Note: This article first appeared at In Military.
By Wes O’Donnell
Managing Editor of In Military and Veteran, US Army and Air Force
Note: The opinions and comments stated in the following article, and views expressed by any contributor to In Military, do not represent the views of American Military University, American Public University System, its management or employees.
Around 9.5 million veterans are enrolled in Veterans Affairs (VA) health care, myself included. That number accounts for just under half of all U.S. veterans.
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As I noted in a previous article, the VA has a full-service hospital in nearly every major city in the United States. In total, the VA runs 1,243 health care facilities in the nation’s single largest integrated health care system.
But despite VA’s large footprint, COVID-19 has a knack for exposing key weak points in any hospital system. At one point, the mortality rate for VA patients with COVID-19 was nearly double that of civilian hospital systems.
Luckily, that rate has now changed. According to reporting by Leo Shane III, “On Thursday, for the first time in two weeks, the death rate among VA patients who have contracted the illness fell below 6 percent and has stayed there. That figure has been as high as 6.5 percent in recent days, and now sits close to the national rate of about 5.7 percent.”
Making a Report Card
As of last Friday, the VA added 2,000 new coronavirus cases in just five days. If we were to score the department’s handling of the coronavirus pandemic thus far, however, they would be earning a C+.
(Note: This article is not a reflection of VA’s frontline workers, but rather VA leadership.)
VA Started Strong When Coronavirus Cases First Appeared
Around the time that the U.S. became aware of coronavirus on U.S. shores in January 2020, I was accidentally invited to a conference call between VA staff members and physicians as they plotted a path forward through the pandemic.
I first thought that the call was intended for VA patients. But then I quickly realized that this call was for VA employees and considered hanging up. The writer in me, however, was captivated by what I was listening to — frontline VA employees discussing how to protect themselves and their patients from the impending coronavirus.
I was struck by the sincerity and compassion with which these government workers spoke. There was an authentic desire to keep veterans safe and still make themselves available to serve as the nation’s backup medical system, should America’s for-profit healthcare system become overrun.
I left the call with confidence and pride in a department that has, historically, been inundated with scandals. Maybe this is a new Veterans Affairs? To my mind, this strong beginning earned an A+.
Personal Protective Equipment Shortages Appear at the VA
For several weeks, nurses and caregivers at VA hospitals complained about working with inadequate protective gear, otherwise known as personal protective equipment (PPE). However, VA officials denied the problem, which I rate as an F.
But in a recent interview with the Washington Post, the physician in charge of the country’s largest health care system, Richard Stone, acknowledged the shortage. He said masks and other supplies were being diverted for the national stockpile.
In fact, the Federal Emergency Management Agency (FEMA) directed vendors with equipment on order from VA to instead send it to FEMA to replenish the government’s rapidly depleting emergency stockpile.
VA Mental Health Programs during This Pandemic Have Been Outstanding
In recent years, VA has demonstrated that its mental health services are on par, if not better, than its civilian counterparts, which earns them an A. The pandemic has certainly put VA’s mental health providers to the test, only to pass with flying colors.
VA has made strides in providing mental health care during the pandemic. That includes the distribution of thousands of Facebook Portal devices to help connect veterans with telehealth services and reduce their feeling of isolation.
In addition to pandemic-related isolation issues, the VA must continue its mission to provide care for veterans suffering from Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), as well as substance abuse patients. In fact, these patients are arguably more at risk now in the era of “social distancing.” And yet, according to my veteran sources, the VA still provides a high level of care to those vets in need.
The VA Excels in Technology and Telehealth
One of the positive lessons learned in the wake of the Phoenix VA scandal (in which numerous veterans died while waiting for care on a secret internal wait-list) was an investment in technology. This investment enabled VA personnel to offer better care for veterans who may be immobile or located in remote areas, which I rank as an “A”.
Indeed, for many veterans, the VA opened up a program called Veterans Choice that allowed remote veterans to seek care at civilian facilities that were geographically closer to them. This strategy, however, resulted in its own set of issues. For instance, veterans found that their credit scores were hurt when the VA was unable or unwilling to pay certain civilian doctors.
But it showed that VA was willing to think creatively about how to care for qualified veterans everywhere.
Also, VA has become something of a pioneer in telehealth through its proprietary VA Video Connect system. As a VA patient who has used this system, I can attest that while it’s not as slick as Zoom, it gets the job done with little or no technical issues.
For nearly a decade, telemedicine — apps that let you consult with a doctor via video — was supposed to be the next big thing in health care. But civilian telemedicine has stalled due to archaic state laws, a lack of awareness and fears about health insurance reimbursement. None of these issues apply to VA, a federal agency that essentially has no borders.
The Controversial Use of Hydroxychloroquine
Some of the recent criticism launched at VA has centered on its use of hydroxychloroquine, a fixture in Trump’s daily COVID-19 briefings, as a treatment for the coronavirus. But a study by VA and academic researchers said it was linked to a higher rate of deaths of veterans who received it, which earns the VA an F.
This high death rate resulted in numerous veterans’ groups speaking out against the continued use of hydroxychloroquine, also known as Plaquenil.
William Schmitz, the national commander of the veteran service organization Veterans of Foreign Wars (VFW), said the VFW is “very disturbed” that VA is still administering the drug for COVID-19 treatment. Schmitz stated, “We request the immediate halt of this drug for our veterans until further information on its true impact is determined.”
The VA Is Working Hard to Manage the Current Crisis
It is entirely plausible that the spike in recent coronavirus cases within the VA, at least for patients, is not the result of inferior care, but a reflection of patient demographics. According to a 2017 VA survey of enrollees, the average age of a veteran patient at VA is 61 years old.
As a result, the average VA patient is automatically in a high-risk group for complications related to COVID-19. In addition, many of these patients suffer from a combination of comorbidity issues like diabetes, heart disease, lung disease, Agent Orange exposure or burn pit issues.
From my point of view, Veterans Affairs is successfully managing the coronavirus pandemic crisis. It is simultaneously managing both its unwieldy bureaucracy and walking a political tightrope, while still providing care to millions of veterans.
Due to this delicate balance, VA needs our continued support. For the VA’s frontline healthcare workers and the veterans they serve, they deserve no less than our full commitment to help them bear this burden.
If VA leadership wants to increase their performance grade from a C+ to an A, they need more PPE for frontline providers and a moratorium on testing unproven drug cocktails on veterans. Our nation’s heroes deserve the best healthcare our country can provide.
Let’s make sure we give it to them.
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