VA denies coronavirus supply shortages. Medical staff say they're rationing masks.

Abbie Bennett
April 10, 2020 - 5:05 pm
VA

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This story originally published April 10 at 5:05 p.m. EST. It was updated April 11 at 9:22 a.m.

The Department of Veterans Affairs has repeatedly denied that there are any coronavirus supply shortages at any of its hospitals and clinics nationwide.

But frontline staff said they're rationing masks and other supplies and in some places, they say they're running out. 

Internal VA memos and communications provided to Congress also show the department is facing a "serious" shortage of personal protective equipment (PPE). 

One of the memos obtained by Connecting Vets dated last week and written for VA's coronavirus team that meets regularly by conference call said the department was "experiencing serious PPE shortage" and "several sites doing 3D printing, but it is not enough. Soon, PPE will be rationed; one surgical mask issued per week, one N95 per day," referring to masks and respirators. 

A second memo on Monday said rationing had begun. One mask per day will be provided to medical staff working with COVID-19 patients and one mask per week will go to nursing home staff. 

VA medical staff and veteran patients from across the country told Connecting Vets they were rationing masks and gowns, not allowed to wear masks brought from home, washing disposable masks and told to wear what they were provided "until the snaps broke." 

‘Well-stocked’

VA officials have continually denied there is any shortage of equipment or any concerns about a shortage. 

“All VA facilities are equipped with essential items and supplies, and we are continually monitoring the status of those items to ensure a robust supply chain,” VA Press Secretary Christina Noel told Connecting Vets repeatedly when asked about supply issues. 

Noel declined to provide VA's total number of masks, respirators, ventilators and other coronavirus response equipment. She called VA staff and veteran patients' accounts of shortages or lack of equipment "false allegations." 

"The department is coordinating closely with FEMA and will work with the agency should the need to address the department’s supply levels arise," Noel said, adding that because VA is a large, integrated healthcare system, if a hospital were to run low on supplies, other VA facilities could send extra. 

Information VA provided to Congress April 8 says “the status of supplies, equipment and beds changes hourly” and showed that VA had:

  • 15-day supply of masks;
  • 18-day supply of N95 respirators;
  • 16-day supply of eye protection;
  • 19-day supply of gloves;
  • 17-day supply of gowns;
  • 14-day supply of hand sanitizer;
  • 12-day supply of powered-air purifying respirators. 

Veterans Health Administration head Dr. Richard Stone used the word "austerity" to describe VA's current PPE situation on a call with staff last week, according to a person with knowledge of the call. During a call with Congressional staff April 3, though, Stone said VA was “well-stocked with PPE.” 
VA Secretary Robert Wilkie has also repeatedly said VA was adequately supplied or had more supplies on the way.

But lawmakers, too, have heard concerns about shortages and “the national supply chain squeezing VA” and Congressional staff told Connecting Vets VA was partnering with Amazon to use its AI services to search through 100,000 possible suppliers “to meet VA needs.” 

‘We are scared’

VA’s denials don’t match its internal memos, communications to lawmakers or what its frontline staff say. 

VA staff spoke to Connecting Vets on condition of anonymity because they said they feared retaliation. 

A nurse at a North Carolina VA hospital provided Connecting Vets emails that showed rationing had begun.

"Effective immediately, staff will be issued one surgical mask per week," the email read. "This news shouldn't be foreign ... because I warned you last week ... Unfortunately, that time has arrived. I will be providing brown bags for weekly storage as soon as I receive them."

A nurse at another VA hospital said she was “denied proper PPE, then forced to do entry-point screenings” in a room “the size of a walk-in closet” used by all who enter and exit the building. The nurse provided Connecting Vets photos showing the expiration date on the masks.

“I was armed only with procedure masks, not respirators, that expired in 2015,” she said. “When I asked for an unexpired box of masks, there was outrage.” 

A nurse at a New York VA hospital told Connecting Vets staff weren’t provided masks until April 6 and were “given two masks, which we were told to wipe down and basically wear until the snaps broke off" because of a shortage.

She said her coworkers were falling ill and “the rules keep changing about the type of protective equipment we should use.” 

