Kansas officials eye VA hospitals for help with expected surge in COVID-19 cases

Kansas health authorities, scrambling to prepare for a possible surge of coronavirus patients within days or weeks, are exploring the use of Veterans Affairs hospitals to handle the influx.

State leaders are studying the potential deployment of makeshift hospital space, called alternative care sites, that Kansas could use if facilities become overwhelmed. While Kansas just crossed the 100-case threshold, some states’ health systems are already straining amid thousands of cases.

Lee Norman, the secretary of the Kansas Department of Health and Environment, said the state hopes to have a plan in place by the end of the week.

“This is on the very fast track,” Norman said Monday.

Projections from ProPublica, based on data from the Harvard Global Health Institute, underscore the urgency surrounding the effort.

Hospitals in Kansas City, Mo., would receive roughly 162,000 coronavirus patients over a 12-month period, according to a model that assumes 40 percent of the adult population will ultimately become infected. Those patients would require 5,400 beds over the course of the year, roughly twice the number of beds available.

In Wichita, hospitals would receive an estimated 79,900 coronavirus patients over a year. The influx would require 2,660 beds, approximately 120 percent of the beds available.

Kansas on Tuesday had 127 reported cases and three deaths. Norman and other health professionals anticipate the numbers will accelerate in the coming days.

“We’re starting to feel the surge,” Steve Stites, chief medical officer of the University of Kansas Health System, told reporters.

VA hospitals explored

Norman has named Veterans Affairs hospitals and ambulatory surgery centers as potential sites for patients. The VA operates facilities throughout the state and has medical centers located in Wichita, Topeka and Leavenworth.

Norman said Wednesday that state officials have spoken with the Veterans Affairs Administration about possibly consolidating VA patients into a single medical center, freeing up the other two for coronavirus patients. He didn’t specify which hospitals are being examined for that purpose.

Secretary of Veterans Affairs Robert Wilkie told National Public Radio last week that the VA was prepared to act as a “surge force” to support the nation’s health care system.

“We have been preparing for what has been coming for a while now,” Wilkie told NPR.

The Wichita-based Robert Dole VA Medical Center, which serves southern and western Kansas, said in a statement it “stands ready” to support “surge capabilities into civilian health care systems in the event those systems encounter capacity issues, but at this time they are not encountering such issues.”

Norman didn’t rule out using university dorms when asked, but said “we’re not near that point yet.” However, he acknowledged state authorities have discussed with the U.S. Army Corps of Engineers what it would take to reconfigure dorm rooms and hotels.

He said he would prefer to use existing hospitals and other health care facilities if possible.

“I can tell you this as an Army medical officer, as much as it seems like ‘Oh, we’ll call in the National Guard and set up MASH tents’ … that’s hard,” Norman said. “We would much rather move into a built environment that was built for patient care that has gases and all the safety features in there.”

It isn’t clear how far planning for makeshift hospital space has advanced. The U.S. Army Corps of Engineers hasn’t received assignments related to Kansas, a spokesman said in an email. Julie Baker, president of the Kansas Association of Ambulatory Surgery Centers, said she hasn’t been in touch with the state and didn’t know whether the agency had approached any centers in the state.

Hospitals prep for surge

As discussions continue at the state level, local hospitals are making their own preparations. Some have canceled elective surgeries, a first step toward preserving critical medical supplies.

Stites said the University of Kansas Health System is working to ensure it has enough supplies and equipment. But he acknowledged that if the surge of patients continues that will become a “challenge.”

Tammy Peterman, president of the system’s Kansas City division, said officials are monitoring the coasts “and we’re preparing because we know there will be an increase in in-patient bed utilization in our city.

“And we’re working not just with our hospital to be prepared, but with hospitals across the metropolitan area and beyond,” Peterman said.

In Wichita, Wesley Medical Center has 84 “surge-planning” beds, meaning existing beds that can be modified for COVID-19 patients if the hospital exceeds its capacity. In total, Wesley Medical Center has just over 150 ICU beds that could be used during a surge, said Chloe Steinhouer, the hospital’s mecical director for the ICU.

“The whole goal of this (stay-home order) is to prevent overloading the system to the point where we even have to think of allocating care,” she said.

Steinhouer said she wants to avoid a situation like the one Italy is facing, where doctors are forced to choose which patients gets the limited supplies available. She said Wesley has ‘allocation of care guidelines’ that would guide those decisions.

“It’s not based strictly on age. It’s actually a really complex set of criteria looking at...degree of critical illness, among other factors,” she said.

In Lawrence, the local hospital has turned its surgical floor of 18 beds into a “COVID floor.” That’s where non-critical coronavirus patients will be treated, said Traci Hoopingarner, vice president of clinical care at LMH Health. The hospital has also assigned 24 beds to treat critical COVID-19 patients.

The hospital could ultimately accommodate 205 patients.

Beth Llewellyn, director of community health at the Lawrence-Douglas County Health Department, acknowledged the county is likely to eventually exceed its capacity.

“We believe that is going to happen, but it’s a matter of timing and then readiness,” Llewellyn said.

The health department, through LMH Health, already has a partnership with architects and engineers to assess spaces available in Lawrence, she said.

Even as they prepare, Kansas health professionals uniformly stressed that how the public behaves now will influence the size and severity of the eventual surge.

Stites said hospitals will know in about a week whether social distancing and other restrictions are having an effect.

“I hope and pray and believe that it will work,” he said.

The Eagle’s Dion Lefler contributed reporting

This story was originally published March 25, 2020 at 6:20 PM.