COVID-19: Interim recommendations for companion animal intake

Interim recommendations for intake of companion animals from locations where humans with COVID-19 are present and for intake of companion animals that have tested positive for SARS-CoV-2

Developed in collaboration by the American Veterinary Medical Association, University of Wisconsin-Madison Shelter Medicine Program, Association of Shelter Veterinarians, University of California-Davis Koret Shelter Medicine Program, University of Florida Maddie's Shelter Medicine Program, and the U.S. Centers for Disease Control and Prevention (CDC) COVID-19 One Health Working Group

Updated September 9, 2020, to include new information on PPE recommendations

The intent of these recommendations is to facilitate preparedness and establish practices that can help people and companion animals stay safe and healthy. At this time, the risk of companion animals, including pets, spreading COVID-19 to people is considered to be low. States may have their own specific requirements that are adapted for local circumstances. These recommendations offer a conservative approach due to the lack of information on risks associated with SARS-CoV-2 infections in companion animals. These recommendations acknowledge that there is currently limited available scientific data on which to base decisions, but also draw on routine guidance for zoonotic disease infection prevention and control in shelter settings. This is a rapidly evolving situation. These recommendations will be updated as new information becomes available.

Animal services and COVID-19

The current spread of COVID-19 is primarily a result of person-to-person transmission. Based on the limited information available to date, the risk of animals spreading SARS-CoV-2 to people is thought to be low. At this time, there is no evidence that companion animals play a significant role in spreading the virus that causes COVID-19; however, we are still learning about this virus. Healthy habits should always be practiced around pets and other animals, because animals can carry germs that can cause various types of illness in people. These habits include washing hands before and after interacting with animals or handling their food, waste, or supplies.

According to the World Organisation for Animal Health (OIE), there is no justification in taking measures against companion animals that may compromise their welfare, such as harming them, abandoning them, or euthanizing them based on unfounded fears over COVID-19.

In response to COVID-19 cases and the hospitalization of people with severe disease in the United States, animal service agencies are collaborating with public health departments to support the companion animals (animals that include service animals and pets) of people who require hospitalization, in-home care, or assistance managing companion animal welfare needs.

Where possible, keeping companion animals together with their owners is desired for at least three reasons. First, previous disasters have demonstrated that companion animals are integral family members and people will place themselves at significant risk rather than be separated from their companion animals. Compliance with recommendations, including disclosure of clinical signs or exposure to an infected person, may be compromised if people believe they may be separated from their companion animals when isolated or quarantined.

Second, companion animals have a beneficial impact on human health, providing companionship and reducing anxiety. Isolation and quarantine can be extremely stressful situations that might cause uncertainty, fear, or anger. Some stress can be reduced by keeping families together, which includes their companion animals. It is important to maintain the health and welfare of both people and their companion animals during a public health emergency.

Third, animal shelters could quickly become overwhelmed by companion animals being relinquished or in need of emergency shelter unless they limit their services to those who truly cannot care for their companion animals. Bringing in large numbers of companion animals would stretch capacity and resources to the point where adequate care could no longer be ensured, which would compromise their overall welfare. Furthermore, placing many stressed animals positive for SARS-CoV-2 together in an overcrowded facility may create the ideal circumstances for increased viral load and spread.

Protocols specific to protecting staff whenin high-risk situations, such as entering an infected person's home or coming into proximity with a sick person, should be consistent with the most up-to-date guidance from local, state, and federal public health authorities,including the CDC. For the most up-to-date guidance, visit your state's Department of Health website and CDC's COVID-19 website.

These interim recommendations are intended for animal services and animal shelters that will care for or intake companion animals that resided or had direct contact with persons with COVID-19 or animals infected with SARS-CoV-2, or test positive for SARS-CoV-2. We are still learning about this virus, but it appears that it can spread from people to animals in some situations. A small number of companion animals around the world have tested positive for SARS-CoV-2, mostly after contact with people with COVID-19. For up-to-date information please see CDC's COVID-19 and Animals, AVMA's COVID-19 FAQs for Veterinarians and Veterinary Clinics and COVID-19 FAQs for Pet Owners, and CDC's What to Do if Your Pet Tests Positive for the Virus that Causes COVID-19.

In-home care

When possible, it is preferable that companion animals remain in their home and that family, friends, or animal service agencies provide essential services such as feeding, providing water, allowing elimination, and other husbandry practices. If in-home care of an animal residing in a home with a person with COVID-19 is an option, procedures to minimize contact with the owners, animal, and home environment should be adhered to.

