By the end of this week, the Veterans Affairs Pittsburgh Healthcare System hopes to begin screening for COVID-19 every person — patient or visitor — who tries to enter one of its facilities at its two campuses in Oakland and Aspinwall.
“The goal is to try to limit the number of people who enter this campus who are at high risk of being COVID-19 positive,” Pittsburgh VA Director Don Koenig said Tuesday at the VA Town Hall meeting held at the hospital on University Drive in Oakland. “It’s just good common sense.”
The Pittsburgh VA appears to be the first healthcare facility in the Pittsburgh area to enforce such a drastic screening protocol for everyone who tries to enter a facility.
This follows a directive from the VA headquarters in Washington, D.C., last week that all VA health care facilities begin screening everyone who enters. Some hospitals in affected areas like Palo Alto, Caif., and Seattle began screening everyone last week.
The Pittsburgh VA began what amounted to a pilot program at its long-term care facility with 169 residents at its Aspinwall campus on Friday, reducing the available entrances down to one and screening everyone who entered.
Screening involves asking people if they have any of the tell-tale signs of COVID-19 infection — fever, cough, shortness of breath — and if the person has visited an affected area or been in contact with someone with a confirmed case of the disease.
UPMC and Excela Health said they have not yet contemplated screening visitors to all of its facilities.
Excela Health Chief Medical Officer Dr. Carol Fox said in an email that the Westmoreland County-based health care system has “not made that determination [whether to screen everyone who enters one of its buildings] but the situation is evolving based on direction from” the state Department of Health and the federal Centers for Disease Control and Prevention.
UPMC spokeswoman Allison Hydzik said in an email that “At this time, UPMC is not screening non-patient visitors who come into our facilities. We have signs asking visitors who are ill or have cold symptoms not to visit. When any region we serve has evidence of community spread of COVID-19, we will begin actively screening all visitors to our skilled nursing facilities in that region for symptoms of the disease.”
The VA’s Aspinwall campus has other services besides long-term care, but has far fewer visitors and patients than the VA hospital in Oakland, which is an acute care hospital that serves patients for a five-state region from hundreds of miles away.
Even so, there were long lines when the Pittsburgh VA began screening visitors to the Aspinwall facility at 5 p.m. on Friday, and Mr. Koenig said his staff knows the experience is going to be much more challenging in Oakland.
“We get so many patients coming here for appointments and a large number of staff, particularly around that morning crush [time], that [when the VA starts the screening system] it will kind of be like dropping the ribbon at Disney World at opening time,” he said. “We know there will be a lot of people in a short period of time.”
“We need to have the flexibility to grow and expand the number of screening lines to make sure we can check everyone with minimal disruption and to be able to grow and contract those throughout the day.”
The Pittsburgh VA is also asking visitors who may be sick to not visit patients who are its facilities, though Mr. Koenig said if a loved one is in hospice, the VA will try to work something out.
Families are being asked to generally limit their visits. If someone from the family has to come, then they’re asked to try to limit it to maybe just one person per day to check in on someone, and to leave children at home to try to shorten the expected long lines for screening.
The Pittsburgh VA — which did more than 19,000 telemedicine visits last year — is also hoping to get more patients to use that technology to further limit people coming in and out of the buildings. Telemedicine connects patients with health professionals online.
“We’re just trying to control the total number of crowds, keep it manageable,” Mr. Koenig said.
Like the Aspinwall long-term care facility, the Oakland VA hospital will try to reduce its many entrances down to one or two, to centralize screening by VA employees and/or volunteers who are going to help.
“Between volunteers and reassigning staff, we won’t have to hire outside folks” to help with screening, he said.
If a person does have symptoms and has been to an affected area or come in contact with someone with COVID-19, Mr. Koenig said that person will “not set foot in the building.”
People who meet the criteria will be given a mask and transported to a location near the hospital’s emergency department where they will be evaluated further.
As long as a month ago, the Pittsburgh VA, like other health care facilities, began asking patients similar questions when they checked in or called in for appointments. The VA also set up similar questions at its self-check-in kiosks.
To date, the Pittsburgh VA has not had any positive COVID-19 results from any patient, though Mr. Koenig would not say whether the Pittsburgh VA has tested any patients for the disease.
Although other private, Pittsburgh health care systems — including UPMC and Allegheny Health Network — have confirmed they have tested patients for COVID-19, Mr. Koenig said the VA policy is only to communicate about testing with the local, state and federal public health authorities.
“We don’t make any announcements [about testing] on our own,” he said.
Sean D. Hamill: shamill@post-gazette.com or 412-263-2579 or Twitter: @SeanDHamill
First Published: March 10, 2020, 7:26 p.m.
