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VA health care, resources utilized during coronavirus response
Iowa City VA sees first nonveteran patient during COVID-19 emergency response
IOWA CITY — For the first time during the pandemic, a nonveteran infected with COVID-19 was hospitalized at the Veterans Affairs Health Care System in Iowa City as part of a federal policy to assist other hospitals in times of crisis.
This past month, Fred Horn, 62, became the first patient during the ongoing coronavirus pandemic who received care at the Iowa City-based VA hospital under what’s known as the VA’s “fourth mission.”
The Chariton resident went to his local hospital, Lucas County Health Center in south-central Iowa, after testing positive for COVID-19 in early October. His health declined quickly and providers needed to transfer Horn to a hospital with an available intensive-care unit bed.
“There was one ICU bed available in state, and it was at VA,” Horn said.
At the time, Iowa was experiencing a surge in new coronavirus cases driven by the delta variant, a more infectious version of the virus that caused hundreds of thousands of infections nationwide.
Due to the increasing number of COVID-19 hospitalizations, Gov. Kim Reynolds requested VA support in the state’s coronavirus response by providing acute care and ICU hospital beds to nonveterans as needed.
“Iowa hospitals have experienced a high patient census due to a number of patient needs, including COVID-19, and the hospitals have expressed challenges finding beds for patient transfers,” Iowa Department of Public Health spokeswoman Sarah Ekstrand said.
“The addition of even a modest number of patient beds provides Iowa hospitals another option in finding appropriate patient care.”
The state of Iowa has never requested the VA provide acute or ICU beds for patients before the coronavirus pandemic, Ekstrand said.
Horn, who has not served in the military, arrived at the Iowa City hospital on Oct. 5. Soon after, as his condition continued to deteriorate, he was put into an induced coma and placed on a ventilator to help him breathe.
"It was a godsend (the ICU bed) was open when it was,“ Horn recalled. ”I was in the right place with the right people taking care of me.”
The standing federal policy is used to allow VA health facilities to take on civilian patients in the event of a crisis — including events that cause hospitals to overflow with patients, such as during the COVID-19 pandemic.
It also can be used to “support national, state and local emergency management, public health, safety and homeland security efforts,” according to the Department of Veterans Affairs.
Under this assignment, if there’s availability, the VA will take a patient regardless of the medical care they need, said Jamie Johnson, public affairs officer for the Iowa City VA Health Care System.
The hospital also will accept patients to assist community hospitals experiencing staffing issues.
That assignment — which began on Sept. 24 and remains in effect — applies to the Iowa City VA as well as the VA Central Iowa Health Care System in Des Moines and the VA Nebraska-Western Iowa Health Care System in Omaha, Neb.
This assignment can be extended in 30-day increments, as agreed upon by the VA facilities, Ekstrand said.
The VA is current providing up to 11 hospital beds in the state of Iowa, including five ICU beds, under the current assignment, according to the U.S. Department of Veterans Affairs.
One other patient has been admitted to the Iowa City hospital since the assignment began in September, Johnson said.
Though it was the first time the fourth mission was used at the Iowa City facility to care for a COVID-19 patient, the state has requested the VA’s assistance during the ongoing pandemic response, Johnson said.
The state received support from the VA to assist the Iowa Veterans Home, in Marshalltown, in April 2020. The Des Moines VA hospital provided “up to 20” hospital beds for patients in need and dozens of nurses and other medical staff were sent to directly support the Marshalltown facility.
The Iowa City VA also sent supplies to the Illinois Veterans home in Quincy earlier in the pandemic, Johnson said.
Horn spent a week on a ventilator after he was admitted to the Iowa City VA. He said doctors told him he had also had a heart attack around the time he arrived at the hospital, though he admits he doesn’t remember much from the early days of his hospitalization.
“From what I’ve gathered, it was a tricky case,” Horn said. “They had to approach things carefully, but I thought they did a great job of it.”
Horn has since recovered and was transferred from the VA hospital to Lucas County Health Center in Chariton on Oct. 19. He was discharged home on Nov. 1.
Horn said he’s not sure how he and his wife, Charlene Horn, were infected with COVID-19. Charlene spent about five days in the hospital.
Horn was unvaccinated when he was infected, and said he regrets not getting the shots based on his experience with the virus. He plans to get the vaccine as soon as he’s eligible.
“If I had to do it over again, I probably would get the shots,” he said.
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