On December 31st, 2019, a pneumonia of unknown cause was reported to the World Health Organization Office in China. In a few short months, the world was united in the fight against a viral pandemic caused by SARS coronavirus 2—or the novel coronavirus. The outbreak has now reached every continent (except Antarctica), sickened millions, tragically taken hundreds of thousands of lives, wreaked havoc on broad swaths of the economy and, not surprisingly, infected some animals.
Veterinary medical professionals have always played an integral role in public health. Whether it is through veterinary medical research, advocating for parasite prevention or reporting cases of possible zoonosis, the veterinary profession has been an invaluable asset in the protection of animal and human health. Whether clients implicitly or explicitly understand our role in protecting pet and human health, they rely on us for sage advice and sound medical guidance—especially in the midst of a pandemic.
There has been a deluge of news regarding the human toll exacted by the novel coronavirus. That news has largely drowned out COVID-specific information related to animal health. In the cacophony of COVID-related information, clients naturally turn towards those whom they trust to sort out fact from fiction. As their veterinarian, you play a vital role in keeping them informed.
We Don’t Know What We Don’t Know
Transparency is paramount in times of crisis. Not only is it okay to admit you don’t know a certain factoid about this virus, but doing so strengthens the relationship you have with your clients. The relationships that you have with your established clients and the connections you are building with your newer clients will be rooted in honesty, truth and evidence. The virus is not only novel in its scientific discovery, but also insofar as new information is being discovered daily. It’s reassuring to clients to know that their veterinary medical team’s understanding of the virus is evolving according to the most updated information.
A natural syllogism for many pet owners is, if their veterinarian is knowledgeable about the most contemporary issues (i.e., COVID-19 infection in pets) then there’s a good chance that their veterinarian will be well versed in other matters related to their pet’s health. The confidence and trust that they build in you during this crisis may impact your relationship with them in the future. Whether you’re educating clients on the importance of parasite prevention, or having a delicate discussion about surgical complications, the confidence that undergirds those conversations is built, in part, on the reputation that you establish with them during times of crisis.
Can Some Pets (And Other Species) Be Infected With the Novel Coronavirus?
Almost all discussions regarding animals and the novel coronavirus have to be couched with the caveat “as of now” or, “as of this date”, because our understanding regarding the COVID pathogenesis in pets and other species is constantly evolving. News is changing rapidly, but as of the time of this writing, it does appear that the virus can affect a few species of animals including some pets.
Those that followed the timeline of confirmed cases of COVID-19 in animals, initially read reports from Hong Kong which documented two dogs testing PCR positive after exposure to COVID-19 positive owners. One 17-year-old Pomeranian tested positive for COVID-19 on PCR and serology, and later died. Although the death is not believed to be due to the novel coronavirus.1-4 Since then, a cat in Belgium, a cat in Hong Kong, tigers and lions at the Bronx zoo, mink in the Netherlands, a cat in the United States and a Pug in the United States have all tested positive for the virus.1-5 (Although Winston the Pug is the first confirmed/documented case of a dog infected in the US, there is a possibility that he is not the first infected dog.)
There is a question of whether Winston’s clinical signs were truly attributable to the novel coronavirus. It appears that SARS-CoV-2 can cause COVID-19-like disease in cats but, as of now, it appears to be subclinical in dogs. Currently, there is no evidence that domestic animals—or any animal within the United States—can serve as a source for human infection with SARS-CoV-2.
A variety of other species have also shown susceptibility in experimental settings, including ferrets, Syrian hamsters and Rhesus macaques.1-4 The virus appears to replicate poorly in dogs and does not readily infect pigs, chickens or ducks.1-4 Experimentally, the virus did infect and replicate well in cats and ferrets. Cats were also able to transmit the virus to other cats.1-4
Many clients understand the implications of zoonosis (animal-to-human transmission of disease); however, reverse transmission (human-to-pet) is a novel concept for some. Helping clients understand these news stories and the implications they have for their pets at home may help keep their mind at ease.
How Can I Protect My Pet?
To be sure, COVID-19 is a disease almost entirely exclusive to humans. However, because pets are such an integral part of our families, there will undoubtedly be more cases of pets exhibiting COVID-like illness and subsequently testing positive for the disease. The news of each new COVID-infected pet will likely fade from the front pages and gradually lose its grip on the twenty-four-hour news cycle. Fortunately, the emphasis from clients has been, and continues to be, how to protect pets from the virus.
The CDC has issued guidelines on how to protect pets from this virus which can be summarized with these main tenants:
• Socially distancing for you and your family includes the species-diverse members of your family as well. Keep all pets inside with you (if possible) and if and when they need to go outside, it is important to limit contact with strangers or any other animals.
• If you’re infected or you have a strong suspicion that you have been exposed to someone who is sick, it is prudent to limit contact with your animals (and people, of course). If possible, recruit another family member living in the same household who is not sick to care for the animal.
