Considerations for equine veterinarians during the COVID-19 pandemic

Published April 5, 2020

Equine practitioners are incredibly diverse in what services they deliver, how they deliver them, the resources they have available to do so, and roles their patients play, including use for pleasure, racing, other performance, work, and therapy.

The One Health aspects of COVID-19 draw attention to the need to balance animal health with human health, considerations that veterinarians take into account daily. Entering a facility where a COVID-19 positive individual resides or works, or interacting with an individual known to be ill with COVID-19, should occur only in ways consistent with guidance from the CDC, state, and local public health officials. Equine practitioners should be very familiar with CDC’s Interim Guidance for Public Health Professionals Managing People With COVID-19 in Home Care and Isolation Who Have Pets or Other Animals and have access to appropriate personal protective equipment (PPE) before making such a decision.

The AVMA shares the following considerations with equine veterinarians during the COVID-19 pandemic. Although little is known about SARS-CoV-2 in domestic animals, it appears that horses owned by COVID-19 patients are unlikely to transmit SARS-CoV-2 to humans. The recommendations that follow are based on proven techniques applied in many different disease outbreaks and are consistent with the Hierarchy of Controls (listed from most effective to least effective).
  

COVID-19 Hierarchy of Controls

 

  • Elimination
  • Substitution
  • Engineering controls
  • Administrative controls
  • Personal protective equipment (PPE)

While PPE serves an important protective function, the optimal way to prevent disease transmission is to use a combination of interventions from across the hierarchy of controls, rather than PPE alone.

Veterinarians should consider asking screening questions when an appointment is scheduled and again on the day of the scheduled visit. Questions should include inquiring about anyone who has fever, cough, shortness of breath; has had contact with a positive COVID-19 person; and whether anyone on the property is under isolation. Clients and/or households that answer “yes” to any of the screening questions may be at increased risk for COVID-19 and the following precautions should be considered:

  • Consider rescheduling non-urgent veterinary procedures for those clients who answer “yes” to any of the screening questions. 
  • Consider use of telemedicine as an alternative to an in-person visit. Such use must be consistent with veterinarian-client-patient relationship and drug prescribing requirements under federal and state law. The AVMA has resources to support your use of telemedicine at avma.org/Telemedicine. While a variety of communication tools are available for use to conduct telemedicine visits, the AVMA has also compiled a list of providers to assist.
  • Entering a facility or interfacing with a COVID-19 quarantined individual should occur only if that can be done consistent with guidance from the CDC or state or local health officials. Consultation with state and local health officials is strongly encouraged so that timely and accurate information can guide appropriate responses in each location.
  • Veterinarians and their staff members should ask to interface with a caretaker who has not been identified as presenting a particular risk for exposure to COVID-19 or should evaluate animals without a caretaker present. If this is not possible, individuals who present an identified risk of exposing others to COVID-19 should wear a face mask (N95 mask, if available, or a surgical mask), and a distance of at least 6 feet should be maintained between the individual identified as presenting a risk and the veterinarian and/or veterinary staff member.
  • CDC currently recommends the use of cloth face coverings in public settings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission.
  • The minimum number of veterinary staff needed for the task should enter the property where anyone who has been identified as presenting a particular risk for exposure for COVID-19 is present.  Veterinary staff members should limit the number of facility employees they interact with while at the facility.

Additionally, the AVMA recommends the following for equine veterinarians and their clients:

  • Practice good hygiene. Wash your hands on a frequent basis with soap and water for at least 20 seconds, per CDC recommendations. Avoid touching your face.
  • Stay home if you are sick. Veterinarians and clients should inform all employees to not come to work if they are feeling unwell. Management should routinely look for ill employees and immediately send them home. Maintain flexible leave policies and make sure all employees know they need to stay home if they are ill.
  • Avoid close contact and practice social distancing when possible. If you or your staff are able, work remotely. Maintain at least 6 feet between contacts.
  • Practice strict biosecurity at all farms, racetracks, performance venues, and other places where equids are kept. Visitors not necessary for the operation of the business should not be allowed onto the premises.
  • Do not hoard supplies. Hoarding of supplies or bulk purchasing in anticipation of a shortage is not necessary and not recommended as it could create artificial product supply issues.
  • Conserve personal protective equipment (PPE). Some states are asking veterinarians to donate or sell any excess PPE to state health departments. Veterinarians are being asked to limit elective procedures to decrease social interaction and decrease the use of supplies, such as gowns, gloves, and masks that are also used in human medicine and are critical for patient care and responder protection during this outbreak.
  • Veterinarians and clients should develop and maintain business emergency plans. Protocols should be developed to handle staff shortages.
  • Prioritize your health and wellbeing. Consider your own, your employees’ and your clients’ mental health and wellbeing. We encourage you to utilize COVID-19-specific wellbeing resources available at www.avma.org/coronavirus, as well as those available on the AVMA wellbeing webpage.

Employers should make a determination as to whether they can provide a work environment for their teams that complies with their legal obligations to protect employees from known hazards, including COVID-19.

Additional resources are available from the AVMA, various agencies of the federal government, and the American Association of Equine Practitioners. See: