Winter is coming – are you prepared?

Winter is coming. . .are you prepared?

I’ve survived this pandemic in part because the weather has been generally nice and I’ve been able to socialize outside.  This week, I can tell that winter is coming.  It is cooler, windier, the days are shorter, and today it is hailing.  Everyone says the virus is going to get worse as we move inside.  COVID caseloads are trending up and everyone is just tired of social distancing. I think all of us have a bit of foreboding about what is to come.

What can you do in your veterinary hospital to prepare ?

Ten Recommendations to prepare for winter

1) Get your flu shot

Currently, we have one virus we can’t yet vaccinate for and one we can.  To minimize the chances of getting sick, every one of us needs to get a flu shot this year.  My family and I did the drive through flu shots at my daughter’s high school.  You can schedule a traveling nurse to come to your clinic for your staff or give people a paid hour off to head to a pharmacy to get the shot.  We are a profession that believes that vaccines save lives.  Let’s promote that to our families and co-workers.

2) Use and enforce symptom attestations.

While asymptomatic spread is definitely an issue, you really do not want sick staff members at work.  Having people sign in everyday and attest that they do not have symptoms is one way to continue to make sure everyone takes the risk seriously.

3) Masks work, but only if you wear them properly all the time.

Staying 6 feet apart helps some but it is not enough in an indoor closed environment.   Everyone in your building needs to have a mask on as much of the time as possible. Taking them off to talk is tempting but talking expels more respiratory particles. Studies showing that this virus is present in higher numbers in hospital bathrooms than in some patient areas means that commonly used small spaces are risky.

If you opt to let clients into your clinic this winter, consider symptom checking at the door, insist on masks, don’t use closed exam rooms, and try to set up one way flow.

4) Check and update the airflow and filters in your HVAC system.

At the beginning of this pandemic, it was extremely concerning that this virus was transmitted by contact with infected surfaces.  We now know that surfaces play a more minor role in transmission and that droplets in low air flow situations are the main issue.  We still need to clean surfaces and wash our hands but our emphasis needs to be on the airborne and droplet nature of spread. HVAC Filters do collect viruses. ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) recommends making sure you have a mechanical filter rating of MERV 13 or higher if possible as these filters are efficient at capturing airborne viruses. Working with a HVAC technician to see if you can increase the air changes in your hospital will also help prevent spread.

5) Buy and use air purifiers. 

I’m not sure why we haven’t talked more about air purifiers.  Just as MERV filters in your HVAC capture droplets, air purifier filters do also. You don’t want one with ozone and you do need units that are the right size for each room.

6) Stagger lunch times or encourage staff to leave the building for lunch.

This one makes me sad as I think one of the best ways to decompress at work is to sit down and eat together.  However, eating and talking without masks in a small room is a really good way to pass this virus.

6) Walk outside even in bad weather.

Walking and talking outside is a much safer way to socialize than meals indoors.  There is also lots of good information that getting exercise and fresh air improves our mood and our health. Encourage your staff to take their breaks outside whenever possible.

7) Buy warm clinic branded apparel for your staff. 

Curbside is going to be harder this winter.  With staff needing to go in and out, keeping them warm and advertising your hospital makes branded jackets, hats or even scarves a win-win purchase.

8) Try new ways to use technology to improve interactions with clients 

Many veterinary hospitals developed protocols and implemented them quickly when this all started in the spring. The summer has been busy enough that no one has had time to think straight, let alone optimize efficiency.  But winter is a time when you can start to evaluate what has worked, what hasn’t, and make changes.  Are you using a telemedicine platform for rechecks?  Can you figure out a more efficient way to use text messaging in your practice and get it into your medical record?  Can you use zoom or another video platform to show radiographs or demonstrate how to give medications?   Even small changes can sometimes have a big impact on your flow.

9) Meet and listen to your staff.

In busy times, it is even more important to not skip meetings, even if we are all tired of zoom.  Meetings right now need to be about asking “What is working? What is not working? What do you need? How can I support you?”  As the holidays arrive and nothing is the same, all of us are going to need times to talk and commiserate about the craziness, and times to brainstorm to come up with ideas for safe celebrations.

10) VOTE.

Democracy is a use it or lose it form of government.  Encourage your employees to vote. If you are in an area where you have to vote on election day in person, give your employees time off to do this.  As I wrote in 2018, decisions by Congress directly impact veterinary debt load and thus our professions’ economic well being.

But why is voting part of facing winter? Well, would you rather face winter with Ned Starck or Joffrey Bartheon?