COVID-19 Information Center

Clinic Plan: Dr. Kim Skibbe
March 1, 2020 (published) | March 13, 2020 (revised)
Dr. Kimberly Skibbe

CLINIC POLICY AND ADVICE to staff per potential coronavirus outbreak 
First drafted: March 1, 2020 / Last update: March 13, 2020

Policy: Masks are on shortage. The preferred surgical tie masks are reserved for the doctor to wear for sterile surgery. For protecting yourself during dental procedures etc use the ear loop masks. Also, if you use one of those masks only briefly, save it in the container with your name on it in case we run out and need to reuse them at a later time. Cloth masks could also be fashioned for this purpose (for protection of moisture/bacteria) if necessary. 

Policy: Use gloves as needed, but be thoughtful and prepared before you put them on so as not to waste them. 

Policy: If you are sick let the manager or owner know ASAP. We are responsible to minimize spread of disease as always, but especially a novel virus that some of our clients may be more susceptible to.

Policy: Keep hand sanitizers up front at all times. Keep paper towel dispensers loaded. The decorative cloth hand towels were removed from the bathroom for now.

Policy: As always, staff is reminded to keep a change of clothes and shoes in the locker or their car. 

Policy: Technicians: review disinfectant protocol for computer screens, keyboards, phones and disinfect daily.

Policy: In addition to washing your hands after being with a pet or client, wash your hands when you enter the building and before you use a keyboard. 

Policy: One phone per employee per day. Add “handset disinfection” to end of day protocol. 

The “Worms and Germs” blog has already been shared on our Facebook page. This will likely remain a good reference if questions continue to arise about risk of COV-19 to or from pets. 

The clinic has ordered more inexpensive sets of eye protection that can be used by us or possibly by clients, disinfected after, etc. Whether or not we will use or share the limited # of N95 masks remains to be seen. 

Tuesday March 3 we reviewed training on infectious disease prevention, including what to do with reusable items such as smocks or eyewear, vs disposable items and how to protect shoes, etc.

Policy: WASTE NOTHING. While maintaining cleanliness, be careful not to waste paper products, cleaners, etc. We do not know what might be in supply shortage in the near future. 

   

Advice: Keep your gas tank full and a few days of groceries at your house. If panic-buying occurs, then you won’t have to deal with that at the last minute.

Reminder on privacy: Should we receive information that any of us or a visiting client tested positive for Covid-19, it is inappropriate and illegal to share that person’s name or information with ANYONE. We will cooperate with public health authorities to make contacts etc in such a situation but no one should share the name of anyone who is infected not even with your immediate family. Of course, we will also all home-quarantine if such a situation occurs. 


Part 2 

Contingency Planning: If there are cases of COV-19 in our area, we may need to enact some of the following policies. Owner and manager will notify staff if these actions are to be undertaken. Our actions during an epidemic may depend not only on medical realities but also on client perception. 

Be prepared for home quarantine if anyone in your home is sick, exposed, etc. You are already cross-trained for other jobs here so that shouldn’t present a problem to the business.

We can minimize staff in the building, thus limiting potential exposure to the need. Manager will determine staff need on a daily or weekly basis. 

If business is slow, we can set up any visits or medication pickup so that only one client enters the building at a time. Manager is to draft an email that will be ready to send to all clients if such protocol is enacted. Clients would call or email ahead for a time and to provide payment info. They would be instructed which door to use or whether we are coming to their car. The doors would stay locked with a sign for the client to knock or use their cellphone before entering. Doctor on duty will determine whether staff will wear any or all of the following: clean smock, N95 mask, eye protection, shoe covers, and gloves. If clients came in the building, then after the client and pet leave, the area they were in, doorknobs and countertops etc will be thoroughly disinfected similar to when a sick pet has been in the room.

We have little use for ink pens now. The signature on the credit card is not very protective anyway so we may forego that rather than sharing pens. Suggest emailing receipts to clients rather than handing them a paper. We may initiate protocol of wiping credit cards before use, or we could switch to inputting card numbers if that becomes necessary (to avoid touching the card altogether). That results in a small fee increase to us.

For current patients (seen within the last 12 mo) telemedicine or phone calls may be an option for medication dispensing, general advice, etc.

If a pet seems likely to need a specialist or ER, discuss this with the doctor before scheduling a visit. It may be prudent to minimize the number of places a client needs to visit during this time. 

Offer in house meds or online ordering if possible so clients do not have to go to pharmacy. We will have far less traffic than a typical pharmacy.

Protocol for packages: Information from WHO suggests this virus will not live on surfaces long, but we really don’t know yet.

March 13: NEJM article indicates potential viral survival time on surfaces for 2 days. While this is not a likely source of transmission, always exercise package protocol for the foreseeable future: 

Open the box, wash your hands, then take items out. Carry the items to where you will inventory them and set them there. Break down the box, take it to the disposal area in the back, then wash your hands again before recording and stocking the inventory. If a utility knife or scissors were used, spray those with disinfectant and set them aside for a few hours.

Employee responsibility: If the employee chooses to travel to an area or attend an event in spite of specific warnings of CDC or local public health officials, that employee must notify the manager. Employee may be asked to self-quarantine for an appropriate period of time. 


Explanatory email sent to clients Thursday March 12.

Temporary policies starting March 13:
- No high school vo-tech students nor other unnecessary volunteers.
- At the end of each day, manager will determine final employee schedule for the next day. The goal is to minimize unnecessary human interaction in the building and to maintain profitability so all employees can get working hours and a paycheck. If normal revenues are maintained, profit sharing will be available.

One person at a time entry in each door. Doors remain locked with sign “knock or call to enter”. Employees to wipe down inner and outer doorknobs with dilute bleach (and door if they knocked on it!) after each person leaves, as well as countertops.

We are probably going to "car pickup only" on March 16th. Take payment and history over the phone. After examining pets, email estimate to clients. If they do not have a smartphone, take estimate out to them or discuss over the phone. **Reminder we still practice on a busy street. Take a slip leash out for secondary leashing for all dogs. Cats MUST come in carrier. No exceptions: we will not take a cat out of the car that is not in a carrier. 



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