Infection prevention and control

Updated on May 13, 2020

Thoughtful application of infection prevention and control principles is required to prevent transmission of communicable diseases in all healthcare settings, including veterinary practices. Recommendations arising from such principles reflect an understanding of the epidemiology of disease; identification of risk factors that increase susceptibility to infection; and practices, procedures, and other actions that are known to either increase or decrease infection rate. Independent of the COVID-19 epidemic, following routine infection control standards is always a good idea for veterinary practices. The National Association of State Public Health Veterinarians has made guidance available in its Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel and USDA has addressed infection prevention and control on farms in its publication Biosecurity: Protecting Your Livestock and Poultry. Specific to COVID-19, CDC has issued Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response, as well as guidance for Meat and Poultry Processing Workers and Employers.

Social distancing

Because COVID-19 is primarily transmitted person-to-person, limiting contact (incidence, closeness, and duration) with others is the best way to reduce its spread. Principles of social distancing include staying at least six feet (two meters) from other people, not gathering in groups, and staying out of crowded places and avoiding mass gatherings. Transmission from asymptomatic individuals is known to occur, so it's important to maintain social distance even from those who do not appear to be ill.

Within veterinary settings social distance should be maintained, to the extent possible, from other veterinary team members, clients, vendors and delivery personnel, and people at any external location visited (e.g., homes, farms, barns, animal control and sheltering facilities, other businesses).

Cleaning, disinfection, and ventilation

Cleaning and disinfection procedures normally applied in veterinary practices will largely inactivate SARS-CoV-2. Normal cleaning with soap and water will reduce how much virus exists on surfaces and frequently touched objects, which reduces risk of exposure. Disinfection, using Environmental Protection Agency (EPA)-approved disinfectants active against SARS-CoV-2, further reduces risk. When EPA-approved disinfectants are not available, alternatives include 1/3 cup of bleach added to 1 gallon of water or 70% isopropyl alcohol solutions (note: bleach should not be mixed with other cleaning and disinfection products). EPA has produced an infographic on using disinfectants safely. Consideration should be given to contracting with a licensed and insured third-party cleaning company to help ensure appropriate practices are followed. Standard cleaning supplies should be stocked on-site, whether used by practice personnel or a third-party cleaning company, and must be appropriately labeled.

High traffic areas will need to be cleaned and disinfected with greater frequency, including practice entrances and exits, hallways, the reception desk, seating areas, restrooms, examination rooms, procedure and surgical suites, and conference rooms. Surfaces in the veterinary clinic/hospital that are touched frequently (e.g., workstations; shared electronic equipment, including tablets, touchscreens, keyboards, and remotes; phones; doorknobs; light switches; countertops; stethoscopes; areas where frequently used products are displayed and stored) should also be cleaned often and wiped down by employees with disposable wipes between cleanings. Provision of no-touch disposal receptacles should be considered. Keep records showing compliance with cleaning protocols for highest-risk areas.

CDC has developed guidance for employers on cleaning and disinfecting facilities, as well as environmental cleaning and disinfection recommendations for US community facilities with suspected or confirmed COVID-19. The Occupational Safety and Health Administration (OSHA) also has guidance on preparing workplaces for COVID-19.

Ensure that ventilation systems operate properly and increase infusion of outdoor air as much as possible by periodically opening windows and doors to admit fresh air (if possible to do so safely; ensure proper and secure screening is in place to prevent veterinary patient escapes) and using fans and other methods to increase its circulation.