Booster clinic - mid lockdown.

RE: Booster clinic - mid lockdown.

Clive Ansell — Thu, 11 Feb 2021 14:52:47 GMT

[quote userid="2185" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228432#228432"]Saturday I had a dog booked in for "health check" because the "owner likes to get him checked twice a year" - why? There's no way that should have been booked. [/quote]

I've had an endless stream of this bilge during both lockdown 2 and lockdown 3. We try and filter them out at reception, but some get through.

last week - dog for a kennel cough vaccine "in case we go away this year and in case he needs it"

Booster vaccines 2 months early "in case we can't get an appointment when its due"

Dog that gets bad ears "His ears are ok at the moment but just want them checked in case they are bad later on"

Checking already short nails to see if they need clipping yet (done within the last month)

Then we have a local Medivet practice still doing routine 3 monthly flea and worm checks on perfectly healthy animals to service their tin-pot health club scheme.

RE: Booster clinic - mid lockdown.

Gillian Mostyn — Wed, 10 Feb 2021 22:09:29 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228468#228468"]We leave the owners outside, but you can keep them out of the consult, so the risk is really to them not you.[/quote]

Yes. That was always the point. The advice to drop to urgent cases only was never about the risk to ourselves, it was about minimising the risk of spread in the greater community by encouraging people to stay at home.

RE: Booster clinic - mid lockdown.

Michael Woodhouse — Wed, 10 Feb 2021 01:07:51 GMT

I did a 'healthcheck' about 2 weeks ago in an older, but perfectly well dog. Found a (presumed) substantial anal gland tumour. Put the dog to sleep this afternoon. Very easy to scoff at the routine things - but I've lost count of the spectacular things owners have missed over the years that we have picked up with a thorough (but relatively brief) examination for a booster or another problem.

There is already talk in the NHS about people getting very sick due to other medical issues they are putting off due to COVID, whether delayed by their own actions or the system. We will get into that place with the animals under our care if we're not careful. To my mind it's further evidence of the danger of remote working and there is nothing even close to the laying on of hands on the patient.

We leave the owners outside, but you can keep them out of the consult, so the risk is really to them not you.

RE: Booster clinic - mid lockdown.

Bob Russell — Tue, 09 Feb 2021 11:38:13 GMT

I was planning to keep things going pretty much as we had been doing for months. As the information about the ease of infection we decided to split into two very small teams. All really odd!

This infection is really serious and not to be taken lightly nor as a way of poaching clients. We are still taking on new people to the area but encouraging rather than requiring clients to stay put with their existing practices at least for the next month or so! One lady went off on one when we told her, so much that I contacted the other practice. They sounded upset that she was still with them!!!

RE: Booster clinic - mid lockdown.

Utlendigur — Mon, 08 Feb 2021 15:00:15 GMT

Saturday I had a dog booked in for "health check" because the "owner likes to get him checked twice a year" - why? There's no way that should have been booked.

The practice has also been asking people (website, facebook, when they phone for appointment, when (more usually if) they phone on arrival, and large notices around reception) to only have one person per pet. Approx 70-80% ignore this. It seems some couples cannot bear to be apart for even 15minutes, and many see the vets as a nice trip out for the whole family so they bring kids too making receptions quite crowded at times. It's in a store so there's limited ability to control the door (although more people seem to respect their "shop alone" policy than the practice's) but it's crazy when there's a more infectious variant, high case numbers yet the precautions, apart from masks, seem less than the first lockdown

RE: Booster clinic - mid lockdown.

Julie Innes — Mon, 08 Feb 2021 14:01:11 GMT

During the first lockdown, we took the advice to postpone all vaccines. Now we are running 3 mths behind with a huge backlog, so we decided to keep doing some vaccines each day, in the hope that we can eventually catch up. Couple of cases of parvo near us now, I can just see the outcry if someone's dog died of parvo because we'd refused to vaccinate...

We are doing our best to continue working and providing a service but with minimal risk to staff and clients, so still no clients coming in, only booking same day appointments (apart from the few slots that are reserved for vaccines) so that urgent things can definitely be seen and so that any staff shortages etc can be taken into account. Still doing telephone consults in the first instance and then vet decides if needs to be seen (Most things we end up seeing, as that is what owners want, and they become more and more dramatic to ensure they get it!) but means at least we have history before we see them. We are using mobile phones to make outgoing calls, to try to keep phonelines free. We are lucky to have a handy vestibule area, so we have a secure drop off for pets and medications (no car park consulting for us, thankfully- think we would have frozen to death! All change into scrubs on arrival, masks worn by everyone. We did try full PPE, but found it virtually impossible, so just try to stay masked and away from each other as far as possible!

Still neutering cats and bitches, castrating some male dogs (eg retained testicles, bitch in family). Doing dentals / lumps/ xrays/ bloods. I do feel that these are things that would affect animal welfare ultimately, and demand is huge- people are so bored at the moment. I have lost count of the number of photos of dogs Arseholes I have been sent in the last few months.......We've closed our books just now, and I'm trying to keep the workload manageable so as not to burn out staff. It's hard to know if we're getting it right, with pretty wishy washy guidelines, we can only do what we think is best.

RE: Booster clinic - mid lockdown.

Clive Ansell — Tue, 02 Feb 2021 12:00:39 GMT

Even pre covid, vaccinations were often delayed or late, because people either choose too or just forget. We even have things like vaccination amnesties to encourage folk to get it done.

Many practices happily extend vaccine intervals to 15 or even 18 months, and don't see any cases of Parvo or Lepto as a result.

Just weighing up the real risks involved of delaying 2 to 3 months during a national lockdown.

RE: Booster clinic - mid lockdown.

Michael Woodhouse — Tue, 02 Feb 2021 10:53:23 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228277#228277"]Why? there is 3 months grace anyway according to data sheets.[/quote]

We use Eurican:

Revaccination: Administer one dose 12 months after completion of the primary vaccination course. Dogs should be revaccinated with a single booster dose on an annual basis.

Pretty clear to me.

Supermarkets open and selling all sorts of non essentials.

(I agree I'd be happy going up to 3 months over on a case by case basis, but not on everything, just end up with such a backlog and at our busiest time of the year. No thanks).

RE: Booster clinic - mid lockdown.

Nick Jackson — Tue, 02 Feb 2021 09:20:32 GMT

The ''3 months rule'' seems to have been a best guess from the profession rather than a datasheet or EBVM decision. Certainly isnt in MSDs literature. A recent document from them however has expressed that 'Key Opinion' varies depending on whose guidance you read, and in some circumstances restarting a lepto course in an adult would require a single dose rather than these strict 4 week protocols many seem to be commiting to. However - ' MSD cannot guarantee'

In fact having read the ISCAID (european) and AAHA guidelines both state a lack of evidence of efficacy over 12 months since leptospirosis vaccine.

RE: Booster clinic - mid lockdown.

Clive Ansell — Tue, 02 Feb 2021 08:16:08 GMT

[quote userid="18566" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228265#228265"]When I explained the reason for the delay because of the pandemic they shouted " I don't care what your reasons are!! " And slammed down the phone.[/quote]

Are these the sort of clients you want anyway? some a***hole that shouts at you and slams the phone down. Life is surely better and less stressful without them.

Anyway, we are supposed to be in lockdown - or so I thought

RE: Booster clinic - mid lockdown.

Clive Ansell — Tue, 02 Feb 2021 08:12:22 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228270#228270"]If my dog's booster was due now, there is no way on earth I'd leave it until April.[/quote]

Why? there is 3 months grace anyway according to data sheets.

I need to get my car and central heating serviced, and hire some large garden machinery, but it, like the pooches booster, can wait until after lockdown.

RE: Booster clinic - mid lockdown.

Michael Woodhouse — Mon, 01 Feb 2021 20:44:37 GMT

If my dog's booster was due now, there is no way on earth I'd leave it until April. I don't think you can really blame clients for looking elsewhere.

Whilst I respect anyone in the profession decisions over what work to do, you can't really be surprised by this. I can go into a supermarket and there is no boss deciding what shopping is essential or not. The other businesses are open as normal. We should have figured out how to do this safely by now. For once, I agree with the corporates.

RE: Booster clinic - mid lockdown.

Sonia Wilson — Mon, 01 Feb 2021 18:39:38 GMT

We have had several clients go elsewhere to get boosters sooner rather than delay them within the window due to COVID and lockdown. Today one couple rang to cancel their delayed booster in April because "they had been fitted elsewhere sooner". When I explained the reason for the delay because of the pandemic they shouted " I don't care what your reasons are!! " And slammed down the phone. This is pretty typical of some of the attitude currently, they want non stop service as usual

RE: Booster clinic - mid lockdown.

Joyce Whitehead — Sat, 30 Jan 2021 21:35:03 GMT

We are just about catching up with vaccinations from the last lock down, and are now doing those that phone up. We are working in teams, so clients may have to wait a couple of weeks for an appointment (we have blocked off certain appointments to be boosters or more urgent consults). We are still significantly quieter than usual, although it feels busy as we are low in staff compared to usual times.

RE: Booster clinic - mid lockdown.

bevs2251 — Fri, 29 Jan 2021 01:16:03 GMT

Agree. Americans don’t understand prepositions. They either don’t use one when they should, as you say EBH, or they use two when only one is required : “get off of me” for example. No need for “of” people !! This is now also becoming a thing in Oz, even newsreaders are saying it. Drives me nuts

RE: Booster clinic - mid lockdown.

Evelyn Barbour-Hill — Thu, 28 Jan 2021 18:19:28 GMT

What annoys me most is this frequent use of "stay home". We are not in America. In English English the phrase is "stay at home".

RE: Booster clinic - mid lockdown.

Jill Butterworth — Thu, 28 Jan 2021 16:51:57 GMT

[quote userid="2457" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228169#228169"]I'm also now pretty convinced that most transmission is happening in family and friend groups. I know lots of folk who have caught it - and all of them know exactly who they got it from. The risks posed to staff from clients should be tiny. [/quote]

Anecdotally I would concur and it makes sense if the R is about 1. Our knowledge of surgical sterility, PPE and barrier nursing should make us pretty safe. I am friends with a vet couple in a multigenerational household: they've successfully isolated their university infected teenage son from granny and the rest of the household. However, I have another employer friend currently with three vets infected by Covid because they wouldn't stop having cups of tea together.

Compliance is the issue. Anyone remember the Norovirus study where people didn't bother to gel on the way in, and only a few squirted on the way out, despite the reservoir being in the community?

I'm also suspicious that the infective dose is important as a couple of distant family members with diabetes and cancer respectively caught it, they think from their grandchildren, despite being 'careful' (who knows what that means as they are non medics) and recovered without hospitalisation.

RE: Booster clinic - mid lockdown.

Gillian Mostyn — Thu, 28 Jan 2021 10:32:01 GMT

I agree Anthony - and I think things really are very different this time.

Last year we were told it was just for a few weeks, there was no routine use of PPE, no acceptance of clients being kept at a distance, and little knowledge of the characteristics of the virus we were actually dealing with. We were just asked to stay home.

This time we are asked to stay home except where it is necessary to leave home for work. We should all now be working in covid secure environments and in a socially distanced manner. We have the 'power' to enforce the behaviour we want in our clients.

The practice I mainly locum for at the moment has obeyed all the rules, the staff have been very grateful for the care taken over their welfare, and everything has been put in place to keep them as safe as possible. All appointments were done remotely in the first lockdown, with people only being told to come down if the vet then found it necessary. No routine ops were done. As we are in the North West of England, we have been under severe restrictions, and coping with staff absences, almost continuously since last March. To try to get the workload manageable, they stopped registering new clients weeks ago, but we still have literally hundreds of routine ops on the waiting list, and a backlog of vaccines, and every appointment is full every day with people sometimes being told to see if they can be seen elsewhere.

In theory, closing the practice to all but essential work would be great. But as this is going to be ongoing for months, I can absolutely see that it isn't feasible or desirable. Staff welfare has to be considered - and how the hell they could ever be expected to catch up is a big question.

I'm also now pretty convinced that most transmission is happening in family and friend groups. I know lots of folk who have caught it - and all of them know exactly who they got it from. The risks posed to staff from clients should be tiny.

Added to this, I've just received an appointment for a routine check up at the dentist.

I do think the RCVS got it wrong this time with their advice to only do urgent work, leading to unnecessary conflict between practices when we should all be pulling together. In the last lockdown, dentists, opticians and other healthcare providers deemed non-essential also closed completely. That is no longer the case. I think that the veterinary profession can be deemed as providing an essential service, and we are certainly ensuring welfare, so should be trusted to use our individual judgement to look at our own practice situation and continue to provide a service if it is possible.

RE: Booster clinic - mid lockdown.

Dinu Catilina — Wed, 27 Jan 2021 22:48:00 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228156#228156"] One has to ask why are they working and is it necessary to make premium brand cars, Range Rovers, during a national so called lockdown ?[/quote]

Because those people have mortgages to pay and children to feed. The country doesn't need the cars but they do need their salaries. And if the company shuts down, it might not open again or if it does it might open somewhere with cheaper workforce and less restrictions.

People who work are not evil or bad and like Anthony said, almost no one is business as usual. We have PPE at all times and no clients entered the building since March. I could furlough everyone, reduce to emergency only, stay myself and maybe another vet and I would make the same profit but my staff would loose money and their mental health will suffer. And trust me, I had enough of long conversations in the car park with the client in the car and me outside soaked in pouring rain.

RE: Booster clinic - mid lockdown.

Iain Richards — Wed, 27 Jan 2021 22:18:52 GMT

Thanks. I appreciate the answer, I struggled to phrase the question without sounding pious!

RE: Booster clinic - mid lockdown.

Anthony Dennison — Wed, 27 Jan 2021 22:07:22 GMT

[quote userid="4367" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228139#228139"]Anthony, can I respectfully ask how working as normal is justified in the present circumstances and why the work can't be deferered until a later point when risks to the staff are lower?[/quote]

Because I work in a busy 24 hour hospital where we do our own out of hours, are contracted to do OOH work for another 2 practices and there are also a couple of practices who we're not contracted to do OOH work for (supposed to go to Vetsnow) but they send us everything anyway.

We're all wearing full PPE at all times, we have to have lunch in our cars alone so we can take the PPE off to eat. We social distance where possible, we have a maximum of 4 clients in the building at a time and the clients socially distance themselves from us, with a hanging screen between vet and client.

When I say 'working as normal' I mean we're still seeing most routine things to a degree. It's still not 'normal'.

We have had a few staff members contract COVID to varying degrees of severity, but it has been an external source and due to PPE there has been little to none in-practice transfer.

I'm with David and Dinu on this one - we can't just stop and wait for it all to get better. We need to adapt and be able to work as close to normal as possible to be able to develop and progress.

With all this in mind, currently we are one of the better performing IVC practices in the country which means our jobs are definitely safe and we're still all getting an annual pay rise, where some others aren't.

RE: Booster clinic - mid lockdown.

Clive Ansell — Wed, 27 Jan 2021 19:41:10 GMT

[quote userid="6550" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228150#228150"]This is a proper lockdown despite the increased number of businesses 'open'.[/quote]

That was my point really, is it?

It seems a half-baked, half-arsed, arrangement where some folk adhere too it and others don't; some businesses open as normal and others don't, and many don't seem to have a clue what they can or cannot, or should or should not do.

Where I live many non-essential businesses seem to be trading as normal; today out cycling I saw a cycle shop, bathroom shop, glass blowing and silversmith studio, delicatessen, B&Q, Curry'sPCworld, all open and the list is endless. As I said earlier, I actually witnessed a couple proudly leaving a garden centre with their newly purchased garden gnome - unbelievable!

Many small business owners who I know are getting really hacked off with all this; their businesses are losing £1000's because they cannot trade, and they can see the likes of B&Q, large stores, and garden centres opening and trading as normal raising two fingers to the rules really. I know 2, a photographer and a hairdresser, who say they probably will have to cease trading.

There is even confusion and disagreement within our own profession. Some are trading as normal, others are not. Some think doing routine boosters, nails and flea checks is OK, others don't. A RVN friend working for Medivet has told me her practice is still doing 3 monthly free of charge flea checks for clients on their care plans.

I know the knock on effects of a lockdown are massive socially and economically, but I think government really need to decide whether we are in lockdown or not; if so do it and do it properly, or not bother at all.

Local car maker, JLR, are still making cars as normal. Staff are working as normal, and are told and "encouraged" to turn off covid tracing apps, not to isolate or take time off, and really keep quite and carry on. They have had something like 400 diagnosed covid cases now, including some deaths. One has to ask why are they working and is it necessary to make premium brand cars, Range Rovers, during a national so called lockdown ?

RE: Booster clinic - mid lockdown.

Bob Russell — Wed, 27 Jan 2021 14:13:44 GMT

We are checking and vaccinating puppies as normal. First year boosters as normal. Others are waiting for now. Any that get close to being 3 months late will be seen. Science suggests this is perfectly safe to do. kittens can stay at home. Cat neutering continues and dogs it is on a case by case basis.

We have split into two teams, working different days. This will allow the practice to keep going should one team have a positive test. This means we cannot really do all the same work we were doing as a single team.

We need the practice to survive and we need to keep staff fit and well. Not great for business but is what is right.

This is a proper lockdown despite the increased number of businesses 'open'. None of this should have a detrimental effect on animal welfare nor disease control.

I admit to getting pretty piss+d off with the whole thing now. Tired and fed up. Had a go at the bank this morning so feel a bit better!

RE: Booster clinic - mid lockdown.

bob lehner — Wed, 27 Jan 2021 13:27:31 GMT

[quote userid="4367" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228148#228148"]

Dinu Catilina said:

or the past 20-30 years, we, as a profession, continuously reiterated to the public that annual vaccinations are not just a jab, they come with a check where we can pick up on things that might have been ignored otherwise.

[/quote]

Yes - I remember a good many years ago when the 'annual booster jab' was changed to the 'annual health check' . To be perfectly honest it was just a way of justifying the rather high charges vets made for the former item, which at that time was receiving adverse publicity in some quarters ('Vets charge £20 for a vaccine that costs them one £ etc.)......

RE: Booster clinic - mid lockdown.

Iain Richards — Wed, 27 Jan 2021 11:20:11 GMT

[quote userid="9239" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/29632/booster-clinic---mid-lockdown/228143#228143"]or the past 20-30 years, we, as a profession, continuously reiterated to the public that annual vaccinations are not just a jab, they come with a check where we can pick up on things that might have been ignored otherwise. [/quote]

Indeed and we will have to call on all our skills to perform these assessments rapidly, so back to 10 minute appointments!