COVID-19 Vet Minutes

Actionable Updates for Veterinarians, by Veterinarians

Telehealth Provider Spreadsheet from the American Veterinary Medical Association

CLICK HERE TO VIEW THE SPREADSHEET

Editor’s Note: Please note that this information is changing rapidly, but nonetheless this remains the most comprehensive resource for exploring veterinary telemedicine options.

“In response to the COVID-19 pandemic, the American College of Veterinary Emergency Critical Care (ACVECC) is working to assemble a list of ventilators that might be made available to human medical providers if needed.

If you have a life support ventilator in your hospital that you would be willing to share with a human facility, please follow the link below. A similar initiative is also underway at American College of Veterinary Anesthesia & Analgesia – ACVAA.” ~Cindy Vaughn Barnes, DVM

ADD TO VENTILATOR LIST

COVID-19 HACCP Protocol
By Dr. Elizabeth Wheeler, DVM, MPH
HACCP – Hazard Analysis and Critical Control Points

Applying the seven HACCP principles make up the major steps to writing a HACCP plan. They
are:

1. Conduct a hazard analysis.
2. Identify critical control points.
3. Establish critical limits for each critical control point.
4.Establish monitoring procedures.
5. Establish corrective actions.
6. Establish record keeping procedures.
7. Establish verification procedures.

For the scope of our practice, Steps 1., 2., and 5. are being evaluated.

Learn more

Pandemic Policy Example by Deanna Armstrong, DVM

The purpose of this policy is to outline provisions related to Time Off Requests, Employee Leave and Pay, and Infection-Control Measures.
This policy outlines steps to safeguard employees’ health and well-being during a pandemic while ensuring our hospital’s ability to maintain operations and continue providing essential services to our clients and patients.

It is the intention of Furever Family Animal Hospital, LLC to protect the health of employees, clients, patients while still providing continuity of services to our clients and patients during times of pandemic or other infectious diseases.

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Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel, 2015
A model infection control plan for veterinary clinics.

Practice Management Resource: Send a COVID-19 Smart Newsletter
Access to send a COVID-19 newsletter to your clients for free, if you don’t already have a system in place for emailing your customers. Reliable communication is more important than ever.

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Mask Alternative
The University of Florida Health’s department of anesthesiology has developed 2 prototypes for masks that can be produced in large quantities using materials already found in hospitals and medical facilities. Details and pattern here.

Need support with a case? Free 24 hour instant consultation by veterinary specialists during the COVID-19 pandemic.

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Educate clients about Coronavirus and pets with these free customized client education videos

Learn More

04/03/2020

Free Webinar Friday, April 3rd at 1:00 PM (PDT)
Find out what CARES Act funding is available to your small business impacted by COVID-19.
Congress just passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act which includes financial assistance to businesses.

Jennifer J. Mansfield, CPA will be reviewing what’s in the CARES Act and answering your questions.
Learn:
– How you can qualify for loans in the CARES Act.
– Loan & grant specifics – such as forgiveness, what the money can be spent on, and other qualifications.
– What paperwork you need to start the application process.

This free event will be held virtually Friday, April 3rd at 1:00 PM (PDT).

3/31/2020

The Governor of Michigan states in an executive order: “…all veterinary services, essential and non-essential, must be performed by telemedicine to the fullest extent possible.”

