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In their opinion piece ‘Vets would not manage Covid-19 this way’ (VR, 18/25 April 2020, vol 186, pp 462-463), Dick Sibley and Joe Brownlie have neglected to consider some essential differences between managing human and animal disease outbreaks. They show little understanding, or acknowledgement, of public health ethics, socioeconomic factors and the environmental, political and legal issues that add to the complexities of Covid-19 management. As public health veterinarians, we reject the reductionist views of Sibley and Brownlie and applaud the efforts of the global public health community.
Around the world many governments are attempting to ‘flatten the curve’, which is not, as the authors have suggested, ‘more of a system of delaying deaths than saving lives’. Interventions to flatten the curve have significantly reduced the expected death toll. These interventions include improving patient access to intensive medical care, decreasing caseloads in hospitals, enabling a less-stressed and better resourced medical workforce, decreasing the risk of infection to hospital staff by decreasing disease exposure and lessening fatigue, and ensuring access to adequate personal protective equipment.
The broad generalisation that ‘it is unfortunate that the medical world has historically invested in therapeutics, diagnostics, technologies and even bigger hospitals to treat the sick rather than the preventive medicine that has become the cornerstone of the veterinary world’ ignores the strong focus on health promotion and the significant successful disease prevention strategies of the past. These include immunisation programmes, anti-smoking campaigns, health screening campaigns and legislation to control hazardous products such as asbestos.
We agree that veterinarians would not manage Covid-19 this way, primarily because Covid-19 is not an animal disease outbreak and cannot be managed as such. Among farm animals, individuals can be contained in groups dependent on their vulnerability. Suggestions to isolate vulnerable members of the population while allowing the robust to develop herd immunity ignores the different social structures of human communities. Further, Brownlie and Sibley offer no practical way of achieving this, let alone acknowledge any potential morbidity and mortality that will still occur among the resilient.
Veterinarians sometimes have failures in outbreak management, for example, bovine tuberculosis in the UK and bovine Johne’s disease in Australia. Invoking the ‘four pillars of disease control’ also ignores the fact that, in some settings, one of our commonly used tools is culling infected or at-risk animal groups.
We acknowledge some countries appear to have had better success in containing Covid-19 through early restriction of entry, thus enhancing biosecurity. This success has also been accompanied by effective contact tracing and testing, restrictions on local movement and messaging for behavioural change such as appropriate hand hygiene and social distancing. We also acknowledge the stress and difficulties faced by our British veterinary colleagues at the moment and offer our full support.
This is not the time for professional chest-beating or tone-deaf commentary – support and respect for our public health colleagues and their respective health departments is critical. Veterinarians need to use their skills in epidemiology and outbreak management to assist human health providers wherever possible. We encourage Brownlie and Sibley to consider practising some epistemic humility1 and appreciate the complexities of managing an unprecedented pandemic in the modern era at a national and global level.
We hope that veterinarians around the world will reflect on the lessons learnt from this pandemic, learn and collaborate with other professions, and help build a foundation towards a shared One Health vision.
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