COVID-19 Resources for Veterinarians

COVID-19, cold, flu, allergies

From the FDA

UPDATE March 24, 2020

As part of the U.S. Food and Drug Administration’s ongoing commitment to combatting the coronavirus (COVID-19) pandemic and providing flexibility across FDA-regulated industries, the agency announced today that it intends to temporarily not enforce certain requirements in order to allow veterinarians to better utilize telemedicine to address animal health needs during the pandemic. READ MORE

From the AVMA

UPDATE March 24, 2020:

An email from Gail Golab:

Good afternoon,

For your awareness and use, the following information was provided to the AVMA HOD—


Just letting you know about an additional resource for practices. Please understand that this is to be used in the context of professional judgement; it is a resource and not a directive.

My team worked with Marcom staff to create a flowchart for case management, which will be linked to the most recent update of our web-based material (finishing that up now) and is also now available here: www.avma.org/sites/default/files/2020-03/.... There are always going to be exceptions that are practice and local-area dependent and this is not a definitive guide, but we thought it would be helpful to practices to have something like this available that also linked to other resources. If/as you use it, we'd welcome your feedback as to what necessary adjustments might need to be made. Hope it's helpful. We continue to watch for and add resources as these become available.

Stay safe and healthy,

Gail

 

UPDATE March 19, 2020:

An email from Gail Golab:

Mar 19, 2020 3:40 PM

Gail Golab

Good afternoon---

Many of you may have already seen the news, but providing the posting from ProMed below FYI. We still have no evidence that dogs or cats become ill, nor that they can spread SARS-CoV-2.

Date: Thu 19 Mar 2020, 8:15 PM HKT
Source: Press release, Government of Hong Kong SAR [edited] <gcc02.safelinks.protection.outlook.com/...>

A spokesman for the Agriculture, Fisheries and Conservation Department
(AFCD) said today [Thu 19 Mar 2020] that a pet dog sent to the AFCD has repeatedly tested positive for the COVID-19 virus. This is another infected case following an earlier case in which a 17-year-old Pomeranian dog tested weak positive during repeated tests for the virus.[see comment].

The current case involves a German Shepherd dog that lived in a residence at Pok Fu Lam. When the owner was confirmed with COVID-19, the dog was sent for quarantine with another mixed breed dog from the same residence to the animal keeping facility at the Hong Kong Port of the Hong Kong-Zhuhai-Macao Bridge yesterday (18 Mar 2020). No positive results were obtained from the mixed breed dog and neither dog has shown any signs of disease.

The Department will continue to closely monitor both dogs and conduct repeated tests on the animals.

The AFCD will continue to work together with the Department of Health in handling relevant cases. To ensure public and animal health, the Department strongly advises that mammalian pet animals including dogs and cats from households with persons confirmed as infected with COVID-19, or close contacts of COVID-19 infected persons, should be put under quarantine in AFCD facilities.

The spokesman reminded pet owners to adopt good hygiene practices (including handwashing before and after being around or handling animals, their food, or supplies, as well as avoiding kissing them) and to maintain a clean and hygienic household environment. People who are sick should restrict contact with animals. If there are any changes in the health condition of the pets, advice from a veterinarian should be sought as soon as possible.

The spokesman emphasised that there is currently no evidence that pet animals can be a source of COVID-19 for humans or that this virus can cause the disease in dogs. Pet owners should always maintain good hygiene practices and under no circumstances should they abandon their pets.
------------------------------
Gail C. Golab, PhD, DVM, MANZCVS, DACAW
Chief Veterinary Officer
American Veterinary Medical Association
o: (847) 285-6618
c: (630) 336-0062
www.avma.org

 

UPDATE March 16, 2020:

Please visit avma.org/coronavirus for the most up-to-date information

Dear Colleagues,

We understand this is an incredibly challenging time for all. We want you, our members, to know that the AVMA is working day and night to advocate for you; to provide useful guidance to help you, your clients, and your practice through this crisis; and to disseminate credible information for all concerned. We are working with federal agencies, including the CDC and FDA; gathering expertise from veterinarians and others working in public health and disaster response; collaborating with state veterinary medical and species-specific organizations, the AAVMC, veterinary schools, and the AAVSB; and other colleagues across the healthcare system to develop the best possible guidance and keep you as updated as possible. Information is being updated constantly on our dedicated COVID-19 webpage.