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EXECUTIVE ORDER No. 2020-32 Temporary restrictions on non-essential veterinary services The novel coronavirus (COVID-19) is a respiratory disease that can result in serious illness or death. It is caused by a new strain of coronavirus not previously identified in humans and easily spread from person to person. There is currently no approved vaccine or antiviral treatment for this disease. On March 10, 2020, the Michigan Department of Health and Human Services identified the first two presumptive-positive cases of COVID-19 in Michigan. On that same day, I issued Executive Order 2020-4. This order declared a state of emergency across the state of Michigan under section 1 of article 5 of the Michigan Constitution of 1963, the Emergency Management Act, 1976 PA 390, as amended, MCL 30.401-.421, and the Emergency Powers of the Governor Act of 1945, 1945 PA 302, as amended, MCL 10.31-.33. The Emergency Management Act vests the governor with broad powers and duties to “cop[e] with dangers to this state or the people of this state presented by a disaster or emergency,” which the governor may implement through “executive orders, proclamations, and directives having the force and effect of law.” MCL 30.403(1)-(2). Similarly, the Emergency Powers of the Governor Act of 1945 provides that, after declaring a state of emergency, “the governor may promulgate reasonable orders, rules, and regulations as he or she considers necessary to protect life and property or to bring the emergency situation within the affected area under control.” MCL 10.31(1). To suppress the transmission of COVID-19, it is crucial to limit in-person contact to the greatest extent possible. While there is currently no evidence that common pets can transmit COVID-19, the provision of veterinary services in-person nonetheless presents the risk of that the virus will be spread from person to person. Furthermore, the provision of veterinary services entails the use of health care resources, such as personal protective equipment, that are in immediate and critically high demand as a result of this pandemic.
Accordingly, to mitigate the spread of COVID-19, protect the public health, provide essential protections to vulnerable Michiganders, and ensure the availability of critical health care resources, it is reasonable and necessary to impose temporary restrictions on the in-person provision of non-essential veterinary services. 2 Acting under the Michigan Constitution of 1963 and Michigan law, I order the following: 1. Beginning as soon as possible but no later than March 31, 2020 at 5:00 pm, and continuing while the declared emergency is in effect, all veterinary facilities must implement a plan to temporarily postpone all in-person non-essential veterinary services until the declared emergency has ended (“plan”). 2. A plan must provide that all veterinary services, essential and non-essential, must be performed by telemedicine to the fullest extent possible while the declared emergency is in effect. If a non-essential service cannot be performed by telemedicine, a plan must require that it be postponed. If an essential service cannot be performed by telemedicine, a plan need not postpone it and may allow it to be performed in person. 3. A veterinary facility must comply with the restrictions contained in its plan. 4. For purposes of this order: (a) “Non-essential veterinary services” means all veterinary services other than those that are: (1) necessary to preserve the life of a pet, as determined by a licensed veterinarian; (2) necessary to treat serious pain that threatens the health and safety of a pet, as determined by a licensed veterinarian; (3) necessary to euthanize a pet, as determined by a licensed veterinarian; or (4) necessary to treat or prevent the transmission of any infectious disease that can be transmitted between animals and human beings, as determined by a licensed veterinarian. (b) “Pet” means any domestic animal not raised for food or fiber. 5. Nothing in this order shall be construed to prohibit any medically indicated vaccination of any animal. Nothing in this order alters any obligation of an owner of an animal to vaccinate their animal as required by law or regulation. 6. This order does not alter any of the obligations under law of a veterinary facility to its employees or to the employees of another employer. 7. The director of the Department of Licensing and Regulatory Affairs shall issue orders or directives pursuant to law as necessary to enforce this order. 8. Consistent with MCL 10.33 and MCL 30.405(3), a willful violation of this order is a misdemeanor. 3 Given under my hand and the Great Seal of the State of Michigan.

3/27/2020

From Casey Barton Behravesh, MS, DVM, DrPH, DACVPM
Captain, U.S. Public Health Service Director, CDC One Health Office
Please don’t panic about some of the headlines you are seeing about pets. It is important to confirm any reports you are seeing from official sources. CDC has all of the information you need on our Animals and COVID-19 website (just google CDC COVID-19 Animals).The US government is using a One Health approach to protect human health, animal health and welfare, and mental health during this global pandemic.

Here are some key bits of information important for every veterinarian to know:
– We do not have evidence that companion animals, including pets, can spread COVID-19.
– There is no reason at this time to think that any animals, including pets, in the United States might be a source of infection with COVID-19.
– To date, CDC has not received any reports of pets or other animals becoming sick with COVID-19 in the United States.
– We do not have evidence to suggest that imported animals or animal products imported pose a risk for spreading COVID-19 in the United States.
– At this time, there is no evidence that the virus that causes COVID-19 can spread to people from the skin or fur of pets.
– At this time, routine testing of animals for COVID-19 is not recommended.
– Veterinarians that see animals that have a new, concerning illness and that animal lives with a person with COVID-19 should contact their state public health veterinarian to discuss the situation and the potential for animal testing.
– If you are sick with COVID-19 (either suspected or confirmed), you should restrict contact with pets and other animals, just like you would around other people.
– Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. This can help ensure both people and animals stay healthy.
– When possible, have another member of your household care for your animals while you are sick. Avoid contact with your pet including, petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with them. ·
– Further studies are needed to understand if and how different animals could be affected by COVID-19.
– CDC is working with human and animal health partners to monitor this rapidly evolving situation and will continue to provide updates as information becomes available.

