The Department of Veterans Affairs is shutting down visitation at its 134 nursing homes nationwide as the number of veterans testing positive for coronavirus grows.
In its first news release about COVID-19, the coronavirus outbreak in the United States, VA announced it will not allow visitors to its nursing homes which serve more than 41,000 veterans across the country.
About half of VA patients are older than 65, a population at elevated risk for infection, according to the CDC.
VA also is prohibiting visitors to its 24 major spinal-cord injury and disorder centers nationwide, since the more than 24,000 veterans at those facilities are also at higher risk of infection.
New admissions to either nursing homes or spinal-cord centers also will be limited, and only allowed if the veteran has not been infected and is not at risk of infection.
Exceptions will be made for veterans who are in the "last stages of life," VA said, in which case those visitors will be limited to that veteran's room only.
At both nursing homes and the spinal-cord centers, VA staff will be screened daily and will work only in their facilities to avoid infection, VA said. Both veteran populations are "two of (VA's) most susceptible patient populations," VA said.
“While the COVID-19 risk to average Americans remains low, 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.”
More veterans test positive
As of March 13, VA Press Secretary Christina Mandreucci told Connecting Vets VA has at least 16 cases of veterans testing positive for the virus.
Wilkie told Congress March 4 that the first veteran had tested positive for the virus -- a California man being cared for at the Palo Alto, Calif. VA. Later, VA confirmed that a second veteran tested positive for COVID-19 at the Southern Nevada VA.
Now that number has grown to at least 16 veterans either testing positive for the virus, or presumptively testing positive. That number will likely change as more veterans test positive, or those who presumptively test positive are cleared through more testing.
VA officials cited privacy concerns when they declined to provide further details about the patients, including where or how they may have become infected.
“The risk of transmission to other patients and staff remains low, as the veterans are being cared for in isolation by staff who are specifically trained on the latest (CDC) treatment guidelines and utilizing personal protective equipment and infection control techniques,” Mandreucci said, though VA did not elaborate on specific measures being taken.
VA also is screening all staff and patients who show symptoms of the virus, including fever, cough and shortness of breath, Mandreucci said. “Per CDC guidance and VA protocols, individuals known to be at risk for a COVID-19 infection are immediately isolated to prevent potential spread to others.”
Lawmakers and their staff on Capitol Hill, veteran service organizations and veterans told Connecting Vets they were "frustrated" by a lack of communication from VA about coronavirus. Tuesday's news release about nursing homes and spinal-cord centers was the first major news release from the department on the virus.
The Department of Health and Human Services is leading the federal government’s COVID-19 response, VA officials told Connecting Vets, but “VA is monitoring the situation through its Emergency Management Coordination Cell” and is working with HHS and the CDC “to ensure veterans benefit from the latest prevention” and to help VA “develop emergency management plans for medical centers.”
Members of Congress repeatedly asked VA what the agency was doing to prepare for and respond to the outbreak. But VA leaders, including Wilkie, provided few details, despite repeated questioning.
VA leaders told Congress the department has space nationwide to care for infected veterans, including about 1,000 negative airflow rooms, designed to prevent contamination and the spread of infection.
VA also began pre-screening outside its emergency rooms and other facilities and leaders told lawmakers VA has about 1,000 coronavirus tests on hand. Veterans Health Administration head Dr. Richard Stone told Congress 1,000 are not enough, and the department plans to design its own.
Last week, Wilkie declined an offer for additional resources from lawmakers on Capitol Hill, saying he believed VA was prepared for a potential outbreak.
“Not at this point,” Wilkie told lawmakers of his need for more resources. “We are a foundational response when it comes to emergencies like this. We train for them year-round … We are testing our processes as we speak … We are checking supply lines.”
But if conditions take a turn for the worse, Stone said things will change.
“If this develops into a pandemic, in which parts of the American health system break down, we’re going to have a different conversation,” Stone said, adding that as of now, “we see ourselves as well prepared.”
VA's role in national emergencies
"We train for this. We train for epidemics," Wilkie told lawmakers, adding that VA is in "constant contact with the CDC and National Institutes of Health as well as the presidential task force."
Wilkie also has a seat on that task force, he said.
In the event of national emergencies, VA essential functions and funding are guaranteed by the federal government and VA and its medical facilities are tasked with supporting “our nation’s communities affected by nationally-declared disasters,” according to VA’s emergency management plan. That includes assisting FEMA and HHS in response to emergencies, including epidemics.
VA is one of four federal partners in the National Disaster Medical System (NDMS), along with Homeland Security, the Defense Department and HHS. The NDMS is intended to establish a national medical response to help state and local authorities respond to public health crises, including national disasters or disease outbreaks, or to help the military medical system care for casualties of war, “from the smallest incident to the largest catastrophe.”
That responsibility includes the Disaster Emergency Medical Personnel System (DEMPS) which deploys clinical and other staff to respond to emergencies or disasters, as well as mobile medical units.
VA has a guide for veterans on coronavirus, which includes that veterans who believe they are infected should call their local VA before they show up to the hospital.