An important question that has been asked is whether veterinary medicine is considered an "essential business".

AVMA is advocating for all veterinary hospitals and ambulatory practices to be considered essential businesses in any situations in which non-essential businesses are asked to close for COVID-19 risk mitigation. Veterinarians and our teams provide important animal and public health surveillance, deliver essential medical care for ill animals, and ensure that only healthy animals enter the food supply.

Veterinary practices can and should defer elective procedures to preserve medical supplies when circumstances call for that. However, veterinarians must also be able to continue to provide medically necessary care for our animal patients, especially during this time when Americans are spending increased time at home with their pets and ensuring the integrity of our food supply is critical. In doing so, and as needed, veterinarians can adapt our approach to ensure an appropriate level of biosecurity that safeguards the health of our animal patients and their owners.

Healthcare professionals are being asked to conserve personal protective equipment (PPE).

All healthcare professionals need to adopt strategies that will allow them to conserve PPE as much as possible, including veterinarians.

The FDA has provided guidance, veterinarian Scott Weese has provided helpful information on his blog, and we are working with other healthcare associations, such as the American Dental Association (ADA), to share best practices. Among issues being discussed are whether/how normally disposable masks might appropriately be reused, substituting reusable cloth masks, whether certain surgical procedures might be able to be performed without masks with minimal risk to our patients and staff, whether adopting modifications to usual protocols allows preservation of an acceptable standard of care, and need for client consent.

HR 6201- Families First Coronavirus Response Act.

The U.S. House of Representatives passed H.R. 6201 very early Saturday, March 14. The bill will be taken up by the Senate very quickly and is expected to pass the Senate this upcoming week. It is possible the Senate will make changes. President Trump has indicated he will sign the bill as soon as it is delivered to his desk.

The bill includes:

  • Up to 12 weeks of family and medical leave benefits related to COVID-19 paid at 2/3 of regular pay rates after the first 14 days, which are unpaid
  • Up to 80 hours of additional paid sick leave for employees affected by COVID-19
  • Tax credits for employers to mitigate the impacts of the expanded leave provisions
  • Free testing for SARS-CoV-2 during the emergency

More information about these programs can be found on our webpage dedicated to COVID-19.

We've gathered insights and guidance to help you continue to provide care during this difficult time.

Animals that are sick or injured should receive veterinary attention. However, you might consider rescheduling or limiting services such as wellness exams, dental services, and elective procedures. If you're in an area with active COVID-19 cases, consider limiting in-person exams to acutely ill animals and/or emergencies.

Telemedicine can be an important tool to protect and monitor patients while preventing spread of COVID-19. With an already established veterinarian-client-patient relationship, telemedicine allows us to appropriately triage patients to ensure that only those really needing to be seen make the trip to the clinic with their owners. AVMA has resources to support your use of telemedicine at avma.org/Telemedicine.

Resources that may help you continue to deliver care during COVID-19

The coronavirus response business toolkit
The U.S. Chamber of Commerce's toolkit includes guidelines on how small business owners can ensure they are keeping their customers and employees safe. You'll also find a business preparedness checklist to help you figure out what to prioritize and to create a plan of communication for your employees. Get the toolkit >

Disaster assistance loans from the SBA
The Small Business Association (SBA) announced it would offer disaster assistance loans for up to $2 million for small businesses affected by the coronavirus. These low-interest loans are available to businesses that have sustained "substantial economic injury" due to the spread of the coronavirus. The money can be used to pay outstanding debts, payroll, and any other bills. While small businesses that have access to credit are not eligible, those with no available credit qualify for an interest rate of 3.75%, and nonprofits will have an interest rate of 2.75%. Read more >

Disaster Help Desk for small businesses
The U.S. Chamber Foundation has a disaster help desk that acts as an information concierge to assist small businesses with disaster readiness, relief, and long-term recovery. They also have a business resiliency toolbox with resources to help companies address preparedness issues while building in flexibility to handle potential business interruptions. Read more >

The AVMA is here for you. We continue to work on multiple mission-critical topics and engage with organizations across the healthcare spectrum, as well as federal and state authorities and public health officials. This situation is quickly evolving, and your association is working diligently and adapting minute-by-minute. Our commitment is to provide substantive information and guidance to you, our members, and the veterinary community as soon as it is available.

