NHS Do’s & Don’ts:
For advice relating to good hygiene practises both personally and more generally in the practice.
In the current situation it is sensible to be diligent in adhering to good hygiene practises both personally and more generally in the practice. Simple measures include hand washing and making sanitizer available to all staff and clients. See basic NHS Do’s & Don’ts here.
If a member of staff does develop COVID-19, please refer to current NHS stay-at-home advice, found here.
WHO infographics:
For useful infographics that can be placed around the practice to remind staff and clients how best to adhere to good hygiene are available here
PHE guidance on social distancing in the UK:
Managing social distancing between staff and also, between staff and clients, in line with Government advice found here is a challenge. To maintain social-distancing, consider the following:
- Ask all clients, to call the practice in advance before arranging a visit
- Maximise your communications about keeping clients up-to-date on your practice measures through direct contact by post or e-mailing and also, through social media channels. Place polite but clear notices at entrances to remind visitors of these measures
- Restrict entry to the practice where possible:
- Consider a pick up box located outside the practice for pre-arranged, staggered medicine collections, prescriptions or other items
- Allow entry only by means of a visitor ringing a doorbell
- Where clients need to visit the practice, minimise queuing by agreeing pre-arranged appointments and pet collections
- To minimise any congestion, designate separate entry /exit points where possible
- Use floor markings or tape to help staff and clients maintain social distancing in reception areas and both waiting and consultation rooms
- At reception areas, consider providing protective screens
- If an examination of a pet is required, where possible carry this out independently of the owner with support from staff. Adhere to RCVS Guidance and depending on the circumstances, wear disposable gloves and apron/overalls.
- If a client is required to be present during a consultation:
- Request only one client accompany the pet
- Provide them with access to hand sanitizer and hand-washing facilities
- Aim to minimise the length of the consultation and the number of staff that need to be involved
- Employers have a responsibility to follow all relevant guidelines. In England, employers can download the notice to display in their workplaces to show their employees, clients and other visitors, that they have complied with the government’s guidance.
In these challenging times, consider in particular the needs of vulnerable pet owners such as the elderly or those with compromised health conditions who are socially distancing for a long period to protect their health. Helpful support can include:
- Posting medicines
- Suggesting they wait outside in the car or carpark
- Visiting at a quiet time of the day
- Planning consultations with more time either side
- Having a telephone conversation with the owner whilst examining the pet
- Organising a home visit (see APHA Vet Gateway below for further advice)
Similar guidance specific to Wales has been issued by Welsh Government on taking all reasonable measures to maintain physical distancing in the workplace.
Travel to Work or Sharing Transport
Make employees aware of how best to manage their journey to work so as to maintain social distancing and minimise spread of the virus. Government advice for travelling in shared cars or on public transport is available here.
If transport is shared for other reasons by practice staff, such as home visits or travel between practice branches, the same principles can be followed. In particular consider the following:
- Use a fixed pairing system for staff members.
- Maximise space between occupants, for example sitting in diagonally opposite seats.
- Maintain good ventilation, for example, keeping windows open and passengers facing away from one another to reduce risk of transmission.
- Clean handles and other areas where passengers may touch surfaces.
- Wash hands before getting into the vehicle before the visit and if possible after the visit.
- Keep hand sanitiser/wipes in vehicles to clean hands after each visit.
APHA Vet Gateway & Pets from Households where COVID-19 is Suspected or Confirmed :
Government advice for companion animal vets and their clients on management of pets in need of examination or treatment which are from a household with confirmed or suspected cases of COVID-19 is available on the APHA Vet Gateway, specifically Briefing Note 10/20.
The APHA Briefing Note includes management of cases from such households in the following scenarios:
- Where pets from such households are brought to the practice
- If a home visit to the household by practice staff is required
- If a pet owner who should be in self-isolation visits the surgery without calling in advance such as in an emergency eg RTA
Please be aware, that there is no expectation that vets should attend an infected or suspected household, in line with the RCVS Code supporting guidance (3.37f and 3.43). If a decision is made to carry out a visit please refer to RCVS Guidance here.
