16 Mar CVMA COVID-19 Resource Center
CVMA is here for you. During this unprecented public health crisis, we are working hard to fulfill our organizational mission of protecting animal and human health and welfare. Our goal is to keep you updated with the information you need to protect your health, the health of your families and practice team, and the health of your patients and clients. Check this page to see how COVID-19 is impacting veterinary professionals in Colorado, as well as a status listing of upcoming CVMA events and how to get in touch with us.
The latest updates
- This page was last updated at 10:27 a.m. MDT on March 27.
- Click here to see the latest count of COVID-19 cases in Colorado on the Colorado Department of Health and Environment (CDPHE) website.
Legal and regulatory updates (including executive orders and public health orders)
See the latest executive orders and public health orders relating to COVID-19 in Colorado.
- 3/25 — Statewide stay at home executive order (D 2020 017): Governor Polis issued a statewide stay at home order that orders Coloradans to stay at home. Some exceptions are permitted, including for employees of essential businesses such as veterinary care or livestock services. The order went into effect March 26. Click here to read the order.
- 3/24 — DORA request for PPE and critical supply inventory: DORA sent an email request to veterinary practices asking them to complete an inventory of available PPE and ventilators in the event of a shortage at human hospitals. Practices are asked to keep only the bare minimum amount of supply to conduct essential or life-saving functions, and to contribute the remainder to the state’s COVID-19 response. Small quantities (1-25 boxes of PPE on average) are to be donated directly to local public health departments or hospitals; practices with more than 25 boxes of PPE or large pieces of equipment such as anesthesia machines or ventilators are asked to complete an online inventory survey. Click here to read more about how you should respond to this request.
- 3/24 — FDA telemedicine requirements: The FDA announced that it will temporarily not enforce specific portions of the federal VCPR to help facilitate veterinary telemedicine during COVID-19. The FDA does not intend to enforce the animal examination and premises visit portion of the VCPR requirements relevant to the FDA regulations governing Extralabel Drug Use in Animals and Veterinary Feed Directive (VFD) drugs. Colorado state telemedicine rules still apply and require a VCPR to be established in-person before conducting telemedicine. Click here to read the FDA announcement.
- 3/23 — Shelter in place order for city and county of Denver: Denver Mayor Hancock issued a shelter in place order for city and county of Denver. This order exempts veterinary professionals as critical businesses. Click here to read the order.
- 3/22 — CDPHE public health order (PHO 20-24): Defines “veterinary care and livestock services” as “critical businesses” that are exempt from a mandate to reduce in-person workforce by 50%. For veterinary professionals, this means veterinary care can continue as-is with the addition of social distancing and no non-essential surgeries and procedures. Click here to read the order.
- 3/19 — Executive order (D 2020 009) prohibiting non-essential surgeries and procedures: Temporarily suspends elective and non-essential surgeries and procedures to preserve important medical equipment like personal protective equipment and ventilators. Click here to read the order.
FAQs: Non-essential surgeries and elective procedures (Executive Order D 2020 009)
Governor Polis signed executive order D 2020 009 on March 19 temporarily suspending elective and non-essential surgeries and procedures to preserve important medical equipment, like personal protective equipment, ventilators, and respirators needed to combat COVID-19. This includes all voluntary or elective surgeries or procedures, whether medical, dental, or veterinary. A voluntary or elective surgery or procedure means the surgery can be delayed without risk to the current or future health of the patient. Additionally, veterinary practices will also be asked to complete an inventory of supplies including ventilators, PPE, and masks. Read the full executive order.
What is the intent of this order? The intent of this order is to conserve vital personal protective equipment (PPE), ventilators and respirators to help manage and prevent the spread of COVID-19.
- How long is this order in effect? The executive order is in effect from March 23 to April 14.
- What type of surgeries and procedures are permitted under this order? Veterinarians are encouraged to use their discretion, with the understanding of the intent of this order, when making a determination whether a surgery or procedure is allowed.