More information on all of these topics is available on our COVID-19 webpage, which includes FAQs to support you, your team members, and your clients. We are all in this together, and we salute the amazing profession-wide commitment and outpouring of effort in this very difficult time.

Sincerely,

John Howe, DVM
President, American Veterinary Medical Association

Rena Carlson-Lammers, DVM
Chair, Board of Directors, American Veterinary Medical Association

Janet D. Donlin, DVM, CAE
Chief Executive Officer, American Veterinary Medical Association

PREVIOUSLY POSTED:

AVMA COVID-19 INFO

Your AVMA is actively engaged on COVID-19 and its potential impacts on veterinary medicine. Our goal is to support you with relevant information in this fast-evolving situation. We are in regular contact with the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), veterinary medical experts, and international agencies to gain the latest resources and intel on the disease and its causative virus (SARS-CoV-2) for you and your clients.

We've gathered information important to veterinary professionals at avma.org/Coronavirus<https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19?utm_source=email-mem&utm_medium=coronovirus200303&utm_campaign=coronovirus&utm_term=linke&utm_content=coronovirus-website> and will continue to provide you with regular updates there and on the AVMA@Work blog<https://www.avma.org/blog?utm_source=email-mem&utm_medium=coronovirus200303&utm_campaign=coronovirus&utm_term=linke&utm_content=avma-blog> as soon as they become available. We are also sharing updates on all our social media platforms. You can subscribe to the blog<https://feedburner.google.com/fb/a/mailverify?uri=avma&loc=en_US> and follow our social media pages for breaking updates.

Coronavirus: What we know as it relates to pets

We are actively monitoring news developments related to animals and the virus. On Thursday, February 27, a dog in Hong Kong tested "weak positive" for coronavirus (the owner tested positive for coronavirus). The dog has since received a second positive result that has been sent to the World Organization for Animal Health (OIE), which is working with Hong Kong health officials on this case. The precise meaning of "weak positive" remains unclear and further evaluation is ongoing. Hong Kong authorities have said the dog shows no clinical signs of illness but remains quarantined. We will keep you updated as we learn more.

At this time, the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) say there is no evidence that companion animals, including pets, can spread COVID-19. However, as with any disease, it's always a good idea to wash your hands after being around animals.

According to the CDC, people who are sick with COVID-19 should restrict contact with pets and other animals, just like you would restrict your contact with other people. When possible, a member of the household other than the individual who is ill should care for any animals in the household. Those infected with COVID-19 should avoid contact with animals, including petting, snuggling, being kissed or licked, and sharing food. Those who must care for a pet, or who will be around animals while sick, should wear an appropriate facemask and wash hands thoroughly before and after interacting with those animals.

Potential Shortages of Drugs and Medical Supplies

The AVMA is also concerned about potential medical supply chain issues, including both pharmaceuticals (specifically active pharmaceutical ingredients [APIs]) and medical products, such as personal protective equipment. We have learned from FDA that there are 32 animal drug firms that make finished drugs or source active pharmaceutical ingredients in China for the United States market. The FDA has contacted all 32 firms and no shortages have been reported at this time. However, six of those firms have indicated that they are seeing disruptions in the supply chain that soon could lead to shortages. The FDA is working with these firms to help identify interventions to mitigate potential shortages. FDA has done similar work on the medical product/device side. An FDA webpage<https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-supply-chain-update> has been created through which the FDA is sharing information around the availability of drugs and medical supplies. Because veterinarians use a substantial number of FDA-approved human drugs under federal extralabel drug use statute and regulations, shortages on the human side will be felt by veterinary medicine as well. The AVMA's concern and our work on behalf of the veterinary profession thereby touches both markets.

AVMA is in close communication with FDA and is supporting its efforts by gathering information about drug needs (from both the animal and human markets) and any related concerns from veterinarians, practices/practice groups, and veterinary distributors. Veterinarians are encouraged to send information regarding any supply chain issues of concern to the AVMA at coronavirus@avma.org<mailto:coronavirus@avma.org>. Detailed information on the product of concern and the manufacturer/distributor of that product will be most helpful.