BSAVA has produced a toolkit of resources to support small animal vets in practice. It is intended to complement BVA and RCVS Guidance.
For RCVS guidance, please see our section on ‘Practice Staff & RCVS Guidance’
For BVA guidance, please see our section on ‘UK Veterinary Resources and Information’
The resources within the BSAVA Toolkit are intended to support veterinary practices throughout the lockdown and the gradual transitioning from lockdown in returning to more normal levels of veterinary services albeit these will not be ‘business as usual’. It is anticipated that practices will need to assess and adapt resources and facilities specific to their individual circumstances before deciding what range and level of services they can provide to clients. There will likely be much variance between practices and the pace at which they can begin to work through transition whilst adhering to country specific and local criteria. Throughout this period of change, making staff and clients aware of what the practice can reasonably and safely cover operationally will help manage expectations of all involved in delivery of veterinary services.
Practices will still need to assess and prioritise veterinary caseloads, including cases that have not been seen during the lockdown. Prioritisation should continue to be based on clinical and professional judgement that supports animal health and welfare and public health.
Remote consultation
Managing social distancing between staff and clients so as to comply with Government advice can present a challenge for vets in practice. To help maintain social-distancing and minimise the need for clients to visit the practice, it may be useful in the first instance to assess a case remotely so it can be decided if the pet needs to be seen for a face-to-face consultation or if it can be managed remotely. BSAVA’s Remote Consulting guide aims to support vets with their initial assessment and is available to download here
Obtaining owner consent remotely
Please see our downloadable easy reference guide written by Carol Gray for ‘Obtaining Owner Consent Remotely’ here.
Neutering
Please see our BSAVA Information Sheet on factors to consider before agreeing to neuter small animals during the Covid-19 pandemic and the related transitioning period. It covers surgical procedures and medical treatments that can achieve neutering in dogs, cats, rabbits and ferrets. The guidance should be read in conjunction with RCVS guidance and the accompanying flowcharts and documentation. It is effective from 14th April 2020 for the next 2 weeks and on a rolling 2 week basis thereafter. All the advice is intended as a guide to assist BSAVA members but it is not a replacement for professional judgement. The responsibility for clinical decisions resides solely with the attending veterinarian. Please access it here.
BSAVA has produced advice for clients as to whether or not their pet can be neutered during the COVID-19 crisis and the related transitionary period. It outlines what to expect when they contact their vet to discuss neutering for their pet. It explains that their vet is required to risk-assess each case and apply their professional and clinical judgement when deciding on the best course of action for a pet’s individual circumstances whilst keeping in mind government requirements relating to travel and social distancing. This advice on neutering which vets can share with their clients is available here and can be shared online.
Anaesthesia Resource
There will be a need for anaesthetics where a veterinary surgeon has risk assessed a case, applied their clinical and professional judgement and deemed anaesthesia is required. Please see our advice on administration of anaesthetics during the COVID-19 pandemic and the related transitioning period here.
We also have a collection on Anaesthesia on the BSAVA Library, freely available until the end of June. Please access it here.
Triage tools for cats and dogs
Triage tool following Lockdown
As the UK in full or in part transitions out of any lockdown period there will be an increasing need to see more cases and return to a more normal range and level of veterinary services. Please find our updated Triage Tool to help vets in practice prioritise canine and feline cases during the challenging circumstances presented by the Covid-19 pandemic. It is intended to provide support during any transitionary period following Lockdown which may involve tiered restrictions depending on the UK country or local area within which a practice operates. The Tool is available to all vets, free of charge. You can see it on our dedicated web-page here.
Triage Tool during lockdown
In some instances there may be a need for Governments across the UK to introduce restrictions similar to those imposed for original lockdown measures in April 2020. These may vary both in terms of severity and the length of implementation depending on local circumstances. It is recommended that you check advice relevant to the UK country or local area within which your practice operates for any applicable restrictions to ensure you are compliant with relevant measures. To support vets in practice, please see our Triage Tool intended to help vets prioritise canine and feline cases during any temporary lockdown period when stricter measures than normal might be in place. The tool is available to all vets, free of charge. You can find it on our dedicated web-page here.
