Could VA hospitals serve as a backup in the COVID-19 surge? Here's what would need to happen.
As Michigan prepares for an expected surge in COVID-19 cases, many hospitals, particularly in Southeast Michigan, are starting to become overwhelmed.
The TCF Center in Detroit is being converted into a field hospital, and the University of Michigan is planning to convert its indoor track field into a field hospital as well. As hospitals and health systems scramble to find more beds, ventilators, and PPE, the question comes up: could VA hospitals and medical centers function as backups during this surge?
With 170 medical centers across the country, including five in Michigan, the VA is the country’s largest healthcare system.
Secretary of Veterans Affairs Robert Wilkie told NPR News the VA stands ready to back up the nation's health care system. "We have been preparing for what has been coming for a while now," Wilkie said. "In war and in case of natural disaster or an epidemic, we are the surge force."
As stated on their website, the VA’s “Fourth Mission” is “to improve the nation’s preparedness for response to war, terrorism, national emergencies, and natural disasters by developing plans and taking actions to ensure continued service to veterans, as well as to support national, state, and local emergency management, public health, safety and homeland security efforts.”
Earlier this week, a VA hospital in New Jersey opened up 20 beds (15 acute care and 5 ICU) to non-veteran COVID-19 patients. According to the VA, the state of New Jersey made the request with FEMA, and the decision to open the beds was made after determining that it wouldn’t negatively affect veteran care. Could VA medical centers in Michigan do the same?
The five VA medical centers in Michigan are in Ann Arbor, Battle Creek, Detroit, Saginaw, and Iron Mountain. But it’s not as simple as just asking any one of these facilities to open their doors to COVID-19 patients.
In the end, the VA’s help is far from a given or a guarantee. According to FEMA Region 5, which serves Michigan and other Great Lakes states, local requests for aid like staffing, equipment, or supplies, would go to the state emergency center. In Michigan, that’s the State Emergency Operations Center, under the purview of the Michigan State Police in Lansing. The goal of SEOC is to work with other Michigan state agencies to see if they can provide resources to fill the need.
If Michigan can’t meet the need, then the state could make a resource request to FEMA’s Region Response Coordination Center in Chicago, which would work with the National Response Coordination Center to find any asset—whether a federal agency or another entity—that meets the requirements of the state’s request. There is no guarantee that the entity in question will be the VA.
Michigan Radio reached out to the Michigan Department of Health and Human Services, which contacted FEMA. An MDHHS official said that in order to specifically request either the use of a VA facility for non-veteran in-patients or the use of VA medical professionals from less impacted areas, a state must be able to demonstrate that they are 72 hours from exhausting all capacity.
It’s unclear what kind of resources the VA might have available. A VA official tells Michigan Radio that there are 13,000 acute care beds and 1,800 ICU beds throughout the national VA system, but were unable to get Michigan-specific numbers on ICU beds, acute care beds, or any count on ventilators.
VA spokesman Bill Putnam says, “VA facilities are equipped with essential items and supplies to handle additional coronavirus cases, but specific operational capabilities of VA facilities are sensitive in nature. VA continues to take necessary preparedness actions to ensure the continuity of our healthcare system to provide care for our Veterans.”
The VA has not been immune to the effects of the pandemic. Earlier this week, a VA employee who worked at the John D. Dingell Medical Center in Detroit died due to COVID-19. They were in their 70s.