Risk management for veterinary workplaces: COVID-19

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Monday, 16 March 2020

The following is an addition to the Infection Prevention and Control document sent 10 March.

NB: Many useful resources for veterinary practitioners and clinic staff can be found on the Department of Health (DOH) website: https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov

We have summarised information from these documents below for your quick reference. There are also 2 client information sheets that you can print out or adapt for your practices at the end of this communique. 

1: General workplace advice

  •  a. Good hand hygiene
  •  b. Social distancing
  •  c. Group meetings within the practice
  •  d. Practice policy for unwell staff
  •  e. Cleaning
  •  f. Signage

2: What to do in the event of an unwell client, or client who has broken quarantine in your clinic

3: Pets of COVID-19 positive/at-risk patients 

Client information sheet 1

Client information sheet 2 

 

  1.  General workplace advice

The only current protections for the public available for COVID-19 are based on hygiene practices and avoidance of droplet infection.

SARS-CoV-2 is most likely to spread from person-to-person through:

  • direct close contact with a person while they are infectious
  • close contact with a person with a confirmed infection who coughs or sneezes, or
  • indirect contact through touching objects or surfaces (such as door handles or tables) contaminated from a cough or sneeze from a person with a confirmed infection, and then touching your mouth or face.

Most infections are transmitted by people when they have symptoms. These can include fever, a cough, sore throat, tiredness and shortness of breath. However people can shed virus for 24 hours before symptoms appear. 

The following points are suggested to minimise risk of infection to staff and clients, and reflect our understanding of this disease and virus at the time of developing this handout. 

a: Good hand hygiene  

Recommendations as per the previous Infection Prevention and Control advice located on our website https://www.ava.com.au/coronavirus/

Key points:  

  • Always wash hands if organic material is present, and dry hands with a disposable paper towel.
  • Use alcohol based hand rub (ABHR) (if available) in the absence of organic matter
  • For the SARS-COV-2 virus, soap and water hand washing over a 20 second period is sufficient.  

We are currently aware of difficulties practices are facing in accessing infection control products such as ABHR, paper towel and P2 masks. We are attempting to get current information from wholesalers about stock, as well as investigating other potential sources of supply for practitioners and will provide an update as soon as possible.

There are a number of recipes for ABHR available from various sources on the internet. We would advise caution in going down this route for the following reasons:

  • Individual ingredients are highly flammable
  • Some suggested ingredients (ie chlorine disinfectant) can cause serious eye damage
  • You have no standardised means of validating the efficacy and quality of the product. 

Moving forward, if supply issues continue, we will investigate whether compounding pharmacies are able to assist practitioners in this regard. 

Given the nature of the SARS-COV-2 virus, washing your hands with soap and water is sufficient to minimise transmission.

b: Avoid close contact with other people– DOH is recommending social distancing of 1.5m

We are mindful of the practicalities of doing this within a veterinary practice, especially with fellow staff members when handling animals. However, it is recommended this be adopted whenever possible with members of the public whose health status may be unclear. 

Seats in waiting rooms may need to be rearranged to minimise risk between clients. Visual boundaries such as lines on the floor and signage could be put in place to encourage appropriate distancing from reception desks.  

Utilising support staff for animal handling during consultations may allow owners to distance themselves rather than being in close contact with the veterinarian and clinic staff. Telephone consultations with sick owners waiting outside while staff members handle animals inside should be considered.

Ask clients to limit visits to one person per animal being brought into the clinic. 

Ask clients to ring and pre-order medications or food they require to minimise the amount of time they need to spend in the clinic 

c: Minimise group meetings within the practice

DOH staff have been advised to limit group meetings to less than 10 people and to use other communication structures if possible. We advise adoption of this recommendation in veterinary clinics.

d: Develop a practice policy for unwell staff

As the pandemic develops in Australia there will be greater numbers of community-acquired cases of COVID-19. All practices should develop clear guidelines for staff regarding taking leave and seeking medical advice if they become unwell. 

Practices should consider the development of clinic-specific guidelines around elective surgical caseload and ongoing medical management of patients in the event staff are quarantined - this disease will put a strain on small businesses like veterinary clinics and the usual mechanisms for compensating for staff availability, such as locums, may not work as quarantine protocols get tighter.

Developing a policy will ensure that all staff are aware of the clinic’s agreed actions.

Specific HR advice for veterinary practices has been posted on the AVA website. https://www.ava.com.au/coronavirus/ .

