Managing Coronavirus in Veterinary Practice

March 27, 2020

Joe Lyman, DVM, MS

The challenge of conducting business during the coronavirus pandemic is putting strains on businesses anywhere. While some businesses are struggling with the reality of forced closures, veterinarians must continue to provide services.

Veterinarians working in livestock sectors and food production in particular have been designated as critical workers for infrastructure by the Department of Homeland Security. Awareness of biosecurity and the unique risks of the profession are paramount to continuing to provide needed service while not contributing to the spread of disease.

Thankfully, the veterinary profession has been leading in the application of biosecurity programs for years. In general, our biosecurity programs have been focused on limiting the impact of infectious animal diseases and zoonoses transmitting from animals to people. Little attention has been paid to the potential for human infectious diseases being transmitted amongst staff and clients. The global coronavirus pandemic has forced that consideration to the forefront. Veterinarians must incorporate changes to their biosecurity practices to be able to maintain business continuity and protect themselves, their staff and their clients. Management of these new risks pose unique challenges for both hospital and ambulatory settings.

Veterinary hospitals have the risk of constant visits from persons of unknown health status. Each client that walks into the hospital presents an unknown risk to everybody who will visit the facility that day, whether an employee or client. While we were comfortable managing the risk of the unknown health status of animals entering the facility, we have not routinely addressed the unknown health status of people risk.

Some clinics have taken to mitigating this risk by not allowing visitors into the clinic at all. Patients are evaluated in the parking lot and only brought in if treatment or hospitalization is required. The owners are not allowed to enter the hospital at all under this new system. Not all hospitals are comfortable with this approach and the additional stresses it may place on the patients, so they are forced to institute additional biosecurity controls within the clinic. 

Not allowing clients to enter the facility until an exam room is available is a valuable and easy measure to employ. Clients phone the clinic upon arrival in the parking lot, and the client is notified when the clinic is ready for them to enter. This prevents mingling of customers in the waiting areas and allows for staff to employ any desired cleaning measures between patient visits.

Most clinics have gone to all treatments and exams being performed in the clinic treatment areas and out of the confined exam rooms with clients present. This allows for appropriate distance from person to person as the necessary work is done. The reality is that human-to-human contact must be minimized in our hospitals to reduce transmission of disease.  Finding the measures that allow for business to be maintained while reducing the risk of transmission is the mission. No measures are universally appropriate for all clinics, except maybe the obvious — no shaking hands with the clients!  

Ambulatory practitioners have a different challenge, where they themselves are the unknown risk entering each facility they visit. By visiting multiple sites each day, they present a risk of transmission of disease to each site. As a result, ambulatory practitioners have had to employ measures to limit their potential exposure to coronavirus at each site.

When practical, ambulatory practitioners are asking clients to have their animals available stalled or penned prior to arrival of the veterinarian so that the veterinarian and assistant are the only ones who need to be present for the examination. This is not practical in all livestock systems, but the critical factor is reduction of persons present to the bare minimum necessary to safely perform examination and treatment of animals. 

Ask all clients to provide an area at the front of the facility to clean boots and hands prior to taking back to the truck. Consider the ambulatory vehicle as having separate zones of biosecurity control. The passenger areas of the vehicle must be treated as “clean” areas, meaning entry into those areas is only allowed after appropriate biosecurity steps, such as removal of coveralls and hand sanitization, have been performed. In order to keep the risk of coronaviral transmission to a minimum, the ambulatory practitioner must ensure they maintain their vehicle as a disease-free, clean zone. 

The good news is that most biosecurity programs already contain measures for environmental disinfection that are adequate for coronaviruses. As enveloped viruses, coronaviruses are generally not difficult to inactivate on hard surfaces. Regular cleaning and disinfection with approved products will be effective.  Porous surfaces, such as unsealed wood or concrete, pose challenges for disinfection, but awareness of the risk of theses surfaces means that hand sanitization and change or cleaning of boots and apparel after contact can be employed to minimize disease transmission. 

Biosecurity plans rarely fail due to bad planning, but rather failure to execute consistently. Each practice should have a designated biosecurity officer to ensure the entire staff is trained on the plan and monitor compliance. Simple reminders of behaviors such as sanitizing hands after animal contact can help turn these steps into regular habits. Remind staff of the importance of these measures in maintain a safe work environment and keeping the practice open for business. Compliance is business continuity. 

The veterinary profession is needed right now, from ensuring the safety of the world’s food supply to maintaining health of the family pets when they are most indispensable. Practicing enhanced biosecurity measures to keep ourselves, our staff and our clients healthy is critical to our ability to continue to provide service. Regular training and reinforcement of biosecurity principles are vital to ensure the success of your biosecurity programs. 

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