• Sheltering in place and quarantining includes your pets too. If you’re infected, keep your pet with you in the same household.
Clients may be dismayed at the shifting and seemingly contradictory recommendations. However, it’s important for clients to understand that pet health advisories will be sculpted and refined based on the newest information. For now, scientists are continuing to work hard to understand the animal and human health implications for COVID-positive pets.
Are You Still Open?
As the pandemic continues to upend normal life for so many across the globe, many clients understand that pets continue to need medical services. Debates about whether veterinary practices should be considered an essential service, news of veterinary hospitals shutting down abroad, and gubernatorial requests for veterinarians to donate Personal Protective Equipment and other supplies to human hospitals left many pet owners unsure if or what services their veterinary team may be providing. Moreover, many clients were calling to ask if veterinary hospitals were still open. That question can be answered with a straightforward “Yes, we are open. Our office hours are….” but that answer may miss an excellent opportunity to connect more deeply with your clients.
Put the pandemic in perspective by discussing briefly what impact this crisis has had on your hospital, the workflow, new protective protocols and perhaps veterinary medicine writ large. Explain to your clients that the designation of an ‘essential service’ was left up to state and local governments; and fortunately, many states declared veterinary medicine an essential service or exempted them from their shelter-in-place orders.
In response to this crisis, sweeping new COVID-specific protocols are being ushered in and clients may find it difficult to adapt quickly to the new regulations. Seize the moment to discuss in granular detail what ‘curbside drop-off’ actually means at your hospital. Not allowing pet owners inside the hospital, having veterinary team members greet clients wearing personal protective equipment and their pet being examined away from them, all culminating to a doctor discussing medical recommendations telephonically, can be difficult for your clients to handle without preparation. Creating a ‘script’ or factsheet for your team to reference is helpful to ensure that the important minutia is not missed.
The COVID-specific information you provide to your clients is not only germane for this moment, but there are also broader implications within those conversations. Concern over client safety, the safety of their pets, the safety of your staff and your nimble response to changing situations are all potential positive client takeaways and contribute to the overall client experience. Excellent patient care, compassion for the clients and your staff, and being a trusted resource for information makes your relationship with the community more inveterate.
How Can I Help?
Sometimes tragedy brings out the best in people. For World Veterinary Day this year, I celebrated the day by posting a short video thanking all those on the frontlines in the veterinary medical community including veterinarians, nurses and all the paraprofessionals in the pet health industry. Following that post, there was an unexpected outpouring of love and affection from pet owners and animals enthusiasts expressing gratitude for the service we provide. In addition to the overwhelming appreciativeness, there were several people that asked a simple question: How can I help my veterinary hospital in these unprecedented times?
That question sincerely caught me off-guard. The question was unexpected mainly because it’s rare for anyone to ask how they can help us. Most of our lives and our careers are spent helping others and we are happy to do it. Although the legislative definition of a ‘healthcare worker’ lies with government officials, clients understand that providing their pets with urgent and essential care puts veterinary health professionals on the frontlines of exposure, similar to other dedicated professionals like human healthcare workers, grocery store team members, first responders, pharmacists and pharmacy technicians, among others.
Of course, there are tangible ways that clients can help; however, one of the most powerful acts they can perform is an act of kindness. The message that I tried to communicate in that World Veterinary Day celebration video was simple: Be Kind.
Being kind includes being flexible to a change in hours and protocols of the veterinary hospital. Being kind also comes with an understanding that many veterinary team members carry a high level of anxiety and moral fatigue which can lead to burnout. When clients ask how they can help your efforts, expressing to them that being treated with respect and kindness, and offering a simple thank you or smile can go a long way. +
References
1. Centers for Disease Control and Prevention. Coronavirus disease (COVID-19). Frequently asked questions. COVID-19 and animals. https://www.cdc.gov/coronavirus/2019-ncov/faq.html#COVID19animals. Accessed April 1, 2020.
2. Centers for Disease Control and Prevention. Interim guidance for public health professionals managing people with COVID-19 in home care and isolation who have pets or other animals. https://www.cdc.gov/coronavirus/2019-ncov/php/interim-guidance-managing-people-in-home-care-and-isolation-who-have-pets.html. Accessed April 1, 2020.
3. World Organisation for Animal Health (OIE). Questions and answers on the 2019 coronavirus disease (COVID-19). https://www.oie.int/scientific-expertise/specific-information-and-recommendations/questions-and-answers-on-2019novel-coronavirus. Accessed April 1, 2020.
4. World Small Animal Veterinary Association. The New Coronavirus and Companion Animals – Advice for WSAVA Members. Advisory document: updated as of March 16, 2020. https://wsava.org/wp-content/uploads/2020/03/COVID-19_WSAVA-Advisory-Document-Mar-19-2020.pdf. Accessed March 31, 2020.
5. https://www.wral.com/coronavirus/pug-with-coronavirus-first-dog/19074499/
