The Veterinarian Response to the Covid-19 Crisis
The controversy regarding origin of Covid-19 has not yet been settled despite the WHO team enquiry in Wuhan that laid out various theories including the one where a notorious laboratory was suspected to have started the spread. Some way or the other, species other than human are inalienably associated with the origin of the deadly virus, if not its unprecedented spread causing deaths and disruption on never-before scale across the world.
SARS-CoV-2, the virus affecting humans evidently spreads primarily through respiratory droplets from coughing, sneezing, or talking. There are also reports that people may be able to spread the virus while being pre-symptomatic or asymptomatic. This unique devastating novel zoonotic virus which is causing deaths on gigantic scale, in some rare situations can also spread from human beings to animals. Although, various aspects related to its molecular structure, genetic modifications, mutations and its effects on various organ systems are under study in almost all the countries.
A small number of animals, including dogs and cats are reported to be infected with SARS-CoV-2 after coming into close contact with people suffering from COVID-19. The United States Department of Agriculture (USDA) and CDC recently reported the first confirmed cases of SARS-Cov2 in pet animals in the USA–two pet cats with mild respiratory illness in New York. The cats had close contact with people confirmed or suspected to have COVID-19, suggesting human-to-cat spread. University of Glasgow detected incidences of Covid-19 in pet dogs and cats and several zoo animals.
There have been cases of tigers infected with the deadly virus at a zoo in New York in May 2020 and several other lions and tigers that exhibited Covid like symptoms. Further studies are needed to understand if and how different animals could be affected by the virus. Though it is becoming evident that the spectrum of clinical illnesses associated with SARS-CoV-2 infection in animals is similar to human beings, if not the death rate; clinical symptoms of the said infection in animals include fever, coughing, difficulty in breathing or shortness of breath, lethargy, sneezing, nasal/ocular discharge, vomiting, and diarrhea which are similar to those exhibited by human beings.
The challenges before veterinarians are not entirely related to the health and disease control in animals and pets but also various aspects of health and well-being of human beings too. Veterinarians play a pivotal role in prevention, management and control of zoonotic diseases. Their contribution towards food safety and ensuring healthy diets is no less significant. Taking care of animal foods and their certification contributes to their health and food safety. Animal rearing is integral part of rural livelihoods and economic well-being of farmers. COVID-19 and its resultant effects have made their role even more vital. This year World Veterinary Day (WVD) is being celebrated with topical theme “The Veterinarian Response to the Covid-19 Crisis”.
In a country such as ours, veterinary practices are essential and remain operational even during the COVID-19 pandemic. It is crucial to provide adequate skills to the staff to deal with the situation through video or written leaflets and make standard operating practices (SOPs) to deal with the situation in order to protect themselves and their families from infection during the COVID-19 pandemic. For example, Veterinary Hospitals should make adequate arrangements to protect both human and animal health. Veterinarians should strictly adhere to SOPs so that while providing care to animals, the doctor and their staff can safeguard themselves from the virus. This also requires postponing non-urgent veterinary visits and delayed procedures. SOPs should include orders about types of procedures that are required to be performed.
Considering the SARS-CoV-2 virus is highly infectious, it is important to take precautions for containing its spread among the staff, animals, their care-givers and other visitors.
- A daily screening of the staff before interacting with any visitors–pet or their owners
- Practice social distancing
- Precautions must be taken to minimize staff contact with all pet owners
- Last year, OPD and surgical operations were suspended for many months keeping in view the engagement of medical staff with Covid care and also to ensure prevention of spread of infection in hospitals
- Telemedicine has emerged to be an effective option where video consultations for treatment of animals can be used effectively. It works out to be cost effective and reasonably trustworthy
- Veterinary hospitals can also establish veterinary-client-patient relationship (VCPR) .
- Communication via telephone or video-chat
- Direct-to-exam-room admissions or enforcing social distancing in all places in hospitals and clinics
- Let staff members, rather than pet owners hold animals to minimize direct contact.
- Veterinarian may also look at concepts in the NASPHV Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary which provides for routine infection prevention practices designed to minimize transmission of zoonotic pathogens from animals to veterinary personnel.
These guidelines are especially important during COVID-19 pandemic.
Care must be taken in disposing off medical waste. Some of the animal waste produced during the care of animals may be infected with SARS-CoV-2 and needs to be disposed of as medical waste while other waste may be categorised as normal trash. Waste that needs to be separated as medical waste includes animal feces, blood and bodily fluids, and any disposable materials and PPE kits soiled with animal waste, blood or bodily fluids. However, gowns, blankets or towels, can be safely laundered and reused. It is pertinent that after washing these articles they should never be shaken and laundered with any detergent with hot water setting.
While testing of deployed veterinarians and staff is essentially required, there is also need to take care about animal testing. Animal testing for SARS-CoV-2 is available for mammalian species for certain situations; testing is not currently available for amphibians, reptiles, fish, or birds. Veterinarians must rule out other, more common causes of illness before considering SARS-CoV-2 testing, especially among companion animals without a COVID-19 exposure.
Though there is no evidence that Covid infected animals cause infection in human beings but whenever any animal is found infected, the matter may be brought to the notice of state and National authorities. Based on the limited data available it may happen that in some rare situations, people can spread the virus to animals.
Further studies are needed to understand if and how different animals could be affected by the virus and the role animals may play in the spread of COVID-19. If infected, the pet can be isolated at home and the pet owner can be advised to follow the guidelines which may include earmarking a sick room for the pet (such as extra bathroom) or separating the affected animal from people and other animals. This is similar to how a person with COVID-19 is kept in isolation separated from others in their household.
