New Covid-19 Guidance from BEVA
The British Equine Veterinary Association has provided some new ideas and considerations that equine practices may find useful when developing their own guidelines for working during the current phase of the Covid-19 restrictions.
These notes are only suggestions and veterinary teams in individual practices should be developing their own guidelines depending on their unique local conditions. In addition, veterinary practices need to be ready to adapt / change their guidelines as necessary as the situation evolves and with changing government advice. Tighter restrictions could be imposed again should a “second spike” of infection occur as the lockdown measures are gradually eased.
Practices need to adapt to new ways of working, but should be aware that these new approaches to work will likely take longer than previously as well as causing anxiety and stress to team members.
- Veterinary teams should adhere to current guidelines and advice issued by the UK government and the devolved administrations. See here for UK government advice and support.
- General information about Covid-19 can be found here.
- The risk of transmission of the coronavirus is believed to be lower when working outdoors and in well-ventilated environments. Equine vets can therefore take advantage of this situation to undertake work with minimal risk so long as social distancing in maintained.
- Social distancing (maintaining at least 2 metres physical distance from other people) is the most effective way of minimising the risk of transmission of the virus when interacting with other people. If it is safe to do, ask the handler stand on the opposite side of the horse and facing away from the vet.
- When visiting a yard it is advisable to request that only one person / client should be in attendance and that 2 metres social distancing must be observed (with the possible exception for emergency cases).
- If feasible (and safe), work should be undertaken without the owner / client being present.
- If possible, ask for any gates to be left open prior to arriving at the yard.
- Only if considered safe, ask for the horse to be tied up so that the vet can work on the horse without a handler.
- If the owner / client is self-isolating, then contact with the client should be by telephone only, and arrangement should be made to enable the vet to examine and treat the horse without any direct contact with the client or anyone from the client’s household.
- The risk of transmission of the coronavirus is also believed to be reduced when contact time between people is kept as short as possible – so if the work needs a client / owner to be present (with social distancing), try to keep the duration of contact as short as possible.
- Prior to visiting a patient for non-emergency work, a risk assessment should be undertaken (and details recorded) (see BEVA risk assessment tools).
- There will be situations where the temperament of the horse, or the lack of appropriate facilities makes the proposed work unsafe. In such cases, it may be necessary to postpone the work or to make alternative arrangements.
- Clients should be warned that the vet may “walk away” and refuse to undertake the requested work if he / she believes the situation to be unsafe.
- Vets should develop and comply with strict biosecurity protocols (and be seen to be doing so) when visiting yards and working in hospitals. This should include washing hands, wearing gloves, and routine disinfection of equipment and surfaces after each examination. Vets should have their own disinfectant wipes and hand sanitising products.
- Do not enter client’s houses or accept drinks / food when visiting yard.
Information and evidence regarding general biosecurity measures can be found on the RCVS Knowledge Covid-19 hub.
Veterinary surgeons should not only be following strict biosecurity protocols (including regular handwashing/hand sanitising, use of gloves, disinfecting equipment, etc) but should also be seen to be doing this in order to reinforce the message to owners about their importance.
SOCIAL DISTANCING AND WORKING IN FIXED TEAMS
Government advice states the following:
Where the social distancing guidelines cannot be followed in full in relation to a particular activity, businesses should consider whether that activity needs to continue for the business to operate, and, if so, take all the mitigating actions possible to reduce the risk of transmission between their staff.
Mitigating actions include:
- Further increasing the frequency of hand washing and surface cleaning.
- Keeping the activity time involved as short as possible.
- Using screens or barriers to separate from each other.
- Using back-to-back or side-to-side working (rather than face-to-face) whenever possible.
- Reducing the number of people each person has contact with by using 'fixed teams or partnering' (so each person works with only a few others).
WORKING IN FIXED TEAMS
For example a vet plus nurse/groom/student.
