“Frontline” typically refers to the part of an army that is closest to the enemy. If coronavirus is the enemy, then healthcare workers are a critical part of the frontline.
Michigan Gov. Gretchen Whitmer announces the state will activate its emergency operations center to prepare for potential coronavirus cases. The State of Michigan Emergency Operations Center (SEOC) is where state, local, and federal agencies coordinate the response to a disaster, emergency, or terrorist event.
Michigan confirms its first two COVID-19 cases. Whitmer declared a state of emergency in response to the first case.
As of noon, MSU suspended face-to-face instruction and moved all coursework to virtual instruction. The suspension was said to last until April 20, 2020.
VMC’s first operational change; closed to all non-emergent appointments until further notice. Change to be effective as of Sunday, March 15 at 11:59 p.m. All Hospital services remained open to emergencies for both large and small animal patients.
First confirmed COVID-19 case related to the MSU community announced. Notification received on March 13, 2020.
MSU suspended face-to-face instruction in classroom settings and moved to virtual instructions for the rest of the semester.
Dean announces all CVM personnel to learn and work remotely until further notice.
Implementation of VMC’s first revisions to operations
The MSU VDL implements measures to limit foot traffic and personal interactions to protect clients and personnel. To better follow CDC guidelines for social distancing, workstations are rearranged to reduce the number of people working in certain areas of the laboratory. Clients are notified of the potential for some impact on workflow and a slight delay in turnaround times.
Other changes took immediate effect across campus: familiar faces were disguised by face coverings, team members who normally work side-by-side were spread out six feet apart, and new shift patterns with fewer people were adopted. At the Hospital, the veterinary healthcare team adapted to their new normal with pride—and fear. Anxious rumblings of, “How do we physically distance when we have to perform surgery or put in an IV catheter?” filled the Hospital. It was difficult to eliminate all instances in which team members would be within six feet of one another for more than five minutes. And this has been unsettling for many of the veterinary healthcare workers.
Clinical students removed from Hospital; CVM leadership deemed unsafe.
College set up a telephone triage system. Every member of the healthcare team gets a text message twice a day, every day, in which they attest to whether they are ill or not, if they have traveled or if they’ve been in contact with a COVID-19 positive individual. We also added mandatory temperature-taking- and recording to these practices.
Though the Hospital’s operations had been severely revised since Monday, March 16, an official directive (2020-32) came from Governor Whitmer on Wednesday, March 31: Temporary restrictions on non-essential veterinary services.
College mandated a face covering requirement. Everyone is required to wear a face covering while in the building—this is now a requirement for everyone on MSU property, both indoors and outdoors. Based on early research and case information indicating that cats and ferrets may be more likely to become infected with SARS-CoV-2, the virus that causes COVID-19 in humans, the VDL implemented increased biosafety protocols for handling feline and ferret samples. While this protocol has worked well, it hasn’t allayed all fears.
Temporary restrictions on veterinary services, adjusts, and clarifies the scope of March 31 executive order (2020-032 > 2020-034).
Temporary restrictions on veterinary services, adjusts, and clarifies the scope of March 31 executive order (2020-032 > 2020-034).
This weekend, an Amur tiger at the Bronx Zoo in New York, tested positive for SARS-CoV-2, the virus that causes Covid-19 in people. This test was confirmed by the USDA’s National Veterinary Services Laboratory. It’s safe to say that fear was in the air, even more so than the week prior.
On Wednesday, April 22, 2020, the US Centers for Disease Control and Prevention (CDC) and the United States Department of Agriculture’s (USDA) National Veterinary Services Laboratories (NVSL) announced the first confirmed cases of SARS-CoV-2 (the virus that causes COVID-19) infection in two pet cats. These are the first pets in the United States to test positive for SARS-CoV-2.
VDL, the first line of defense in safeguarding Michigan’s animals from deadly disease, is working to develop testing capabilities to detect the virus that causes COVID-19.
VDL announces testing capabilities for SARS-CoV-2 in animals.
Campaign to thank MSU CVM essential workers.
https://msu.co1.qualtrics.com/jfe/form/SV_2mM5PSgZ0myLJMFWhile regular veterinary services have been permitted to reopen statewide beginning May 29, the MSU Veterinary Medical Center will maintain its current level of operations in order to best protect its clinical staff, patients, and clientele. This means the Hospital will continue to see only emergency and critical care patients at this time. In coming weeks, Hospital administrators will begin implementing a plan to gradually reopen the Hospital to allow for specialty service visits.
Memorial Day Weekend 2020, the hospital had its busiest day ever in recorded history with 460 patients.
Students (some) to return to VMC.
This timeline reflects the beginning of COVID-19 in the state of Michigan and the decisions that were made at the state level. Represented next is how those state decisions were reflected at Michigan State University, and then at the MSU College of Veterinary Medicine.
Protecting animal health and, by extension, human health and the human-animal bond is central to the mission of the Michigan State University College of Veterinary Medicine, as well as its two service units: The Veterinary Diagnostic Laboratory and the Veterinary Medical Center. Diagnosing and treating life-threatening conditions, diseases that can be transmitted from animals to humans, and infectious diseases that threaten entire herds or populations of animals are part of the everyday work performed by the diagnosticians, laboratory technologists, clinicians, veterinary nurses, and other personnel. Throughout the novel coronavirus pandemic, teams from both the Laboratory and Hospital continued to operate, guided more than ever by their mission to heal and protect.
Keeping out SARS-CoV-2, the virus that causes COVID-19, is critical to protect the health and safety of patients, clients, personnel and their families. For the College, working remotely is a helpful and doable way for many faculty and staff to reduce population density and, therefore, the risk of virus transmission. However, much of the work performed at the Laboratory and the Hospital requires a significant number of people to work on site.
While frontline workers at the Hospital and Laboratory fought to heal and protect animal and public health, they also had to keep themselves safe.
The Hospital—usually an inviting space for animals and their owners and a place where excited and eager students would smile and fill the halls with their questions and ideas—looked foreign to even its most senior team members. The Laboratory, normally a place where scientists openly collaborate and work together, was scarcely populated with workers who carefully fulfilled their duties. These dramatic changes conveyed the most important objective: keep the Hospital and Laboratory open so the Spartan veterinary healthcare team could provide life-saving treatment and diagnostics.
At the Laboratory, several measures were taken to reduce the number of people in any space at one time. Workstations were relocated to other areas of the Laboratory and schedules were changed to rotate employees between remote and on-site work. Employees also left the building as soon as their on-site work was completed. As added safety measures, acrylic partitions and shields were installed in reception areas, between workstations in areas with open floor plans, and at double-headed microscopes.
“When Michigan’s Stay Home order first went into effect, I had to find a way to socially distance all of my staff,” explains Nicole Grosjean, manager for the Laboratory’s Immunodiagnostics and Parasitology Section. “We have a fairly small work area, so this was not easy. I had to cut my staff by 50 percent each day. We were fairly busy before this time, so I was apprehensive about doing this, but we had no choice. I had techs come in 2–3 days a week and stay home 2–3 days a week. Unfortunately, it is extremely difficult for lab techs to work from home.”
Other changes took immediate effect across campus: familiar faces were disguised by face coverings, team members who normally work side-by-side were spread out six feet apart, and new shift patterns with fewer people were adopted. At the Hospital, the veterinary healthcare team adapted to their new normal with pride—and fear. Anxious rumblings of, “How do we physically distance when we have to perform surgery or put in an IV catheter?” filled the Hospital. It was difficult to eliminate all instances in which team members would be within six feet of one another for more than five minutes. And this has been unsettling for many of the veterinary healthcare workers.
“Mentally, that was quite challenging for a number of reasons. As a team, the Hospital rallied together. I think that situations like this can either make or break you; for the most part, this is making us and not breaking us. We’ve been staying ahead of what we need to. For example, we made a mask rule before it became a legal requirement so we could stay safe and operational,” says Dr. Marc Kinsley, associate professor and section chief of Large Animal Surgery.
“We continued to readjust our teams so that we had more separation between essential staff and their shifts. If someone happened to come down positive for COVID, we had an entirely separate team that could come in, fulfill the goals of the Hospital, and maintain continuity of care for our patients—the ones that were already at the Hospital and the emergencies that were inevitably going to come in,” Kinsley continues. “Everyone shifted to a more definitive team approach in both the small and large animal clinics so we could continue to function.”
While this reduction and rearrangement of employees helped reduce the risk of COVID transmission, it also meant that the Hospital couldn’t take as many cases—not just because they no longer had enough people, but to conserve personal protective equipment (PPE) for human hospitals. That’s when the College launched its Medical Mask Initiative, a call-to-action that would allow the Hospital and Laboratory teams to be protected through the use of hand-made masks and share more supplies with local human hospitals in need.
“The Hospital and Laboratory’s show of teamwork is exactly what being a Spartan veterinary professional is all about—the hard work, sacrifice, and expertise we provide for our patients and their owners, no matter the circumstances. And we’re very lucky; teams are only as good as the individuals who form them, and we’ve got some of the best individuals in the world,” says Dr. Birgit Puschner, dean of the College. “When we unite, put our minds together, and tackle a challenge, we succeed.”
All the hard work at the MSU College of Veterinary Medicine paid off. The College community didn’t report a positive COVID-19 case until late August, per the Hospital and Laboratory’s mandatory screening system.
