COVID 19 - Stop doing routine work.

RE: COVID 19 - Stop doing routine work.

Richard Carter — Tue, 24 Mar 2020 17:57:30 GMT

we already seeing myxomatosis so probably would view rabbit vaccines as essential - the last two rabbits seen this week are in the freezer

RE: COVID 19 - Stop doing routine work.

KMurphy — Tue, 24 Mar 2020 16:39:18 GMT

We're not posting either. Down to minimal staff and I definitely don't want them in the post office!

RE: COVID 19 - Stop doing routine work.

Julie Innes — Tue, 24 Mar 2020 15:50:26 GMT

[quote userid="5012" url="~/001/nonclinical/veterinary-practice-management/f/occupational-health/28967/covid-19---stop-doing-routine-work/220739"]Folk have been told not to leave home unless necessary, so surely these could be ordered and paid for over the telephone[/quote]

I have thought of that, but it would almost be a full time job posting them out to people! Also having to send staff to the Post Office to get things weighed not ideal (and a few post-offices here are closed too). Last time I was in the Post Office people were jammed in like sardines....

RE: COVID 19 - Stop doing routine work.

Clive Ansell — Tue, 24 Mar 2020 15:27:40 GMT

[quote userid="7811" url="~/001/nonclinical/veterinary-practice-management/f/occupational-health/28967/covid-19---stop-doing-routine-work/220737"]ed up getting abuse from clients who are breaking down the doors for worming tablets and flea treatment[/quote]

Folk have been told not to leave home unless necessary, so surely these could be ordered and paid for over the telephone, then posted via Royal Mail. Hardly an emergency situation though.

RE: COVID 19 - Stop doing routine work.

Julie Innes — Tue, 24 Mar 2020 15:02:07 GMT

We moved to doors closed, emergencies only from yesterday. Completely fed up getting abuse from clients who are breaking down the doors for worming tablets and flea treatment. It's a joke. Some woman arguing with me this morning that her rabbits (not quite due) vaccination WAS an emergency. Skeleton staff, bored out of our trees

RE: COVID 19 - Stop doing routine work.

Clive Ansell — Tue, 24 Mar 2020 13:28:11 GMT

[quote userid="2457" url="~/001/nonclinical/veterinary-practice-management/f/occupational-health/28967/covid-19---stop-doing-routine-work/220725"]It just requires us to use our common sense to keep people from leaving home unless absolutely essential[/quote]

Easier said than done.

Friday was the last day that I worked, and I was fully booked, snowed under, with nonsense all day: boosters, nails, flea and worm checks, and a dog with a fatty lump since last July! of about 30 appointments, only 2 really needed to be seen. Absolute wuck-fit idiots all day. No common sense whatsoever I'm afraid.

My dentist has locked down until 15th June at least, no routine work at all. Telephone triage for emergencies only, and they will see patients only if absolutely needed.

RE: COVID 19 - Stop doing routine work.

Gillian Mostyn — Tue, 24 Mar 2020 12:56:21 GMT

I don't think vets could or should ever shut completely. GPs and hospitals have to continue to do urgent work. Supermarkets have to be open. Post offices need to send mail. It just requires us to use our common sense to keep people from leaving home unless absolutely essential.

RE: COVID 19 - Stop doing routine work.

Andrew Henfrey — Tue, 24 Mar 2020 12:00:03 GMT

I cancelled just about everything last night after Boris's announcement, and then had to re-text to say the urgents and emergencies could still come in after the clarification. Hasty notices from Government in the evening don't help. Have had to field many messages this morning about closure.

RE: COVID 19 - Stop doing routine work.

Bob Russell — Mon, 23 Mar 2020 23:54:42 GMT

I have been off today so am going on what I was told earlier. I very much doubt routine stuff will happen.

RE: COVID 19 - Stop doing routine work.

Gillian Mostyn — Mon, 23 Mar 2020 22:01:16 GMT

The RCVS have finally released a statement. No more routine work.

https://www.rcvs.org.uk/setting-standards/advice-and-guidance/coronavirus-covid-19/

RE: COVID 19 - Stop doing routine work.