“The nursing staff is feeling let down,” she said. “Many of us do not have the luxury of working from home and we have families we are scared are going to get sick because we exposed them. There is no empathy from management who is now mostly working from home.” 

Another VA employee said non-medical staff were asked to continue to come into the office rather than telework and were not provided any protective gear because of a shortage or outright lack. Those employees also are working 80-hour weeks and were told if they don’t meet that requirement, they will be considered absent without leave.

“They are being careless and only caring about themselves and not their employees or veterans’ health,” said the employee, who works on processing veterans’ benefits payments.

A former Long Island VA employee said that hospital “has completely run out of masks.” 

Other VA medical staff said they were limited to one mask per day -- or per week -- and were running low on gowns, gloves and other protective equipment.

A Texas veteran has a VA nurse live with him in his home and said the nurse was told she was not allowed to wear a mask while working “even if they purchased them and brought them from home.”

The veteran said he tried to buy a mask for the nurse to protect her and himself because he said he is immunocompromised. 

“I purchased her a reusable N95 mask in order to protect her as a first responder and myself when she comes home after work,” he said. “To hear that she was told to take her mask off and not allowed to wear it again, even if she brought it from home, scares me. We need to protect the front line.” 

VA denied all of the allegations. 

A union representing federal workers, including thousands of VA staff filed a federal complaint accusing the department of endangering staff and veterans because of a lack of equipment and telework denials. 

As of April 8, at least 1,281 VA employees had tested positive and nine had died of the virus.

“The vast majority of VHA facilities are reporting no significant problems regarding staffing,” VA told lawmakers, though the department issued a call in recent weeks for retired medical staff to return to fight COVID-19. VA on Friday said it was offering $5,000 to medical staff willing to deploy for at least two weeks to areas hardest hit by the virus, starting with New Orleans.

VA's coronavirus plan includes the assumption that up to 40 percent of its staff could be absent during a severe outbreak.

America’s backup

VA manages about 170 medical centers nationwide and serves 9 million veterans, about half of which are older than 65 -- a population at higher risk for the virus, according to the Centers for Disease Control and Prevention. 

As of Friday, VA reported 200 veteran deaths from the coronavirus, 3,700 vets infected and said it had administered more than 32,160 tests nationwide.

When asked about supply shortages, VA spokespeople at department headquarters and medical facilities across the country parroted the same statements denying a lack of PPE or any rationing, repeatedly saying “the premise of your inquiry is false.” 

“VA facilities are using PPE in accordance with CDC guidelines, and all employees have the appropriate personal protective equipment, PPE, as per those guidelines,” Noel said. 

Those guidelines include: 

  • Employees performing high-risk procedures or activities on suspected or confirmed COVID-19 patients will receive N95 respirators needed, but are encouraged to reuse them;
  • Employees treating COVID-19 positive patients for low-risk procedures will receive one facemask a day;
  • Employees screening patients for COVID-19 receive one facemask a day;
  • Employees working in VA community living centers, Spinal Cord Injury facilities, and inpatient mental health wards will receive one facemask per workweek to protect high-risk veterans from COVID-19 exposure.

A VA Inspector General report last month also showed that leaders of some VA medical facilities were concerned about supplies and staff.

VA officials also have repeatedly refused to provide information on VA’s capacity, including intensive care beds and ventilators, arguing such information is “sensitive in nature” but refusing to cite any specific statute or rule keeping that information from the public. 

The data VA provided to lawmakers showed that as of April 8, about 42 percent of VA acute care and ICU beds were occupied and VA had a total of: 

  • 8.818 acute-care beds;
  • 2,723 intensive care beds;
  • 2,713 negative air pressure beds;
  • 1,899 ICU ventilators with 25 more on the way;
  • 993 transport ventilators. 

VA is tasked with serving as America’s last line of defense during health emergencies, opening its facilities to non-veterans in areas hit hardest by disasters or pandemics. VA already is providing that aid --part of its fourth mission -- in multiple states.

“While specific operational capabilities of VA facilities are sensitive in nature, VA continues to take necessary preparedness actions to ensure the continuity of our healthcare system to provide care for our veterans,” Noel said. 

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Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett.

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