- There is a threat to the patient’s life if the surgery or procedure is not performed;
- There is a threat of permanent dysfunction of an extremity or organ system if the surgery or procedure is not performed;
- There is a risk of metastasis or progression of staging of a disease or condition if the surgery or procedure is not performed; or
- There is a risk that the patient’s condition will rapidly deteriorate if the surgery or procedure is not performed and there is a threat to life, or to an extremity or organ system, or of permanent dysfunction or disability.
- Are spay, neuters, or dental cleaning still permitted under this executive order? The order suspends all voluntary or elective surgeries or procedures that can be delayed for a minimum of three months without undue risk to the current or future health of the patient as determined by the guidelines of the veterinary practice. Veterinarians are encouraged to use their discretion, with the guidelines above, when determining if a spay, neuter, or dental cleaning is essential.
- Are surgeries and procedures designed to relieve pain and suffering still permitted? Veterinarians are encouraged to use their discretion, with the understanding of the intent of this order, when making a determination whether a surgery or procedure is allowed.
- Are vaccinations still permitted under this executive order? Yes. It is crucial that public health continue to be protected — vaccinations are permitted with appropriate social distancing.
- What kind of PPE should be conserved? CDPHE has requested the following be conserved:
- Eye protection and goggles
- Face shields
- Surgical masks – with shields
- Surgical masks – without shields
- N95 masks
- Non-sterile gloves
- Sterile gloves
- Disposable gowns
- Biohazard bags
- Are services such as rehab still permitted? Yes they are still permitted at this time with appropriate social distancing measures. This specific order only applies to surgeries and procedures that require use of PPE.
- Are rural veterinary hospitals excluded from this order? Yes. Rural veterinary hospitals are strongly advised to comply with this order, but are not required to comply.
- Are non-profits and shelters included in this order? Yes, shelters, rescues, and other similar facilities that provide veterinary services (to the public or the organization) are included in this executive order.
- What else is included in this executive order? This executive order also directs all veterinary professionals to complete an inventory of PPE, ventilators and anesthesia machines by March 27. Veterinary practices are asked to complete an online form if they have 25+ boxes of PPE or ventilators or anesthesia machines as a part of a statewide effort to inventory available medical supplies. Practices with less than 25 boxes of PPE are asked to keep only the bare minimum they need to conduct essential or life saving functions and to donate the rest to local hospitals and public health departments. Read more here.
FAQs: Veterinary practices as essential businesses (Public Health Order 20-24)
The Colorado Department of Public Health and Environment issued a public health order on March 22 defining essential businesses. The order was amended after Governor Polis’s executive “stay at home” order on March 25 to direct everyone except for those engaged in essential businesses to stay at home. Read the full public health order.
- Are veterinary practices permitted to stay open under this order?
- Yes. This order defines veterinary practices and livestock services as “essential businesses.”
- Do I have to keep my practice open if I feel unsafe or have concerns about COVID-19 and its impact on the health of my practice, staff, or community?
- No. You are not required to keep your practice open. Please use your professional judgement in determining what is right for your staff, practice, and community.
- Are boarding and daycare services allowed to stay open?
- Boarding and daycare are permitted as a strategy to help people keep their pets and avoid relinquishing their animals.
FAQs: Personal protective equipment (PPE)
The following are recommendations from the AVMA based on FDA and CDC information. Read the full information on the AVMA website.
- May disposable, single use PPE be re-used when supply levels are adequate (conventional capacity strategies)? Generally, no. Most PPE is designed to be used only once by a single person prior to disposal. However, there are exceptions in limited situations identified by FDA, CDC, and OSHA which include gowns, surgical masks, N95 respirators, reusable face shields or goggles. Details for each are briefly mentioned below.
- Can we use expired gowns and surgical masks? Do they offer the protection needed? These products were designed to serve as protective barriers and thus FDA believes they may still offer some protection even when they are used beyond the manufacturer’s designated shelf life or expiration date. The user should visibly inspect the product prior to use and if there are concerns (such as degraded materials or visible tears) the product should be discarded.
