Second coronavirus case at Cleveland VA comes as hospital restricts visitors, moves appointments online
By EVAN MACDONALD | The Plain Dealer | Published: March 20, 2020
CLEVELAND, Ohio (Tribune News Service) — The Louis Stokes Cleveland VA Medical Center confirmed its first case of the novel coronavirus Sunday, and its second on Thursday. They’re unlikely to be the last.
The hospital, like others throughout Northeast Ohio, is taking decisive steps to protect its unique patient population of U.S. military veterans.
The Cleveland VA is the flagship of a VA Northeast Ohio Healthcare System that serves more than 112,000 veterans annually. Nearly 58 percent of Ohio’s veterans are over the age of 60, a population that healthcare experts say is at greater risk for COVID-19.
The VA has taken steps at all of its U.S. facilities to reduce the risk of patients contracting the coronavirus, and the Cleveland VA has followed suit. Staff screens visitors to the University Circle hospital through a series of questions. Anyone flagged for a risk factor such as contact with someone known to have the virus continue to a clinician for additional assessment, said Dr. Usha Stiefel, the Cleveland VA’s chief of infectious disease.
The Cleveland VA plans to implement more stringent visitor restrictions starting Friday, such as a temporary ban for visitors under the age of 18, Stiefel said. Healthcare experts say children are known carriers of the virus, but it’s hard to detect if a child has COVID-19 because many of them are asymptomatic.
“I know sometimes that sounds a little harsh when you’re hearing it for the first time,” Stiefel said of the visitor restrictions, “but this is really for the benefit of our patients.”
Visitors are also temporarily restricted at all VA nursing homes, including the one located at the Cleveland VA. The hospital makes exceptions for visitors for patients in the last stages of their life or in hospice care.
The Cleveland VA is taking the temperature of visitors flagged during the screening process but is not currently doing it for all visitors. That could change moving forward, but it is still under consideration, Stiefel said.
The various measures implemented at the Cleveland VA are intended to protect the hospital’s unique patient population, she said.
“We know that the elderly are particularly vulnerable,” Stiefel said. “We definitely have some unique facets for our population as a whole.”
The first veteran who tested positive for COVID-19 on Sunday was placed in isolation, Stiefel said. The VA is following U.S. Centers for Disease Control and Prevention guidelines for notifying and monitoring anyone who may have had significant contact with the veteran. The VA confirmed the second positive case late Thursday afternoon, a spokeswoman confirmed.
Nationally, the VA had identified 83 cases of COVID-19 by noon Thursday, including one death in Portland. Oregon. Those figures include the first Cleveland case and another in Dayton.
Apart from screenings, the hospital took other measures to reduce the risk of spreading COVID-19 at the Cleveland VA and other VA facilities. Veterans should immediately contact the VA if they are displaying COVID-19 symptoms such as fever, cough or shortness of breath, but they should call ahead before visiting a facility. They can also contact a VA healthcare professional online or by phone, and receive a diagnosis remotely.
Stiefel said the Cleveland VA is moving most outpatient visits online or over the phone to reduce the number of visitors to the hospital.
The VA is the most extensive healthcare system in the U.S., so Stiefel believes the Cleveland VA is well-situated for a rise in coronavirus cases.
“We have a lot of systems in place where we can really rapidly disseminate information and best practices between hospitals, so I think that actually makes it easier,” she said. “We’re not reinventing the wheel. We get a lot of guidance, and we’re sharing information with people around the country.”
As coronavirus cases have risen internationally, healthcare experts have raised alarms about the availability of ventilators used to help the most seriously-ill patients breathe. A VA spokeswoman said the Cleveland VA is adequately staffed and resourced, but did not offer a specific number of ventilators at the hospital. Other Northeast Ohio hospitals estimated they have more than 1,000 ventilators among them.
Jon Reiss, the executive director of the Cuyahoga County Veterans Service Association, said he has full confidence the VA will meet veterans’ healthcare needs.
“We have one of the best VA hospitals in the country,” Reiss said. “They have strong leadership and are reacting quickly to this crisis.”
The CCVSA, which assists local veterans through hardships, has closed its offices until at least March 31 in response to the coronavirus threat.
The Legal Aid Society of Cleveland also assists veterans, and is keeping its intake line open for them to report issues. The coronavirus threat is fluid, so it’s unclear if it could present any challenges unique to veterans, said Melanie Shakarian, the society’s director of development and communications.
“I think there’s a lot that remains to be seen,” she said. “We know there will be really unique challenges as it comes to our veterans.”