May 15, 2020
Stay at home orders and social distancing may be the current norm, but eventually businesses will re-open and gradually come back to life. In the rush to return to normal, veterinary practices must carefully plot the safest and smoothest path forward. In this article, we address many of the issues veterinary practice owners need to be mindful of as they re-integrate their workforce, including employment rules, guidance for managing the care of household animals that reside with a person with COVID-19, and best practices for implementing curbside service and/or telemedicine.
What kind of medical information can veterinary practice employers ask their employees?
Employers covered by the Americans with Disabilities Act (“ADA”) may ask employees who report feeling ill at work, or who call in sick, questions about their symptoms to determine if they have or may have COVID-19. Currently these symptoms include, for example, fever, chills, cough, shortness of breath, or sore throat. These inquiries are not disability-related and are thus permitted under the ADA. Similarly, an employer can send home an employee who has reported to work with COVID-19 or symptoms associated with it. Further, because the CDC and state/local health authorities have acknowledged community spread of COVID-19, employers may also measure employees' body temperature as an additional measure to protect the practice. However, as with all medical information, employers must maintain all information about employee symptoms and illness as a confidential medical record in compliance with the ADA.
May a veterinary practice employer compel its employees to take a vaccine during a pandemic?
No. An employee may be entitled to an exemption from a mandatory vaccination requirement based on an ADA disability that prevents him from taking the influenza vaccine. This would be a reasonable accommodation barring undue hardship (significant difficulty or expense). Similarly, under Title VII of the Civil Rights Act of 1964, once an employer receives notice that an employee’s sincerely held religious belief, practice, or observance prevents him from taking the influenza vaccine, the employer must provide a reasonable accommodation unless it would pose an undue hardship as defined by Title VII. Although there is no currently known vaccine available for COVID-19, ADA-covered employers should consider simply encouraging employees to get the vaccine rather than requiring them to take it.
May a veterinary practice employer require employees who have been away from the workplace during a pandemic to provide a doctor’s note certifying fitness to return to work?
Yes. Such inquiries are permitted under the ADA either because they would not be disability-related or, if the pandemic influenza were truly severe, they would be justified under the ADA standards for disability-related inquiries of employees. As a practical matter, however, doctors and other health care professionals may be too busy during and immediately after a pandemic outbreak to provide fitness-for-duty documentation. Therefore, new approaches may be necessary, such as reliance on local clinics to provide a form, a stamp, or an e-mail to certify that an individual does not have the pandemic virus.
What guidance exists for veterinary practices that manage the care of household animals that reside with a person with COVID-19?
In addition to other prevention measures, people with COVID-19 should be advised to limit interaction with household animals. Specifically, while a person infected with COVID-19 is symptomatic, they should maintain separation from household animals as they would with other household members, and avoid direct contact with pets, including petting, snuggling, being kissed or licked, sleeping in the same location, and sharing food. If possible, a household member should be designated to care for pets in the home and should follow standard handwashing practices before and after interacting with the household animal. If a person with COVID-19 must care for pets, they should ensure they wash their hands before and after caring for pets. If an owner is sick with COVID-19, a family member or friend from outside the household may bring the animal to a veterinary hospital or clinic. Telemedicine may also be appropriate to provide consultation with a veterinarian if the owner is a COVID-19 case and is unable to find an alternative caretaker to bring the pet to the hospital.
Veterinarians and their staff should review and adhere to their biosafety and biosecurity protocols for infectious diseases to ensure the safety of their patients. Further, they should familiarize themselves with the concepts in NASPHV Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel. This document outlines routine infection prevention practices designed to minimize transmission of zoonotic pathogens from animals to veterinary personnel. These infection prevention and control guidelines should be consistently implemented in veterinary practices and hospitals, regardless of ongoing outbreaks of infectious diseases, but are especially important during an outbreak of an emerging infectious disease such as COVID-19. Further, a state public health veterinarian should be contacted by animal health professionals or veterinarians that have discovered a household animal with a new, concerning illness that has had close contact or resides with a person with COVID-19.
How should veterinary practice managers change their protocols to continue providing excellent service while keeping people and animals as safe as possible?
Social distancing has proven to be an effective way to mitigate the spread of COVID-19. Therefore, many veterinary practices and hospitals have changed their workflow completely to offer curbside service. If your practice has not implemented telemedicine or curbside services yet, this may be the best way to ease back into life after COVID-19. Many practices made the decision early on to stop elective procedures and ancillary services (e.g. grooming, boarding) and currently are providing only outpatient services and emergency surgeries. With a few exceptions, namely euthanasia appointments, clients are being asked to remain in their cars and are not permitted in the building.