- Can we use surgical masks and gowns on more than one procedure? Gowns may be worn to see multiple patients with the same infectious disease diagnosis or exposure when they are maintained in a common area. Gowns may be worn for multiple surgeries where the surgical procedure has a low risk of contamination. In all cases, if the gown becomes contaminated, replace it. Surgical masks may be worn for extended periods (re-used) during care for multiple patients where they are used to protect the patient from droplets from the surgeon. If the mask becomes wet or contaminated, replace it.
- Can reusable cloth gowns be used in a shortage? FDA cleared or approved reusable cloth gowns can be used. Adequate laundering, or sterilization if available, can reduce the level of pathogen contamination to a negligible level, thus lowering the overall risk of disease.
- What is an N95 respirator and what do I need to know to use one properly? An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles. The ‘N95’ designation means that when subjected to careful testing, the respirator blocks at least 95 percent of very small (0.3 micron) test particles. If properly fitted, the filtration capabilities of N95 respirators exceed those of face masks. However, even a properly fitted N95 respirator does not completely eliminate the risk of illness or death. N95 respirators are rarely used in veterinary medicine and most veterinarians are unfamiliar with how they are to be used. AVMA is not recommending the routine use of N95 respirators however there may be specific situations where it may be considered (e.g. house call veterinarian under extreme circumstances needing to enter the home of a positive COVID-19 patient). If you find yourself in a situation where an N95 mask is needed, please refer to the additional information section below for further information on proper use.
- What does reuse mean? CDC defines reuse as:1 the practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) after each encounter. The respirator is stored in between encounters to be put on again (‘donned’) prior to the next encounter with a patient. When N95 respirator reuse is practiced or recommended, restrictions are in place which limit the number of times the same respirator is reused, this is “limited reuse”. Limited reuse has been recommended and widely used as an option for conserving respirators during previous respiratory pathogen outbreaks and pandemics.(2, 3, 10-12)
- How do I minimize the need to reuse N95 respirators? CDC recommends the following steps to minimize use of N95 respirators:
- Minimize the number of individuals who need to use respiratory protection through the preferential use of engineering and administrative controls;
- Use alternatives to N95 respirators (eg, other classes of filtering facepiece respirators, elastomeric half-mask and full facepiece air purifying respirators, powered air purifying respirators) where feasible;
- Implement practices allowing extended use and/or limited reuse of N95 respirators, when acceptable; and
- Prioritize the use of N95 respirators for those personnel at the highest risk of contracting or experiencing complications of infection.
- How may I reuse N95 respirators? If reuse of N95 respirators is permitted in the locality, healthcare facilities should provide staff with clearly written procedures to:
- Follow the manufacturer’s user instructions
- Conduct a user seal check
- Only reuse for up to five donnings (unless the manufacturers label recommendation explicitly states another number)
- Follow recommended inspection procedures
- Discard any respirator that is obviously damaged or becomes difficult to breathe through
- Pack or store respirators between uses so that they do not become damaged or deformed.
- Other resources
Minimizing COVID-19 exposure in your practice
Keeping your staff, clients, patients, and self safe during COVID-19 is crucial. Read below for best practices on how to minimize exposure in your practice.
- Recommendations for veterinary practices from the state of Colorado: The Colorado Department of Public Health and Environment (CDPHE) is recommending veterinarians follow these guidelines (click here to read more).
- For all upcoming appointments, determine how you would classify pets as needing to be urgently seen, versus ones that need routine care or surgery that could possibly be delayed.
- If a client has a pet with an urgent need for veterinary attention and is a case of COVID-19, under in-house quarantine or isolated at home, please consider how you might arrange for the pet to receive an evaluation. It is recommended that a family member or friend pick up the pet in a pet carrier if the owner cannot leave the home.
