated frequently

Dr. Guiqing Liao (Sun Yat-Sen University) – Treatment and rehab of oral cancer patients under the pandemic
- Wuhan locked down 1/23, initial wave of Covid-19, peak around mid Feb. China is now in mitigation phase
- Postpone surgery for stable tumors
- PPE for patients and PPE and hand hygiene for practitioners – inquired for epidemiological history form
- Oral cancer patients are more susceptible to infections (due to immunosuppressive state)
- Covid symptoms vs post op symptoms, some similarities.
- Divided OMFS procedures into Levels - 1 is Cancer/ life threatening, 2 is
benign path, 3 is orthognathics/electives.
- Give up surgery for extensive cancers, prefer pedicled flaps
- Online follow up for patients, with emphasis on psych health
- Rehab – sensation, motor, pronounciation, swallowing, feeding exercises
only through video
- Potential 2 wave – due to asymptomatic and imported coronavirus cases this is possible. False negative of the
nd

NAT is up to 50% for the test.

- Measures to prevent 2nd wave in china – (i) quarantines at checkpoints (ii) medical obs and isolation at designated
venues (iii) community screening (iv) fever clinics (v) keeping Covid patients isolated to special hospitals/wards
- Chinese authorities do not place much importance in herd immunity

Dr. Victor Nannini (President of AAOMS) – AAOMS has been working to bring the community best scientific evidence
despite it rapidly evolving. AAOMS has a covid webpage that is updated frequently.
- As a program director in NY and private practitioner both perspectives are being considered in making
recommendations. Regardless of the popularity of such recommendations, explanations are readily available
- AAOMS has reached out to White House and Congress informing them of OMFS needs as first responders for PPE
allocation. Including speaking to Rep Paul Gosar and letters to Rep Nancy Pelosi and Sen Mitch McConnell
- Local societies and AAOMS are reaching out to states/governors for PPE allocation.
- CARES Act should be reviewed by us all since it has
- Complimentary CE on demand by AAOMS for residents and practitioners (over 100 courses)
o Small Business Administration loans webinar coming the few weeks
- Advocates for survey responses
- AAOMS Connect has covid committee for faculty and residents
- Working to secure rapid tests and telehealth resource page for current practitioners
- AAOMS is exploring how to facilitate opening of practices for oral surgeons once this pandemic ends
- This was a problem that took the Nassau hospital system somewhat by surprise yet preparation had begun in Feb
o 1 covid floor was made into 6 as the pandemic worsened
o Hospitals needed full masking
o Several attendings and people have been effected by this and have passed away regrettably
_________________________________________________________________________________________________
Question session #3 with Drs. Quinn, Nelson, Schlieve, Liao, Nannini
- Is PPE utilization in OMFS going to change over time?
o Dr. Nannini – Likely yes but will depend on studies and sciene
- When the pandemic is over how will hospital manage the surge of patients needing surgery?
o Dr. Quinn – Staff will have PTSD after the surge of Covid and this may be a problem. Secondarily how many
people even want to come back immediately? Patients may not want to come in as quickly as we think.
- Resident anesthesia graduation requirement changes?
o Dr. Nelson – No specific comment till after Monday’s meeting, for now do what you are doing
- Do you think there will be a significant number of OMFS practitioners retiring?
o Dr. Nannini – We don’t know how this will play out. With the stocks going down, more people may work
longer. We will persevere
o Dr. Quinn – Oral surgeons in private practice may want to be employed in health systems as a result of this
event, hospitals may want to hire oral surgeons
- Do you have any thoughts on taking hydroxychloroquine prophylactically?
o Dr. Quinn – Do not follow the president’s recommendations. No good evidence yet on treating or using
prophylactically
o Dr. Schlieve – Agrees with Dr. Quinn, no current evidence to use prophylactically
- Regarding the rapid test from Henry-Schein, are you in contact with them to make it available to OMFS?
o Dr. Nannini – In contact with them everyday and this is a goal for AAOMS, no specific info yet but in contact
with them and other vendors.
- Thoughts regarding use of OSCEs for residents or students?
o Dr. Schlieve – There is a lot of leeway in educating students and residents. This is also acceptable so long as
the program director can assess the residents’ readiness, competence and quality of education.
o Dr. Nelson – Positive aspect of this is that there might be more flexible and creative education opportunities
that are created due to this event.
- Any commentary on the testing or use of antibody testing?
o Dr. Quinn – We are somewhat behind on testing front but we will want to use antibody testing at 2 sites in
the UPenn system on all healthcare workers. This would help the workforce feel somewhat immune and
better prepare for the ramp up efforts needed afterwards
- Do you any idea of how haptic controller, virtual reality surgery for virtual tactile learning can be implemented?
o Dr. Schlieve, Quinn, Nelson – no specific experience with this but worth exploring new learning modalities
through simulations.

Dr. Quinn – this was an enormously helpful symposium and worth doing a truncated version in a few weeks with all speakers
if feasible
__________________________________________________________________________________________________

Drs. Neeraj Panchal and Anh Le (UPenn) – Thank you to all the speakers, AAOMS, ACOMS, IAOMS, Women in OMFS and
Drs. Deepak Krishnan and Andrew Reed-Fuller. Thank you to the UPenn Staff in helping organize this conference.