Dr. Behravesh references the CDC website for more details.

3/24/2020

Licensed Health Care Practitioners Can Provide Telemedicine Services to Pennsylvanians During Coronavirus Emergency
Illinois and Georgia are collecting names of veterinary professionals for a database of potential volunteers willing to help in human health care, if needed, in the coming weeks.

For more information in Illinois, contact Stephanie Keating, DVM, DVSc, DACVAA, Service Head, Anesthesia and Pain Management at the University of Illinois, College of Veterinary Medicine.

FDA Helps Facilitate Veterinary Telemedicine During Pandemic by temporarily suspending enforcement of portions of the federal VCPR (State VCPR laws still apply, but are also in flux in many states)
As part of the U.S. Food and Drug Administration’s ongoing commitment to combatting the coronavirus (COVID-19) pandemic and providing flexibility across FDA-regulated industries, the agency announced today that it intends to temporarily not enforce certain requirements in order to allow veterinarians to better utilize telemedicine to address animal health needs during the pandemic.

“The FDA recognizes the vital role veterinarians play in protecting public health. This pandemic has had impacts on many of our everyday lives and professions, and during this time, we need to provide veterinarians with the latitude to expand the use of telemedicine in the care of animals, not only pets but also the animals that produce our food,” said FDA Commissioner Stephen M. Hahn, M.D. “The FDA is providing flexibility that will help veterinarians maintain the health of animals during the pandemic, while allowing for the social distancing that is so important in limiting the further spread of coronavirus disease across the country and the world.”

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The agency intends to temporarily suspend enforcement of portions of the federal veterinarian-client-patient relationship (VCPR) requirements relevant to certain FDA regulations. The VCPR is the professional relationship between the veterinarian, client (e.g., animal owner or caretaker), and the animal patient(s). The federal VCPR definition requires that veterinarians physically examine animal patients and/or make medically appropriate and timely visits to the location where the animal(s) are kept. Therefore, the federal VCPR definition cannot be met solely through telemedicine.

In order to help veterinarians utilize telemedicine to address animal health needs during the COVID-19 pandemic, the FDA generally does not intend to enforce the animal examination and premises visit portion of the VCPR requirements relevant to the FDA regulations governing Extralabel Drug Use in Animals and Veterinary Feed Directive (VFD) drugs. This will allow veterinarians to prescribe drugs in an extralabel manner or authorize the use of VFD drugs without direct examination of or making visits to their patients, which will limit human-to-human interaction and potential spread of COVID-19 in the community.

For example, the owner of a sick dog could share a video with a veterinarian. If necessary, the veterinarian could then prescribe a drug not approved for use in dogs or for that illness (extralabel use). As another example, a veterinarian could remotely examine and diagnose a group of food-producing animals with a skin disease, and then authorize the use of certain drugs in the animals’ feed.

Although the FDA intends to temporarily suspend certain federal VCPR requirements, veterinarians still need to consider state VCPR requirements that may exist in their practice area.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

3/22/2020

From our colleague on the front lines, Barbara Jones, DVM, CVA, MPH, DACVPM
“This is based on current science and will change as research continues into this novel virus. I can cite everything in the current post, but something will be wrong at some point, I’m sure!” ~Dr. Jones

“As a COVID19 responder and an epi/infectious disease boarded specialist (DVM MPH DACVPM), I feel I need to address the innumerous comments on the need for tests. This is long, but I feel important.

