Veterinarians, if anything, are adaptable. One day at the clinic rarely looks like the next, and it’s often hard to know what’s going to walk in the door.
The COVID-19 pandemic certainly tested the adaptability of veterinarians. Community transmission of SARS-CoV-2, the novel coronavirus that causes COVID-19, was first detected in February 2020 in the U.S. By mid-March, all 50 states; Washington, D.C.; and four U.S. territories had reported cases. Not long after came disruptions in supply chains and major clampdowns on businesses, resulting in more than 20 million people losing their jobs in the spring. By year’s end, only half had found employment. In all, there had been more than 28 million confirmed cases of COVID-19 and more than 500,000 deaths caused by the disease as of late February in the U.S.
Rising to the occasion
The novel coronavirus caught many off guard, but in some ways, veterinarians were better prepared for the pandemic than most. Veterinarians keenly understand how viruses infect hosts and can mutate over time. So Dr. Rob Conner, a practice owner in rural northern Arkansas, took matters into his own hands by securing personal protective equipment in a creative manner (see story). He remains convinced that veterinarians should have been put in charge of the response to the coronavirus given the U.S. Department of Agriculture’s efforts with animal disease traceability.
“It’s a little befuddling to me to watch our government not know what to do or corral it (COVID-19),” Dr. Conner said. “It is a very complex thing. Fortunately, kind of like any problem, you study it, dissect it, learn details about it, and figure out how to battle it.”
Indeed, veterinarians have been involved in cutting-edge research on SARS-CoV-2, not only helping develop potential vaccines, but also studying how the virus affects humans and animals (see story). Veterinarians in the clinic quickly figured out how to continue to meet the needs of their patients while keeping everyone safe.
Equine veterinarians have had to limit how many people attend an appointment and more rigorously disinfect their vehicles and equipment, among other protocols. Zoo veterinarians, too, had to take extra precautions, particularly for certain species in their care after lions, tigers, snow leopards, and gorillas have caught the virus from asymptomatic staff members.
Swine veterinarians encountered a uniquely difficult situation early in the pandemic when processing plant workers’ exposure to COVID-19 led to a backlog of market swine. At its lowest, daily processing capacity dropped to approximately 42% during April 2020, which meant approximately 215,000 hogs per day were not able to be harvested at that time, according to Dr. Harry Snelson, executive director of the American Association of Swine Veterinarians, in the September and October 2020 issue of the AASV’s Journal of Swine Health and Production.
Farmers and swine veterinarians responded by attempting to hold animals in place, slow growth, repurpose vacant facilities, adopt nontraditional marketing strategies, and alter breeding programs to enable producers to avoid or delay much of the anticipated depopulation.
Ultimately, however, depopulation was unavoidable for thousands of animals.
Busy, Busy, Busy
And throughout this time, the AVMA and others have worked relentlessly to keep veterinarians apprised of the latest information and what it means, from whether SARS-CoV-2 can be transmitted to animals or vice versa to how practice owners could apply for Paycheck Protection Program loans. The AVMA has produced dozens of tools, guidance documents, and webinars to help practitioners navigate telehealth, manage exposed staff members, and more. These resources help veterinarians provide care for pets, horses, and livestock, including safeguarding the nation’s food supply; laboratory animals; and aquatic, exotic, and wild animals. Cumulatively, AVMA webpages dedicated to COVID-19 had received nearly 2 million page views as of Jan. 31. And the AVMA has tracked 7,672 mentions of the AVMA in coverage of COVID-19 by the media as of Jan. 31, with a total reach of 16.46 billion impressions.
So here we are, a year later. Veterinarians remain as resilient as ever, even through these difficult times. On the one hand, many practices are doing better than ever (see story), and the number of pets continues to increase. On the other hand, clinics have gotten so busy they’re doing what was once unthinkable to many—turning clients away.
Dr. Michael Longoni is medical director of Diamond Veterinary Hospital, a 24-hour emergency and general practice in Everett, Washington, where the first cases of COVID-19 in the U.S. were documented. He said business slowed for two weeks when the pandemic first hit. Since then, he said, “We got even busier because a lot of practices that could have theoretically stayed open, a fair amount just closed. Their clients ended up coming to us for emergency care and chronic illness things. Our ER (emergency room) got busier and stayed growing and getting busier through the whole thing (pandemic), to the point where there are two other ERs close by, and they are swamped, too. It’s gotten to the point where we’ve added a midshift ER doctor and started calling capacity,” not seeing more emergency cases until the staff catches up, except for certain critical cases. “We had never done that before, but we had to just for our employees’ sake. We have to have a relief valve. It’s hard because we’re turning people away, which makes our receptionists’ job harder.”
He says some clinics still can’t get clients in for an appointment for three to four weeks.
“When we see an emergency, we tell them to go back to your vet for a follow-up, but they can’t get in any sooner than they can for a recheck here. We’ve built some leeway in our schedule to anticipate that,” he said. “It’s kind of a concentrated problem in the ERs, not able to help as many animals as they want.”
Self-care and communication
Burnout, compassion fatigue, and suicidal ideation are as much, if not more so, issues for practitioners during the pandemic.
Melissa Mace, executive director of the Wisconsin Veterinary Medical Examiners Board, said it was somewhat lucky that the board established a Veterinary Professional Assistance Program in November 2020 as the program has provided important resources during this stressful time. The board started working on the program more than two years ago. Similar to programs in other states, the VPAP offers guidance and assistance with family issues, finding child and adult care, workplace concerns, legal and financial issues, stress, health and wellness, and other issues that concern veterinary professionals. It also offers personal, confidential guidance, coaching, and counseling for all veterinary professionals and their household members. The VPAP has resources geared toward helping veterinary professionals navigate the COVID-19 environment, too.
“They (veterinarians) are a unique group of people who have a unique group of stressors, which can be more exacerbated in some areas. We wanted to give them support across the board,” Mace said. “If they’re in crisis, they can pick up the phone and call and have no ramifications against their credential.”
Since COVID-19 has hit, Mace said, the board has seen an increase in complaints having to do with veterinarian-client communication.
“Good communication in a stressful situation is always challenging. COVID is a good example of difficult communication in the clinic setting. Clients are sitting in the car. Their pet is in the clinic with staff, who are calling them to discuss diagnosis and treatment options. The conversation isn’t the same as it would be in person, and at times the consent is not quite as clear,” Mace said. “If a client is stressed and doesn’t understand what they’re being told, clinic staff can’t see them to read the body language that may help them figure out their message is not being received, and if there’s a bad outcome, that leads to a complaint and hard feelings.”
Despite the challenges, curbside pickup and dropoff along with telehealth have allowed veterinarians to maintain services and interact with clients quickly and efficiently while also reducing their risk of exposure to the virus.
But not all have not gone untouched, as colleagues have fallen ill or died of the virus. Although considered health care workers and owners of essential businesses, not all veterinarians were at the front of the line for vaccines when they became available (see story).
In this issue, JAVMA News seeks to tell stories of the hard work of clinicians and researchers, clinic staff members, and students who have had to navigate uncharted waters during what was already a time of stress and uncertainty. Their dedication to the veterinary profession has helped ensure the health and safety of animals and people alike.