- If someone who is known to be infected with COVID-19 should contact you, the recommendation is to have a different member of the household care for the animal, if possible. The ill owner/household member should avoid contact with the pet, including petting, snuggling, being kissed or licked and sharing food. If the ill individual must care for the pet, they should wash their hands before and after interacting with the pet and wear a facemask if one is available.
- Consider making arrangements to have clients call you from their car upon arrival, and have someone from your practice pick up the animal outside so the client does not have to come inside the practice. Discuss care measures via cell phone.
- Recommend implementing restriction of employee visitors (family, friends, and pets) to business purposes only, and limiting the number of people coming into the clinic.
- Because there is no vaccine available to prevent COVID-19, the best way to prevent illness is to avoid exposure to the virus and to follow strict handwashing and hygiene protocols.
- Other resources
- Protecting your team during the pandemic (AVMA)
- Coronavirus owner contact guidelines (Clinician’s Brief)
- What to do if you are sick (CDC)
- Colorado Department of Public Health and Environment handout for veterinarians (CDPHE)
- Colorado daily COVID-19 count (CDPHE)
- COVID-19 resource center for veterinarians (AVMA)
- FAQs for veterinarians and veterinary hospitals (AVMA)
- What veterinarians need to know (AVMA)
- Tips for protecting yourself and your staff (Veterinary Practice News)
Get the latest information on telemedicine and how it can help you and your patients during COVID-19.
- FDA relaxes telemedicine requirements: The U.S. Food and Drug Administration announced on March 24 (click here to read) that it intends to temporarily not enforce certain requirements in order to allow veterinarians to better utilize telemedicine to address animal health needs during the pandemic. The FDA does not intend to enforce the animal examination and premises visit portion of the VCPR requirements relevant to the FDA regulations governing Extralabel Drug Use in Animals and Veterinary Feed Directive (VFD) drugs. Federally, this allows veterinarians to prescribe drugs in an extralabel manner or authorize the use of VFD drugs without direct examination of or making visits to their patients to limit human-to-human interaction and potential spread of COVID-19 in the community.
- State of Colorado continues to require VCPR for telemedicine: Despite the FDA relaxation of extra-label drug use and the VFD, current telemedicine rules in Colorado require an in-person exam prior to offering telemedicine services to a patient. CVMA encourages veterinary professionals to exercise their professional judgement when it comes to specific patients and scenarios based on both state and federal requirements.
- Other resources
- Small business loans: Colorado small businesses impacted by COVID-19 can seek individual small business loans up to $2 million as part of the SBA Economic Injury Disaster Loan Program.
- Tax Day is now July 15: The IRS announced announced the federal income tax filing due date has been automatically extended from April 15, 2020, to July 15, 2020. Taxpayers can also defer federal income tax payments due on April 15, 2020, to July 15, 2020, without penalties and interest, regardless of the amount owed. This deferment applies to all taxpayers, including individuals, corporations and other non-corporate tax filers as well as those who pay self-employment tax. To avoid delays, the IRS urges taxpayers to file electronically rather than on paper; using direct deposit is also critical to speed up refunds. Click here to read more from the IRS.
- HR 6201 – Families First Coronavirus Response Act: National legislation will offer relief to small businesses across the nation such as veterinary hospitals. President Trump signed HR 6201 – Families First Coronavirus Response Act into law. Click here to read more from the AVMA. Highlights of the bill include:
- FMLA COVID-19 Benefit – This benefit provides up to 12 weeks of family and medical leave benefits related to the coronavirus to be paid at 2/3rds of regular pay rates after the first 10 days which are unpaid. The leave is only available for child care in the event of school closure or if the employee’s child care provider is unavailable due to the public health emergency.
- COVID-19 Sick Leave – This benefit applies up to 80 hours of additional paid sick leave for employees related to the coronavirus. There are daily and aggregate caps on the sick leave benefit of either $511 per day and $5,110 in the aggregate if the employee is sick or quarantined, and $200 per day and $2,000 in aggregate if the employee is caring for someone else.
