Medical and dental offices can reopen in Washington if they can meet certain guidelines for protective gear, hygiene and physical distancing for patients and staff.

If cases of COVID-19 begin to spike in their area and put a strain on medical facilities, they’ll need a plan to grow or shrink elective procedures.

A new state emergency proclamation from Gov. Jay Inslee sets up the process for allowing medical and dental offices to operate under three different pandemic conditions or phases. State and local public health officials can decide whether some services must be reduced or closed.

In the Conventional Care Phase, all appropriate clinical care can be provided.

In the Contingency Care Phase – the current phase for Washington– all appropriate care can be provided if there is enough personal protective gear, rules are followed and hospitals have adequate surge capacity.

In the Crisis Care Phase, emergency and urgent care can be provided along with elective care if the delay would cause harm, plus family planning services, newborn care and vaccinations.

Many dental offices reopened for routine care Monday, said Dr. Bob Lutz from the Spokane Regional Health District. Offices locally are following recommendations from the American Dental Association, Lutz said at a morning news conference.

While infection prevention has always been important for dental care providers, patients will now be asked screening questions before their appointments. Things such as magazines and children’s toys that are difficult to sanitize will be removed from offices, Lutz said.

“They’re really really trying to make sure that your overall health in addition to your oral health is really their priority,” Lutz said.

Heather Gallagher, who runs the SRHD Access to Baby and Child Dentistry program, said patients could be asked to wait in the car until their appointment times.

“Given the backlog of patients who are waiting to be seen it can take a while for you to get in for your cleaning or checkup,” Gallagher said.

The new guidelines are designed to start moving back to non-emergency medical and dental care in the state while being prepared for a potential uptick in COVID-19 cases, Inslee said. It was based on the availability of personal protective equipment, which the medical and dental offices will have to acquire, and adequate numbers of intensive care unit beds and ventilators in hospitals.

Offices will screen patients, staff and visitors before or immediately on arrival for temperature and other COVID-19 symptoms. Visitors will be limited to people essential for a patient’s care. When possible, patients should wear masks while in medical offices. Employees who are COVID-19 positive must stay home, and an office should follow Centers for Disease Control and Prevention guidelines for a deep cleaning after a report of an employee with a suspected or confirmed case of the illness.

Because of the restrictions put in place as the pandemic began to take hold in Washington, some people have delayed getting needed care for other medical conditions, Inslee said.

“If you need care, you really need to contact your provider,” he said.

Dental offices “stepped up early” and closed or restricted operations to save protective equipment for people fighting COVID-19 in hospitals, Inslee added.

Reporter Emma Epperly contributed to this report.