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What's a day look like for a veterinarian during COVID-19 restrictions?

Today's Monday, and I actually have a three day weekend. We, the DVMs met on Friday after work to discuss a small change in the schedule. We want to start becoming prepared for when the Ontario government lifts its restrictions. As mentioned previously, we had a newly appointed Medical Director (MD), and our senior er... seasoned veterinarian stepped down and took more of a surgical role. He essentially does not want to do any appointments, only surgeries.

We have decided that Mondays we will do surgeries, or I should say, he will do the surgeries, and myself and our new MD will alternate on appointments. We are still going to be offering Telemedicine for the remainder of the week. Myself and the MD are full time - and we actually don't mind doing the calls. I'm finding that it really helps my communication skills. I learnt from a mentor during my first year out that when you are running behind, or any type of inconvenience for any owner, how you word it can be important. My opening line tends to be now, thank-you for your patience during all of this social distancing. We are trying to do our part by government orders, while still trying to provide care for our patients. I can tell you that 99% of my calls the owners are fabulous. Almost all of them understand, and are very appreciative.

So what's a day like for me during these days of COVID-19 restrictions? Two to three days a week, I am on telemedicine and I have two days in the clinic with a skeleton staff of a registered veterinary technician, a veterinary assistant and our receptionist and a trainee in reception (she got hired right before the closures). My telemedicine days start at 9 am, but my commute, like many others, is from the bed to the living room. It's nice not having to get dressed or drive anywhere, just make breakfast and make a coffee. By 9 am I'm logged into my computer with remote access to my work system. Sometimes I will already have a teleconsultation booked. We have an app on our cell phones, that we can dial into the system, so that we have access to our client's numbers, but our personal number gets blocked when we call. Basically, anything that would be considered non-urgent, that we could potentially diagnose with a history and video or photos of the patient, these are the teleconsultation calls. A few of the calls however, I have had to make a judgement, based on how stable the patient seemed, and what the consequences of a missed diagnosis could mean, of getting some more information in order to prescribe the appropriate treatment. Since we do not have the full physical examination information from these calls, the tricky ones we make a call to get them scheduled in for an exam and blood work or imaging with the veterinarian that is in the clinic. So far things have gone fairly well.

On the days I am in the clinic, we are doing curbside medicine. The client and pet arrives outside the clinic. They call to let the team know they have arrived. Our assistant or technician dons the PPE, and goes to retrieve the pet from the vehicle. Then again, I am on the phone, thanking the owner for their patience during these restrictions and getting a thorough history. After the history, I then go to perform my physical examination, have any diagnostics performed where necessary, and if the physical examination has changed my treatment plan, I call the owner back to discuss the findings, and what the next best step would be for treatment. After which, I pass the call on to the receptionist and they collect payment for the visit over the phone. I have to say, my phone communication has improved, though I think with my experience working in reception at the racetrack definitely helped me there.

Due to spending so much time on the phone and not being able to get in to see my physiotherapist, I kinked my neck trying to hold the phone between my ear and shoulder while doing one of these calls. When I'm at hold I use my ear buds/head set and can keep my neck neutralized while typing notes during the history taking portion of the call.

At the end of the work day, some days it can take be 3 hours to finish my medical records. We have radiographic interpretations to type up, surgical notes, blood work interpretations, pharmacy refills to process, not to mention all the follow up calls from previous patients that have problems that are not yet resolved. Occasionally I'll have some cytological slides to look at, often from owners who decided that they didn't want to send the samples to a pathologist, but I like to stain a few slides of masses in hospital and compare my results with the clinical pathologist, as part of my own learning.

In Ontario, the government restrictions started March 12th - with the schools not reopening after spring break. My husband and I had landed back in Toronto from L.A. on March 8th. I remember that the airport was dead. A bizarre reality. I retrieved Indi from my sister's place that week, and then the lock downs started to increase. After the schools, closure of international travel went into effect. Canadians travelling abroad were told to come home, and self-isolate for 14 days. Large gatherings were restricted as the NBA halted when players tested positive, and suddenly all sporting events, theatres, concerts and even churches were postponed - indefinitely. On March 17th, Ontario's Premier declared a state of emergency. I have to say, despite the fact that I do not have conservative political views, I think Premier Ford has done a great job leading us during this unprecedented time. Our Prime Minister Justin Trudeau has been outstanding, first setting an example of social distancing at his home when his wife tested positive for SARS-COV-2, then ensuring that Canadians had access to up-to-date information when he reported daily and answered questions by the media. Veterinarians went to shorter hours, and skeleton crew, and then to only being allowed to see urgent cases. All elective surgeries were put on hold. Our clinical judgement was pushed to its limits, and our anxiety reaching an all time max, without knowledge of whether we would have a job. Trudeau stepped up and offered Canadian businesses a wage subsidy, and the CERB (Canadian Emergency Response Benefit) for Canadians that were stranded without work. Prior to this announcement, our parent company, MARS, stepped up and offered to cover full time wages for every staff member, even when we were skeleton crew and they had their hours cut. In all of this, we heard the news from our southern neighbour, the disease causing devastating losses in New York, then Florida, and all I could think of was how proud and thankful I was to be Canadian under a liberal-socialist government.

Here we are in the beginning of May. The weather is starting to turn warm, and Toronto restrictions of staying two meters apart are still in full swing, despite a lot of non-abiding citizens, like by-laws are meant to be tested. My husband and I can see the Humber River bridge from our condo, and I can say we witnessed a lot of people gathering on the weekend. Most people are still not wearing masks, and most people are not social distancing. We discuss the Darwin awards on a daily basis, and that selfish gene.

A few groups of Canadians have protested the by-laws, and when I joked that these same people were also the anti-vaxers, it's actually true for the most part. The thing is, that if people did their part to decrease the number of cases by limiting their activities outside, by social distancing when they need to be out, and wearing PPE if they have potential or proven exposure, then we would all be able to get back to our 'normal' lives sooner. Ford announced today that he would like to see 2 to 4 weeks of a drop in new positive cases prior to lifting the emergency measures. I'm glad that the province has a plan - even if they don't have a timeline. We should all prepare for the second wave of infection - because it's going to happen.

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