VA coronavirus plan: 40 percent of staff could be absent during severe outbreak

Abbie Bennett
March 27, 2020 - 11:35 am

Photo courtesy gop.gov

The Department of Veterans Affairs released its coronavirus plan, which projects that 40 percent of staff could be absent during a severe COVID-19 outbreak, which could last 18 months. 

The 262-page plan comes amid a sharp spike in veteran cases and as Congress is weighing providing the agency with $20 billion more for virus response after VA Secretary Robert Wilkie declined additional aid lawmakers offered a month ago. 

“VA has a world-class medical team doing incredible work on the frontlines of this fight,” Wilkie said in a statement accompanying the plan. “We will continue to share best practices and lessons learned with other government agencies and the private health care system as appropriate so we can defeat COVID-19 as a nation.” 

The plan outlines VA's strategy to care for its more than 9 million patients, but also how VA fits into the federal government's overall response. That includes VA's fourth mission, to serve as a backup and last line of defense for Americans -- not just veterans -- during national health emergencies such as pandemics. 

"The primary goal of the operations plan is to protect veterans and staff from acquiring COVID-19 infection by leveraging technology, communications as well as using dedicated staff and space to care for COVID-19 patients," the plan reads. 

The plan includes creating a system where each VA facility operates as two separate "zones," one for standard inpatient care and one for COVID-19 inpatient care. 

"This approach minimizes the risk of infection, supports expansion to meet an increasing need for COVID-19 services, and provides Veterans in routine VA care consistent access to VA care," the plan reads. "The plan includes strategies to address a large number of COVID-19 cases to include alternative sites of care for veterans with COVID-19."

VA has two main purposes during the pandemic: to protect veterans and staff from the virus and ensure veterans continue to have access to care and to support the Department of Health and Human Services "as requested." 

VA's plan also includes a list of "generalized assumptions" for COVID-19, such as: 

  • Susceptibility to the virus may be universal;
  • Illness rates may be highest among the elderly;
  • About 20 percent of those infected will require hospitalization, and of those, about 5 percent will require ICU-level care and about 2.3 percent will require ventilator support. 
  • In a severe outbreak, as much as 40 percent of employees may be absent because of illness, caring for ill family members or fear of infection;
  • There may be shortages of personal protective equipment, hospital beds, ventilators, morgue capacity, refrigeration space for the deceased and other resources;
  • "Similar to influenza, the event could last 18 months or longer and could include multiple waves of illness." 
  • "Multiple waves of epidemics are likely to occur across the country, lasting many months altogether. Historically, the largest waves have occurred in the fall and winter, but the seasonality of a pandemic cannot be predicted with certainty."

VA's overall role in the national coronavirus response includes:

  • Provide medical training for federal staff;
  • Provide VA staff for FEMA teams;
  • Provide vaccination services;
  • Furnish hospital care and medical services to people responding to the emergency, such as active-duty service members, Guard and Reservists;
  • Provide ventilators, medical equipment and supplies;
  • Provide burial services;
  • Deploy medical, surgical and mental health support.  

There are four main phases to VA's overall response plan: 

  • Phase 1: Pre-incident response, including working to contain the virus, planning and training. This phase is triggered by an outbreak outside the U.S. and ends with an outbreak within the U.S.
  • Phase 2: Initial response, including deploying available medical, surgical and mental health support, providing mortuary assistance for internment of human remains, furnishing available VA hospital care and medical services, provide acquisition and logistics support to public health/medical response operations. This phase is triggered during an initial U.S. outbreak and ends when existing VA capabilities and supplies can't meet demand or when response is able to sustain indefinitely. 
  • Phase 3: Alternate sites of care, where VA works with its network of community providers to "address overwhelming numbers of patients who need hospitalization." This phase is triggered only if VA cannot meet demand, and ends when capabilities are stabilized. 
  • Phase 4: Extended operations and recovery, beginning when the outbreak starts to wane and clinical operations stabilize.

Veterans Health Administration head Dr. Richard Stone committed in a letter included in the report to release updates to the plan, which he referred to as "a living document" that likely will change "just as the pandemic evolves." 

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

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