Veterinarians maintain safeguards as states ease restrictions
COVID-19 still a concern as parts of the U.S. take a phased approach toward reopening businesses
June 24, 2020
Dr. John Lu runs three veterinary practices in Queens, one of the New York City boroughs hardest hit by the COVID-19 virus.
Of his 10 doctors, two are recovering from SARS-CoV-2 infections, one is isolating himself because his wife became infected, and another is older and staying home to protect himself. Clinic staff members are worried but regrouping.
“We have pets that need to be helped,” he said.
Dr. Lu, medical director at Amerivet Partners, was reopening his hospitals six days a week in June, up from five in May and four in April. He estimated revenue in May was down 5%-10% from May 2019 only because he lacked the staff to meet client demand.
As of May 26, New York’s state government determined all veterinary services were considered essential, letting veterinarians resume providing nonurgent care, according to the New York State Veterinary Medical Society. As local governments relaxed stay-at-home orders, veterinarians adjusted their practices but kept added protections to prevent disease spread.
Surveys by veterinary organizations indicate most clinics across the country added distancing measures this spring—especially curbside patient drop-off—to reduce the risk of disease transmission. Dr. Lu is among clinic owners who said they plan to continue using precautions as states remove restrictions affecting practices.
Clients stay outside
As of June 1, New York City had about 200,000 confirmed COVID-19 infections with 52,000 hospitalizations, 17,000 human deaths confirmed to have been caused by the disease, and another 5,000 human deaths likely to have been a result of the disease, according to the New York City Department of Health and Mental Hygiene. Queens had 5,060 confirmed deaths from COVID-19 and 1,211 likely caused by the disease, the second most behind Brooklyn, which had 5,121 confirmed and 1,621 likely.
“In New York City, it’s a pretty scary thing,” he said.
Staff members at Dr. Lu’s practices have been collecting pets that clients drop off at the front door. They wear N95 masks and gloves at all times at work and clean and sanitize surfaces and their gloves throughout the day.
He also is giving extra hazard pay to the support staff.
Dr. Sue Sayles said her clinic in southern Michigan eliminated all elective procedures in the first months of the pandemic, on orders from her state’s governor. She performed only emergency care and rabies vaccinations at first and added leptospirosis vaccination in May.
“We also went to a curbside-only practice where no one was allowed in the building except for employees,” she said.
She made an exception when a pet was euthanized, allowing in one client per pet. Those clients wore masks and kept their distance from employees, she said.
Effective May 29, Michigan Gov. Gretchen Whitmer lifted a requirement that health care providers delay some nonessential procedures, including veterinary procedures. By that day, Dr. Sayles said, her clinic was already fully booked for appointments and several colleagues had said they couldn’t provide enough appointments to meet demand.
“The demand is so high, and we, in our office, have even stopped taking new clients,” she said. “We do hear on a daily basis, ‘Well, no one’s taking new clients. I can’t get in anywhere.’”
She hopes that demand will ease as veterinarians work through a backlog of wanted services.
Dr. Molly McAllister, chief medical officer for Banfield Pet Hospital, provided a statement that the company had been reinforcing precautions throughout its 1,000-plus hospitals. Those measures include cleaning, disinfection, physical distancing, drop-off appointments, increasing use of video and telephone consultations, and requesting form completion prior to arrival. The company also created a policy for supplemental pay for associates’ illnesses and quarantine, expanded company-paid sick leave, and offered professional counseling to associates and their family members.
Dr. McAllister said Banfield has encouraged veterinarians to exercise their professional judgment to determine which services and procedures may be postponed and has helped them locate information from reputable sources.
“It’s times like these that we’re reminded of the power of the human-animal bond,” she said. “Regardless of what life throws our way, pets are right there with us—and veterinary professionals tirelessly stand committed to being there for them.”
About 84% of respondents to the AVMA survey asked clients to wait in their cars while animals were being examined or treated, and majorities reported that they had implemented contact-free payments, had implemented contact-free patient history collection, were seeing patients by appointment only, or were allowing drive-up drop-off.
Almost one-third had conducted telemedicine or other distance-based visits. One-fifth switched to emergency-only services.
About one-third indicated they were asking clients to maintain physical distances, and one-third asked ill staff members to stay home. Some veterinarians canceled appointments, sanitized and reused personal protective equipment, adopted new sanitation standards, asked that ill clients go home, or asked staff members to telecommute.
The survey also indicates many practice owners had steep declines in client visits and income, and about 5% stopped seeing clients.
Regional survey results similarly indicated clinics were trying to maintain distances between employees and clients.
On April 15, the Missouri VMA published survey results that indicate about 60% of respondents implemented curbside drop-off only and 33% provided curbside drop-off but let at least some clients enter their practices. About half of those surveyed indicated they had made no changes in their services offered.
Independent Vets, a company that provides relief veterinarians in the Northeastern U.S., found through a series of four surveys that more than 80% of respondents had added curbside drop-offs and 80% prohibited clients from entering the hospital. More than 60% added remote checkout.
Expanding services with care
Once Dr. Sayles lets clients enter the building again, she will admit one mask-wearing client per pet. They will sanitize their hands upon entry and move only between the exit and an examination room, where exhaust fans will run continuously.
Dr. Sayles said her clinic would resume elective procedures in June, though. She stocked enough PPE to last everyone in the office eight weeks.
She also had resumed boarding, along with curbside drop-off.
Staff members at Dr. Sayles’ clinic check their temperatures when entering the building and stay home when they are sick or if they live with someone who has COVID-19 symptoms. One employee has an elevated risk from infection and was staying home.
Dr. Sayles also added hand sanitizer and hand-washing stations and sanitizing wipes at each computer. She said the 19-person practice has had open discussions, and staff members expressed comfort with clinic procedures.
Dr. Sayles has heard varied responses from colleagues, most of whom are allowing curbside drop-off only and a few who let clients back into examination rooms. But sanitation, cleaning, and mask requirements seem to be universal, she said.
Dr. Lu said many people in Queens felt unsafe and a few of his staff members whose shifts were cut earlier in the pandemic wanted to remain at home. But others want to return.
“We love what we’re doing,” he said.
Dr. Lu said veterinary practice always has been stressful, and COVID-19 added to that stress. But he thinks veterinary medicine is lucky in comparison with, say, the restaurant industry, and he is happy to help clients and pets that need veterinarians.
“It shows that our profession is a very important part in the community,” he said.
The AVMA has information on how to minimize COVID-19 exposure at the clinic and managing exposed staff members as well as case management guidance, a listing of COVID-19 state orders, and more.