The Department of Veterans Affairs has taken the drastic step of banning visitors from its spinal cord injury wards and 134 nursing homes, except for close family members of dying veterans.

All VA medical facilities began screening visitors this month for the novel coronavirus, COVID-19, and many have started limiting the number of visitors or barring children under age 18, and in some cases, 16, from medical campuses.

But on Tuesday, the department announced that its nursing homes, also called community living centers, and 24 spinal cord injury and disorder centers will have a “no visitor” rule starting immediately and lasting “until further notice.”

The facilities house or care for more than 65,000 veterans.

“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 release. “VA will make every effort to minimize the impact of these policies on veterans while putting patient safety first.”

According to VA, many of its nursing home residents and all its spinal cord injury patients have complex medical conditions that make them susceptible to infection. The COVID-19 outbreak in the U.S. has killed 25 people, 13 of whom were housed at the Life Care Center nursing home in Kirkland, Washington.

A study of more than 72,000 COVID-19 cases in China published online last month by the Journal of the American Medical Association found the virus affects patients with severe underlying medical conditions as well as the elderly more severely than younger, healthier patients.

According to the study, the case fatality rate among those already critically ill from another existing medical condition was 49 percent. For patients over the age of 80, it was 14.8 percent, and for those ages 70 to 79, 8 percent.

For the vast majority, however, the illness was mild, meaning it did not cause pneumonia or resulted in only a mild case of pneumonia. According to the research, compiled by the Chinese Center for Disease Control and Prevention, 81 percent of the 72,000 cases were mild and resulted in no deaths.

Across the country, VA is caring for or monitoring six COVID-19 cases among veterans, mostly in the western U.S.

A VA spokeswoman said Tuesday that in addition to one patient at the VA Palo Alto Medical Center in California with a confirmed case, the VA Southern Nevada Healthcare System in Las Vegas and Southeast Louisiana Veterans Health Care System in New Orleans each have one patient awaiting confirmation from the Centers of Disease Control and Prevention on their positive screenings.

Three other veterans — patients of the VA Puget Sound Health Care System, the Rocky Mountain Regional VA Medical Center and the VA Portland Healthcare System — are under quarantine at home with presumed positive cases that must be certified by the CDC, VA Press Secretary Christina Mandreucci said.

According to VA, veterans who have flu-like symptoms should call their providers first or send a secure message through MyHealtheVet before venturing to a hospital or clinic. If they have a medical appointment, they should arrive at least 30 minutes before the scheduled time to get through the medical screening process now being held outside VA medical facilities.

In addition to temperature checks, they will be asked whether they have a fever, cough or flu-like symptoms, if they have traveled to China, Japan, Italy, Iran or South Korea in the past 14 days or had close contact with someone confirmed to have COVID-19.

In addition to the “no visitor” rule at VA nursing homes and spinal cord injury centers, VA also will not be taking any new veteran residents and will limit inpatient admissions to its spinal cord injury centers to patients needing acute care. Respite care will be suspended until further notice.

The exceptions to the “no visitor” rule include veterans who are in the final stages of their life in hospice, according to VA.

“In those cases, visitors will be limited to a specific veteran’s room only,” according to VA.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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