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The US did NOT turn down WHO tests. The WHO never offers the US tests because they provide them to countries that do not have the resources or capabilities to develop their own. CDC has developed their own test irrespective of administration and does a fantastic job. (if you don’t believe me, see https://www.snopes.com/fact-check/us-coronavirus-test/ or https://www.politifact.com/factchecks/2020/mar/16/joe-biden/biden-falsely-says-trump-administration-rejected-w/)
CDC’s COVID19 test was FDA approved Feb4; however, during validation after being sent out, it was found the tests couldn’t be validated and they had to be remanufactured. Everyone saw the need for a test and was working it long before needed. The first US case was confirmed January 21. Travel was banned from China for non-US citizens in the previous 2 weeks on January 31, and a CDC test was FDA approved Feb4. The CDC was on the ball! If the manufacturing error wouldn’t have occurred, this would be a different narrative.
This is a novel betacoronavirus and is behaving very differently than other pandemics we have had. This is the FIRST coronavirus pandemic in recorded history. This meant countries (all – see Europe) didn’t realize the amount of presymptomatic shedding that occurred, which is different than influenza. With an average Ro of 2.2, this means it can spread quickly before any cough, fever, or tickle of your throat.
Even with widespread testing, the validation and sensitivity are very important. Right now tests are being rolled out due to public demand without validation. This is actually WORSE than having no/few validated tests. If there is a low negative predictive value, then people with a negative test are actually positive and feel they can move around the community. Research shows even though most of the original tests were PCR, they are NOT necessarily sensitive (for a variety of reasons) and have a low negative predictive value. There are some studies suggesting pooled samples from multiple patient sample sites might improve the negative predictive value and sensitivity; however, this is not amenable to drive through testing.
We are still at the end of the influenza and cold seasons and starting allergy season. Symptoms are the same. Not everyone with a cough has COVID19. This is making my tracebacks interesting to say the least…
CDC’s case definition is very clear on who should be tested. Regular physicians do not decide who gets tests and do not have the tests – DPH has to test. This may be changing due to public outcry, but DPH has always been the one to control case definitions and who should be tested in an outbreak.
As someone responding and mitigating, I would love to have data, but the public’s focus on testing is NOT helping! Many countries are testing thousands and doing so rapidly and it is NOT slowly their curve. The science is clear that social distancing is MORE important than testing – likely due to the presymptomatic spread.
Tests won’t slow the spread if we don’t socially distance and stop interacting!
Finally, we have never in history had a coronavirus pandemic and I think the ProMed moderator said it best: “Reviewing the media on a daily basis, I have seen the politicization of these epidemics within countries, especially on the part of leaders and their oppositions and seen how this is counterproductive to say the least. Those mixed messages to the public lead to lack of trust and confidence in advice given by the official public health sector. Mistakes and errors will happen; trying to cast blame on others for political gain makes everyone a loser as the trust is eroded. Admitting there were errors and correcting them builds trust. And dealing with a 1st documented pandemic of a coronavirus means every day is a learning day, and we should learn from our mistakes. – Mod.MPP”

New York State Veterinary Medical Society – COVID-19 Update
Here is a summary of what we are hearing from veterinarians across NY State to help you with your decision making.

Should I stay open?
For most of this week Animal Hospitals were mostly making decisions on their operations based on their (or our lawyer’s) interpretation of the Governor’s Executive Orders.

3/21/2020

Unleashed Veterinary Podcast hosted by Bruce W. Francke, DVM
COVID-19 and You! Veterinary Style with Dr. Carrie Jurney – CLICK HERE

From the NJVMA: COVID-19 AND NJ VETERINARY PRACTICES
The NJVMA agrees with the AVMA position that telemedicine is a useful adjunct for providing care to patients that already have a physically-established VCPR. New Jersey Veterinarians may look at the state’s proposed telemedicine rules which, although not adopted yet, have been approved for adoption by the state Board. Veterinarians should comply with the specifics in the unadopted regulations, but generally, veterinarians should determine if they can provide services through telemedicine to the same standard of care as they would if those services were provided in person. If they cannot do so in their professional judgment, they should not provide services through telemedicine. NJVMA Veterinarians interested in providing this service should review the telemedicine rules at: https://www.njconsumeraffairs.gov/Proposals/Pages/vetmedc-06172019-proposal.aspx

BREAKING NEWS: Veterinary Practices Are Essential For Emergencies
“Governor Cuomo issued Executive Order No. 202.6, requiring, effective March 20, 2020 at 8 pm, that all businesses in the state reduce their in-person workforce at any work location by 75 percent.(Now up to 100%) Any “essential business,” however, is not subject to this restriction.

The New York State Department of Economic Development has issued a list of essential businesses that are exempt and this list includes:

Updated 3/21/2020
– Veterinary and animal health services Emergency veterinary and livestock services (Read full list of EDC exemptions)

Also the Department of Agriculture and Markets have identified some essential businesses that are exempt from reducing on-site personnel (Visit site)
– Food producing farms, fisheries, operations that care for animals…”
– Businesses and vendors supplying goods and services to these essential industries, such as agri-businesses and operations supporting animal health, are also exempt.

