The Department of Veterans Affairs is beginning to divide its inpatient units into two zones to separate non-infectious patients from those with novel coronavirus, officials said. And when the need arises, as the new phased plan predicts it will, officials plan to discharge non-critical patients and even build new facilities.
The plan is part of a four-phased pandemic response blueprint released Friday, weeks after the VA was criticized for not publicly disclosing its plan to help veterans and the federal government respond to the COVID-19 pandemic.
The VA is currently in Phase 2, "Initial Response," which means staff are focusing on mitigating local or regional outbreaks by creating two zones.
Phase 3 is when the condition becomes drastic -- patient demand surpasses the VA's capability or supply chain. All routine care will be reduced or stopped at VA medical facilities, and the VA staff will then begin using other spaces like an outlying ward or field hospital to take in veterans and possibly the civilian public.
In outbreak mitigation phase, standard and COVID-19 zones will have separate air flows and staff restrooms and break and call rooms to eliminate the chance of cross contamination. This new division is in addition to the VA's current practice of pre-screening patients and asking them to call instead of just walking into a clinic.
The VA pandemic response plan projects COVID-19 could last at least 18 months, and include multiple waves of illness. It also estimates that about 20% of patients infected with COVID-19 will need to be hospitalized, including about 5% who will need intensive care unit-level care and 2.3% who will need ventilator support.
To make room for these patients as the number of cases grow -- there were about 570 veterans diagnosed with the virus Friday -- the VA has suggested clinics reduce elective procedures, consolidate or shift non-coronavirus patients' quarters and set up tents.
The plan also suggests discharging patients who don't immediately need to be hospitalized, including those in residential programs. A Cincinnati news station reported last week in nearby Fort Thomas, Kentucky, some of these homeless VA patients are already being released and a few have said they have no place to go.
The plan's last phase, "Sustainment and Recovery," is a return to normal operations, but "a couple of the top priorities to consider would be to prepare for a second wave, reinitiate curtailed services during the surge phase, monitor the health and well-being of staff and rehabilitate (clean, service, and renew) all rooms, equipment and resources utilized in the response phase."
-- Dorothy Mills-Gregg can be reached at firstname.lastname@example.org. Follow her on Twitter at @DMillsGregg.