- Potential Exemption – There is language granting authority to the Dept. of Labor to create regulations that can exempt small businesses with fewer than 50 employees from the leave requirements when the imposition of the requirements would jeopardize the viability of the business as a going concern.
- Tax Credits – Tax credits for employers intended to mitigate the impacts of the expanded leave provisions; and
- COVID-19 Testing – Free testing for the coronavirus during the emergency.
- Other resources
- Business disaster preparedness resources (Colorado Small Business Development Center Network)
- Business resource center (Colorado Office of Economic Development and International Trade)
- Alternatives to layoffs — work-share or job-attached programs (Colorado Department of Labor and Employment)
- Federal disaster loans (U.S. Small Business Association)
- Small business emergency relief (City of Denver)
- Cash grants and advertising credits (Facebook)
- Filing for unemployment pay (Colorado Department of Labor and Employment)
It’s important to take care of your physical wellbeing during a crisis…but it’s also equally important to focus on mental health. The wellbeing of Colorado’s veterinary professionals is crucial to our veterinary community. Make sure you are taking care of yourself during this difficult time.
- You’re not alone: Colorado Crisis Services provides free, confidential professional support 24/7. Call 1.844.493.8255 or text TALK to 38255.
- How to deal with isolation and social distancing: Whether you consider yourself extraverted or introverted, humans are social beings, and the current social climate can be difficult for many of us. The good news is that humans are also inventive solution seekers. There are a variety of ways to stay connected to each other, such as live online exercise classes, FaceTime or Zoom calls, waving to neighbors on walks, and more. Many things are being offered online now, so you might have an opportunity to explore something that you might not have done otherwise. Get more ideas from the AVMA.
- Managing uncertainty: Human beings like certainty. We are hard-wired to want to know what is happening when and to notice things that feel threatening to us. When things feel uncertain or when we don’t generally feel safe, it’s normal to feel stressed. Learn steps to respond to uncertain times.
- Tips for managing anxiety and stress: Learning how to cope with stress will make you, your staff, patients, and clients stronger. Get tips from the CDC.
Other updates and resources
- X-ray machine certification: The CDPHE announced March 17 it would exercise regulatory flexibility and provide an extension to the requirements for select radiation machine and facility certification evaluations as a measure to help prevent transmission of COVID-19. For those radiation machines and facilities that require an initial certification evaluation within 90 days of use as per Section 188.8.131.52 the department is providing an additional 90 days for the completion of the initial evaluation. Please note, the requirements of 184.108.40.206 and 220.127.116.11 still remain in force and an evaluation of those machines prior to being used to perform any human examination is still required. Radiation machines and facilities that are due for a certification evaluation, as per Section 2.5 of the Regulations, during the months of March, April, May and June of 2020 shall be granted a 6 month extension to complete that evaluation. Contact the X-ray Certification Unit with questions at 303.692.3448 or via email at firstname.lastname@example.org.
- Rabies testing: The CDPHE is asking veterinarians to send all rabies tests to the CSU Veterinary Diagnostic Laboratory for testing instead of to CDPHE.
- Additional resources
- For animal shelters
- For mobile and house call veterinarians
- For pet owners
CVMA office status
- To do our part in helping to protect public health, CVMA staff will be working remotely until further notice.
- There are lots of ways to get in touch with us! We’d love to hear from you and stay connected during this time.
- Email: email@example.com
- Text: 303.318.0447
- Call: 303.318.0447 (we have limited ability to answer calls but please leave a voicemail and we will return your call if we miss you)
CVMA events status
- CVMA Chapter 6 West Area Luncheon on April 10 — Cancelled
- CVMA Power of 10 Communications Workshop on April 17 — This event will be postponed until July 2020.
- CVMA Professional Development Series on cannabis on April 29 — We’re going digital! This event will be presented digitally and will offer 4 hours of CE to veterinary professionals. Learn more and register at colovma.org/pds.