For more information on veterinary-specific WHS and workplace relations considerations during this time, contact the AVA HR Advisory Service on 1300 788 977.

Clinical signs to be noted are fever, a cough, sore throat, tiredness and shortness of breath. A link to a concise video by a local expert about the symptoms of COVID-19 is attached:

https://www.science.org.au/curious/video/covid-19-vs-flu?fbclid=IwAR1QUrEsNDvMSi8VpTV_uGXfmepqH4LMJESdSKONDLf4bCH6uAmpKiCWMDc

General recommendations for employers are contained in this link from the DOH

https://www.health.gov.au/resources/publications/coronavirus-covid-19-information-for-employers

e: General cleaning

When cleaning, staff should minimise the risk of being infected by wearing gloves and using alcohol-based hand sanitiser, or washing and drying hands before and after wearing gloves.

Advice regarding cleaning including appropriate disinfectants is located in this document from the DOH. Whilst some of the information is directed at health care settings, the first three pages contain helpful advice for use in veterinary clinics.

https://www.health.gov.au/resources/publications/environmental-cleaning-and-disinfection-principles-for-covid-19

f: Signage

Have signage at the entrance of your clinic advising clients under quarantine, at risk of COVID-19, who have travelled to high risk countries in the preceding fortnight or who are displaying COVID-19 clinical signs to return to their car and ring the clinic for instructions on how to proceed. 

Veterinary clinics should also use other modalities such as newsletters and social media to communicate their protocols.

Please see the client information sheet available at  https://www.ava.com.au/coronavirus/ and the example provided (with permission) below.

2: What to do in the event of an unwell client, or client who has broken quarantine in your clinic

We have had a report from one member about a member of the public attending their clinic with their pet after breaking quarantine. Unfortunately, this is likely to become a regular occurrence with reports of similar incidents across many sectors. Clients should be asked to leave the premises if they reveal they have broken quarantine or self-isolation.

If a person has attended your clinic after breaking quarantine, with a known COVID-19 infection or is displaying pathognomonic clinical signs you will need to contact the DOH, or your local public health unit, for further advice about the need for self-isolation. Call the COVID-19 Public Health Hotline 24/7 on 1800 020 080.

We suggest you keep a log of all individuals in the clinic present at this time, in case contact tracing is required. This includes staff and clients.

Risk to you and your staff will be reduced if you have the procedures detailed in Section 1 in place.

Cleaning procedures of all in contact areas should be instituted as soon as possible.

If cleaning rooms or areas of the workplace where a person with a confirmed case of COVID-19 or a person in isolation has frequented, staff should wear a mask as an added precaution.

Recommendations for cleaning are on the DOH website. https://www.health.gov.au/resources/publications/environmental-cleaning-and-disinfection-principles-for-covid-19

3: Pets of COVID-19 positive/at-risk patients

We have been advised that the risk to veterinarians from contact with pets from clients infected with COVID-19 is low. Infection usually requires prolonged close contact (>15 minutes) with someone who has a high viral load or from extended casual contact (>2 hours). Animals may have viral fomites on their coat, however the risk of infection is much lower as it will be a low viral load (similar to surfaces). 

We would recommend the following precautions: 

  • When initially handling animals from high risk environments, you must wear gloves, a mask, eye protection and a disposable apron.
  • Remove PPE carefully, taking care not to touch the outside of masks, gowns and gloves. Watch the PPE for equine vets video which illustrates a number of levels of PPE, and practice PPE removal with your staff.  https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf
  • Wash the animal if you are especially concerned, as soap will remove/deactivate the virus. If the animal does not require hospitalisation, or if this will cause undue stress to the animal, or its medical condition is such that it will be inadvisable to do so, we suggest using PPE as described above. The risk of transmission in such cases is thought to be low.
  • Above all, practice and promote good hand hygiene.

Additional Resources (designed for human health care workers) are available here: http://cec.health.nsw.gov.au/keep-patients-safe/infection-prevention-and-control/Coronavirus-COVID-19/standard-and-transmission-based-precautions-including-ppe

Please note that this is an evolving situation. Advice provided here is reflective of the evidence at hand. This document will be updated as required. For the most up-to-date advice on the COVID-19 situation in Australia, visit health.gov.au

 
Client information sheets

See below examples of Client information sheets  which can also be used as the basis for Facebook posts. 

COVID-19 (Coronavirus) info hub

Latest updates and communications from the AVA on the unfolding COVID-19 situation.

Contact the AVA

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