Veterinarians on front line of COVID-19 battle
I swore this long ago and now, more than ever, I still believe it to my core — “As a member of the veterinary medical profession, I solemnly swear that I will use my scientific knowledge and skills for the benefit of society. I will strive to promote animal health and welfare, relieve animal suffering, protect the health of the public and environment and advance comparative medical knowledge.”
We have new scientific terms that were virtually unheard of a month ago; social distancing. Wash your hands for 20 seconds with soap. Shut down of non-essential services. Flatten the curve. Stay at home. Shelter in place. Curfew. Not enough ventilators. These terms may have had obscure meanings, but they are now part of the science of our daily conversations.
The Board of Veterinary Examiners came out with two pages of clarification after Thursday’s meeting. Some veterinarians were using their essential status to conduct business as normal. From the tone of the letter, it seemed to me that the board was more than a tad annoyed. To be fair, they should have been. Veterinarians are trained in infectious diseases, epidemiology and knew the word pandemic before this happened. Veterinarians should understand the danger of not following the guidelines. We have a lot of scientific knowledge and skills. But vets are also trained to help clients, and these clients were not trained in these things, so the board came out with specific guidelines for the vets.
Flatten the curve. The point is if this pandemic runs rampant throughout our population at the unchecked rate of spread, too many people will get sick at one time. We do not have facilities for thousands of people to get sick at once. We don’t have enough ventilators to be used during one short period of time. We don’t have enough personal protection gear (PPE) to protect all of our hospital and medical personal, so they will get sick. If these cases are spread out over time, we can replace PPE, we can clean and reuse ventilators and we won’t have to treat people in a tent in a soccer field. This is all for the benefit of society.
Social distancing. In life, get out the tape measure. Except for your family that are going down with you, I mean, living with you, endeavor to be more than six feet away from them. No, just do it.
For us, the board recommends, “Continue to ensure that your protocols are following the governor’s current executive orders and directives to keep social distancing. You should not allow clients into the building of clinics and hospitals unless there is critical need; please endeavor to use curbside exchanges.”
Wash your hands. Washing your hands is more effective than sanitizer. Washing your hands gets rid of the organic material that has the virus particles. If you don’t have the virus particles, they cannot infect you. Sanitizing works on the top layer of the particle. If your hands are clean, then the film of stuff will be thin and the sanitizer will kill everything. Too thick (because you didn’t wash well) and there will be a layer of virus underneath that can still infect you.
Non-essential services. Well, that is obvious. The things that we do not need. We need medical care, dental care, food, veterinary care. Except it is not always obvious. A fractured tooth may be an urgency or maybe even an emergency, but an exam and cleaning can be delayed. Nobody should argue that a dental cleaning is not important, but it could be put off. Likewise, nobody would want to put off a tooth repair. Governor Andy knows not allowing pets medical care would increase human stress, but he is trying to help prevent the spread of the coronavirus and protect Kentucky communities.
There is even a flow chart created by AVMA to help minimize exposures and therefore coronavirus spread. Because of our oath, “I will strive to promote animal health and welfare, relieve animal suffering,” many veterinarians would have treated sick animals anyway, but the board said, “Patient emergencies should always be treated.”
The problem is that there is a lot of gray area between various components of care. Vaccines are an extremely important component of veterinary care, but if the “booster vaccines for animals one year or older, and well-patient exams” are delayed by “possibly up to 30 days,” it will reduce human exposure to SARS-CoV-2/COVID-19. However, “puppy/kitten/baby animal vaccinations and rabies vaccines for the previously unvaccinated are critical and should continue to be administered.” Remember, not all vaccines are time critical, therefore the board specifically states that “Rabies clinics are NOT allowable under current social distancing orders.”
Protect the health of the public and environment and flatten the curve. Blood work and monitoring that is routine should be postponed by 30 days. Of course, there is some blood work that is of an “emergent or urgent nature” and should be done. “Spays and neuters are recommended to be delayed, as doing so uses important medical equipment, for 30 days or until the medical supply stabilizes. If you feel you must continue with these surgeries, the board encourages you to implement the use of reusable PPE.” That means that your pet’s sterile surgery will be more of the nature of a 1970’s clean or even farm surgery. (Maybe you should wait.)
If you postpone your pet’s routine grooming for 30 days, fewer people will need a ventilator at the same time. Medically necessary grooming can still be done. Likewise, we have not held our advanced daycare for a few weeks because “boarding or doggie daycares should follow the governor’s orders on social distancing. Please consider how to handle fomite (physical items that allow spread) contamination.”
One thing that the board did loosen up on is hands-on care. “The board encourages the use of telehealth where possible, within the bounds of a current, valid or VCPR. The board considers a VCPR [Veterinary-Client-Patient-Relationship] to be current if the patient has been seen within the last 12 months.” Although I was a skeptic, I have completed several telemed consults on our medici app.
Everyone realizes that pets are an important part of our families. Nobody wants to withhold care from them, but if all of the routine, non-critical appointments were delayed by 30 days, the curve would flatten and fewer people would die.
“And advance comparative medical knowledge.” Veterinarians use human medicine knowledge to care for pets. We have for decades. The reverse is now true. Some of our equipment may end up being used for humans, some veterinarians will work on humans.
By the way, because we care about you, we were following the recommendations before the board wrote them out. You and your pets are as important to me as my oath.
MJ Wixsom, DVM MS is a best-selling Amazon author who practices at Guardian Animal Medical Center in Flatwoods, Ky. GuardianAnimal.com 606-928-6566
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