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Miami VA hospital reports first ‘positive’ coronavirus case as it steps up screenings

Miami VA Medical Center (Veterans Health/Flickr)
March 20, 2020

A patient at the Miami VA Medical Center has tested “positive” for COVID-19 in the first such case at the downtown veterans facility since the novel coronavirus started spreading across Florida earlier this month, hospital officials confirmed Wednesday.

The veteran, one of ten patients who have been tested by the Miami VA for infection by the coronavirus, was admitted for treatment.

“The risk of transmission to other patients and staff remains low, as the veteran is being cared for in isolation by staff who are specially trained on the latest Centers for Disease Control treatment guidelines and utilizing personal protective equipment and infection control techniques,” the Miami VA said in a statement.

But the statement issued by the VA did not indicate the status of the other nine patients who were tested for COVID-19. Those results could be available later Thursday. Also, it was not clear from the statement whether medical professionals, such as VA doctors, may have been exposed to any of those patients who underwent the test.

While it’s difficult to gauge the VA Medical Center’s preparedness for the coronavirus pandemic, there had been no reported positive cases at the facility or at other VA hospitals in Florida before the latest development Wednesday evening, according to the Centers for Disease Control and Prevention data.

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Of the 322 veterans nationwide who had been tested for COVID-19, there were 44 with positive results for the infection, according to the CDC data on the Department of Veterans Affairs web site. But of those positive cases, none had been reported in Florida, records show. Overall, the greatest concentrations of positive cases were in Atlanta (8), New Orleans ( 5) and Puget Sound (5).

In total, there has been one death, up from zero on Monday, the VA’s data shows.

Last week, with the coronavirus advancing in Florida, the VA Medical Center in downtown Miami began screening veterans, staff, volunteers and guests around the clock for flu-like symptoms before letting them into the facility. Visitation hours have been suspended.

Staff, patients and others must all enter through the west entrance of the VA facility at 1201 NW 16th St. The 372-bed hospital cares for about 58,000 patients annually, while the veterans population in South Florida is estimated to be about 150,000.

“We have implemented enhanced screening protocols at all our facilities,” the Miami VA Healthcare System said on its web page. “We understand this may be an inconvenience to some, but it is important that we quickly identify individuals who have these symptoms and direct them for further triage and treatment.”

But some people with knowledge of the screening process say that the Miami VA’s system is based on staff, patients and others telling the truth. They are being asked about their health — whether they have a fever or any other symptoms of the coronavirus — but their temperatures are not being taken with an infrared thermometer to determine whether they should be allowed into the hospital.

“The screening process is inadequate,” said one person familiar with it. “It’s an honor system.”

Nationally, the VA says it has adopted an “aggressive public health response” to the threat of the coronavirus, including outreach to veterans and staff, clinical screening at VA healthcare facilities, and protective procedures for patients admitted to community living centers and spinal cord injury units, according to the Department of Veterans Affairs web site. It says any veteran with symptoms such as fever, cough or shortness of breath should immediately contact a local VA facility.

VA officials are urging veterans to call before visiting their closest VA facility. Alternatively, Veterans can sign into My HealtheVet to send a secure message to VA or use telehealth options to explain their condition and receive a prompt diagnosis, officials said.

Veteran Richard Izzi, commander of the American Legion Post in North Miami Beach, said he was scheduled for surgery on his left knee at the Miami VA Medical Center on Wednesday morning but the procedure was canceled on Tuesday. He said the VA called him and said he could not go forward with his elective surgery because the hospital needed to use its medical equipment for emergency situations.

“I was ready to go in this morning,” Izzi told the Miami Herald. “My surgery was scheduled for 8 a.m., but yesterday [Tuesday] they called me and canceled it. They have rooms, but they can’t do elective surgeries. They don’t want to take a chance on anything.”

Izzi said he and other members of the American Legion were less concerned about the coronavirus scare and more worried about the fate of their post, which will face financial difficulties due to a 30-day closure of all Florida bars ordered by Gov. Ron DeSantis.

If the coronavirus continues to spread across Miami-Dade and Broward counties, the VA Medical Center has a collaborative agreement to work with other hospitals in Miami-Dade on veterans’ healthcare, including Baptist Hospital, Nicklaus Children’s Hospital and the University of Miami Hospital.

Unrelated to the coronavirus crisis, the Miami VA Medical Center has been the subject of past scandals involving unreliable HIV lab tests and infections transmitted through contaminated medical equipment.

In 2018, an independent federal investigator found that at least eight military veterans who were tested for HIV at the Miami VA Medical Center received a different result when they were screened for a second time by an outside lab. The discrepancy was discovered only after an employee at the Miami facility complained to outside agencies and the White House that local managers were ignoring his concerns. VA officials disputed that claim.

A decade earlier, federal investigators learned that staffers at the Miami VA Medical Center and other VA facilities in the South were rinsing colonoscopy equipment instead of steaming and sterilizing it as required by the manufacturer. Of the 3,000 veterans who were exposed, blood tests showed five later tested positive for HIV, eight for hepatitis C, and one for hepatitis B. VA officials said there was no way to know for certain whether the improperly cleaned equipment transmitted the diseases.

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© 2020 Miami Herald