Where social distancing is impossible to maintain or guarantee, then working in small fixed teams (eg a vet / nurse or groom combination) could be considered. This also has the advantage of significantly reducing the risks of veterinary surgeons attempting to work with horses on their own (without a horse handler).
This may be helpful in situations where you need assistance but know that you will be unable to maintain 2 metres social distancing, eg for horse holding, trotting up, flexion tests, pre-purchase examinations, intravenous injections, etc.
A fixed two person team can be considered as a single epidemiological unit, so in the event of one or other of the team members developing Covid-19, only one other person will have been potentially exposed, and the other person can be asked to self-isolate / get tested.
When travelling to yards, teams should ideally travel in separate vehicles, however if this is not practical, travelling in the same vehicle is possible if precautions are observed, see our practical advice on travelling.
Fixed teams should also be utilised in hospitals where managing cases will frequently require several team members working closely together.
PERSONAL PROTECTIVE EQUIPMENT INCLUDING FACE COVERINGS AND CLOTHING
PERSONAL PROTECTIVE EQUIPMENT
The UK government currently advises people in England to wear “face coverings” in places where social distancing isn’t possible, such as public transport or at work where colleagues need to be closer together than 2 metres (see links above). Practices should develop their own policies regarding the wearing of face masks within their teams, and when interacting with clients – again considering the importance of being seen to take precautions in order to reinforce the message to owners.
There is no current evidence to suggest that horses can become infected with the SARS-CoV-2 virus or transmit it to people. However, it is possible that headcollars, lead reins, rugs, tack, passports, etc. could act as fomites for disease transmission and should therefore be handled with caution (eg wearing gloves).
FACE COVERINGS AND MASKS
The routine wearing of face masks at work is not recommended by the government since the evidence for their efficacy is limited, and social distancing is much more effective. However, when working in situations where 2 metre social distancing is not going to be possible or has the potential of being compromised, then wearing face coverings would be considered to be appropriate. Wearing a face covering may not prevent you from being infected by coronavirus, but it could reduce the risk of you spreading the virus to others should you be asymptomatically or pre-symptomatically infected.
In addition, wearing a face covering /mask can be helpful for reinforcing the importance of biosecurity to others (including clients and other team members). However, face coverings should not be used instead of other biosecurity measures.
Government advice about wearing face masks whilst at work (excluding clinical settings dealing with human cases of Covid-19):
- Wash your hands thoroughly with soap and water for 20 seconds or use hand sanitiser before putting a face covering on, and after removing it.
- When wearing a face covering, avoid touching your face or face covering, as you could contaminate them with germs from your hands.
- Change your face covering if it becomes damp or if you've touched it.
- Continue to wash your hands regularly.
- Change and wash your face covering daily.
- If the material is washable, wash in line with manufacturer's instructions. If it's not washable, dispose of it carefully in your usual waste.
For further information about face masks see the RCVS Knowledge website.
Consider wearing overalls over normal clothes so that the overalls can be removed before leaving the premises and placed in a bag for laundering.
The use of sedation whilst undertaking procedures such as routine dentistry, radiography, etc should be considered as a means of reducing the requirements for physical restraint (remembering withdrawal times and medication regulations for racing and competition horses). Where appropriate, oral sedatives could be prescribed and dispensed to owners to administer prior to undertaking the procedure.
Government advice regarding travelling with more than one person in a vehicle includes:
- Make sure vehicles are well-ventilated to increase the flow of air, for example, by opening a window.
- Ensure regular cleaning of vehicles, in particular, between different users.
When driving to clients with another person in the vehicle (eg when working in a fixed team), try to maximise the distance between the two people (eg sitting diagonally opposite rather than side to side).
PAPERWORK AND BILLING
- Restrict the use of paper and pens.
- Wearing gloves is recommended when paperwork is being passed between different people.
- Utilise electronic forms, documentation, and payment processing.
- Wash your hands well after touching cash payments.