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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, logged nearly 3,000 new cases in six days. On Monday, it recorded 36,062 confirmed coronavirus cases in all 50 states, the District of Columbia and Puerto Rico.
Deaths are at 1,997. Those deaths include only veterans diagnosed at VA hospitals and medical centers. Since the pandemic began in mid-March, 41 workers in 28 facilities have died, including six workers at the VA New Jersey Health Care System, with 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 2,585, those health centers have added 27 cases since Tuesday, a low number compared with some in California, Florida, Illinois and Texas. Three centers in the Chicago area added 69 cases since July 21 to total 1,736, and three in the Los Angeles area added 99 cases in less than a week, bringing their total to 1,365.
In Florida, two centers in the Tampa area surpassed a 1,200-case total, adding more than 200 cases in six days, and two in the Miami area are approaching 1,100 cases, adding nearly 100 cases in six days. By contrast, two VA health care centers in the Boston area reported five more cases since July 21 for a total of 912.
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 virus 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, Phoenix, whose mayor previously said that the city was in a coronavirus “crisis situation,” continues to have the highest case count with 1,058 veterans diagnosed, an increase of 51 from Tuesday. San Antonio has 1,035 cases, an increase of 151 patients over six days, and Houston added 93 cases for 1,006 total.
Orlando, Florida; 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, each have more than 800 confirmed cases, adding 90 or more new cases in less than a week. New Orleans, an early hot spot, added 20 cases in the past six days to reach 794.
The Texas Valley Coastal Bend area continues to have the highest number of active cases in the country with 331, but they have decreased by more than 80 since July 21. More than three-quarters of the VA’s COVID-19 patients across the country are 14 days beyond their last positive test or have been home from hospitalization 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.