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En español | The Department of Veterans Affairs (VA) is increasing efforts to protect its most vulnerable patients from the coronavirus by prohibiting visitors at its 134 nursing homes and 24 spinal cord injury centers.
No outsiders are permitted to see these residents except for “compassionate cases,” when a veteran is in the last stages of life in hospice. Additionally, all nursing homes have suspended new admissions except for transfers from other VA facilities after a doctor's clearance.
Spinal cord injury and disorder centers aren't admitting new patients for routine matters. All staff is being screened daily.
"These commonsense measures will help protect some of our most vulnerable patients,” VA Secretary Robert Wilkie said in a statement. “VA will make every effort to minimize the impact of these policies on veterans while putting patient safety first."
Reflecting a steep rise in COVID-19 across the country, the Veterans Affairs medical system, which includes both care homes and health care centers, has recorded more than 40,000 cases in all 50 states, the District of Columbia and Puerto Rico. That’s an increase of more than 1,000 cases in two days, for a total of 30,911, as of Wednesday.
Deaths are at 2,211, an increase of almost 70 since Monday. Those deaths include only veterans diagnosed at VA hospitals and medical centers. Since the pandemic began in mid-March, 42 workers in 29 facilities have died, including six workers at the VA New Jersey Health Care System, which has campuses in East Orange and Lyons; and three each at facilities in Indianapolis and Reno, Nevada.
Although a cluster of three VA facilities in the New York City area continues to have the most cases, at 2,665, those health centers have added 12 cases in two days, a low number compared with some in California, Florida, Illinois and Texas. Three centers in the Chicago area added 58 cases since Monday, to total 2,083, and three in the Los Angeles area added 19 cases in two days, bringing their total to 1,467.
The two VA centers in South Carolina added 35 new diagnoses in two days, for 1,535 cases total. In Florida two centers in the Tampa area totaled 1,382 cases, adding 72 cases in two days, and two in the Miami area are at 1,275 cases, adding almost 50 cases since Monday. By contrast, two VA health care centers in the Boston area that had surged early in the pandemic were stable since Aug. 3, for a total of 964.
Fewer recently diagnosed veterans appear to be dying than in the early days of the U.S. outbreaks — in part because doctors and researchers have learned more about how the coronavirus behaves but also because death generally doesn’t happen until about 18 days after symptoms appear, according to March studies of early Chinese cases.
At individual health care centers, San Antonio is at the top of case counts, with 1,151 veterans diagnosed, an increase of 17 cases in two days. Houston added 65 cases in two days, for 1,136 total. Phoenix, whose mayor previously said the city was in a coronavirus “crisis situation,” now has the third-highest case count, with 1,107 veterans diagnosed, an increase of nine since Monday. Orlando added 34 veterans to its caseload and now has topped 1,000.
Atlanta and the Texas Valley Coastal Bend Health Care System, a set of seven VA clinics in four cities including Corpus Christi in southeast Texas, have more than 900 confirmed cases apiece. Atlanta added 23 cases since Monday, and Texas Valley had eight more. New Orleans, an early hot spot, added 31 cases in two days, to reach 846.
Gainesville, Florida, about 100 miles northwest of Orlando, now has the highest number of active cases, at 142. More than 4 out of 5 of the VA’s COVID-19 patients across the country are 14 days beyond their last positive test or have been home from the hospital for at least two weeks, the agency reports.
Increased screening at VA med centers
VA medical centers across the country are taking precautions to screen patients, staff and visitors. Veterans with symptoms of COVID-19 are asked to call their health care facility if they have symptoms of the infection and may be directed to use telehealth so they won’t have to leave home.
Veterans who have appointments for other needs are advised to come early to allow time for screening. Everyone is being screened for signs of respiratory illness and coronavirus exposure.
One example: The Connecticut VA Healthcare System is funneling those who want to get inside to two entrances on each VA campus. Screening questions include whether guests have a fever or flu-like symptoms, where they've traveled in the past 14 days and what contact they've had with anyone confirmed to have the coronavirus.
Telemedical care is an option
If a VA client has a cough, fever and shortness of breath, the veteran is advised to call the local VA medical center and select the option to speak to a nurse before visiting. The client also is asked to consider using the VA's telehealth and virtual care options so that he or she can be evaluated without leaving home.
"We need to do that to make sure that those who use VA are protected, that they are cared for,” Wilkie said at the American Legion Winter Conference. “We will get over this and we will make sure everything is done to protect those who have done so much for our country."
Editor's note: This story, originally published March 11, 2020, has been updated to reflect increased coronavirus cases in the VA system.