“I’m proud of the way the Hospital team has embraced all of the new protocols that help provide a safe environment. I’m most impressed with how healthy the team has stayed. I want to believe that the rigorous health screening process that we go through and the precautions that we take has had a big impact in keeping us healthy,” says Dr. Matt Beal, head of the Hospital’s Interventional Radiology and Emergency and Critical Care Medicine Services and chief of staff for the Small Animal Clinic.
In addition to protecting themselves, frontline workers also had to protect their clients. The Hospital limited face-to-face client interaction by transitioning to curbside service and only bringing patients, not owners, inside the building. “As always, the vast majority of our clients have been wonderful and tolerant of the curbside service that we are providing. Mutual respect goes a long way,” says Beal.
Telephone check-ins, parking lot triages, and frequent phone conversations helped change client communication at the Hospital. While this decision was a major adjustment, it also was dual-purpose; it helped keep the Hospital team healthy and able to heal their patients. And it helped protect clients from potential COVID-19 exposure.
“I have only run into a few clients that have been really, truly upset by the inability to come into the building. But, when I explain the importance of us being healthy in order to save their animal and provide them the care, they seem to accept these necessary changes,” says Kinsley.
In contrast to the Hospital, the Laboratory has much less direct, face-to-face contact with clients. However, local veterinary clinics regularly drop off samples for testing at the Laboratory. Animal owners, producers, and animal health agencies also bring in animals for postmortem examinations.
To limit contact, the Laboratory transitioned to a no-touch animal drop-off process. Those bringing animals to the Laboratory call upon arrival and a client services representative collects all necessary information over the phone. Clients sign all documents electronically and staff retrieve the animal from the vehicle. Clients delivering samples to the Laboratory deposit samples into a collection box just inside the front door. Client services representatives monitor drop-offs and ensure that specimens are immediately retrieved for processing. These changes helped limit Laboratory access to MSU personnel only.
“Unfortunately, with Michigan’s Executive Order that required us to do only emergency services, more emergencies were bred out of only being able to see emergencies,” says Kinsley. “Preventative care is very important in the hindrance of health crises. So, we’ve had an increase in our emergency numbers of very sick patients.”
Despite an increase in the number of emergent patients, the Hospital and Laboratory continued to provide life-saving diagnostics and care, even while operating under challenging conditions. Around the clock, doctors, nurses, diagnosticians, and veterinary caretakers worked to protect animal health. This work continued even when stress and worry were higher than ever, fatigue was very real, and vacations were much needed.
“First and foremost, the challenges that we’ve been met with are common across all of the veterinary community. Our profession is struggling with the ramifications of COVID-19. It is without a doubt a national trend based on communication with ACVECC—the American College of Veterinary Emergency Critical Care—colleagues around the country. They are reporting that most practices like ours are seeing a 30–40 percent increase in caseload,” says Beal.
Though frontline workers are heroes, they aren’t super heroes, and functioning at this level of busyness with fewer staff is not easy.
“I’ve truly appreciated how nurses from across different services at the Hospital have supported the Small Animal Intensive Care Unit, even though their own services shut down to all but emergencies during COVID,” says Beal. “Along with our own team of ECCM nurses, they were critical to continuing our operations. Special thanks to the doctors from other services that volunteered their time to help out in the ECCM, even though it isn’t their specialty!”
While submissions dropped approximately 45 percent in April due to restrictions on veterinary services in Michigan and around the country, submissions returned to normal in May. The caseload for each week in June exceeded cases received in June 2019.
“As soon as clinics and states opened back up, we have been busier than ever before,” says Grosjean. “We are receiving record numbers of packages every day, which is great. It just makes it very difficult to get all of our testing done while socially distancing, wearing masks, and preparing for COVID testing.”
Veterinary clinics, diagnostic laboratories, and hospitals across the country are going through the same challenges and adjustments as the Spartan veterinary healthcare team. At MSU, the Hospital and Laboratory have been fortunate to receive exceptional support from their community—animal owners, veterinarians who refer patients for treatment and samples for testing, and the Spartan community at large. This unity is a testament to the College, Laboratory, and Hospital’s dedication to animal care and health.
“Overall, the most important part that our team keeps focusing on is the care of the animals. And we continue to limit our operations at the Hospital, as of the beginning of August, to ensure we have adequate staff per case,” says Kinsley. “We want to be sure that we can provide the care that the owners are paying for and what they deserve.”
The work performed at the Hospital is crucial; so is that which is done at the Laboratory. Veterinarians order diagnostic tests to verify health status, determine the cause of illness, and/or to guide treatment decisions in patients. In food animals, diagnoses for infectious diseases are needed to identify and remove affected animals to protect other animals. In the case of zoonotic diseases in both large and companion animals, this also protects humans.
“The Laboratory always provides us with exceptional, quality-driven, and efficient service. We couldn’t do our jobs without them,” says Beal.
By Courtney Chapin
The World Health Organization declared 2020 the Year of the Nurse and Midwife. Licensed Veterinary Technicians (LVTs) are the nurses of veterinary medicine. We see them in clinics, hospitals, and in the field working with animal patients, but many might not realize that they also work in other settings as well. While LVTs were on the frontlines providing patient care in the Hospital during the pandemic, they also were working in the Veterinary Diagnostic Laboratory. Meet two of them and learn more about what it was like to be a frontline worker while most Michigan residents were under a “Stay Home, Stay Safe” Executive Order.
Laboratory Technologist Manager, Immunodiagnostics and Parasitology Section
What motivates you to keep going to work every day during a pandemic?
I enjoy coming to work every day because of the importance of what we do. Every day, when we send results out, we contribute to a veterinarian’s diagnosis. We may provide a result that stops an infected animal from going into the food supply. I enjoy being on the front line of that regulatory disease testing. I also love the variety of what we do. You never know what is going to come in that day. This is one of the biggest challenges of being a lab manager, but also the most exciting.
How does your work contribute to animal and human health?
Much of what we do is companion animal testing, for pets. But another part of what we do, which is often overlooked, is the agricultural testing that is so important to industry. It’s important in food safety, sale or transport of animals, herd management, and disease surveillance. All of these also can affect human health. We are seeing, now more than ever, that there is a direct connection between animal health and human health. The “One Health” concept that we are using is so important.
How do you think your education and training as a veterinary technician contributes to your role as a laboratory technologist?
The education and training I received as a veterinary technician, or veterinary nurse, has contributed greatly to what I do in the Lab. I talk to clients, veterinarians, and government agencies on a daily basis. I am very comfortable speaking to clients, and in fact, enjoy this very much. I am confident speaking to clients due to the client communication training I received in MSU’s Veterinary Technology Program. The Program also gave me the medical background to understand different disease processes and animal physiology. This knowledge is important when I interpret results, or when I am discussing results and cases with clients.
Laboratory Technologist, Immunodiagnostics and Parasitology Section
What motivates you to keep going to work every day during the pandemic?
Knowing firsthand how desperate it can feel to want answers as to why your pet is sick or not feeling well.
How does your work contribute to animal and human health?
A lot of animal diseases are zoonotic, meaning they can be given to people. By providing our testing, we can give veterinarians information for treatment and also prevent further transmission.
What did you find to be the most challenging professional and personal aspects of the pandemic, especially during the “Stay Home, Stay Safe” Order?
Our job requires us to be in the Lab and present. There is not much we can do remotely so the Order was tough. To limit exposure, we went down to limited staff in the lab and left when our work was completed. It was different and I found myself wanting to be back to work full-time. We made it work well, regardless.
My husband and I both have jobs that are considered “essential,” so we remained working throughout the pandemic. We felt a personal responsibility to make sure we were keeping up on hand washing and social distancing to keep everyone safe.
Throughout the State of Michigan “Stay Home, Stay Safe” executive order, the Laboratory requested that clients send only samples for which diagnostics would play a critical role in the treatment and/or management of a patient. This ensured that the personnel were only working on critical cases and not routine health and wellness screening. Zoonotic diseases are essential cases. This critical work included testing for bovine tuberculosis and canine brucellosis, verifying animals to be clear of infections prior to sale or transport, and diagnosing malignant cells in biopsies. The decrease in submissions in April helped the Lab adjust to reduced and altered staffing while handling these critical cases and developing testing capabilities for SARS-CoV-2.
Experts at the Laboratory have been monitoring SARS-CoV-2 since January. As the situation evolved, the Laboratory focused on the development of an in-house test that would not deplete needed reagents or supplies for human testing.
“The preparation to begin SARS-CoV-2 testing for animals and for humans, if surge capacity is needed, has consumed most of our time in our lab section,” says Grosjean. “This has been a long process and involved many different people. Dr. Steve Bolin, section chief of the Laboratory’s Immunodiagnostics and Parasitology Section, has been instrumental. As the lab manager in that section, I am directly involved in working with Dr. Bolin to bring this testing on board. I have been working with many different groups to get the equipment, materials, and processes in place to begin testing. We’ve done everything from getting certified to test human samples, to getting procedures and training records in place, to processing samples in our Biosafety Level 3 laboratory. This has been a new and exciting challenge.”
Dr. Rachel Reams, former director of the Laboratory, led the Laboratory through the pandemic until her departure in late October of 2020. She agrees that COVID-19 has made work more difficult. “The current pandemic has challenged us to continue testing for high-consequence diseases to protect human and animal health, while simultaneously adapting our staffing and procedures to protect our team and clients, all the while working to develop testing capabilities to detect SARS-CoV-2,” she says. “But we continue to do this important work in the face of these challenges, and we will certainly face new ones in the future. We are here and we are ready.”