Microchipping
Please find information on ‘Microchipping’ under the ‘UK Veterinary Resources and Information’ section.
Vaccination information
This is a BSAVA Information Sheet on factors to consider before agreeing to vaccinate small animals during the Covid-19 pandemic and the related transitionary period. This guidance should be read in conjunction with RCVS guidance and the accompanying flowcharts and documentation. It is effective from 14th April 2020 for the next 2 weeks and on a rolling 2 week basis thereafter. All the advice is intended as a guide to assist BSAVA members but it is not a replacement for professional judgement. The responsibility for clinical decisions resides solely with the attending veterinarian. Please access it here.
BSAVA has produced advice for clients as to whether or not their pet can be vaccinated during the COVID-19 crisis. It outlines what to expect when they contact their vet to discuss vaccination for their pet. It explains that their vet is required to risk-assess each case and apply their professional and clinical judgement when deciding on the best course of action for a pet’s individual circumstances whilst keeping in mind government requirements relating to travel and social distancing. This advice on vaccination which vets can share with their clients is available here and can be shared online.
Testing pets for SARS-CoV-2 & International & Legal Reporting Obligations
The detection of infection with SARS-CoV-2 in animals meets the criteria for reporting emerging infections to the World Animal Health Organisation (OIE) (of which the UK is a member country). Whilst SARS-CoV-2 is currently not a notifiable disease in animals in the UK (or EU), vets in practice have a professional obligation to report any positive test results to the competent authority to support the UK’s international reporting obligations to the OIE. From the week commencing 22nd February 2021 there is a legal obligation in England and Scotland to report the presence of SARS-CoV-2 in mammals. Wales and Northern Ireland also intend to introduce similar legislation shortly thereafter to make SARS-CoV-2 reportable. Please check the status of the country within which you are working for the latest updates.
Globally only a small number of cases of naturally acquired SARS-CoV-2 infections in animals have been reported. Human-to-human transmission is still considered the main route of disease spread. Testing for SARS-CoV-2 in pets should only be undertaken where it is in the interest of the health and welfare of the pet.
Detailed information on the background to testing of pets is available in our section on ‘UK Veterinary Resources and Information’. This includes requirements vets in small animal practice should fulfil when undertaking testing or reporting results as outlined in APHA Briefing Note 18/20 available here. To support vets in small animal practice, BSAVA has produced guidance on the differential diagnoses that should be considered in deciding whether to test a pet for COVID-19. The guidance should be used only in conjunction with the full APHA Briefing Note. Please note that the BSAVA guidance is advisory and veterinary surgeons should exercise their own professional judgement based on individual circumstances. BSAVA Guidance is available here.
Please see additional Government guidance for vets in practice on management of pets in need of examination or treatment which are from a household with a confirmed or suspected case of COVID-19, in APHA Briefing Note 10/20 available on the APHA Vet Gateway
Please see RCVS advice on testing for SARS-CoV-2 in the RCVS’s FAQs (Question 22) on COVID-19 here
Guidance on Behavioural issues
Please see our BSAVA and BVBA Q&A which has been written for vets to pass on to their clients easily, and helps pet owners to prepare their pets for return to normal life as lockdown eases. The Q&A explains some of the key behavioural issues that might be encountered and how these can be prevented and managed. Topics include separation-related issues, animals becoming anxious as the world around them becomes busier and noisier, and puppies lacking appropriate skills when greeting animals (including dogs and people) from other households. Please access the Q&A here.
