San Antonio’s Audie L. Murphy Memorial VA has thrown out a lifeline to an overwhelmed hospital near the Texas-Mexico border which saw its coronavirus caseload spike after Gov. Abbott reopened the state in May.
Starr County Memorial Hospital in Rio Grande City has struggled with supply and bed space shortages, and only recently expanded its COVID-19 unit from eightbeds to 18. It is the sole hospital in Starr County, which has one of the largest COVID-19 outbreaks in the state.
As of last week, at least half of patients admitted to the hospital's emergency room tested positive for the virus. The county’s total caseload is now approaching the 2,000 mark.
Though the state and FEMA sent in backup medical teams, Starr County Memorial still lacked bed space, and was sending overflow patients to hospitals in other parts of Texas. But they too were becoming increasingly strapped for resources.
By July 20, Starr County’s health board was weighing critical care guidelines to help medical workers assign limited resources to patients with the best chances of survival. It couldn’t accommodate patients needing to remain on ventilators for extended periods, and was unable to perform tracheostomies and insert feeding tubes.
“We cannot continue functioning in the Starr County Memorial Hospital nor in our county in the way that things are going. The numbers are staggering,” said Dr. Jose Vazquez, Starr County's health authority, at a July 25 press conference.
Back in San Antonio, South Texas VA Medical Director Christopher Sandles read about the Starr County situation in People Magazine.
“The headline of the article was pretty heartbreaking,” Sandles said. “It talked about a Valley Hospital that was sending some other sicker — perhaps older — patients home to die. So it definitely caught my attention.”
VA Secretary Robert Wilkie announced back in April that his agency had initiated its “Fourth Mission,” to assist the nation in times of emergencies and disasters. As part of that, VA pledged to make 1,500 acute care and intensive care beds available nationwide to FEMA, for use by non-veteran patients. Not long after, at the request of Texas Gov. Greg Abbott, VA hospitals throughout the state were authorized to start accepting non-veterans pending availability.
Sandles reached out to the director of the VA Coastal Bend Health Care System, in the vicinity of Starr County Memorial. The two collaborated on a plan to help address the critical care gap.
On July 29, officials from the Department of Veterans Affairs offered a direct line of transfer between Starr County and the Audie L. Murphy VA Hospital, a Level 1 facility which offers specialty services. The VA will accept COVID-19 patients and others who require high levels of care. That includes patients nearing respiratory failure who are in need of ventilator support.
Patients will be transported by ambulance and medevac, depending on the severity of their situation. Sandles acknowledged that the travel distance of more than 200 miles poses a risk. But he thinks it’s worth it.
“Is it a risk when you move patients long distances? Absolutely,” Sandles said. “But when you hear some of the stories about how overwhelmed some of these other hospitals are, I think it's definitely their best chance at survival in some cases.”
“Most of the patients that we have received from the Valley area are very sick and require ventilation, unfortunately. But we're just happy that we have the capability to provide the services,” said Valerie Rodriguez-Yu, the Nurse Executive at the South Texas VA. “We have the equipment, we have the PPE. We have the staff.”
The South Texas VA reserves about 20 beds for humanitarian purposes. As of Thursday morning, it had received two patients from Starr County.
Carson Frame can be reached at Carson@TPR.org and on Twitter at @carson_frame.
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