We are working with State Officials and our lawyer for further clarification about essential veterinary services such as inoculations to prevent the spread of zoonotic diseases.

Tim Atkinson
NYSVMS
Albany NY
518-869-7867″

3/20/2020

Stacee Santi Longfellow, DVM
“Hi there corona peeps! I made this tutorial for our customers at Vet2Pet and wanted to share it with you in case you are looking for an overview of this combo: Youcanbookme, Stripe [editorial recommendation: use PayPal instead due to challenges with Stripe for vet hospitals], Google cal and Zoom…Good luck and keep washing your hands :)”

From The California Veterinary Medical Board:

Can we dispense medication to a client for use on their animal even though the exam is not current?

Governor Gavin Newsom declared the COVID-19 virus to be a state of emergency in California on March 4, 2020. California law allows veterinarians to provide medications to animal owners during declared states of emergency. The Veterinary Medicine Practice Act states the following:

Business and Professions Code section 4826.4
a. A California-licensed veterinarian at premises registered in accordance with Section 4853 that is located within a 25-mile radius of any condition of emergency specified in Section 8558 of the Government Code may, in good faith, do both of the following in addition to any other acts authorized by law:

Render necessary and prompt care and treatment to an animal patient without establishing a veterinarian-client-patient relationship if conditions are such that one cannot be established in a timely manner.
Dispense or prescribe a dangerous drug or device, as defined in Section 4022, in reasonable quantities where failure to provide services or medications, including controlled substances, may result in loss of life or intense suffering of the animal patient. Prior to refilling a prescription pursuant to this paragraph, the veterinarian shall make a reasonable effort to contact the originally prescribing veterinarian.
b. A veterinarian acting under this section shall make an appropriate record that includes the basis for proceeding under this section.
c. A veterinarian who performs services pursuant to this section shall have immunity from liability pursuant to subdivision (b) of Section 8659 of the Government Code.”

5 Actionable Telemedicine Tips During COVID-19

“Do the right thing. Use that as your guiding principle to the best of your ability. Treat people right, provide a value, charge a reasonable fee. Only diagnose and recommend to the level you can defend.”

“Yesterday I spoke with Dr. Rolan Tripp, Executive Director of the Televeterinary Coalition. These were his common sense words of wisdom on how to handle telemedicine as our profession launches into this unknown frontier.

If your practice needs nitty gritty, tangible help with telemedicine, here are some resources to help guide you (I have no personal affiliation with any of them) ~Julie Buzby, DVM

WEBINAR: Tonight (Friday, March 20) at 5:30 p.m. ET by Babel Bark—BabelVet Overview: Telehealth & Remote Patient Monitoring Solution Description.
ARTICLE: Petriage’s Telemedicine to the Rescue, in Today’s Veterinary Business.
ARTICLE: AAHA’s Keep Scheduling Wellness Appointments With Teletriage Service includes an overview of five veterinary telehealth providers.
PODCAST: Learn about creating a quick-and-dirty version of telemedicine in How to Create a Telemedicine System for Your Practice as explained by Brandon Breshears, host of The Veterinary Marketing Podcast.
COMING SOON: A comprehensive chart of “veterinary connected care companies” compiled by the AVMA

Elizabeth Miller Smith, DVM
“This made me tear up this morning. I got a call Wednesday from my nurse practitioner. She is smart and kind and helpful and exactly the person you want on the front lines of this. She’s running one of the first testing clinics here and was asking me if she knew anywhere she could get masks and gowns, they had NONE. None. So I boxed up what I had, ordered what I could, and took them to her. I can use cloth masks, I’ve got a surgery gown I can autoclave for emergencies…

Veterinarians, I urge you to follow the AVMA guidelines. The very people who are trying to save us humans from this mess don’t have the proper protective gear. They are literally touching humans who HAVE this virus, and they don’t have the proper protection. We have taken an oath to protect public health, and this is how we can. #giveupyourgear #inthistogether“

Melanie Metz Goble, DVM
“Day 1: Self-imposed isolation.
On Tuesday, I had a difficult situation with a client. He was aggressive and spit when he spoke. He did not allow us to provide the necessary care of his pet, so I don’t know why he even came in. As he was leaving, he announced that he has been sick – fever and upper respiratory infection – and now we are all infected. We don’t know if he was just being a jerk or being honest. We did contact the local health department.