For details on precautions to take when entering the home of a person with COVID-19, refer to Interim Guidance for Public Health Professionals Managing People With COVID-19 in Home Care and Isolation Who Have Pets or Other Animals, the AVMA Considerations for Mobile and House Call Veterinarians During the COVID-19 Pandemic, and Caring for Someone Sick at Home.
Personal protective equipment (PPE) considerations
1. If the animal appears healthy, a face mask and gloves should be worn when interacting with the animal.
2. If the animal has signs of an illness
  1. Contact a veterinarian immediately, and notify the public health veterinarian or state animal health official
  2. Wear PPE appropriate for the type of contact and clinical signs
3. Whenever possible, for the safety of staff and the animal avoid contact and stay at least 6 feet away from the pet and from people in the household.
4. Wear a face mask and gloves when touching items the animal has/will come into contact with (e.g., toys, dishes, etc.).
SARS-CoV-2 positive animals
1. Guidance for caring for a pet infected with SARS-CoV-2 can be found here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/positive-pet.html

Intake and sheltering of companion animals exposed to the virus that causes COVID-19

By far, the greatest risk of COVID-19 exposure to staff, volunteers, and the public at animal shelters remains person-to-person contact. Shelters should follow CDC guidance on preventing COVID-19 exposure in veterinary facilities to plan, prepare, and respond to COVID-19. In particular, staff and volunteers should wear masks when indoors and especially within 6 feet of each other, not come to work if sick, and should take steps to help prevent the spread of COVID-19.

For people who cannot arrange for in-home care for their companion animals during their hospitalization, animal service support may include temporary sheltering of their companion animals. Shelters receiving household animals from a home with a person known or suspected to have COVID-19, or a SARS-CoV-2 infection, should ensure they review and adhere to these guidelines, including established biosafety and biosecurity practices for infectious diseases.

If removal of an animal to a shelter becomes necessary, the following suggestions are provided to ensure coordination with the appropriate public health and animal health officials and to minimize infection risk to shelter staff and volunteers. While the risk of people contracting COVID-19 from contact with such animals is considered low, it is imperative for shelters to use the best available information on infection prevention for contagious diseases, including coronaviruses.

In-home pickup

In anticipation of an animal service agency being requested to assist with collection of one or more companion animals from the home of a person with known or suspected COVID-19, agencies should work closely with their public health department including the state public health veterinarian or designated health official to make a plan, which should include how to minimize the risks to staff.
Whenever possible, entry into the home where a person with COVID-19 lives or home environments that might be contaminated with the virus should be avoided in order to prevent person-to-person transmission. Additionally, companion animals should be collected by animal services staff with minimal contact with people living in the home; this includes remaining a minimum of 6 feet away from other people and limiting contact with the home environment. For details on precautions to take when entering the home of a person with COVID-19, refer to Interim Guidance for Public Health Professionals Managing People With COVID-19 in Home Care and Isolation Who Have Pets or Other Animals and the AVMA Considerations for Mobile and House Call Veterinarians During the COVID-19 Pandemic.
If collection of the animal requires interacting with people from a household with COVID-19 or being exposed to home environments that might be contaminated with the virus, public health officials may recommend PPE and provide training in the proper use of such equipment.
Recommended PPE to use when handling animals exposed to SARS-CoV-2 depends on the type of handling, clinical signs in the animal, and procedures being performed.

Intake process

A face mask and gloves should be worn while doing intake exams and treatments. Other PPE may be advised, depending on the clinical signs of the animal or the procedures being performed.
Items such as bowls, leashes, and toys should not be removed from the household.
There is no need to bathe an animal because of COVID-19 concerns; at this time, there is no evidence that SARS-CoV-2, the virus that causes COVID-19, can spread to people from the skin or fur of pets.
Refer to the Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel by NASPHV for additional details on standard protocols for biosafety.

Sheltering exposed animals

Animal housing plans for the shelter should be made for companion animals that were in contact with a person or animal with known or suspected SARS-CoV-2 infection.
Until more information is available, it is recommended that exposed animals be housed in an area separate from the rest of the shelter population, for 14 days from the last known exposure, preferably in double-sided housing that can be spot cleaned as needed when soiled.
1. Exposed animals should be separated by species (e.g., dogs in a separate ward from cats).
When possible, dedicate separate staff for each group of animals (whether exposed or test positive) or enhance hygiene precautions for staff that need to transfer between groups.
1. If possible, designate space for animal care staff to put on and take off (don and doff) PPE prior to entering the room, and immediately upon exiting.
2. A sink with soap and water (preferred) or alcohol-based hand rub should be easily accessible and used before donning and immediately after doffing PPE.
Dogs should be walked outside for elimination and exercise, but there should be at least 6 feet (2 meters) of space maintained between the dog and other people and animals.
1. Ideally, dogs should be walked in a dedicated area that can be readily sanitized and that is separate from that used for the general animal population.

Animal handling and hygiene

Animal handling should address human health, animal health, and animal welfare needs.
Limit the number of staff that have contact with the animal.
If possible, people who are at increased risk of complications from COVID-19 should avoid having contact with these animals.
Maintain a log of all personnel who have had contact with the animal for occupational health monitoring.
Clean hands often. Wash hands with soap and water before and after handling a companion animal.
1. Avoid touching your eyes, nose, and mouth with unwashed hands.
2. Handwashing should also be done right after removing gloves.

Personal protective equipment (PPE)

See updates from CDC, FDA (mask, gown, and gloves), and AVMA on current PPE shortages.

