COVID-19 Information Center

OLD LYME VETERINARY HOSPITAL COVID-19 PLAN

Updated March 12 & April 8, 2020

Sources: 

• CDC Interim Guidance for Businesses and Employers Coronavirus Disease 2019
• Safe Workplace Rules for Essential Employers (4/8/2020)
• A good source reviewed for, but not referred to in this document is the Oregon VMA website
• The best way to prevent illness is to avoid being exposed to this virus

We require sick employees to stay home:

• Employees who have symptoms of acute respiratory illness will stay home and not come to work until they are free of fever (100° F [37.7° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
• You may use personal days for any purpose. This is a good one.
• You will not be penalized for prioritizing your health.
• OLVH will not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, and certainly not as part of a self-quarantine following presumptive exposure.
• OLVH understands you may need to stay home to care for a sick family member. 
• OLVH will endeavor to separate sick employees:
• CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).

We emphasize staying home when sick, respiratory etiquette, and hand hygiene.

• We have placed posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene.
• We reemphasize our standard protocols to clean hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash hands with soap and water for at least 20 seconds.
• There are soap and water and alcohol-based hand sanitizer at every workspace.
• You are encouraged to visit the coughing and sneezing etiquette and clean hands webpage for more information and to share best practices with the hospital.
• The top to the gauze in each room is open and off to allow individual alcohol or parvosol disinfectant wipes at each keyboard/phone use. 
• Rooms and workstations are assigned by day.
• When feasible, maintaining 6 feet distance from clients is encouraged.
• For client expectations visit https://www.oldlymevets.com/hospital-policies.pml

We perform routine environmental cleaning and meet CDC guidelines already.

• We routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
• CDC does not recommend additional disinfection beyond routine cleaning at this time.
• There are disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.

We advise employees before traveling to take certain steps:

• Employees must inform their supervisor of any travel. We may require a self-quarantine away from work for any travel.
• Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for travel out of the country
• Check for symptoms of acute respiratory illness before work each day. Notify your supervisor and stay home if you are sick.
• Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and stay home. Refer to CDC guidance for how to conduct a risk assessment of their potential exposure. Consult your doctor, or if you have OLVH health insurance you can call 1-800-700-9184 the 24-Hour Nurse HelpLine 
• If an employee is confirmed to have COVID-19, OLVH will inform fellow employees of their possible exposure to COVID-19 in the workplace. We will maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
• We presume clients are possible exposures at all times. Our plan is to reduce your workplace exposure for the good of all.

We are preparing for possible increased numbers of employee absences due to illness in employees and their family members, and anticipate disruptions in childcare and home responsibilities.

• You may be expected to fill in other positions temporarily and we may change work scheduled to keep the hospital functioning. 
• Local health officials will be issuing guidance and we will monitor that. https://portal.ct.gov/Coronavirus
• Our plan is flexible and you are encouraged to improve it.
• We will review best practices at least weekly.

At our meetings we’ll consider any gaps or problems that need to be corrected.

It is possible there will be changes in employee taxes and we will keep you apprised.

We encourage you to share and learn best practices with other organizations to improve our readiness.

CLIENT EXPECTATIONS AS OF 3/17/2020

COVID-19 Adjustments

• We are here for your family pets during this emergency.
• We will do our best to protect your family.
• We are maintaining social distance.
• We are reducing or eliminating touches here at the hospital. 
  • Please call ahead to arrange your appointment. (860) 434-8387
  • Your technician will meet you at the front door or your car to admit or discharge your pet. To minimize your exposure to other clients, no clients are allowed inside the hospital. 
  • We will text and email you before your appointment so all your questions can be addressed, or we'll conduct the appointment on speakerphone with you at your car on your cell phone.
  • Please plan to remain available for consultation or additional treatment authorization by cell.
  • We will take payments by phone and bring your food or medication to you. There is no need to touch anything here. 

These precautions conform with CDC recommendations and current DPH regulations.

3/17/2020

Notes 4/1/2020

• Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and stay home.
  • As always, each of us should make decisions about work with our own health and that of our family as the first priority.
• We will all wear masks at all times in the facility and when facing clients to reduce the risk of transmitting from ourselves to each other, or from ourselves to clients no matter how fleetingly we see them.
• The best way to stay healthy is not get the coronavirus.
• The best way to do that is to isolate yourself at home in a home where everyone is isolated.

Coming to work is an option, if:

1. No one in your home is sick with cough, sneeze, fever, or illness
2. You do not have a cough, sneeze, fever, or a sense of illness (loss of smell/disinterest in taste is a reported early sign, which sounds to me like the ‘impending cold’ feeling)
3. You feel safe.

Daily: Check your temperature.

• Only come to work if you feel fully well and your temperature is normal, and not over 100 degrees. 

We don’t let clients in the hospital.

• We require you to stay six feet from clients to protect both of you. (WHO says 3 feet, CDC, 6, - stay six. That is a bit more than two arm lengths away. Both of you should have to take a step before you would even be able to reach out to touch fingertips. But - Take two steps back if they approach.)
• Persons getting pets outside should wear masks. Gloves are optional given the handwashing stations but preferred, as when delivering medications. No paper need change hands under nearly all circumstances. Medications can be left on the well or the box. A wipe box will be placed outside during business hours.
• In the hospital, please wear a surgical mask when in the common room, or whenever you are within 6 feet of another staff member and at all practical times.
  • Masks reduce the risk of spread from you to others.
  • This matters because a significant number of infections are asymptomatic. People can be infectious for days before they develop symptoms, as well.

We request that you not visit high traffic areas like shopping markets during the workday. This only a request - your lunch is your time, and errands may be necessary.