Yesterday, I developed a cough that worsened throughout the day and a sore throat in the evening. I will be receiving my thermometer this afternoon/evening so that I will be able to monitor my temperature. I am staying in isolation for 14 days.

Please, do not go out if you are sick. Please, stay home and quarantine yourself. If you are not sick right now, remember that you are still supposed to stay home or at minimum isolate yourself by maintaining social distance of 6+ feet from others.

If you have a person or animal that needs medical care, please call ahead. Many places are doing urgent and emergency care only. Now is the time to preserve PPE (personal protective equipment) and limit exposure to others so that we can flatten the curve.

In some locations, equipment and veterinarians are being asked to step up and provide equipment and time to help in the human efforts. This is not a joke. It is not a hoax. This is serious. Please treat it as such.”

3/19/2020

“In executive order D2020 009, the governor of Colorado ordered that starting Monday, March 23rd, voluntary/elective procedures have been banned (until April 14th at the earliest). The order also reads:

‘All [veterinary practices] in possession of PPE, ventilators, respirators, and anesthesia machines that are not required for the provision of critical health care services undertake an inventory of such supplies by no later than March 26th, 2020 and prepare to send it to the State of Colorado. I direct the Emergency Operations Center to allocate any supplies received pursuant to this order to support activities related to the COVID-19 response.'”

Colma Police, San Mateo County, California
“San Mateo County is looking for any and all current or retired medical professionals who may be able to assist in response to COVID-19. They need doctors, nurses, dentists, veterinarians, medical assistants, etc. To volunteer please contact [email protected] or 650-997-8300.”

Lauren Smith, DVM
“Dear Veterinary Hospital,
I am writing in regard to the recent developments of the COVID-19 pandemic. I want you to know that I appreciate the hard work and dedication you and your team are putting in in order to continue to provide veterinary care to the community. I know this is a scary time, not only for the health of yourself and your loved ones, but for the health of the business you have worked hard to grow.

I am scheduled to work relief shifts for your hospital in the coming month. I would like you to know that, should the need arise to cancel my shift due to decreased need for non-emergent services, the financial health of your practice, or the presence of ill team members or clients, I will be waiving my normal cancellation fee for any shifts in the month of March or April.

Should you still need my services, I would like to make you aware of a few stipulations. Under normal circumstances, I have always valued reliability as a fundamental trait in a relief veterinarian and strived to always show up and do my best, even when I wasn’t feeling my best. These are not normal times. The decisions I make no longer affect only myself, but the health and wellbeing of the entire community. I will be doing a temperature check prior to any work shifts and should I develop a fever or feel ill in any way, I will institute a self-quarantine and will not be able to work.

I also request written notification of the safety precautions you have taken to protect not only my health while I work there, but the health of your entire team as well as the health of your clients and the community you serve. It is extremely important that as veterinarians we strive to uphold the oath we took to protect the health, not only of animals, but of the public as well. At this time that means conserving personal protective equipment by temporarily suspending elective surgeries such as spays, neuters, and prophylactic dental procedures. It also means instituting social distancing practices to the best of our ability. There are many ways to do this, including postponing vaccine and wellness appointments so as not to encourage clients to risk their health for non-emergent services, instituting curbside services, and/or limiting or eliminating the presence of non-staff members within the building.

If I do not feel that the proper precautions are being taken, I reserve the right to cancel my upcoming relief shift and strongly encourage you to reconsider your policies. These measures may seem extreme, but they will benefit everyone in the long term.

Thank you for your understanding.
Sincerely,
Lauren B. Smith, DVM”

Robert Walter – Practice Owner at Stafford Oaks Veterinary Hospital
“Everyone needs to do this today:
1. Call landlord and ask for rent relief for the next 3-6 months. Effective immediately. Offer to add the months onto the end of your lease or to amortize the amount over the remaining payments once you start paying again. Most will do this because they know they aren’t going to be able to lease it anytime soon and it will be better to keep you there and help you survive.

2. Call all your loan lenders. Ask for disaster relief deferral on your loans for 3 months. Effective immediately. Same thing offer to add payments at end or to amortize over the remaining payments. Tell them you need to keep all cash on hand to pay employees and weather the storm.

3. Ask big suppliers for 3 month terms on paying back for orders. Anything to keep cash on hand.

Please at least do 1&2. The goal here is to keep as much cash on hand and not to be able to keep employees and stay in business when this is over.”

