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July 21, 2020
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Speaker addresses increase in COVID-19 cases, outlines procedures of VA Medical Center

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As COVID-19 cases continue to rise in Texas, Stephen Z. Fadem, MD, FASN, of Baylor College of Medicine, detailed some practices implemented by the Veterans Affairs Medical Center in Houston.

At the virtual Global Innovations in Patient-Centered Kidney Care: International Summit, Fadem told the audience that while his observations are limited to the response of medical centers within one area, it is one of the world’s largest, with a surgery every 3 minutes, a birth every 20 minutes and 160,000 visitors a day.

Hospital beds
Source: Adobe Stock

He emphasized the gravity of the situation, as 1,582 people have tested positive for COVID-19 in a day; this is four times what had been designated the peak of the virus in April.

“After the state opened up, there was Memorial Day,” he said. “People were going back to the beaches, back to the malls and to restaurants, bars and protests. Everybody pretty much acted like it was a normal day in Houston. Most people who didn’t wear masks were younger people. As a consequence, we are now one of the states with the highest rates of new COVID[-19] cases.”

According to Fadem, although the health care system has faced a shortage of nurses, a “surge plan” is in place. This plan is centered in the ICU and involves ensuring an adequate number of ventilators, beds and nurses.

“When you have a patient who is short of breath and they have pneumonia, the only way you can take care of them is by intubating them, putting them on a ventilator and taking over their respiratory functions until disease has time to improve,” he explained. “The only way you can do that is in a critical care unit where you can monitor them.”

Additional nurses have been sent from the military, he added.

He also addressed Baylor’s 10-point program which is designed to prevent the spread of the virus through steps taken by employees, doctors and nurses. The program includes the following:

  • daily health checks, including temperature being taken by an infrared thermometer upon entry to hospital;
  • face coverings worn outside of the workplace to limit community exposure;
  • face shield worn in hospital;
  • shorter food breaks (eating spaced out and turned to an angle);
  • an avoidance of confined shared spaces for prolonged periods of time (eg, an elevator); and
  • limited meetings in conference rooms (conference calls whenever possible).

Fadem added that COVID-19 has increased utilization of telehealth, which he strongly supports.

“One of the things we’ve done to take the load off is extensive telehealth encounters,” he said. “It really has made a difference in how we’ve been able to take care of patients.”

Fadam concluded that the VA Medical Center in Houston has announced an upcoming study to examine tocilizumab (a drug currently indicated for pneumonia) for the treatment of COVID-19.