We also have a collection on Behavioural Issues in the BSAVA Library, freely available until the end of July. Please access it here
Companion Animals and COVID-19
Currently, the advice from governments across the UK is that there is limited evidence to suggest that companion animals can contract COVID-19 and if they do, they tend to show only mild symptoms and recover within a few days. The evidence available at present suggests that coronavirus:
- May pass from infected humans to certain pets such as cats and ferrets following close contact
- Does not easily pass between cats or most other pets, but this cannot be ruled out
- May pass between ferrets and humans based on the evidence from mink infections
Ferrets
Ferrets are known to be susceptible to SARS-CoV-2, the virus which causes COVID-19. As a precautionary measure, government advice is that ferret owners should isolate their ferret for 21 days if:
- They or a member of their household are self-isolating
- They have brought their ferret to England or Scotland from a country not on the travel corridor list or, for Wales that they have recently returned to Wales with their pet through the Pet Travel Scheme
Isolation means avoiding contact with either ferrets or people from other households. Although it is advised that an owner isolates their ferret for 21 days, the owner only needs to isolate for the required 14 days (Dec 2020).
If the ferret needs emergency veterinary care, the owner can arrange to have it taken to the vet but should notify staff of the situation before visiting the practice.
Detailed information is available here.
Government advice on ferrets specific to each country in the UK is available as follows:
England: https://www.gov.uk/guidance/coronavirus-covid-19-advice-for-people-with-animals#animals-with-coronavirus
Wales: https://gov.wales/advice-pet-owners-coronavirus-covid-19#section-57160
Scotland: https://www.gov.scot/publications/coronavirus-covid-19-advice-for-animal-owners/pages/self-isolating-households/
Northern Ireland: https://www.daera-ni.gov.uk/articles/coronavirus-covid-19-advice-animal-owners#toc-3
For further advice from governments across the UK to pet owners on the current UK status covering COVID-19 & pets and also, specific advice on ferrets, please see our section on ‘Government advice for Pet Owners’ here. Please ensure you regularly check for any updates to Government advice.
British Veterinary Association
A range of COVID-19 resources are available from the British Veterinary Association -
Updated guidance issued by BVA (03/21) is available here. It is intended to support veterinary practices in mocing from providing services that are “essential for animal health and welfare only” to a more normal range of veterinary services, in line with the easing of lockdown restrictions. It recognises that that each individual veterinary practice will need to make changes to their service provision at their own pace and that practices will need to work in line with national and devolved legislation and local guidance. It will remain in place for as long as necessary and will be updated as the governments update their guidance on safe working. This BVA guidance is supplementary to the RCVS guidance, which is regularly reviewed and updated in line with legislative changes.
BVA have made the following advice for veterinary practises for dealing with behaviour cases.
You can find the links to all of the BVA webinars for COVID-19 and the veterinary profession here.
RCVS Knowledge - COVID-19 resources here
SPVS - COVID-19 resources here.
NOAH - Information on supply of veterinary medicines can be found here.
VMD - News and guidance about the impact of COVID-19 on veterinary medicines related issues are available from VMD. Information covers the availability of authorised veterinary medicines, arrangements for inspections, and also, changes affecting veterinary practices and prescriptions. The latter covers the temporary relaxation of the enforcement of specific provisions of the Veterinary Medicines Regulations (VMR) 2013. All updates are available here.
Test and Trace for Veterinary Practices
Government contact tracing programmes that have been launched across the UK are intended to avoid blanket national lockdown restrictions and facilitate local lockdown situations that manage spread of the virus. Each of the four nations have launched separate programmes and veterinary staff are advised to check their local, country systems for relevant details.
Public Health England (PHE) has issued advice (07/20) for veterinary practices in England which indicates that for veterinary professionals, if you are identified as having been in contact with someone who has tested positive for COVID-19, but at that time you were wearing the minimum required PPE as recommended by PHE (gloves, apron, a fluid repellent surgical face mask and eye protection), you would be considered to have had adequate protection against transmission and should not be advised to self-isolate.
However, given that in many circumstances where veterinary workers are identified as contacts, this will be not have been whilst wearing the minimum required PPE, you will be advised to self-isolate. If you are advised to self-isolate, and this would have an impact on the provision of veterinary services, the incident can be discussed with the local PHE Health Protection Team who will decide whether a local risk assessment is warranted.
