UPDATED MARCH 27, 2020
Executive Order (EO) 20-20 issued by Governor Walz on March 25 requests that people in Minnesota stay home and designates veterinary medicine as a critical workforce health profession. The Order does not supersede Orders 20-09, 20-16 or 20-17. All Executive Orders can be found on the Governor’s website: https://mn.gov/governor/news/executiveorders.jsp
The Board expects veterinarians to fully abide by these Orders to protect human life. Willful violation of the Governor’s Orders remains a misdemeanor and could result in action by this Board.
Executive Order 20-20 includes this directive for critical workers from the U.S. Department of Homeland Security’s Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19. (page 13 of EO 20-20)
- Everyone should follow guidance from the CDC, as well as State and local government officials, regarding strategies to limit disease spread.
- Workers should be encouraged to work remotely when possible and focus on core business activities. In-person, non-mandatory activities should be delayed until the resumption of normal operations.
Veterinarians should adhere to these recommendations as well as social distancing requirements. To reduce opportunities for the corona virus to spread between clients and veterinary professionals, appointments and procedures should be limited to animals with essential needs. Spays and neuters are elective surgeries and should be postponed.
March 23, 2020, Governor Walz issued two new Executive Orders that impact veterinarians. These will be posted on the Board’s website as soon as these are available.
Here is the link to a summary provided by the Office of the Governor: https://mn.gov/governor/news/#/detail/appId/1/id/424399
Executive Order 20-16 requires all non-hospital entities, including veterinarians, to conduct an inventory of their PPE, ventilators, respirators, and anesthesia machines, report the result to the state, and either donate such equipment to a local coordinating entity or preserve it. (Link to pdf)
The inventory form and more information are available at: https://mn.gov/ppe
The PPE Inventory form is due MARCH 25, 2020 and lists the following as PPE: face mask and shields, isolation or disposable gowns, gloves (non-latex or nitrile), N95 respirators, and goggles or eye protection.
Executive Order 20-17 clarifies that Executive Order 20-09 applies to veterinary medicine. ordering all elective surgeries and procedures be postponed to conserve protective equipment. (Link to pdf) Surgeries and procedures that prevent loss of life, permanent dysfunction of an organ or extremity, or risk of metastasis or progression of staging for non-COVID-19 patients should not be postponed under this order. Additionally, in the context of veterinary medicine, threats to public health, the owner, or the animal may also be considered.
The Board advises veterinarians that routine spay and neuter surgeries are examples of elective surgery. Veterinarians are encouraged to use their professional judgment to determine the urgency of procedures, and record that reasoning in the medical record if a non-emergency procedure utilizing PPE is performed.
In response to the declaration of peacetime state of emergency, the Minnesota Board of Veterinary Medicine issues the following advisories:
1. Executive Order 20-09 issued by Governor Walz on March 19. 2020 requires health professionals to delay elective surgeries and procedures during the COVID-19 Peacetime Emergency.
This Order recognizes that conservation of critical resources such as ventilators and personal protective equipment (PPE) are critical resources that must be preserved.
The Board expects veterinarians to use professional judgement and expertise in determining the urgency of case interventions in conformance with paragraph 2 of Executive Order 20-09. The Board strongly recommends that reusable PPE be used for all urgent and emergency surgery and other procedures whenever possible. Examples of reusable PPE include cloth surgical gowns, caps and masks that can be sterilized.
2. Extension of the time frame for a valid veterinarian-client-patient relationship as defined in Minnesota Statutes section 156.16, Subd. 12 (b). https://www.revisor.mn.gov/statutes/cite/156.16
During the peacetime emergency, the Board will construe the “timely visits” requirement for a valid veterinarian-client-patient relationship with a patient or herd to be met if the veterinarian has examined the patient or visited the premises where the animal is kept within the past 18 months. This advisory will remain in effect until January 1, 2021.
3. Extension of time for accrual of continuing education credits for license renewal.
Veterinarians whose license expires on February 28, 2021, who have not completed sufficient continuing education for license renewal, will be granted an extension until February 28, 2023 upon written request to the Board.
To date, no evidence suggests that companion animals can become infected and ill with COVID-19. Current information regarding potential zoonotic transmission to share with clients and staff is posted on the Minnesota Board of Animal Health’s website: https://www.bah.state.mn.us/covid-19/
Veterinarians are strongly recommended to follow and stay abreast of current recommendations for limiting spread of the virus between people on the Centers for Disease Control and Prevention’s website and the Minnesota Department of Health’s website.
Providing professional veterinary services to animals via telemedicine within a valid veterinarian-client-patient relationship (VCPR) can be medically appropriate and a means to maintain social distancing. A valid VCPR temporarily now requires that a veterinarian within the practice has seen the patient in the last 18 months or made timely visits to the premises where the animal is housed within the last 18 months. Medical record keeping for telemedicine interactions should include as many of the same parameters as a patient visit, including history, clinical signs as reported by the client, tentative diagnosis, treatment plan, medication and treatment, including amount and frequency. Within this framework, veterinarians can dispense and prescribe medications.
If a veterinarian does not have a valid VPCR with a client and their animal, advice provided via electronic means should not include patient-specific recommendations. Record keeping for those interactions as well is strongly encouraged.
When a veterinary clinic is forced to close because of quarantine or insufficient staffing, or to limit appointments to emergencies only, an effort should be made to inform clients. If at all possible, provision of resources to aid clients in finding an open veterinary clinic is advisable.
Under Minnesota Board of Pharmacy law, veterinarians are classified as prescribers, practitioners. Upon request by a Minnesota-licensed veterinarian whose practice may be closed, a veterinarian may dispense medication for a patient of the closed practice so long as the veterinarian making the request has a valid veterinarian-client patient relationship with that patient. The dispensing veterinarian must maintain a record of the prescription order that was dispensed.
Shortages of supplies such as disinfectants, sterile gowns, surgical masks and personal protective clothing are creating additional challenges. Professional judgement should determine what can be reasonably substituted, when a patient cannot be safely accommodated, or sterility cannot be maintained.
Pharmacies and pharmacists are greatly impacted by the COVID-19 pandemic. The Minnesota Board of Pharmacy has compiled a list of frequently asked questions (FAQ’s), many of which touch on the issues facing veterinarians. The FAQ’s and corresponding answers are posted on the Board of Pharmacy’s website home page under Notices & Updates. This document will be updated as new information becomes available. https://mn.gov/boards/pharmacy/