Cindy Vaughn Barnes, DVM
“I’m going to try and make this as simple as possible for my colleagues, since even the AVMA hasn’t convinced you.

Human hospitals manage their inventory (COGS) on a “just-in-time” basis, the way most efficient animal hospitals do. What that means, is that they will only have a 1-2 week supply of equipment, supplies and medication on hand, at any given time.

Now that COVID-19 is here and the hospitals are flooded all at once, and because the supply chain has been disrupted (most of our supplies come from China), the human hospitals don’t and won’t have enough critical PPE to take care of humans. I pray that you will never need to go to the hospital during this pandemic, but if you do, you’d want them to be able to take care of you, no?

This is why the AVMA, the AMA, and your fellow colleagues are asking you to 1. stop doing elective surgeries and procedures, and 2. donate your surgical gloves and masks if you have an abundant supply.

This is a matter of public health and it’s real whether you want to believe it or not. And thank you to those of you who have taken steps to conserve our precious resources!”

Breaking News: COVID-19. Telemedicine. VCPR. 3/19/2020

“The world is changing so fast that my head is spinning. Last week, the North Carolina State Veterinary Board forbade the practice of Veterinary Telemedicine.

However yesterday, in light of COVID-19 concerns, they issued a more lenient statement: COVID-19 and the Practice of Veterinary Medicine in NC.

A couple hours ago, the Oregon Veterinary Medical Board issued the following statement which removes the requirement of a VCPR to provide Veterinary Telemedicine:

Governor Kate Brown has determined that compliance with certain portions of OAR 875-015-0035 (Veterinary Telemedicine) would prevent, hinder, or delay mitigation of the effects of the COVID-19 emergency.

Pursuant to her emergency powers under ORS 401.168(2), Governor Brown therefore declares and orders that portions of these rules be suspended for the duration of the COVID-19 state of emergency declared by Executive Order 20-03.

Effective immediately and until further notice, the highlighted requirements (in red below) in the rule are suspended. This means that veterinarians have the option to provide treatment via Veterinary Telemedicine without first having conducted a physical exam. Please note that all other portions of the rule continue to apply.

875-015-0035 Minimum Standards for Veterinary Telemedicine

(1) Veterinary Telemedicine (VTM) occurs in Oregon when either the animal who is receiving the care is located in Oregon when receiving VTM or the person providing the care to the animal is located in Oregon when providing VTM, pursuant to the provisions of ORS 686.020. VTM may be provided only under a valid VCPR.

(2) VTM may be used when a veterinarian has a VCPR only when it is possible to make a diagnosis and create a treatment plan without a new physical exam.

(3) VTM may be used with an existing client when there has not been a previous physical examination for the purpose of prescribing sedation for an aggressive or fractious patient prior to an initial visit.

(4) Prescriptions may only be issued when VTM occurs if the veterinarian has evaluated the safety of doing so via VTM, and in compliance with all state and federal laws.

(5) A veterinarian shall not substitute VTM for a physical exam when a physical exam is warranted or necessary for an accurate diagnosis of any medical condition or creation of an appropriate treatment plan.

(6) When practicing VTM in Oregon, licensees must conform to all minimum standards of practice and applicable laws. Licensees are fully responsible and accountable for their conduct when using VTM under the Board’s statutes and rules.

(7) Whenever VTM is practiced in Oregon, a veterinarian must:(a) Ensure that any technology used in the provision of VTM is sufficient and of appropriate qualityto provide accuracy of remote assessment and diagnosis.(b) Ensure that medical information obtained via VTM is recorded completely in the patient medical record and meets all applicable requirements of OAR 875-015-0030(1).

(8) A veterinarian may only delegate the provision of VTM to a Certified Veterinary Technician who is acting under direct or indirect supervision and in accordance with OAR 875-030-0040. A valid VCPR established by a physical examination conducted by the veterinarian must exist for the CVT to provide VTM services.

(9) Veterinarians and CVTs providing VTM shall at the time of service provide their contact information to the client or practice using the service. All VTM records shall be provided to the client or practice and are subject to the provisions of 875-011-0010 (12), (13)

California quickly followed suit, amending their definition for the establishment of the VCPR.”

3/18/2020

Social Distancing and Dogs – Blog by J. Scott Weese, DVM, DACVIM, which includes an Owner Contact Guidelines flowchart

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