Prevention tips you can implement

There is currently no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to the virus and to follow strict handwashing and other hygiene protocols.
·         Designate your practice/workplace as a temporary NO HANDSHAKE ZONE. Ask colleagues and clients to refrain from shaking hands (fist bumps or forearm bumps are good substitutes).
·         Practice good hygiene: Wash hands often with soap and water for at least 20 seconds, especially after using the restroom; before eating; after blowing your nose, coughing, or sneezing; and between client/patient visits.
·         If soap and water are not readily available, use an alcohol-based hand sanitizer with 60%-95% alcohol.
·         Place hand sanitizer, sanitizing wipes, and tissues in all exam rooms, meeting rooms, restrooms, break rooms, and other common areas.
·         Avoid touching your eyes, nose, and mouth with unwashed hands.
·         Cough or sneeze into your elbow or use a tissue to cover your nose and mouth, then throw the tissue into the trash can.
·         COVID-19 symptoms are similar to those of influenza (e.g., fever, cough, and shortness of breath), and the current outbreak is occurring during a time of year when respiratory illnesses from influenza and other viruses, including other coronaviruses that cause the common cold, are highly prevalent. To prevent influenza and possible unnecessary evaluation for COVID-19, all persons more than 6 months old should receive an annual influenza vaccine. Vaccines are still available and effective in helping to prevent influenza.
·         Voluntary home isolation: If you are ill with symptoms of respiratory disease, such as fever, cough, shortness of breath, sore throat, runny or stuffy nose, body aches, headache, chills or fatigue, stay at home. The CDC recommends that you remain at home until at least 24 hours after you are free of fever (100 degrees F or 37.8 degrees C) or signs of a fever without the use of fever-reducing medications.
·         Take steps to prevent the spread of disease among veterinary personnel and to/from clients by following guidelines and procedures laid out in the National Association of State Public Health Veterinarian's Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel.<http://nasphv.org/Documents/VeterinaryStandardPrecautions.pdf> While the primary focus of this resource is controlling the spread of pathogens between animals and veterinary personnel, many of its principles apply to infection control in general and following it is simply good practice.

We want to emphasize that we're here for you. We are working with all of the relevant agencies and key stakeholders to be your source of veterinary-related information so that you can make the best decisions for your practice, your employees, your clients, and your patients. If you have any questions regarding how the AVMA Trust may be able to help you or your practices, visit www.AVMAPLIT.com<http://www.AVMAPLIT.com> or call 800-228-7548.

Please check back in with us on the AVMA website<https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19?utm_source=email-mem&utm_medium=coronovirus200303&utm_campaign=coronovirus&utm_term=linke&utm_content=avma-website> or follow our social media channels, where we will continue to share the latest developments regarding COVID-19.

John Howe, DVM
President, American Veterinary Medical Association

Rena Carlson-Lammers, DVM
Chair, Board of Directors, American Veterinary Medical Association

Janet D. Donlin, DVM, CAE
Chief Executive Officer, American Veterinary Medical Association

Additional tips and information:
·         From the CDC:
o    Prevention and treatment<https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html>
o    Symptoms of COVID-19<https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html>
o    How it spreads<https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html>
o    Frequently asked questions<https://www.cdc.gov/coronavirus/2019-ncov/faq.html>
o    Travel information<https://www.cdc.gov/coronavirus/2019-ncov/travelers/faqs.html>
·         From the WHO:
o    Advice for the public<https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public>
·         From the U.S. State Department:
o    Travel information<https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/>
·         From the World Organization for Animal Health (OIE):
o    Questions and Answers<https://www.oie.int/scientific-expertise/specific-information-and-recommendations/questions-and-answers-on-2019novel-coronavirus/>
·         From the World Small Animal Veterinary Association:
o    Frequently Asked Questions<https://wsava.org/news/highlighted-news/the-new-coronavirus-and-companion-animals-advice-for-wsava-members/>
·         From the AVMA:
o    What you need to know about COVID-19<https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19>
o    COVID-19 in humans<https://www.avma.org/sites/default/files/2020-02/AVMA-Human-Coronavirus-Summary.pdf>
o    Coronaviruses in domestic species<https://www.avma.org/sites/default/files/2020-02/AVMA-Coronavirus-Taxonomy-Notes.pdf> (AVMA members only)
o    Coronavirus: Detailed taxonomy<https://www.avma.org/sites/default/files/2020-02/AVMA-Detailed-Coronoavirus-Taxonomy-2020-02-03.pdf> (AVMA members only)

 

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