Andrew Henfrey — Mon, 23 Mar 2020 21:54:52 GMT

Bob. I think you need to be cancelling all except absolute emergencies from tonight. Message people to say you will contact by email tomorrow andd then Skype, Video Messenger, Facetime. RCVS already looking to relax code on prescribing.We can go to work. Clients should not be travelling to us unless emergencies.

RE: COVID 19 - Stop doing routine work.

Bob Russell — Mon, 23 Mar 2020 21:41:52 GMT

For every younger person being hospitalised, presumably likely to survive, an elderly person will not be able to get intensive care. For every selfish b'stard people are likely to die.

We were cancelling appointments on Friday, spreading them out to allow cleaning between clients. Today, door locked and opened specifically for arranged visitors.

Still have one or two routine consults in the morning but it stops there.

Emergencies only!

Does anyone really believe these measures have been introduced for a 'bit of flu'?

RE: COVID 19 - Stop doing routine work.

Michael Woodhouse — Mon, 23 Mar 2020 21:38:40 GMT

I wish! Not stopped all day, and not a scrap of routine work. 2 bitch caesers and I had to push a lame horse from today to tomorrow.

RE: COVID 19 - Stop doing routine work.

Gillian Mostyn — Mon, 23 Mar 2020 21:24:14 GMT

[quote userid="9440" url="~/001/nonclinical/veterinary-practice-management/f/occupational-health/28967/covid-19---stop-doing-routine-work/220697"]I presume we are still ok to continue emergency work! [/quote]

I should hope so.

RCVS ...?????.....

RE: COVID 19 - Stop doing routine work.

janine redman — Mon, 23 Mar 2020 21:13:04 GMT

I presume we are still ok to continue emergency work!

RE: COVID 19 - Stop doing routine work.

Utlendigur — Mon, 23 Mar 2020 21:10:22 GMT

This is quite a good illustration of why it's needed - maybe stick it or one of the others like it on practice websites

https://twitter.com/ProfWoodward/status/1241663295028854784

RE: COVID 19 - Stop doing routine work.

Gillian Mostyn — Mon, 23 Mar 2020 20:58:14 GMT

I wish . I genuinely would prefer to stay home. I fortunately don't need the income. But someone has to do the urgent work, and it is neither fair nor epidemiologically sound to send clients from a large area to just a few OOH centres. I just hope clients understand our refusal to do anything other than what is essential.

RE: COVID 19 - Stop doing routine work.

Arlo Guthrie — Mon, 23 Mar 2020 20:50:38 GMT

Yup, we’re all on three weeks gardening leave now.

RE: COVID 19 - Stop doing routine work.

Catherine Churchill — Mon, 23 Mar 2020 20:46:42 GMT

That's us in full lock down. Emergency work only. No more emergency vaccination now

RE: COVID 19 - Stop doing routine work.

Gillian Mostyn — Mon, 23 Mar 2020 20:45:21 GMT

Considering the amount of people (morons) who 'popped in' today (or tried to....I kept the doors locked and nobody was allowed in) it was inevitable we would get to this point. I'm glad ... it is only fair to our healthcare workers.

I'm assuming most practices are staying 'open' for urgent work? (My dentist has also emailed to say they're shut to everything other than urgent or emergency work).

RE: COVID 19 - Stop doing routine work.

Clive Ansell — Mon, 23 Mar 2020 18:58:14 GMT

[quote userid="10813" url="~/001/nonclinical/veterinary-practice-management/f/occupational-health/28967/covid-19---stop-doing-routine-work/220682"]We have seen two cases of leptospirosis this year where the booster had lapsed by a few months. How long do you think it’s ok to postpone boosters for (genuine question)[/quote]

The last case of leptospirosis that I was involved with had been vaccinated within 12 months. but n= only 1

I see endless cases where vaccinations have lapsed, or not been given for years, yet there isn't a constant stream of parvo and lepto cases coming through the door daily.

