After all those memes kicking 2020 out and cheering 2021 in, it doesn’t look like we’re in for such a great time after all. Of course, none of this has been a surprise but more of an uncomfortable awakening, with the realisation that life as we knew it has unequivocally changed. As the RCVS announced its updated guidance there was much unrest on social media regarding the varying interpretation. The diversity within veterinary practice makes it very difficult to produce guidance to suit all and for that I do not envy the RCVS, nor the BVA. The threat of this virus does not depend on the species your practice attends, nor does it vary specifically between procedures being carried out. The risk posed to any individual is a summation of numerous factors which cannot be assumed by anyone who is not privy to the details involved. Therefore, any broad guidance can only provide basic points of reference by which individuals must make their own decisions. This is not a cop out, as some have implied, but merely a reflection of the facts. More specific guidance is not possible without advising the cessation of all veterinary work. Even the instruction to carry out “emergency work only” during the first lockdown was met with queries as to what constitutes “emergency work”. Then came the questions “what is ‘urgent work’?”, and “what does ‘essential’ mean?” So, the only way to create guidance which provides complete clarity for all would be to close all veterinary practices until further notice.
Clearly, this is not a sensible option. Animal welfare must remain a priority, albeit second to that of humans. We, as a profession, cannot allow animals to suffer needlessly, but we must ensure no humans are sacrificed in the process. Everything we do carries risk and so there is no way of removing risk from an action or procedure. We have to use our, hopefully well-honed, professional judgement to make appropriate decisions which take into account all those potential risks and reach an appropriate conclusion for what action should be taken. This again is not a black and white process, so should not be treated as such. There will always be disagreement across individuals, and we cannot eliminate that factor, but we should discuss things openly and honestly in an attempt to minimise any adverse effects that may result from the extremes.
If I am called to inject a horse which has previously been very easy to do, but on attempting to carry out this procedure whilst physically distancing from the owner I find the horse becomes dangerous, then I would absolutely consider abandoning the procedure. It is necessary to forewarn the owner of this possibility and for that reason BEVA have encouraged what many practices are doing, in opening up these discussions at the time of booking. From the word go, receptionists and vets are planting the seed with owners, making it clear that the risk posed by COVID, together with that posed by physical safety in general when dealing with horses, will trump the necessity to complete the procedure in this event. Where an owner is surprised, there is a need to explain the reasoning behind our actions, but where there is frank disagreement with your judgement there is no question as to who has the right to terminate the visit. I hope these incidents are rare, and that the majority of horse owners (whilst possibly some of the least risk-averse members of the population, as demonstrated by their choice of hobby!) are conscientious and compassionate enough to appreciate the choices made by the vets trying to serve their horses. Should any member of a practice be met with disregard for their safety or animosity towards their judgement, then it is the role of the practice to support their decision where appropriate. No client is more valuable than the practice members who are the very substance of that practice.
I, personally, have revealed in the opportunity provided to demonstrate to owners the importance of behavioural training to facilitate these simple procedures. I have shared BEVA’s #dontbreakyourvet videos countless times via WhatsApp over the last year and have even had people ask me if I have seen them!
The same principle of listening to and validating each other applies within practices. It has not gone unnoticed that some employees within our industry feel like cannon-fodder, being forced to take risks they feel are unacceptable, perceiving their employers to be pushing for “business as usual” to avoid financial losses. For those individuals it is important to find a voice. It is entirely possible those in charge are unaware of the difficulties you are facing, and if you do not raise their awareness you are not doing anybody, never mind yourself, any favours. Find the appropriate way to communicate your concerns, ensuring the message is not lost in a sea of anger and frustration. Take time to consider the pressures which you all are facing, including the employers and managers of your practice. It is unlikely they are without considerable stress themselves. Try to approach the concerns you are airing constructively, and with the aim of collectively finding a solution which satisfies all involved. The desire to blame the “other side” is never stronger than when fear is in the driving seat, so try to practise the art of negotiation at times when cortisol levels are not peaking.
Equally important, and as in question at this time, is the respect between practices. Concerns have been voiced over the potential, real or perceived, for competitive practices to steal the work which others have declined to perform due to COVID risk. I sincerely hope this kind of behaviour does not occur other than in the most paranoid reaches of our imagination. Having said that, any practice or individual has the right to refuse any work at any time based on any number of reasons, even without COVID in the equation. This refusal has, and will always, run the risk of that work being accepted by another, whether that is based on other safety factors or, much more commonly, cost. If you are in no doubt of your own decision then you should stand by that and rise above it. Easier said than done, but unless that person is crossing the line laid out by the government it is very difficult to deal with in any other way. If a practice or individual finds a client who is equally willing to take risks which you deem to be excessive given the circumstances you should probably involve yourself no more than if you saw the two of them playing Russian Roulette. Sometimes it is just better to focus on what matters most and will serve you better in keeping yourself healthy and sane. This current chapter in all our lives will be unpredictable enough without joining two madmen for another go round the barrel.
And finally, the equine racing industry. While many of us work with pleasure riders and “happy-hackers”, there is the huge £3.45 billion industry of racing which relies on veterinary professionals to function. The “sport of kings” might seem frivolous against the backdrop of COVID, but it is the livelihood of 85,000 people in the UK. So, while the economy would undoubtedly suffer if it should, the detrimental effect it would have on people is not to be sniffed at. Nor can it be put on hold. Racehorses aren’t built in one day, so the UK Thoroughbreds involved in racing, estimated at some 20,000 of the 1 million total horses in the UK, would suffer immeasurably over the ensuing years. If the work can be done safely, without excessively increasing the risk to any human beings involved, then we must try to strike a balance. Of course, we would all like to stop the world and get off until this virus has passed, but in our heart of hearts we can all see that is not an option. With the government varying the speed in response to the numbers, it is up to the rest of us to try to keep to the rhythm and stay in line so that we may finish the race together.
