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August 15, 2020

Pandemic takes global toll on profession

Veterinarians around the world strive to continue providing essential services
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Dr. Carol Liew, a veterinarian at Companion Animal Surgery in Singapore, described the COVID-19 pandemic as turning the world upside down, “posing one of the greatest challenges humanity has ever faced.”

Writing in an April 28 lockdown diary for the World Small Animal Veterinary Association, she went on, “Despite this, the veterinary industry marches on and we continue to provide essential services for animal health and wellbeing.”

Dr. Liew at work (left) and at home (right)
Dr. Carol Liew, a veterinarian at Companion Animal Surgery in Singapore, wrote about her experiences at work and at home during the COVID-19 pandemic in a lockdown diary for the World Small Animal Veterinary Association. (Courtesy of Dr. Liew)

On March 17, the AVMA issued a statement urging that veterinary practices be considered essential businesses. On March 18, the World Veterinary Association joined with the World Organisation for Animal Health (OIE) to issue a statement advocating that veterinary activities crucial to public health be considered essential businesses. On March 20, the WSAVA called for veterinary clinics to be classified as essential businesses globally.

In many countries that imposed social distancing, veterinary practices no longer provided elective or nonurgent procedures. Regulatory activities such as food inspection and export processes continued, as did some essential research and related support activities.

WSAVA president’s perspective

Dr. Shane Ryan, WSAVA president, said the impact of the pandemic on companion animal veterinarians has been variable depending on where in the world they practice.

“In more-developed economies, often companion animal practices were classified as essential services soon after lockdowns,” Dr. Ryan said.

In developed countries, Dr. Ryan said, the challenge for companion animal practices has mainly been in adapting to rapidly changing government guidelines to stay open and financially viable. In many cases, companion animal practices were, for a time, allowed only to provide emergency care. Among the new approaches to practice are pet owners staying outside the clinic.

“While it is likely that business will recover once the worst of the pandemic is over in the more-developed economies, many of their pet-owning clients may be left struggling with financial uncertainly, which may have a knock-on effect on the type of procedures they can afford,” Dr. Ryan said. “This means that the financial effects will be felt for some time to come, and there may be a need for veterinarians to consider new ways of working to help them rebuild.”

An example is the accelerated adoption of digital technology to interact with pet owners and their animals, with vastly increased use of telemedicine in Europe and the United States amid relaxation by regulatory authorities in many countries of the requirements for establishing the veterinarian-client-patient relationship.

“In developing economies, the struggle has been even greater,” Dr. Ryan said. The WSAVA heard from member associations in Southeast Asia that animal hospitals have had difficulty in staying open or getting staff members in to work, and hospitals also have experienced shortages in supplies. In parts of Africa, it has been the same story.

There are some inspiring stories, too, such as furloughed veterinary staff members in the United Kingdom signing up to work temporarily in human hospitals.

In June, the WSAVA postponed its World Congress 2020, scheduled for September in Poland, until March 2021.

Lockdown diaries

Dr. Liew in Singapore wrote in her WSAVA lockdown diary: “Our work has become more intense as only emergencies and urgent medical cases come through our door. I work 12 hour shifts for half a week; day or night, rotating with a second team in place. Working in split teams means I don’t see half my colleagues in person; I miss seeing their faces and having lunch and laughs together during downtime.”

Safety measures were a challenge at first, from triaging patients via telemedicine to managing worried pet owners on the phone to controlling crowds of distressed clients during emergencies. Clients occasionally brought snacks to help sustain the practice team.

“Outside work, family time and staying active are keys to my sanity,” Dr. Liew wrote. She is an outdoorsy person, but outdoor activities were not possible, so she channeled her inner bookworm. She spent quality time with her family trying out new recipes. She and her friends participated in online group workouts and yoga sessions.

“It has been a highly reflective period in my life, teaching me to embrace the lemons life throws at us and make the most of it all,” she wrote.

Dr. Ni Made Restiati, founder of Bali Veterinary Clinic in Indonesia, wrote in another lockdown diary for the WSAVA that she realized in early January that Indonesia was likely to be affected by the COVID-19 pandemic. She met with her clinical staff members to discuss four scenarios: No infections would mean business as usual, a mild outbreak would mean a reduction in the staff roster and clinic hours, a moderate outbreak would mean asking some staff members to take unpaid leave, and a serious outbreak would mean closing the practice’s two clinics.

In early March, after the first COVID-19 case in Indonesia, the practice started following the protocol for the second scenario. Patient numbers at the clinics crashed. By late March, with COVID-19 cases rising in Indonesia, the practice moved to the third and fourth scenarios. Dr. Made had to close one of the clinics.

When patient numbers began increasing again, staff members started picking up patients from owners’ homes to avoid having pet owners come to the practice. Some clients were not following hygiene protocols, and Dr. Made has even heard some say that COVID-19 is a hoax.

“We are desperate for the virus to be gone soon and for a vaccine that will enable us to return to our normal lives,” Dr. Made wrote.

WVA president’s perspective

Dr. Patricia Turner, WVA president, said the concept of the essential role of veterinarians was not adopted universally by all countries, or there was a delay in doing so, making it difficult for some veterinarians to continue to do their work.

Veterinarians who could continue to practice shifted their mindset to develop alternate means of working with clients through telehealth and to provide alternate means for clients to purchase goods other than coming into a clinic.

Workplaces have also adjusted personnel management, often resorting to shifts. Costs have increased for personal protective equipment, hand sanitizers, and so on. Clinic staff members have had to deal with a higher risk of infection and psychological stress when social distancing in the workplace has not been possible because of animal needs. In some countries, reduced importation and movement of goods led to shortages of medicines and other materials, and some livestock and companion animal vaccination programs were halted because of social distancing.

Dr. Turner said, “Because in many regions of the world, there has been a significant impact on employment and a downward spiral of the local economy, clients are less able to afford health care for their animals—of all species.” This together with the restriction for conducting nonemergency animal health services has resulted in a significant reduction in revenue for veterinarians and the need to furlough or lay off support staff.

Veterinary colleges in many regions were able to complete the school year by switching to an online teaching format, but not all institutions had that option. Various restrictions created uncertainty regarding how veterinary students would complete applied components of their training.

In some countries, closures of meat processing plants, restrictions on livestock movement, and infection of animals such as minks have resulted in veterinarians’ involvement in animal depopulation. Companion animal practitioners have donated equipment such as ventilators for use in human health. In Portugal, veterinarians were asked to provide support to human health professionals.

The WVA canceled its in-person 2020 congress, scheduled for April 6-8 in New Zealand, and held the congress virtually April 25-May 15. In June, the WVA indefinitely postponed its 2021 congress, scheduled for April in Taiwan.