I wonder if there is any reliable evidence or data that shows delaying booster vaccinations by 1, 3,or 6 months months is detrimental in any way, and how much higher the chance of becoming infected is?

My dentist has just announced they are closing until at least the 15th June.

RE: COVID 19 - Stop doing routine work.

easy307 — Mon, 23 Mar 2020 18:38:22 GMT

Latest Advice from MSD from today :-

(Sorry, not the best format for easy reading, but covers the issues discussed)

MSD Advice to Nobivac customers:

Pet vaccination during the current COVID-19 pandemic Technical document developed in response to a volume of requests from customers

1. Risk assessment considerations

Many of the risks of infectious disease are highest where animals freely mix and we would expect reduced contact with other individuals will reduce the risk of disease to an extent. However, despite a possible lockdown, the risks of some diseases in unvaccinated pets could remain significant whether or not direct contact with other animals occur because some infectious diseases are acquired through environmental contact Pets that have never received a primary vaccination and in higher risk groups are most likely to be at risk, but there are a number of mitigation measures that might also be considered as below:

a) Boosting a pet early than 12 months might be possible where it is considered there may still be time to do so before further movement restrictions are imposed

b) Measures related to distancing from other pets or higher-risk environments may help mitigate certain pet disease risks and especially those that are spread by close contact In assessing the pets needs and developing a balanced approach it is important to consider the current status of the various pet diseases we vaccinate against, the likely risks to which the individual pet is likely to be exposed, the duration of immunity expectations from the vaccines administered as well as possible mitigation measures which could reduce the risk of disease exposure. The decision as to when or whether to boost a pet when facing a potential “lockdown” situation is therefore a finely balanced risk assessment that must be taken in consultation between the attending vet and pet owner taking all risks within the context of current official UK government and local medical advice.

2. Duration of immunity and lapsed vaccine courses

New BVA advice(5) is that a delay to booster vaccinations to minimise contact with clients should be considered as part of a package of measures to minimise the risk of transmission of coronavirus. MSD are unable to guarantee vaccine coverage for companion animal vaccines beyond the minimum duration of immunity, but in the case of a number of the diseases evidence(1-4) suggests many animals will derive some durable benefit beyond this timing, whilst for others such as leptospirosis or kennel cough immunity may decline more quickly. (Please See professional guidelines and further references below). Key opinion (1-4) suggests a different approach for restarting boosters in lapsed animals depending on which guidance one reads.

Viral dog vaccines (DHP, DHPPi) and rabbit vaccination requires a single dose of vaccine to restart the course in an animal that has lapsed. For inactivated Leptospirosis vaccines in dogs (Nobivac Lepto2 and L4) there seems to be some consensus (1,3) at least for animals up to 6 months overdue -where two vaccine doses would normally be needed for priming immunity a single dose of vaccine could be considered for a restart.

Professional guideline advice for cats differs - WSAVA guidance (4) proposes that a single dose is sufficient to boost core vaccine (e.g. Tricat Trio) immunity in a cat that has lapsed whatever the interval, however ABCD guidance (1) advises if a cat has lapsed more than three years then a two dose course of vaccine may be preferable to optimise immunity. This advice is based on immunological principles rather than definitive studies and so there is a discrepancy in the advice offers. In the absence of consensus and definitive studies, for lapsed cat vaccines single dose boosters up to 3-6 months overdue is a pragmatic approach which falls inside all the above guidance. This approach is widely used in practice as a potential cut-off beyond which two doses are given. On a similar basis, in the case of an incomplete primary course where two doses are required a restart rather than a single dose would be recommended by key opinion guidance if the intervaccine interval exceeds 6 weeks. None of these approaches listed above should be taken to indicate ideal booster intervals or longer than indicated duration of immunity than stated on-label but these do at least provide a framework to aid a veterinary risk assessment for individual patients presented late for revaccination.