• This advice is based on prudence: shopping markets congregate many hundreds of people.

Please take your temperature at home each morning as a habit. If you have a temperature over 100.0, do not come to work. That’s ok. We have a thermometer here and covers/gloves if you forget.

I am grateful for your willingness to share any concern - there are no minor concerns.

We have considered contingencies ranging from closing entirely to emergencies only (2 doctors, no staff).

When you (a staff member) is at home in a quarantine as a presumptive case, please let Dr. Neil know as soon as possible by text at his cell phone number.

When a staff member is themself a presumptive case, we will inform you by text, just as we will (when given permission) for informing you of a home quarantine of a staff member related to one of their household or possible exposures. 

To review from our plan last month:

We are preparing for possible increased numbers of employee absences due to illness in employees and their family members, and anticipate disruptions in childcare and home responsibilities.

• You may be expected to fill in other positions temporarily and we may change work scheduled to keep the hospital functioning. 
• Local health officials will be issuing guidance and we will monitor that. https://portal.ct.gov/Coronavirus
• Our plan is flexible and you are encouraged to improve it.
• We will review best practices at least weekly.

If you have any questions concerning your own health:

• Consult your doctor, or if you have OLVH health insurance you can call 1-800-700-9184 the 24-Hour Nurse HelpLine 
• If an employee is confirmed to have COVID-19, OLVH will inform fellow employees of their possible exposure to COVID-19 in the workplace. We will maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
• We presume clients are possible exposures at all times. Our plan is to reduce your workplace exposure for the good of all.

Be of Good Cheer - You are doing a great job and your best , and your best is very, very good.

Animal agriculture workers to include those employed in veterinary health (including those involved in supporting emergency veterinary or livestock services); are essential per USG, and Governor Lamont’s executive orders. They provide for our business to open, but are not an obligation to you to work.

MEETING notes:

These concerns were raised: 

1. Are we now all exposed if a staff member stays home?
   • According to current CDC guidelines, the answer is no. A quarantine of a staff member does not constitute an exposure.

   • I reviewed the CDC guidance we put in place nearly a month ago: 
     "If an employee is confirmed to have COVID-19, OLVH will inform fellow employees of their possible exposure to COVID-19 in the workplace. We will maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure."

   • In the meeting I repeated the advice to consult your doctor about any health concerns, or possible exposures, to get your personal medical professional to answer questions about your own health.

   • This is the same as in the initial plan -- your health is always paramount and you should protect yourself.

2. Are clients adequately informed of the risk of coming here?

   • Yes. We are in compliance with DPH and CDC guidelines.

   • Each client gets text/email and phone information before arriving for their protection.

   • In terms of client exposure we have been tighter than AVMA guidelines since last month.

   • We advised to use positive, clear directions: 
      
     “Yes, we are treating patients by appointment only” 
     “Please call us when you arrive. We will come to your car to get your pet. For your protection you should stay in your car until we speak”  
       
     This avoids having to say “We’re making you …. Or “Clients are not allowed…”, since as professionals it is our role to give clear directions on what they should do, rather than what they can’t. (Think of ‘touch’ training for puppies!!! Tell ‘em where to be and meet them there with a treat)

   • We reviewed the risk at euthanasia of inadvertenly encroaching, to emphasize the distance and Mind The Gap.

   • We set up a bucket and wipe station outside.

   • There are now two locations to hand off medications, more than 10 feet apart, at the well or the box

3. Should we alert them to the health status of our employees now and in the future, if there is a case?

   • No. We should not divulge employee information.

   • By law we protect your privacy. We will not divulge your medical history to anyone without permission as required by law. Each of our personal medical histories is private.

   • That said, we are grateful for frank conversation and extra caution. We all appreciate the courage it takes to discuss your own health and concerns at meetings. We encourage openness at our daily checkins and weekly meetings, but we will not divulge your personal information to others unless directed by the government.

   • There is widespread community transmission of COVID19 in Connecticut.

   • There are no COVID19 cases among our staff currently. 

   • That may change.

   • COVID19 is a mandatory reportable disease by your doctor. 

   • It is a work requirement here to report any case or quarantine in yourself or household to Dr. Neil on his cell phone.

   • Public Health authorities warn that every person in our state should be considered at risk and a risk to others.

4. Are we violating the meeting rules at work?

   • No. The Order is for social meetings, not work. 
     
     THE ESSENTIAL BUSINESSES OR NONPROFITS DESIGNATED IN THIS GUIDANCE are not subject to the in-person restriction set forth in Executive Order 7H.

   • Other changes: We are closing on Saturdays. 

   • Other continuing stuff: We have limited the staff, the procedures, and proximity within 6 feet of staff to staff as low as possible. We are scheduling to minimize people in the building.

5. Should employees file for workman’s comp?

   • The question of filing forms with Workers Comp in the event that you become ill or injured and believe it is work-related is best addressed to the state and federal government FAQ sites directly. Information is changing.

   • http://www.ctdol.state.ct.us/DOLCOVIDFAQ.PDF is the most current information from the Connecticut Department of Labor. 

   • The March 30 version is saved on the Oldlyme Google drive

   • Employee Rights Poster 04.01.20 is the hot off the presses poster about this month’s version of the federal Families First Coronavirus Response Act (FFCRA or Act). It requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID-19. These provisions will apply from April 1, 2020 through December 31, 2020.

   • The Connecticut one also addresses some scenarios for filing for unemployment, an unasked but reasonable question during the pandemic. That was updated March 30, 2020.

We are doing our best and I appreciate you thinking through all these questions.