For all animals, shelters should use routine PPE described in their biosafety protocols to prevent transmission of contagious pathogens.
1. General PPE recommendations can be found in the NASPHV Compendium of Veterinary Standard Precautions for f Zoonotic Disease Prevention in Veterinary Personnel.
2. PPE recommended for animals that have been exposed to or that have tested positive for SARS-CoV-2 should be followed as applicable.
The use of protective clothing, such as gowns or coveralls that can be laundered, and dedicated footwear, is an alternative that may be preferable to preserve disposable PPE.
Handwashing should be performed after removing PPE.

Cleaning and disinfection

Routine cleaning and disinfection are important in animal areas. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19 and other illnesses. Coronaviruses are readily inactivated by disinfectants typically used in animal shelters, including accelerated hydrogen peroxide at concentrations used for other more common shelter pathogens (e.g., at least 1:64 [2 oz/gallon] for 5 minutes for coronaviruses). Normal cleaning and disinfection protocols used in shelters are sufficient for both animal housing and common areas. Increased sanitation of surfaces frequently touched by people (e.g., light switches and doorknobs) is recommended to reduce exposure to/from shelter staff.
1. Refer to EPA and CDC disinfection protocols written for households for some guidance on coronavirus disinfection, while still being aware of potentially more stringent requirements for sanitation of non-enveloped virus animal pathogens in shelters.
2. Disinfectants licensed by the EPA must be used in accordance with their label directions. Many disinfectants have the potential to cause significant harm if direct contact with human or animal skin occurs. Do not wipe or bathe animals with chemical disinfectants, alcohol, hydrogen peroxide, or any other products not approved for animal use.

Testing

If a companion animal that has had close contact with a person or animal suspected or confirmed to be infected with SARS-CoV-2 develops an unexplained illness during their shelter stay, animal shelter staff should work with appropriate state or municipal public health or animal health authorities to determine whether testing for SARS-CoV-2 and further precautions are warranted. Existing biosecurity and infection prevention control protocols should be adhered to in such cases.

The CDC, USDA, AAVLD, NASPHV, NASAHO, and AVMA recommend against routinely testing companion animals for SARS-CoV-2 at this time. Companion animals presenting with illness or injury should receive veterinary care. Where appropriate, testing for infectious diseases and other conditions that more commonly cause signs of respiratory or gastrointestinal illness in companion animals should be conducted first. There is no reason to euthanize an animal that has been confirmed positive for SARS-CoV-2 unless the animal is irremediably suffering. Similarly, shelter facilities should not be placed under forced closure or quarantine if an animal tests positive for SARS-CoV-2. However, animals exposed to a person with COVID-19 or animals infected with SARS-CoV-2 while in the shelter should be placed in an area separate from other animals; this could occur within the home of an adopter or at the shelter facility.

The decision to test an animal should be made collaboratively between the supervising veterinarian and the state public health veterinarian or state animal health official after careful and deliberate consideration of available guidance. If it is determined that testing an animal for SARS-CoV-2 is appropriate, it will be necessary to coordinate that testing with local, state, and/or federal public health and animal officials.

Please refer to USDA's frequently asked questions for sample collection, transport, storage, and reporting of results.
If samples are sent to state animal health, university, or private laboratories for initial testing, all samples should be collected by a licensed and, preferably, USDA-accredited veterinarian in duplicate, because positive samples must be confirmed through additional testing by the USDA National Veterinary Services Laboratories (NVSL).
The USDA is responsible for reporting any animal that tests positive for SARS-CoV-2 in the United States to the World Organisation for Animal Health (OIE).

Additional precautions to take with animals that have tested positive for SARS-CoV-2

If a companion animal tests positive for SARS-CoV-2:

The state public health veterinarian or state animal health official will be in touch with the supervising veterinarian at the facility regarding next steps or additional guidance.
There is no need for a companion animal that tests positive to be euthanized or to have additional veterinary care unless there are other health concerns.
Companion animals who become infected may develop clinical signs or show no signs of illness. Of the pets who have developed clinical signs, most only had mild illness and fully recovered. In general, only supportive care is required for SARS-CoV-2 positive animals with clinical signs. Medical treatment, if required, is similar to treatment for other respiratory illnesses seen in animals.
House the animal in an isolated space designated for animals being evaluated and receiving veterinary care for SARS-CoV-2. In addition, species should be separated (e.g., dogs in a separate ward from cats or ferrets).
1. If possible, designate space for animal care staff to don and doff PPE prior to entering the room, and immediately upon exiting.
2. Use recommended PPE for the type of contact that is occurring.
3. Use gloves when handling the pet's dishes, toys, or bedding, and when picking up feces. Throw out gloves and place waste material or litterbox waste in a sealed bag before throwing away in a trashcan lined with a trash bag.
4. Limit the number of staff that have contact with the animal and maintain a log of all personnel who have had contact with the animal for occupational health monitoring
Animals that test positive should be isolated from other animals, which may include in-home isolation, until criteria for return to normal activity have been met.

Criteria for release

Monitoring, isolation, and movement restrictions for companion animals (either hospitalized or isolated) diagnosed (test-positive) with SARS-CoV-2 can end if the following conditions are met: