“We are not only in the process of responding, but also significantly planning for what is to come. Inventories of ventilators will be critical.”
Those words helped convince Dr. Beth Davidow that it was time to act. She had reached out to Geoff Austin, chief operating officer of the University of Washington Medical Center, after the new coronavirus reached Washington and its residents started testing positive for COVID-19. The response, specifically regarding the local hospitals’ need for life-support ventilators, urged Davidow to activate the power of the professional veterinary community.
“As you read the news of people dying because there’s not a ventilator available,” she said, “it makes you want to help as much as you can.”
Davidow, president-elect of the American College of Veterinary Emergency and Critical Care, worked with the ACVECC leadership to organize a Google Form to identify and list any available ventilators from the emergency and critical care veterinary community.
“We shared that list of ventilators with the human Society for Critical Care Medicine, the American Hospital Association, and the American Medical Association,” said Davidow, who also connected with veterinarians in zoos who listed their equipment for donation.
The response flooded in.
“There’s about 190 facilities with just over 200 ventilators listed on the spreadsheet,” said Davidow on Friday. “Somewhere between 30 and 40 of those hospitals have already made contact and promised hospitals they could provide ventilators, if needed. Close to 10 hospitals have already shared their ventilators, especially in New York and New Jersey, which have been hit really hard.”
Infographic by Elizabeth Fleener
Life-support ventilators play a critical role in the care of human patients with severe cases of COVID-19 or pneumonia. The supply of ventilators as COVID-19 cases increase—exponentially in some communities—has risen to the forefront of discussions among medical professionals, government officials, and more.
This list from veterinarians throughout the United States, and some in Canada, includes life-support ventilators and other medical equipment such as anesthetic ventilators, high flow nasal oxygen systems, and renal replacement therapy machines.
Emergency and critical care facilities use life-support ventilators for a variety of scenarios in which a patient needs lung support. As opposed to anesthetic ventilators, which supply 100% oxygen, life-support ventilators give medical professionals crucial flexibility by allowing them to adjust the percentage of oxygen delivered, breathing rate, and more.
Davidow—who co-owned a 24-hour emergency and critical care veterinary hospital for a decade—has used life-support ventilators on animals dealing with severe cases of pneumonia, lung damage from inhaling smoke in a fire, and bleeding inside their lungs after being hit by a car. She acknowledges that offering this life-saving equipment creates a potential gap in care.
“We could definitely be left vulnerable. What’s hard with this situation is certainly no one would want their relative to pass away because there wasn’t a ventilator available, but it does mean these hospitals that have always had ventilators to treat pets now don’t have them available,” said Davidow, who now teaches as a clinical assistant professor at Washington State University and writes on her blog, The Veterinary Idealist. “Our network does give them the chance to say, ‘Hey, we’ve given up our ventilator, but there’s something here that’s available.’ It will help somewhat, but this crisis has ripple effects that touch both people and their pets in terms of who’s vulnerable and who’s left without care.”
“This crisis has ripple effects that touch both people and their pets in terms of who’s vulnerable and who’s left without care.”
The cost of this equipment with economic uncertainty looming also plays a factor.
“There’s a ton of anxiety if you are a veterinary practice owner or if you’re in a practice. These ventilators are expensive. If you buy a used ventilator—they are all human machines that we are being refurbished on the human market—you might spend $5,000 to $10,000. And, if you bought a new model, you might spend $25,000 to $50,000,” said Davidow. “So, we don’t want to lose our equipment. There’s been discussions about how to label it, keep receipts, and make sure we get it back at some point. In the grand scheme of things, it’s more important that somebody’s life is saved, but hopefully the equipment makes it back where it belongs.”
Despite these considerations, members of the veterinary community are making a difference.
Dr. Tim Hackett, director of the Colorado State University Veterinary Teaching Hospital, helped organize a ventilator donation to the UCHealth Poudre Valley Hospital in Fort Collins, Colorado, the Cornell University College of Veterinary Medicine donated personal protection equipment and ventilators to the Cayuga Medical Center in New York, and others have taken similar action. The NAVC made a large donation of unused medical shoe covers, masks, gowns, gloves, and more to the Florida Department of Health, the estimated value of which exceeds $10,000.’
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Davidow notes there’s still opportunity to contribute, but also stresses the importance of limiting the spread of COVID-19.
“If you are an emergency/critical care veterinarian and you haven’t listed your ventilator on our spreadsheet, I would encourage you to do so,” says Davidow. “I would look at how much personal protection gear you have in your hospital and make a clear plan of where you need that and how you use it. Only order what you really need to protect you, your staff, and your pets.
“If one client comes into your lobby and is positive for coronavirus, if you have 15 people that are exposed to them versus no one, that’s a big difference in terms of disease transmission. If you’re not using curbside admission right now, then you should be. If you’re not asking your staff to social distance when they’re outside of work, you should be.”