Why COVID-19 patients at the VA hospital in Spokane aren't counted as 'hospitalized'

click to enlarge Many veterans with COVID-19 staying at Mann-Grandstaff VA Medical Center hospital aren't "hospitalized" according to the Spokane County Regional Health District. - SPOKANE VA FACEBOOK
Spokane VA Facebook
Many veterans with COVID-19 staying at Mann-Grandstaff VA Medical Center hospital aren't "hospitalized" according to the Spokane County Regional Health District.
If you go to check how many people are hospitalized with COVID-19 in Spokane, the Spokane County Regional Health District website will give you an answer. Right now, it lists eight people as currently hospitalized with COVID-19, and that number has been trending downward.

That decline in hospitalizations is partly why Spokane Mayor Nadine Woodward said earlier this week that Spokane had hit the "benchmark" needed to accelerate reopening.

But that number doesn't capture everyone being treated in a local hospital for COVID-19. People being treated in Spokane, but who come from out of the area, are not counted. And dozens of veterans staying at the Mann-Grandstaff VA Medical Center aren't counted as a hospitalized patient either.


That's confounded some within the VA hospital.

"They are definitely receiving hospital-level care, including medications. They were admitted as inpatients," says Bret Bowers, a spokesman for the VA. "We too have wondered why this accounting hasn't made it to the regional health district's website, or some place where everybody can understand the reality." 

The Spokane Veterans Home, home to the largest cluster of COVID-19 cases in Spokane, started transferring dozens of residents with the virus to the VA Medical Center just over two weeks ago. There, the residents can be in isolated zones, meet daily with physicians and receive "more hospital focused care," with an ICU on site.

As of two days ago, the VA said 34 Spokane Veterans Home residents were transferred to the medical center. Several others were being cared for in area hospitals, and one resident preferred to receive care back at the Spokane Veterans Home. Yesterday, the VA announced another resident diagnosed with COVID-19 died, at a local hospital. It was the sixth resident of the home to die with COVID-19. Five of those deaths occurred in the VA hospital.

"All patients had multiple serious medical problems not coronavirus-related and, per the wishes of the patient and family, were provided with comfort measures only," the VA says in a statement to the Inlander.

But the Spokane Regional Health District says it's not a matter of whether or not a person is receiving care in a hospital that dictates whether they're counted as hospitalized. They must have more severe symptoms requiring an "acute hospitalization" to be counted by the health district, says Dr. Bob Lutz, Spokane County regional health officer. And many of the individuals at the VA hospital don't have those symptoms.


"What I report are community members, Spokane residents, who have been hospitalized for acute COVID-19 infection," Lutz says. "With rare exceptions, the individuals who have been at the VA home have been asymptomatic or mildly symptomatic. For those individuals who become significantly symptomatic, they have been transferred over to other hospitals for higher acuity care."

At the VA hospital, patients are receiving much of the same care they were at the Spokane Veterans Home, though now with additional surveillance to detect complications with coronavirus. They were transferred there to be in a more secure, isolated setting — at the Spokane Veterans Home, for instance, residents shared rooms with each other. 

Breean Beggs, Spokane City Council president, says that the number of hospitalizations may not be indicating how many people are seriously ill, but it is an indicator of how strained the local health care system is. The VA hospital is "not part of our surge capacity," Beggs says.

Yet the number of hospitalizations listed by the health district still isn't a perfect indicator of the strain on local hospitals, because it doesn't count people from other counties being cared for in Spokane. Many smaller communities outside Spokane County don't have the capacity to handle any surge in COVID-19 patients, meaning that in an outbreak just outside the county, hospitals could be seeing way more patients with COVID-19 than what's being reported by the Spokane Regional Health District.

"What I report, and what every county reports, are those [Spokane] County residents hospitalized in county facilities," Lutz says.

The VA hospital, meanwhile, just wants the community to remember that there are dozens of veterans currently battling COVID-19.


"These patients are here," Bowers says. "They're part of our community." 

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About The Author

Wilson Criscione

Wilson Criscione, born and raised in Spokane, is an Inlander staff writer covering education and social services in the Inland Northwest.