When a confirmed case of COVID-19 occurs, the determination of who should be considered contacts and who should be advised to isolate follows the same principles regardless of the sector involved.
The RCVS has provided advice here.
It is also advisable that you refer to your employer’s protocols in the first instance.
General information on Track and Trace in the four nations is available below:
For England here
For Scotland here
For Wales here
Fore Northern Ireland here
Please continue to adhere to Government guidelines on good hygiene and social distancing. Relevant BSAVA resources can be found in our sections on ‘Good Hygiene and Social Distancing’ and ‘Practice Staff & RCVS Guidance’.
Testing pets for SARS-CoV-2 & International & Legal Reporting Obligations
The detection of infection with SARS-CoV-2 in animals meets the criteria for reporting emerging infections to the World Animal Health Organisation (OIE) (of which the UK is a member country). Whilst SARS-CoV-2 is currently not a notifiable disease in animals in the UK (or EU), vets in practice have a professional obligation to report any positive test results to the competent authority to support the UK’s international reporting obligations to the OIE. From the week commencing 22nd February 2021 there is a legal obligation in England and Scotland to report the presence of SARS-CoV-2 in mammals. Wales and Northern Ireland also intend to introduce similar legislation shortly thereafter to make SARS-CoV-2 reportable. Please check the status of the country within which you are working for the latest updates.
Globally only a small number of cases of naturally acquired SARS-CoV-2 infections in animals have been reported. Human-to-human transmission is still considered the main route of disease spread. Testing for SARS-CoV-2 in pets should only be undertaken where it is in the interest of the health and welfare of the pet.
Based on existing scientific knowledge, the UK Government advises that private testing should only be considered in pets which meet all four criteria set out in the case definition and that oropharyngeal and rectal swabs are the only suitable specimen types. Testing undertaken at private laboratories should be based on the detection of SARS-CoV-2 viral RNA in animals via PCR (typically RT-qPCR) or an equivalent assay.
In the event of a positive test result, vets in practice are asked to make clients and diagnostic laboratories aware of certain actions required by Defra. All information should be handled with appropriate confidentiality.
Further information on the background to testing of pets and the detailed requirements vets in small animal practice should fulfil when undertaking testing or reporting results, are available in APHA Briefing Note 18/20 available here.
To support vets in small animal practice, BSAVA has produced guidance on the differential diagnoses that should be considered in deciding whether to test a pet for COVID-19. The guidance should be used only in conjunction with the full APHA Briefing Note. Please note that the BSAVA guidance is advisory and veterinary surgeons should exercise their own professional judgement based on individual circumstances. BSAVA Guidance is available here.
Please see additional Government guidance for vets in practice on management of pets in need of examination or treatment which are from a household with a confirmed or suspected case of COVID-19, in APHA Briefing Note 10/20 available on the APHA Vet Gateway
Please see RCVS advice on testing for SARS-CoV-2 in the RCVS’s FAQs (Question 22) on COVID-19 here
ABCD - A detailed veterinary resource that answers common questions on COVID-19 and cats can be found here.
The Links Group -The Links Group are there to help raise awareness of the link between the abuse of people and animals through support, training and inter-agency working. See their website here.
VDS Advice on policy cover during the COVID-19 outbreak is available here. If you need bespoke advice please contact VDS on 01565 652737 or e-mail admin@thevds.co.uk
A number of free webinars have also been made available to provide support for all veterinary staff and students, including ‘Sunday Surgeries’ for vets, RVNs and the wider practice team; ‘Wednesday Wellness’ for veterinary students; and a webinar to support vets new to remote consulting.
SAVSNET
SAVSNET are aiming to help practitioners through data collected from contributing veterinary practices and veterinary diagnostic laboratories and to support this aim have released a specific report detailing the impact of COVID-19 social distancing measures on the following key areas of companion animal practice - consultation volumes, vaccination, telemedicine and vaccine preventable disease. The report can be accessed here. This is the first of regularly released reports and whilst it is primarily intended to be a source of evidence-based support for practitioners, it may assist policymakers and practice group leaders when making broader decisions too. As time goes on, SAVSNET intend to further develop these reports. SAVSNET works in partnership with BSAVA and BBSRC and if you would like to contribute data from your practice to SAVSNET, please visit their website to find out more here.
