COVID-19: Clinic Administration & Patient Care Guidance

We will continue to update Oregon veterinarians with important developments regarding COVID-19 that impact the veterinary community. We are all in this together.

For employer-related financial issues such as new sick leave rules, business financial support programs, and related topics, visit our COVID-19 Employer Guidance page.

As medical professionals, veterinary practices can model appropriate and necessary behavior to clients, staff, and the general public during this public health crisis.

Oregon Health Authority Recommendations for Veterinary Facilities During COVID-19

The Oregon Health Authority has issued guidance for veterinary facilities to help safeguard veterinary staff health. In addition to medical advice or direction from the patient's healthcare provider and/or public health department, if you have specific questions about how a possible COVID-19 exposure or a confirmed case within your team or a team member's household could affect your practice, we encourage you to reach out to Dr. DeBess, State Public Health Veterinarian.

To ensure the health and safety of veterinary clinic staff and clients, the OHA recommends taking the following precautions:

  • Veterinary employees should take their temperature at home prior to work. (Note: Some clinics take the temperature of all working staff twice daily).
  • Upon arrival, staff should be asked about or report any symptoms such as:
    • Fever of 100.4 degrees F or more
    • New onset of cough or difficulty breathing
    • Sore throat
    • Fatigue or muscle aches
    • Headache
    • New loss of smell or taste
    • Diarrhea
    • Nausea or vomiting

If any of the symptoms mentioned above are present, staff should not be allowed to work.

Exposures

As the number of confirmed COVID-19 cases and related hospital admissions continue to rise, so does the does the risk of potential exposure. Any staff member exposed to a confirmed case within their household should not work and be quarantined for 14 days. Quarantine is mandatory even if an exposed person has a negative test. This means staying at home and away from other people for 14 days after the date of the exposure, while you monitor yourself for fever and other signs of infection. Note: The CDC recently changed this guidance to 10 days without a test and no symptoms and 7 days with a negative test and no symptoms. OHA guidance will follow and we will update when this happens.

What Constitutes an Exposure?

  • Close contact to COVID-19 occurs when you are within 6 feet of someone who is showing symptoms of the virus, for at least 15 minutes or more within a 24-hour period, or an infected person who is asymptomatic but later tests positive. This is considered an exposure, regardless of whether one or both parties were wearing a mask.
  • A confirmed case sneezed, coughed, or somehow got respiratory droplets on you.
  • You provided care at home to someone who is sick with COVID-19.

Addressing COVID-19 Cases in Veterinary Facilities

When veterinary staff test positive for SARS-CoV-19 in a veterinary setting, it is necessary to help the local health authority with contact tracing to identify those exposed to COVID-19.

  • Exposed individuals should be advised to get tested as per testing guidelines (page 3, section 3).
  • Exposed individuals may be quarantined for 14 days.
  • Only with the approval of the local health department under the guidance of the health officer and the state public health veterinarian, exposed individuals may to return to the workplace in accordance with CDC guidelines for medical staff. Any new workplace contact with exposed staff should be limited to the greatest extent that is feasible while maintaining essential operations.
  • Exposed individuals may not attend gatherings, outings or have extended contact with anyone else outside of their home during the 14 days.
  • When at home, exposed individuals should wear a face covering and follow OHA quarantine guidance for 14 days to limit exposure to other household members.
  • See also OSHA requirements below regarding work restriction and return to work.

Oregon OSHA Adopts Temporary COVID-19 Rules, Including for Veterinary Facilities

Many states, including Oregon, have moved forward to augment the current federal OSHA regulations by implementing additional temporary COVID rules to further address workplace infection control guidelines.

The new Rule generally reflects pandemic safety recommendations previously released by the Oregon Health Authority (OHA), such as social distancing and masking. Other provisions add additional layers of infection control, notice to employees, requirements to assess COVID-19 exposure risk, and workplace monitoring that are new to Oregon employers, including those in veterinary medicine, and will require action and planning.

The Rule’s provisions take effect November 16, 2020 and will remain in place until May 4, 2021, unless revised or repealed by that date.

Additional Resources:

Summary of OSHA COVID-19 Rule Requirements

1. Physical Distancing Measures

Veterinary-specific: Employers must ensure physical distancing by adopting a curbside model for all animals while the owner remains in the vehicle, or strict enforcement of a 6-foot distancing within a waiting area (not exam room), or a combination of the two. 

Owners may not enter exam rooms, except under the following circumstances:

  • Owners and caretakers may come into the facility exam room for the purpose of euthanasia.
  • Owners and caretakers may come into the facility exam room for the purpose of receiving instruction as to providing home care for pets including but not limited to giving medication, fluids, managing feeding tubes or catheters, etc.
  • In the case of examining or treating animals that may pose a threat to the veterinary worker, the animal owner or caretaker may be allowed into the veterinary facility as long as source control is observed.

Unless one of these exceptions is met, owners are to stay in their vehicles or in a waiting area (not exam room) if strict 6-foot distancing can be maintained. Any employees or clients (owners) who enter the clinic must wear a mask, face covering or face shield. In addition, physical distancing must be adhered to, whenever possible, by all employees inside a veterinary facility, whether indoors or outdoors. Work activities and workflow must be designed to eliminate the need for any employee to be within 6 feet of another individual in order to fulfill their job duties, unless such physical distancing is not feasible for certain activities.

2. Masks, Face Coverings, & Face Shields

To minimize the risk of airborne spread of COVID-19, veterinary facilities must review and implement the Oregon Health Authority’s guidance. Mask, face coverings, or face shields are required. In addition:

  • It is strongly recommended that individuals wear a mask or face covering as source control rather than relying upon a face shield alone.
  • When employees are transported in a vehicle for work purposes, regardless of the travel distance or duration involved, all occupants in the vehicle must wear a mask, face covering, or face shield. Note: This requirement does not apply when all occupants within the vehicle are members of the same household.  

3. Cleaning and Sanitation

The rule requires regular cleaning of all common areas, shared equipment, high-touch surfaces at least once every 24 hours if the workplace is occupied less than 12 hours a day or every 8 hours if the workplace is occupied for more than 12 hours per day.

4. Posting Requirements

The COVID-19 Temporary Standards Poster must be permanently placed conspicuously in a central location. Any employee working remotely must be provided with a copy of the poster through electronic or equally effective means.

5. Special Requirements for Building Operators

No later than November 23, 2020, where feasible, building operators must ensure that the facility layout allows for appropriate physical distancing and that a “Masks Required” sign is posted in common areas including shared entrances, waiting rooms, corridors, examination and treatment rooms, etc.

6. Ventilation Requirements

No later than January 6, 2021, HVAC maintenance must be performed to ensure the maximum amount of outside air recirculation to the extent of system capacity. This includes cleaning and maintaining filters, but it does not require the installation of new ventilation equipment.

7. Conduct a COVID-19 Exposure and Risk Assessment

No later than December 7, 2020, all employers must perform a COVID-19 exposure risk assessment. The assessment must involve feedback and participation from employees via a safety meeting or a supervisor. Employers with >10 employees must document their exposure risk assessment using the OSHA questionnaire for each job title. Risk assessment must involve participation and feedback from employees via safety meeting, supervisor meeting, or any other similar interactive process.

8. Infection Control Plan

No later than December 7, 2020, all employers must implement an infection control plan. For employers with > 10 employees, the plan must be in writing and available to employees. If an employer has multiple facilities, the plan may be formulated for facility type rather than individual facility.

Note: You may also choose to complete the template developed by OVMA.

9. Employee Information and Training

No later than December 21, 2020, employers must provide workers with information and training on COVID-19 and ensure that employees are provided an opportunity for feedback about topics covered. (Documentation is not required.)

  • Training must cover workplace requirements on physical distancing, masks/face coverings, sanitation, characteristics and methods of COVID-19 viral transmission, asymptomatic transmission, COVID-19 symptoms, employee reporting of COVID-19 signs and symptoms, workplace COVID-19 infection notification process, and safe and healthy work practices.
  • Oregon OSHA states it will provide sample training materials that can be used to complete this requirement. To the extent that an employer has already provided training before adoption of the final Rule, the employer does not have to repeat the training, but “may need to take steps to ensure that additional information is covered and that appropriate employee feedback can be provided.”

10. COVID-19 Infection Notification Process

Employers must establish a mechanism for notifying both exposed and affected employees within 24 hours of the employer’s knowledge of a potential COVID-19 workplace exposure (eg. an individual with COVID-19 in the workplace.)

11. COVID-19 Testing for Workers

Employers must cooperate with the Oregon Health Authority or local public health if workplace COVID-19 testing is indicated by those agencies (making employees and space available).  If testing is directed by employer (not OHA or a local public health agency), costs (test, employee time, travel expense) is to be borne by the employer requesting the testing.

12. Medical Removal

If the OHA or local public health agency recommends an employee be restricted from work due to mandated quarantined or isolation, the affected individual should be directed to go home. The employer has no obligation to enforce the individual’s quarantine apart from the workplace. Quarantined individuals must be allowed to work from home if suitable work is available. The affected individual is entitled to return to their previous job duties if still available. Return to work and testing decisions must be made in concordance with public health guidance and the employee’s medical provider.

Mask Guidance

CDC PPE Guidance

Minimum Standards of Care

  • A reminder that nothing in these orders or guidance changes the minimum standards of care to which you must continue to adhere as licensees and veterinary facilities.

Telemedicine

  • When appropriate, consider the use of Veterinary Telemedicine to limit visits to the clinic.
  • Pursuant to the Governor's Executive Order 20-03, the OVMEB has determined that veterinarians have the option to provide treatment for the duration of the State of Emergency by Veterinary Telemedicine without first having to conduct a physical exam to establish a VCPR. Please note that all other portions of the VTM rule continue to apply.
  • When using telemedicine, you can issue prescriptions if you believe it is safe and appropriate to do so. You must ensure that the technology you are using is sufficient and of appropriate quality to provide accuracy of remote assessment and diagnosis of the patient. You must also ensure that medical information obtained via VTM is recorded completely in your patient’s medical record and meets all applicable requirements of current medical recordkeeping requirements.

Updated: 2020-12-03 08:00:00

Author: Oregon Veterinary Medical Association