Berks County Medical Society Medical Record Spring 2020 - 13

that outbreak, a total of 8098 people worldwide became ill and 774
died (mortality rate of 9.5%).4 Only eight people in the US were
identified as infected and all these infections were attributed to areas
of the world with SARS. Like COVID-19, SARS was spread from
person to person and caused mild to severe respiratory symptoms,
including pneumonia and death. Since 2004, there have been no
additional known cases.5

Did you know

the airway and
jaw joint share
the same anatomy?

MERS was first reported in Saudi Arabia in 2012 and most
cases were associated with travel to the Arabian Peninsula. It was
thought that this infection came from an animal source, possibly
camels. Most patients with this infection also had mild to severe
symptoms, including fever, cough, and shortness of breath. Only 2
patients in the US tested positive for MERS infection, both in May
2014, occurring in health care workers who lived and worked in
Saudi Arabia.6 Both of these patients survived. The WHO reported
2,494 laboratory-confirmed MERS cases worldwide with 858 deaths
(mortality rate of 34%) involving 27 countries.7

For over 20 years, Dr. Tammy Balatgek has been providing
successful diagnosis and treatments for TMJ Disorders (such
as headaches and jaw issues), snoring, and sleep apnea. These
conditions often overlap due to shared anatomy. Physicians and
dental providers refer patients to our office knowing that we will
work together to improve the quality of life for those patients.
We offer:
* Immediate Diagnosis and Treatment Plans
* Dental Cone Beam Scans on Site
* Customized Oral Appliances for Snoring and Sleep Apnea
* Treatment Options for TMJ Dysfunction
We welcome the opportunity to serve you and your patients
through referrals or direct appointments.
Call us today, 610-796-2835.

What is a pandemic? A pandemic is an outbreak that extends
worldwide and affects a large number of people. Pandemics occur
when significant viral antigenic shifts (in the case of influenza)
or mutations (in the case of coronavirus) occur which leave large
portions of the population vulnerable. Prior pandemics of the last
century have included the Asian flu pandemic of 1956 - 1958 and
the Flu Pandemic of 1918. The 1918 Flu Pandemic infected one
third of the world's population (approximately 500 million people),
causing approximately 50 million deaths (mortality rate of 10%).8
This outbreak was unusual since it attacked younger, healthier people
more severely than what was seen during prior flu outbreaks. This was
attributed to a major antigenic shift in the circulating virus and travel
related to the deployment of troops during World War I.
The current statistics are very concerning. From the WHO press
conference on 3/23/2020: "More than 300,000 cases of COVID-19
have now been reported to the WHO from almost every country in
the world. That's heartbreaking. The pandemic is accelerating. It took
67 days from the first reported case to achieve the first 100,000 cases,
eleven days for the second 100,000 cases, and just four days for the
third 100,000 cases. You can see how the virus is accelerating. We can
change the trajectory of this outbreak. What matters most is what we
do."9
So what can we do to get ahead of this outbreak?
1. We need to continue social distancing. Schools and businesses
have closed. Sporting events and large events have halted. Everyone is
encouraged to stay home. Since the virus is spread by large droplets,
spacing people more than 6 feet apart will help to decrease the
spread. This will slow down the trajectory of new infections and the
number of patients that need hospitalization and ICU care.
2. We need to continue to quarantine those who are exposed and
infected so that they don't infect others.
3. We need rapid identification of infected patients, with shorter
turnaround times for test results to allow timely diagnosis of patients.
These tests are being developed and we need them now. This would
decrease the use of personal protective equipment so that we target
this equipment for those who are infected.
4. Health care systems need more PPE. Donate any PPE that isn't
being used to your local hospital.

Tammy Balatgek, DDS, MS
Diplomate, American Board of Dental Sleep Medicine
Diplomate, American Academy of Craniofacial Pain

2433 Morgantown Road (Route 10), Suite 200, Reading, PA 19607
www.TMJSleepCenter.com * 610.796.2835

5. We need rapid production of a vaccine. About 35 companies are
developing vaccines and at least 4 have started animal testing. One
vaccine trial has started human trials on March 16th to evaluate safety.
It is projected that it will take 12-18 months until a vaccine is available.
This is the only way to truly protect the unexposed population.
6. We need approved medications for COVID-19. The primary
treatment currently is supportive care. Several medications are being
evaluated in clinical trials and there is very little supporting evidence
for many of the proposed treatments to date. Physicians should try to
enroll patients in clinical trials in order to collect data to determine
which medications work.
7. And finally, we should do what our mothers taught us. Everyone
should use good respiratory hygiene (cough into a tissue or your sleeve
and dispose of contaminated secretions in a safe fashion), stay home
when you are sick, and wash your hands.
1

CDC website. https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30195-X/fulltext

3
WHO website. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situationreports/
4

WHO website. https://www.who.int/csr/sars/country/table2004_04_21/en/

CDC website. https://www.cdc.gov/coronavirus/mers/about/index.html

CDC website. https://www.cdc.gov/coronavirus/mers/about/index.html?CDC_AA_
refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2Fnovelcoronavirus%2Findex.html
6

WHO website. https://www.who.int/emergencies/mers-cov/en/

https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html

https://www.youtube.com/watch?v=YP5bJDYq9MI

SPRING 2020

http://www.TMJSleepCenter.com https://www.cdc.gov/coronavirus/2019-ncov/about/index.html https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30195-X/fulltext https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situationreports/ https://www.who.int/csr/sars/country/table2004_04_21/en/ https://www.cdc.gov/coronavirus/mers/about/index.html https://www.cdc.gov/coronavirus/mers/about/index.html?CDC_AA_ refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2Fnovelcoronavirus%2Findex.html https://www.who.int/emergencies/mers-cov/en/ https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html https://www.youtube.com/watch?v=YP5bJDYq9MI

Berks County Medical Society Medical Record Spring 2020

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Spring 2020