It is also essential that interaction with the isolated pet is restricted as much as possible, while still ensuring appropriate care. Dogs in households with access to private areas for elimination (e.g., backyard) should not be taken on walks. When walks are unavoidable, they should be limited to bathroom breaks, and restricted to the immediate neighborhood of the dog’s home. Interaction with other people or animals should be avoided. Likewise if a cat gets SARS-COV-2, they should be kept inside in an earmarked area away from people and other animals, and should never be permitted to roam outside. As a precautionary measure gloves must be used when picking up feces which should be disposed in a sealed bag before transferring it to trash. Always wash your hands with soap and water for at least 30 seconds immediately after cleaning up the pet.
In spite of the fact that there is no evidence that pet animals play any significant role in spreading the virus that causes COVID-19, there are other zoonotic diseases that can spread between animals and people, so it is always necessary to practice healthy habits around pets and other animals, including washing your hands with soap and water for at least 30 seconds before and after interacting with them.
If a pet animal is under home isolation for suspected or confirmed SARS-CoV-2, provide bedding, bowls or containers, treats, and toys that are separate from those used by other people or animals in the household; regularly disinfect bowls, toys, and other animal care items with disinfectant and rinse thoroughly with clean water afterwards. Other articles such as towels, blankets, and other bedding, can be safely laundered and reused. Dirty laundry that has been in contact with an ill animal can be washed with other items. Also never take the pet to human healthcare facilities, schools, dog parks, parks, groomers, and pet daycares, pet stores, boarding facilities, or similar places until the animal is declared safe to resume normal activities.
If it is not feasible to avoid direct contact with the ill animal then it is required that similar recommended precautions must be followed as for humans caring for other infected humans at home.
- There is need for Veterinary clinic and other installations’ isolation.
- In veterinary hospitals and centres caring for ill, tested-positive companion animals should have a separate airy room where SARS-CoV-2-positive companion animals can be isolated from the rest of the patient population
- Also these pets and animals must have a different sanitized route for moving the animal from the transport vehicle to an isolation space where only animals being evaluated and treated for SARS-CoV-2 should be kept for treatment and observation.
- In these hospitals and facilities where such animals are kept or treated, there should be separate space for putting on PPE prior to entering the room, and immediately upon exiting.
- Alcohol-based hand rub, or a sink with soap and water should be easily accessible and used before donning and immediately after doffing PPE.
- Veterinarians and veterinary staff should follow appropriate PPE guidance when providing care to sick, test positive
- The veterinarian and the staff attending such animals must be thoroughly briefed and sensitized and proper record of all the personnel should be maintained who have had contact with the animal for occupational health monitoring.
- It is also desirable to limit or prohibit visitors and additional clinic or hospital traffic in the area where sick, test-positive household animals are being housed and treated.
- After an interval of each week or at appropriate interval repeat testing of pets for SARS-CoV-2 or additional testing (e.g., serology) should be conducted to rule out persistence of the infection.
If the pet animal has tested positive for SARS-CoV-2, monitoring, isolation, and movement restrictions can end if animal has not shown clinical signs consistent with SARS-CoV-2 infection for at least 72 hours without medical management; and if it has been at least 14 days since their last positive test from a lab that uses a validated SARS-CoV-2 RT-PCR diagnostic assay; or sample types collected at follow-up are negative by a validated SARS-CoV-2 RT-PCR diagnostic assay. There is need to develop testing facilities for animals large and small. The most recent development in the veterinary diagnostics is the introduction of a PCR panel for testing the COVID-19 virus in animals by IDEXX Laboratories April 2020. It is noteworthy that rapid tests provide results within 24 hours or during the initial examination period of an animal. Thus, molecular diagnostics are important diagnostic tools for both farm animals and pets to protect the animals from diseases.
Based on currently available data, older adults and people of any age who have certain underlying medical conditions might be at increased risk for severe illness from COVID-19 as are pregnant women. Therefore veterinarian must consider limiting exposure of these individuals to both pet owners with confirmed or suspected COVID-19 and to sick animals with a history of exposure to a human COVID-19 case.
Pet owners must be sensitized about the COVID-19 outbreak and certain facts that are important to safeguard animals against the deadly virus. Though there is no evidence of animals playing a significant role in spreading the virus among humans, in some situations, people can spread the virus to animals. If anyone is sick with COVID-19 (either suspected or confirmed by a test), then they should restrict contact with pets and other animals, just as with people and let someone else care for the pets. Also, as some people are asymptomatic it is better to avoid contact with pets, including petting, snuggling, being kissed or licked, sharing food, or sleeping in the same bed. Also always wash hands before and after interacting with them and ensure to wear a mask.
Some bacteria and fungi stick on fur and hair but there is no evidence about viruses including the virus that causes COVID-19 sticking to skin, fur or hair of the pets. Therefore it is not advisable to wipe or bathe pet with chemical disinfectants, alcohol, hydrogen peroxide, or other products, such as hand sanitizer, counter-cleaning wipes, or other industrial or surface cleaners. However, one must ensure that pets do not interact with people outside household. In case of dogs it is required that they have a leash at least 6 feet away from others and all public places where large numbers of people gather are to be avoided. There is no question of putting masks on pets as covering their face may harm them. Likewise cats must be kept indoors and should not be allowed to roam freely outside.
These challenging times have brought concept of One Health to forefront and there is need to have holistic view to safeguard the world from the onslaught of Covid-19 and Veterinarians have significant role in safeguarding lives of human beings and animals as well as food safety.
Dr.Neelam Bala
Veterinary Officer,Govt of Uttar Pradesh