Pet insurance and claims
Currently (08/04/20) The Association of British Insurers (ABI) advice for pet insurance policies during the COVID-19 outbreak is available here.
If a pet owner or practice client has a pet insurance policy underwritten by RSA including those by John Lewis, >Than, Tesco and Marks & Spencer, RSA advises that policy holders visit the retailer’s website for further information here.
Availability of Medical Gases
Currently (08/04/20) there is no indication that there is a shortage of available medical gases. In preparation for an escalation of COVID-19 cases, BOC has been building stocks of medical gases, where able, to ensure their supply chain is in the best possible position to respond to customer requirements. BOC has now implemented a ‘Full for Empty’ supply of all medical cylinder gases to ensure that supplies can be maintained and fairly distributed to all customers.
Customers with medical oxygen are being encouraged to manage their cylinders in an effective manner and ensure that empty cylinders are available promptly for collection and reprocessing by BOC. An increased frequency of deliveries and collections is available to assist with cylinder turnover. Customers are asked to be vigilant and ensure that medical gas cylinders are kept as secure as possible to deter potential misuse or theft. BSAVA understands that if a practice is closed for the foreseeable future, BOC will collect cylinders free of charge. For further information individuals can call BOC’s Customer Information Centre on 0800 111 333. Further information is available here.
Potential use of Propofol by NHS
There have been anecdotal reports that veterinary practices might be approached by the NHS or DHSC to discuss requests for propofol intended for use in supporting safe mechanical ventilation when treating patients for COVID-19. BSAVA has liaised with VMD to ascertain the validity of these reports. It has been confirmed that DHSC has not initiated a call directly or indirectly to requisition veterinary medicines. There are ongoing cross-Government discussions between relevant Departments to assess the potential for VMPs to be used in an emergency for human use however, to date this work in incomplete.
Whilst no call has been made by DHSC (as of 09/04/20), if at any point a veterinary practice is approached with a request to release propofol to DHSC, please keep in mind some important information outlined below which has been produced by BSAVA and AVA President, Carl Bradbrook, working closely together. The information is intended to ensure no human lives are unintentionally put at risk.
- There are different formulations of propofol some of which can be fatal if applied for human use. In particular, some preservatives such as benzyl alcohol must not be applied for use in humans.
- The non-preservative preparations of propofol might be suitable for humans however, it should be for DHSC staff to ascertain and confirm suitability.
- If a veterinary practice is approached, before releasing any propofol to DHSC, it is advisable to always provide the datasheet for DHSC to check it is suitable for human use, especially to confirm it is a preservative free formulation.
- Only transfer propofol after you have written confirmation from DHSC that it is suitable to do so and the formulation is appropriate. Ensure appropriate records are kept of any stock transferred to allow for tracing and eventual replacement.
It is good practice to apply the above principles to any veterinary drugs if you are requested to release them to NHS or DHSC.
Microchipping
CFSG has provided advice for animal related businesses (excluding veterinary practices) and breeders where it indicates that it may not be possible to vaccinate and microchip puppies or kittens in the current lockdown. Breeders and purchasers are advised to contact their veterinary practice to discuss individual and local circumstances relevant to their pet. Where there is a high risk of infection with severe disease such as Canine Parvovirus the practice may be able to provide suitable arrangements for vaccination. If vaccination is undertaken the pet should be microchipped at the same time if not already implanted. CFSG information can be found here.
Mental Health and Wellbeing for Practice Staff
Webinar Vet Mental health webinars, including MMI webinars with RCVS, are freely available and can be accessed here.
FECAVA resources on mental health and wellbeing can be found here.
Vet Life Obtain individual advice and support by accessing Vet Life services here.
RCVS Mind Matters Initiative - here.