Like many private sector hospitals, the Manchester VA is taking steps to limit the spread of the coronavirus. The VA is asking anyone with possible symptoms of COVID-19, such as fever or cough, to call the VA before showing up, and providers are deciding on a case-by-case basis whether to go forward with elective, non-urgent surgeries and procedures.
But some VA staff have been concerned that some procedures, like colonoscopies and routine vaccinations, are still taking place. They say these come with unnecessary risks to patients and staff.
NHPR’s Peter Biello spoke with Kevin Forrest, Manchester VA's interim director, to learn more about how they’re responding to the coronavirus.
The Manchester VA says it's curtailing non-urgent elective surgical procedures. How do you decide which kind of procedure falls in to what is non-urgent, elective and which is urgent and necessary?
So, Peter, you know, we look at the guidance that comes out from the national office on different categories of care. And, you know, we depend on our specialists to look at all the procedures we do in the facility here. And they make a clinical determination of what care is elective and what needs, you know, more prompt attention. And then it's their decision to work with the patient and coordinate that care.
So sources have told me that the VA has done colonoscopies, bladder cystoscopies as recently as Thursday. There was concern among staff that have spoken to me that these examples of surgeries should not have happened today. They should have been postponed. What do you think about that?
Those surgeons, those urologists, those gastroenterologists, they review those procedures. They are the subject matter experts. And, you know, it's them providing that care. They do a complete review of that care and make that determination and work with those patients.
The VA is reportedly planning on setting up 12 inpatient skilled nursing beds. Is that true?
It is. We are in the process now of adding those beds as a surge capability to be able to handle veteran patients out there that require that skilled nursing care. For instance, we may have veterans at other VA medical centers that might be occupying a bed that might be more appropriate to someone with more acute health care needs. You know, we're going to stand tall to be able to receive those patients, provide them the care that they need and be able to allow those other beds to be freed up for those other patients.
The Manchester VA has a nursing facility attached to it-- The Community Living Center. I don't know the precise demographics of the people living there. But I imagine that they're elderly veterans. And elderly, of course, being an at-risk population for the coronavirus and COVID-19. How is the Manchester VA making sure that possible infections or any kind of contamination doesn't transfer from the rest of the medical center to the attached Community Living Center?
Peter, you're exactly right. And, you know, I think we realize with our Community Living Center nursing home here, that that is our most vulnerable population. And we identified that right up front, which is why we made such immediate steps to start the screening at the entrances, make sure that people, you know, visitors, veterans and employees coming in were screened properly, coming into the medical center for the CLC. You know, at that time we made the call to stop visitors from coming into the CLC. You know, that was challenging. We know veterans, you know, depend on visitors in there. But, you know, out of an abundance of caution we thought it was the right thing to do. We also made measures to allow only essential staff into the unit there so that we really just cut down the amount of traffic and access to the unit.
Does the VA have enough personal protective equipment for staff?
Yes. I think one of the benefits of the VA and an integrated health care system here is, you know, we have the N-95 masks and PAPRs and gowns that we use. And, you know, if we run into a point where it's a challenge, we're able to cross level and look at the supply chain across all the VA medical centers and offer assistance when needed.
Dartmouth-Hitchcock was soliciting donations of personal protective equipment. Is the VA also accepting donations of that kind of thing?
So, Peter, not to my knowledge. You know, I know that the supply chain in the private sector is different from the federal government. But, you know, I... So I can't speak on what Dartmouth-Hitchcock may be doing at this time.
But would the VA take donations if people were interested?
You know, I would say if someone was interested that that, you know... it's gracious that people would offer that. We would, I think, process those requests and look at it and, you know, consult with the supply chain for the VA and see if that's appropriate.
Overall, what would you say is the biggest challenge the Manchester VA is facing right now?
Well, I think it's for us to be prepared, ensure that we give veterans the confidence. We are here for them. We just may be delivering health care in a different way of using, you know, telephone care, remote care, video, tele-health. We just stand poised to continue combating this pandemic and moving forward.
And so far, as far as you know, no known cases of COVID-19 at Manchester VA?
No known cases that I am aware of. Nope, Peter. We've been very fortunate.
