Update on Governor Kemp’s Executive Order 3.31.21.03
Reopening the State - 4.22.21

The Public Health Emergency due to COVID-19 continues to be an evolving situation.  However, Gov. Kemp has announced his desire to slowly re-open the state for business. In his Executive Order 3.31.21.03, as of April 8, 2021, all organizations and businesses that continue in-person operations during the effective dates of this order (through April 30, 2021) shall implement measures which mitigate the exposure and spread of COVID-19 among its workforce. Such measures may include the following:

1. Any measures that have been proven effective to control the spread of COVID-19;
2. Screening and evaluating workers who exhibit Symptoms of COVID-19;
3. Requiring workers who exhibit symptoms of COVID-19 to not report to work or to seek medical attention;
4. Posting signage at the entrances to the facility stating that individuals who have been diagnosed with COVID-19, have symptoms of COVID-19, or had contact with a person that has or is suspected to have COVID-19 within the past fourteen (14) days and have not completed the Post-Exposure Quarantine Protocol shall not enter the facility;
5. Enhancing sanitation as appropriate;
6. Disinfecting frequently touched surfaces regularly, including, but not limited to, PIN entry devices, signature pads, and other point of sale equipment, door handles, and light switches;
7. Increasing space between workers’ worksites to maintain social distancing;
8. Permitting workers to take breaks and meals outside, in their office or personal workspace, or in such other areas where proper social distancing is attainable;
9. If the organization engages volunteers or has members of the public participate in activities, prohibiting volunteering or participation in activities for persons diagnosed with COVID-19, having exhibited Symptoms of COVID-19, or having had contact with a person that has or is suspected to have COVID-19 within the past fourteen (14) days and having not yet completed the Post-Exposure Quarantine Protocol;
10. Ensuring ventilation systems operate properly and increasing circulation and purification of air within facilities as practicable;
11. If the organization provides childcare services, complying with the regulations for “Childcare Facilities” included in the executive order titled “Education & Children;” and
12. Any food service areas within an organization’s facility must adhere to the guidelines set forth in the executive order, titled “Restaurants & Bars.”

FULL LINK: Georgia Guidance for Businesses In-Person Operations

• What does this mean for your dental practice? Under the current Executive Order and through April 30, 2021, your practice may choose to continue to ask patients to wait in their cars or have patients socially distance in reception areas. Masks are still strongly encouraged, especially for businesses that may generate a high amount of aerosols. Please be advised that the CDC and ADA have not updated their guidelines for dental practices, so Georgia dentists are still strongly encouraged to continue with pre-appointment screening and patient monitoring at check-in (i.e. temperature checks, etc). 

• CDC Guidelines for Dental Offices (Updated 12/4/2020)
• ADA Return to Work Interim Guidance Toolkit (Updated 7/23/2020)
• Georgia Department of Public Health Guidance for Healthcare Providers
• Post Vaccine Considerations for Workplaces (Updated 4/2/2021)
• Interim Public Health Recommendations for Fully Vaccinated People (Updated 4/2/2021)
• Steps to Take if a Patient Reports COVID-19 Exposure After Treatment (Updated 3/3/21)
• DPH Healthcare Personnel Return to Work Guidance after COVID-19 Illness or Exposure (Updated 3/17/21)

• Have there been any changes to the GA DPH guidelines if someone in my office has COVID-19 or is exposed to someone with COVID-19?  On March 17, 2021, GA DPH issued updated Healthcare Personnel Return to Work Guidance after COVID-19 Illness or Exposure.  However, one of the main changes is bolded in bullet 3 below:

Return to work for healthcare personnel after laboratory confirmed or suspected COVID-19:

1. Symptomatic persons who are health care personnel with confirmed or suspected COVID-19 can return to work after:
   • At least 10 days* have passed since symptoms first appeared and
   • At least 24 hours have passed since last fever without the use of fever-reducing medications and
   • Symptoms (e.g., cough, shortness of breath) have improved

2. Asymptomatic persons who are health care personnel with confirmed COVID-19 can return to work after:

   • At least 10 days* have passed since the positive laboratory test and the person remains asymptomatic
   • Note, if you later develop symptoms, you should follow the guidance for symptomatic persons above.
3. Return to work for healthcare personnel after exposure to a person with COVID-19 Asymptomatic HCP who were exposed to a person with COVID-19 without appropriate PPE should not return to work until 14 days have passed since their exposure.

• CDC and DPH recommend that HCP not return to the workplace/healthcare setting until 14 days have passed since their exposure due to the extensive and close contact with patients required of these individuals. More information can be found at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html
• Even if HCP choose to follow the shortened duration of quarantine guidance, these recommendations pertain to daily activities outside of the workplace/healthcare setting only (https://dph.georgia.gov/contact).
• Asymptomatic, HPC who are within three months of their initial infection might continue to work with ongoing monitoring for COVID-19 symptoms and strict adherence to infection control practices, including source control. If symptoms occur, HCP should immediately be restricted from work and tested. If a facility is uncertain of a HCP’s prior infection or the durability of person’s immune system, HCP should be restricted from work regardless of previous infection status.
• Fully vaccinated HCP with higher risk exposures should typically be restricted from work for the full 14 days. Although CDC recently determined that under certain circumstances, fully vaccinated persons may not be required to quarantine after an exposure, this determination does not apply to HCP with higher risk exposures unless staffing shortages are an issue. Higher-risk exposures generally involve exposure of the eyes, nose, or mouth of the HCP to material potentially containing SARS-CoV-2, particularly while in the room for an aerosol-generating procedure.
• When staffing shortages are anticipated, the facility may consider implementing contingency staffing strategies (see crisis strategies to mitigate staffing shortages below).

Both CDC and DPH DO NOT recommend using a test-based strategy for returning to work (2 negative tests at least 24 hours apart) after COVID-19 infection†. CDC has reported prolonged PCR positive test results without evidence of infectiousness. In one study, individuals were reported to have positive COVID-19 tests for up to 12 weeks post initial positive.   

• Does my office need to keep daily COVID-19 check-in information from patients? If temperature checks, etc. have been recorded into the patient’s chart it, is considered part of their dental medical record which must be kept by law for a minimum of 10 years. If temperature checks are recorded on a reception area chart and not in the patient’s chart, they can be securely destroyed after 30 days.

• Does my office need to keep the poster providing us with limited legal immunity from COVID-19 related transmission claims in the reception area where patients can see it after April 30, 2021? Yes. The GDA recommends that dental practices continue to keep the liability poster posted until further notice. One of the new bills passed by the Georgia General Assembly in 2021 extends the window of immunity until July of 2022.
• Are temperature checks for patients still required in dental offices? The CDC’s Guidance for Dental Settings have not been updated since December 2020 and still recommend temperature checks as a screening measure.   However, Gov. Kemp’s Executive Order 03.31.21.03 does not expressly require such temperature checks in dental offices.