Making oral pathology lemonade from COVID-19 lemons

It goes without saying that 2020 has been a challenging year. The current pandemic negatively affected every aspect of our personal and professional lives. While there have innumerable downsides to situation, the necessary restrictions forced us find alternative ways continue pursuits in education, patient care, scholarly activity. In sum, adaptation perseverance become operative words. March 2020, American Academy Oral Maxillofacial Pathology (AAOMP) was confronted with reality having cancel annual meeting Nashville, Tennessee, scheduled for April 24 29, 2020. Recognizing importance its continuing education opportunities scientific content, AAOMP staff, Executive Council, speakers rapidly pivoted worked tirelessly make lemonade out lemons by constructing virtual little over 6 weeks’ time. Though obviously did not replicate Annual Meeting terms interpersonal interactions, it certainly rivaled past meetings quality content. Furthermore, we experienced significant increase registrants, particularly from individuals outside United States who would otherwise unable attend meeting. fact, number registrants nearly doubled after format announced. At time writing this editorial, fate 2021 Salt Lake City, Utah, hangs balance. is my sincere hope will take place because also an incomparable venue new friends renew old acquaintances. However, if are unable, I am certain adapt persevere yet again provide another outstanding attendees. Similarly, given COVID-19 travel restrictions, directors Board were navigate uncharted territory administering certifying exam. As result, exam conducted September 30 October 2, via secure, live tele-proctored system provided Pathology. Grading examination performed review consensus decision candidate responses each surgical case Zoom. clinical written portion computer as previous years addition remote proctoring oversight. board any oral pathologist previously endured, unqualified success testament resiliency dedication candidates directors. all aspects owing social distancing constraints, workflow pathologists dramatically altered COVID-19. addition, need be physically present traditional pathology settings raised possibility unnecessarily putting themselves, their families, co-workers at risk. For years, revolutionary prospect digital whole slide imaging sign-out lurking on horizon. lack Food Drug Administration (FDA) approval had major stumbling block. On 12, 2017, first received FDA clearance.1US Administration. allows marketing [news release]. https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm552742.htm. Accessed 19, 2020.Google Scholar Several additional systems subsequently cleared setting FDA. important caveat these clearances. Specifically, they based position entire (scanner, monitor, software) required singular closed unit substitution individual components considered off-label use.2Evans A.J. Bauer T.W. Bui M.M. et al.US primary diagnosis: key milestone reached questions raised.Arch Pathol Lab Med. 2018; 142 (https://www.cms.gov/files/document/qso-20-21-clia.pdf-0): 1383-1387Crossref PubMed Scopus (90) Google under Centers Medicare & Medicaid Services (CMS) rules, instance performing diagnostic require own Clinical Laboratory Improvement Amendments (CLIA) license. One can immediately see practical challenge department 40 faculty members obtain CLIA licenses sign out. Understanding urgent nature implications universal stay-at-home work orders, CMS released memo 26, titled “QSO-20-21-CLIA: Guidance During Public Health Emergency.”2Evans This allowed temporary relaxation guidelines, including rules regarding sign-out. example, now reporting slides locations CLIA-licensed facilities such pathologist's home or hotel room. “closed system” requirement, thereby allowing utilize validated monitors/screens, laptops, tablets modifications time, organizations College Pathologists Association Informatics successful advocating permanent changes. With respect activity, caused shuttering university research activity across globe prolonged period necessitated acceleration platforms continued investigation. previously, increasingly ominous condition proliferative verrucous leukoplakia (PVL).3Lingen M.W. We “ring around collar” problem.Oral Surg Med Radiol. 2020; 129: 1-2Abstract Full Text PDF (2) Unfortunately, considerable unknowns biology, presentation, histopathologic diagnosis, treatment, prognosis. To address PVL, working group maxillofacial head neck pathologists, conjunction North Head Neck Society, sought produce guideline standardized assessment PVL. mechanics study initially developed during in-person conference Orlando, Florida, 21, 2019. subsequent held before 23, like meeting, replaced all-day Zoom July conference, polls used live-poll order share results related cases consideration. discussion, led indefatigable Drs Lester Thompson, Sarah Fitzpatrick, Donald Cohen, lively spirited ultimately proposed PVL criteria categories serve framework future validation studies. product resulted peer-reviewed manuscript published near term.4Thompson L.D.R. Fitzpatrick S.G. Müller S. al.Proliferative leukoplakia: expert reporting.Head Pathol. 2021; (in press)Crossref (23) Importantly, deliberations fifth edition World Organization Tumour Classification begin early 2021, hoped included document Without flexibility group, still likely remain unfinished. summary, living unprecedented times 100 years. hopeful different myriad vaccines antiviral therapies investigation allow regain some sense normalcy future. Nonetheless, though timeline return unclear, confident pathology, well dentistry whole, poised innovate so patients care.