As the number of confirmed and suspected cases of COVID-19 infection start to increase across Maine, the state’s Veterans Affairs Medical Center and its satellite facilities have launched plans to limit exposure to patients and staff.

Among them are restricting access to facilities, setting authorized access points at the VA Maine Healthcare-Togus campus and imposing screening at Togus and at the outpatient clinics across the state.

Following the guidance of the American College of Surgeons, all elective hospital procedures have been halted. Any surgeries or procedures that are not urgent have been rescheduled until after May 1. Dental procedures that are not urgent or emergent are being rescheduled after May 1.

Most prescriptions will be delivered by mail, and veterans can request expedited shipments.

Tracye B. Davis, medical center director for VA Maine Healthcare-Togus, said Sunday that while staff members at the campus have trained and performed drills for a variety of emergency scenarios, none in their experiences have been anything like this.

“For the VA system, I don’t think we have seen a response of this magnitude,” Davis said. “Definitely not in my health care career or in many of the healthcare careers of (people in) the VA system. We have clinical staff that have worked in another country where they may have been involved in a public health emergency of a significant magnitude.”

The change in circumstances from last Sunday, when Maine had no reported cases of coronavirus infection, to this Sunday, when the count stands at seven confirmed and five presumptive positive cases, has been immense.

“It’s very different,” Davis said. “I think we’re all quickly realizing that pretty much hour by hour we are having to stay informed with what’s happening and make sure we have everyone available and ready to go and shift gears if we need to.”

Last weekend, Togus officials were starting to think about what implementing emergency procedures would look like and when the point to put them in place would be reached. On Tuesday, officials decided to take steps to get ahead of the outbreak by starting to limit access at its facilities before the outbreak reached Maine.

“The VA remained hopeful that that would be all we would have to do,” she said. “I did not think by Sunday, a week later, that the VA would be implementing these procedures.”

While other organizations are looking at a two-week time frame for closure, Davis said the VA is looking at a longer time frame. If conditions improve quickly, restrictions would be lifted, but if the infection continues to spread, officials might make additional shifts in nonurgent care.

Togus staff navigate the shifting conditions through and incident command structure, with a daily standing meeting of senior staff and other meetings throughout the day of groups that focus on individual areas.

“Normally, we would meet face to face, but in this particular health emergency, we felt it was better to have a virtual command center,” she said.

The campus on the Augusta-Chelsea line is also home to Cabin in the Woods and a Fisher House, which provides free lodging for families of veterans who are at the Togus campus for in-patient care.

“We would like to keep those folks as close as possible,” Davis said, noting that Fisher House residents are being screened daily for signs of coronavirus infection.

Because the Cabin in the Woods, which provides permanent housing for homeless veterans on the Togus campus, is a program of the Volunteers of America, Davis said that agency will oversee coronavirus response to the residents.

Gary Burns, a retired service officer for Disabled American Veterans, had surgery earlier this month at Togus.

“I’m pleased they are taking all the precautions in the world,” Burns said Sunday. “I get all my medical care there now and I am completely confident that if I had to go back in tomorrow, they would take care of me.”

In addition to the steps that VA officials are taking, Davis said patients can also help by providing information.

If any veteran served by the Veterans Administration in Maine has been been tested for coronavirus at a community health care facility or has been contacted by the Maine Center for Disease Control & Prevention, Davis said veterans should let them know they receive health care through the VA healthcare system.

Davis said VA Maine Healthcare-Togus is partnering with the Maine CDC in providing care for veterans, but it also helps in the public health arena to show the spread of the infection.

For veterans who cannot reach outpatient clinics, other options like phone calls and telehealth are options that are available.

“I am so proud of the VA for taking the advanced steps it has taken in terms of telehealth. I think this will really help us and the veterans we are serving in this challenging time so we can continue to provide ongoing services for the veterans,” Davis said.

“My hope that this will serve as a new format that everyone across the country can take on because you never know when something like this is going to happen.”

 

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