Considerations for mobile and house call veterinarians during the COVID-19 pandemic
Updated on April 19, 2020
Mobile and house call practitioners are incredibly diverse in what services they deliver, how they deliver them, and the resources they have available to do so.
Entering a home or interfacing with a COVID-19 quarantined individual should occur only if consistent with guidance from the CDC, state, and local health officials. Veterinary practitioners should be very familiar with CDC’s Interim Guidance for Public Health Professionals Managing People With COVID-19 in Home Care and Isolation Who Have Pets or Other Animals and have access to appropriate Personal Protective Equipment (PPE) before making such a decision.
The One Health aspects of SARS-CoV-2 virus draw focus to the balance of animal health with human health that veterinarians routinely consider.
The AVMA provides the following considerations for veterinarians with house call or mobile practices (small animal and large animal) during the COVID-19 pandemic. Although little is known about SARS-CoV-2 (COVID-19 in humans) in animals, pets of COVID-19 patients are unlikely to transmit SARS-CoV-2 to humans. The following recommendations are based on proven techniques applied in many different disease outbreaks, consistent with the following Hierarchy of Controls:
![Hierarchy of Controls Chart Image](https://webarchive.library.unt.edu/web/20210120021433im_/https://www.avma.org/sites/default/files/inline-images/MCM-COVID-19-HierarchyOfControls-500x325_1.jpg)
- Elimination
- Substitution
- Engineering controls
- Administrative controls
- Personal protective equipment (PPE)
The optimal way to prevent disease transmission is to use a combination of interventions from across the hierarchy of controls, not PPE alone.
Veterinarians should consider asking screening questions when an appointment is scheduled and again on the day of the scheduled visit. Questions should include inquiring about anyone who has fever, cough, shortness of breath, contact with a positive COVID-19 person, and if anyone in the home is under quarantine. Clients and/or households that answer “yes” to any of the screening questions may be at increased risk for COVID-19 and the following precautions should be considered:
- Consider rescheduling elective veterinary procedures for those clients who answer “yes” to any of the screening questions.
- Consider use of telemedicine when a veterinarian-client-patient relationship already exists. AVMA has resources to support your use of telemedicine at avma.org/Telemedicine.
- If seeing an animal during the quarantine period of a known COVID-19 patient is indicated, veterinarians should avoid entering the residence, if possible.
- Be familiar with CDC’s Interim Guidance for Public Health Professionals Managing People With COVID-19 in Home Care and Isolation Who Have Pets or Other Animals.
- If veterinary procedures for animals of known COVID-19 persons cannot wait, veterinary personnel should consider providing care for the animal(s) outside of the home, when feasible. This may be on property in a mobile unit or a different building from the owner, such as a barn, or through transport of the animal to a veterinary hospital. If transporting off-site, animals should be contained in a species appropriate crate or trailer.
- When providing care outside of the home is not feasible, interfacing with a COVID-19 negative person in the home should be done. If this is not possible, the COVID-19 quarantined individual should wear a surgical mask (or an N95 mask if available) and a distance of at least 6 feet should be maintained between the COVID-19 quarantined individual and the veterinarian/staff.
- The minimum number of veterinary staff needed for the task should enter the home of the COVID-19 quarantined individual.
- Access to handwashing (soap & water, alcohol, etc.) and disinfection materials should be available.
In the United States, there is no evidence to suggest that any animals, including pets, livestock, or wildlife, might be a source of COVID-19 infection at this time. As essential personnel in many regions, veterinarians may choose to continue providing non-elective veterinary services.
The intent of this information is to provide considerations for mobile and house call veterinarians who then use their professional judgement to determine whether providing services may present increased risk to them, or to their staff, and to assist them with risk mitigation strategies, should they choose to provide those services.
This information should not be interpreted as AVMA advocating for providing non-essential services by practitioners during the COVID-19 pandemic. Rather, AVMA anticipates that there may be situations where mobile and house call practitioners will be called upon by state public health, animal health officials, or the client directly to provide essential services at the client’s property. Aspects of this information may provide considerations for such practitioners delivering services at on the property of a client of unknown COVID-19 status in addition to guidance on the rare instances when entering a COVID-19 home may be necessary.