3. Appropriate decision making around kennel cough vaccination

All vaccination decisions for non-core vaccines are made based on a risk-benefit analysis The risk of a dog contracting CIRD may be lessened in the current climate if the owner of the dog is in selfisolation and not being socialised around other dogs, in which case vaccination against CIRD might reasonably be delayed until such time that the risk level changes. At the same time where there is a high risk of respiratory disease related to CIRD in a population of dogs, it is likely that vaccination will reduce the risk of disease and its circulation and would generally be a useful preventative health measure Whilst there is the precautionary statement on the product’s SPC and Datasheet regarding avoiding the use of the product in households with immune compromised individuals, what is regarded as a population who are at increased risk from a COVID-19 point of view (eg. Adults over 70, people with asthma, hypertension, heart disease etc) does not correspond to the rare population of typically severely immune compromised people that have been identified with field strain Bronchiseptica bronchiseptica - typically such individuals identified with Bordetella have profound immune deficiency, and there is no evidence that owning a pet or indeed previous vaccination history of the pet has any bearing on this. Bordetella bronchiseptica is a ubiquitous organism found in a range of species and the label warning is a precautionary statement. Given the benefits of vaccination against Bordetella bronchiseptica in an at-risk population, and an absence of any evidence of a causal association between intranasal Bordetella vaccination it is not appropriate to have a blanket policy on this matter. The veterinary duty of care is to make a risk assessment taking all the above factors into account including the full context of current government and local medical advice. Other than in a situation where there is clear immune compromise in the household or the act of vaccination in a locked down household will compromise essential biosecurity for COVID-19, the usual considerations determining the need for kennel cough cover should apply. Summary Ultimately all vaccine decisions are a careful balance between risks and benefits, with certain pathogens likely to be picked up from mixing with other animals and others that could present a risk from the environment. All such decisions will necessarily be contingent on a reasonable current assessment of Government advice on the current pandemic, so that veterinary staff and public are not put at unnecessary risk.

For further support on any of the above questions please contact our Technical Product Support Team on 01908685685 Option 1 should further advice be needed.

Further reading 1. AAHA Vaccination Guidelines 2017 (www.aaha.org/.../) 2. ABCD Matrix Vaccine Guidance 2017 (www.abcdcatsvets.org/.../) 3. ISCAID European Consensus Statement on Leptospirosis in Cats and Dogs: Journal of Small Animal Practice (2015) 56, 159–179 4. WSAVA Vaccination Guidelines 2015 (wsava.org/.../WSAVA-Vaccination-Guidelines-2015.pdf) 5. BVA Webinar Sunday 22/3/2010: www.thewebinarvet.com/.../covid-19-andthe-veterinary-profession Date of Preparation 23 March 2020

RE: COVID 19 - Stop doing routine work.

Gillian Mostyn — Mon, 23 Mar 2020 13:52:14 GMT

Same as Beats - risk assessment for individual animal. At the moment, the owner has a greater chance of dying than their dog. Reassess monthly.

RE: COVID 19 - Stop doing routine work.

Beats — Mon, 23 Mar 2020 13:20:22 GMT

Specifically on the lepto question, I guess it is a locality question (and if you wish to be really fancy, then an individual pet risk assessment).

Where I am, we see perhaps 3 cases of lepto at most a year, last one bothered to type was Lepto hebdomadis....

We can have 100 consults up to 1pm on a Saturday morning if really busy to put that in perspective here.

For me, here, it would be a no-brainer, risk to pet of owner getting ill from visiting the veterinary clinic would likely vastly outweigh risk to pet from lepto (even if we assumed that the vaccine was 100% effective - it's not).

I would personally suggest that postpone for a month (or extra month if already "lapsed") and situation will be reviewed then is perfectly adequate for now (here at least).

RE: COVID 19 - Stop doing routine work.

David Shepherd — Mon, 23 Mar 2020 13:08:08 GMT

We have seen two cases of leptospirosis this year where the booster had lapsed by a few months. How long do you think it’s ok to postpone boosters for (genuine question)