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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."
The Veterans Affairs medical system, which includes both care homes and health care centers, has recorded more than 55,000 cases in all 50 states, the District of Columbia and Puerto Rico. That’s an increase of almost 2,000 cases in a week, for a total of 55,137 as of Friday.
Deaths are at 3,139, an increase of almost 100 since Sept. 4. Those deaths include only veterans diagnosed at VA hospitals and medical centers. Since the pandemic began in mid-March, 54 workers in 38 facilities have died, one more employee death in the past week. The total includes six workers in the VA New Jersey Health Care System with campuses in East Orange and Lyons, and three each at facilities in the District of Columbia, Indianapolis and Reno, Nevada.
A cluster of three VA facilities in the Chicago area has surpassed three in the New York City area to have the most cases nationwide at 2,892, an increase of 111 in seven days. In contrast, the New York City area cases increased by 17 to 2,831 in the same period and three centers in the Los Angeles area added 42 cases in a week, bringing their total to 1,822.
Two VA centers in South Carolina added 48 new diagnoses in a week for 2,041 cases total. In Florida, two centers in the Tampa area have totaled 1,842 cases, adding 139 cases in seven days. Two centers in the Miami area are at 1,656 cases, adding 72 cases during the same time. Two Boston-area VA health care centers that had surging numbers early in the pandemic added three cases, for a total of 1,038.
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 coronavirus infections behave, but also because death generally doesn’t occur until about 18 days after symptoms appear, according to March studies of early Chinese cases.
At individual health care centers, North Chicago is now at the top of new case counts, adding 75 cases in a week for 1,590. It also has the highest number of active cases at 163.
San Antonio added 30 cases in seven days for 1,506. Houston added 15 cases for 1,454 total.
Other VA medical centers with more than 1,000 cases: Phoenix, with 1,323 (21 more than Sept. 4); Orlando, with 1,287 (50 additional); Atlanta, with 1,265 (26 additional); Texas Valley Coastal Bend Health Care System, a set of seven VA clinics in four cities including Corpus Christi in southeast Texas, with 1,254 (23 additional); and Gainesville, Florida, with 1,082 (82 additional).
New Orleans, an early hot spot after Mardi Gras, added six cases in seven days, to reach 1,005.
Nearly 9 in 10 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.