Busy occasions, stress for veterinarians throughout pandemic

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The veterinary information forum of the AVMA House of Delegates dealt with the topic “Veterinary medicine after COVID-19: What have we learned that will guide our future?” The forum practically took place on July 30th during the regular annual meeting of the HOD.

Delegates discussed how busy their practices are now, what concerns they have about keeping themselves and their staff healthy, how to balance work with children who do not attend school in person, and more. Federal agency officials also shared information about SARS-CoV-2 in animals, their efforts to communicate with those on the front lines and prevent drug shortages and the sale of fraudulent products.

Drs.Issac Bott, Delegate of the Society for Theriogenology, and Diana Thomé, Deputy Delegate from Washington State, speak about their experiences during the COVID-19 pandemic at the Veterinary Information Forum of the AVMA House of Delegates, which is practically at the regular annual meeting on Sept. July took place. (Photos by Malinda Larkin)

Not good options

Delegates took plenty of time to express their concerns and suggestions about how to work safely and effectively during a pandemic.

Dr. Diana Thomé, Washington State deputy delegate, said she is looking at strategies for parents to deal with getting back to work while their children are at home. “There is a potential staff shortage that can arise for working families, and especially working mothers, as they have to raise their children this fall,” she said.

Further questions about wellbeing were answered by Dr. Wendy Hauser, delegate for the American Animal Hospital Association. She has brought her own pets to foster and talked to staff.

“From the outside, things are going efficiently, but from their perspective, they are stressed,” said Dr. Houses. “One is a lack of efficiency, the extra time it takes. I understand the floodgates are now open, but we cannot ask people to work consistently during these longer days to make up for a lack of efficiency. “

“The other pain point is the customers’ lack of patience. What communication tools could be improved for our veterinary clinics to help them deal with unhappy customers instead of firing them with a jerk? “

Dr. William Grant, a California delegate, said his clinic performs an average of 70 to 100 transactions per day. There were also two exposures to COVID-19 among employees. The infections came from family members or others outside of the hospital.

“I think our focus, which was on keeping employees safe from the public, actually protected employees from one another. It worked out fine, ”he said. “We have quite a bit of stress with the number of cases we see, but when we really focus on taking care of our co-workers, it really protects them not only from people coming in, but also from the people at home, which was the case with the two we saw. We were lucky. “

Another practitioner was not so lucky. Dr. Issac Bott, a delegate for the Society for Theriogenology, has a mixed animal practice in Springville, Utah. Despite his team diligently wearing masks and following guidelines, he and two other employees signed COVID-19 in late June, forcing him to close his practice for two weeks. He also applied for and received a loan for the paycheck protection program.

“Without that my clinic, which has been running since 1966, would have failed,” said Dr. Bott. “I wanted to thank AVMA for their work on COVID.”

Dr. Kate Boatright, Associate Delegate in Pennsylvania, works with many veterinary students and graduates. She believes it will be important for practitioners to mentor the youngest graduates over the next few years as the pandemic has had a huge impact on their education.

“We’ll fill in gaps in the road,” she said. “We have to be patient. This will have an impact on their training over the next few years. “

Dr. Cheryl Greenacre, Association of Avian Veterinarians delegate, is a faculty member at the University of Tennessee College of Veterinary Medicine.

“We need to make sure we are teaching fourth year students, getting practical instruction, and getting them to the clinic,” said Dr. Greenacre. However, she said, “You need to put yourself in my shoes and other faculties, technicians, and staff who work at a university. We have no choice; We have to go inside. We are considered important workers that students and patients see.

“We have a faculty that is sick with COVID-19. How bad do you let it get and where do you draw the line? Nobody had a good answer to that. Myself and others, we are at moderate risk and my husband is at serious risk. I don’t have a choice, I have to go to work. “

Dr. Greenacre suggested that AVMA create an advocacy group for the veterinary faculty to give this group a collective voice.

COVID-19 virus in animals

Drs. Casey Barton Behravesh, director of the One Health Office of the National Center for Emerging and Zoonotic Infectious Diseases of the Centers for Disease Control and Prevention, and Jane Rooney, assistant director of the Department of Agriculture’s One Health Coordination Center for Animal and Phytosanitary Inspection The veterinary services of the service gave the presentation “Mobilizing a One-Health Approach to Understanding the Role of Animals in COVID-19”.

“Since the emergence of SARS-CoV-2, a lot of emphasis has been placed on the one-health aspects of the pandemic,” said Dr. Barton Behravesh. “This is important to address the pandemic as well as future health threats. We have coordinated, collaborated and communicated with all relevant sectors, including CDC, USDA, government partners and the Department of the Interior. “

She also noted that published and preprinted research on experimental or natural infections with the COVID-19 virus in animals has found that cats, ferrets and mink, golden hamsters, non-human primates and shrews are very susceptible to SARS-CoV-2 infections . Dogs and Egyptian fruit bats are moderately susceptible. Mice, poultry and pigs are not susceptible.

By August 5, 27 cats, 18 dogs, four tigers, three lions and 31 affected mink farms worldwide were positive for SARS-CoV-2. Most of the mink farms were in the Netherlands. A total of 1 million mink were depopulated.

Drug shortage prevention, fraud

Dr. Steven Solomon, director of the Food and Drug Administration Center for Veterinary Medicine, said drug shortages, fraudulent products and veterinary telemedicine were the focus of the center during the pandemic.

“As COVID-19 started affecting facilities, we proactively contacted manufacturers of veterinary drugs and put in place a mechanism for them to forecast and report so they could keep veterinary drugs available,” said Dr. Solomon. “We’ve worked together to alleviate several drug shortages.”

Examples of active pharmaceutical ingredients and finished products that were either at risk of deficiency or that were in fact scarce were sedatives and anesthetic products, nonsteroidal anti-inflammatory drugs, heart medications, and antimicrobial agents under the FDA-CVM. Some of the main causes of production slowdowns have been a lack of personal protective equipment for manufacturing, sudden closures due to COVID-19-related issues, decisions by foreign governments to stop exporting certain active pharmaceutical ingredients, and a decline in air travel leading to shipping products by sea led to delays in shipping, the agency announced.

The pandemic also presents a tremendous opportunity to capitalize on fears by selling products that have false claims, said Dr. Solomon.

“We monitor for damage and dangerous products. When hydroxychloroquine appeared, we warned against it. We did the same for ivermectin and worked with online marketplaces to remove (these drugs) from websites, ”he said. “Fraudulent products for COVID-19 were abundant, such as claims that CBD could cure COVID-19.”

On July 21, the FDA issued additional warning letters to CVM Fishman Chemical of North Carolina and New Life International regarding the marketing of unapproved chloroquine products labeled for use in ornamental fish. A spokesman for the agency said that although none of the products mentioned in these warning letters made any claims of use in humans, the agency fears that consumers could confuse unapproved veterinary medicines containing chloroquine phosphate with the human medicine chloroquine phosphate.

Finally, Dr. Solomon that the FDA-CVM realized that many veterinarians could not see patients in person while the states stay home and even after the reopening.

“Through guidance, we have temporarily relaxed some of the personal visit requirements for the vet, client, and patient relationship,” he said. “This will allow veterinarians to expand the use of telemedicine instead of doing a personal check-up before prescribing extra-label drugs and veterinary drug guidelines.”