The always underfunded, often chaotic Veterans Affairs (VA) medical system is straining to cope with the novel coronavirus. According to agency documents the AP obtained, so far 1,900 VA healthcare workers have become ill with the novel coronavirus and 20 have died. On top of that, right now 3,600 are in quarantine and can't work. The total VA medical workforce numbers just over 300,000.
Nearly 380 veterans in the VA system have died out of more than 5,700 who've been treated in VA hospitals. Like all hospitals, they went into this without the kind of protective gear they needed. They now do what so many doctors and nurses have had to do—keep using the same masks for entire shifts. Heather Espinal is one of the nurses at a VA center in New York. "We thought we were doing everything right, even with reusing these N95 respirators. But we still ended up getting sick," Espinal said. She's recovering now.
But in the Trump administration, that practice is not something they'll admit to in public. "VA's PPE conservation posture is precisely why the department has not encountered any PPE shortages that have negatively impacted patient care or employee safety," spokeswoman Christina Mandreucci told AP. According to the official line, there are no shortages. According to "nurses and other employees at facilities around the country, internal VA documents, and a March report by the agency's inspector general," AP found otherwise.
As staff continues to get ill, the AP found that VA hospitals were lacking both in staff and in equipment "like masks, eye shields, hand sanitizer and gowns." AP was even told by nurses that the staff "were forced to reuse masks for days or weeks." Adequate screening processes for visitors coming into the VA facilities were lacking in nearly a third of hospitals, the VA inspector general's staff—which visited 230 facilities in March—found. More than half of the facilities the inspector general surveyed reported shortages of supplies and equipment.
On April 7 the VA issued guidelines in a memo, which told workers they'd have to ration because of "shortages" and the inability to get "adequate supplies." This memo, obtained by AP, said "staff working with high-risk elderly or vulnerable patients, such as those in nursing homes or spinal cord facilities, would only get one face mask per work week." On April 16, after staff rebelled and the VA found some supplies, it revised that guideline to allow staff that work with high-risk older or vulnerable patients to have one mask a day. One. But the patients who are not elderly or vulnerable will be cared for by doctors and nurses wearing days-old masks. Which isn't good for anybody in the hospitals throughout the whole system.
The Occupational Safety and Health Administration is investigating claims from VA workers that even those who had come into contact with someone suspected of having COVID-19 were required to report to work on orders of VA Secretary Robert Wilkie. They should have been quarantined for 14 days. They're forced to work because of the staffing crisis, because of how many workers have become ill, and because of the caseload. "Usually the ratio is one nurse to two critical patients. I’m having five critical ICU patients on ventilators," said Maria Lobifaro, an intensive care nurse in Brooklyn, New York. "This has happened four times in the last week and a half. It's to the point where [ …] my hands are trembling because of what I'm going to walk into. […] I've never seen anything like this."
Wilkie, like the Trumper he is, refuses to acknowledge the problem. "We have the lowest employee infection rate in the world. It is less than half of 1 percent," AP quotes him as having told MSNBC Wednesday. But one nurse calls bullshit. Irma Westmoreland, a nurse at the Charlie Norwood VA in Augusta, Georgia, said they're not getting tested, so who knows what the infection rate is. "We are told if you have symptoms or feel like you have been exposed and you want to be tested unless you are veteran, you can't be tested," she told AP. "It's stressful for the nurses to be in this environment," she said. "But it's even more stressful when they don’t have information they need."
Democratic senators are demanding accountability from the VA, writing to the White House to demand Trump fix the "broken procurement and distribution system developed by this administration," and assist the VA. The letter to Trump was sent from Sen. Jon Tester of Montana, a ranking member of the Senate Veterans Affairs Committee, and more than a dozen senators, including Sens. Bernie Sanders of Vermont, Elizabeth Warren of Massachusetts, and Kamala Harris of California.