VA Flouts Reality Amid the Coronavirus Outbreak

BY PETE PETERSON AND GOVERNMENT AFFAIRS STAFF

What is the proper role of a public information officer working for a government department such as the VA? It’s to inform, to tell the truth about plans and processes and the progress and pitfalls of the agency. It is to announce an achievement of significance or acknowledge a failure of policy or personnel. It is to explain, to explicate, and, at times, even to enlighten.

Of course, a gifted PIO knows how to spin a story, putting the boss in a shining light when possible, minimizing failures when necessary. Confronted with a negative story or a potential scandal, the PIO might not deny it outright, but rather note how the boss, very concerned, has already begun looking into the matter, and will take appropriate action at the appropriate time. Next question.

A PIO, though, should never lie. A flight from reality is what VA spokesperson Christina Mandreucci seems to have presented the investigative team from Reveal, from the Center for Investigative Reporting, which was looking into the VA’s readiness to protect and treat veterans from the raging coronavirus. The department’s COVID-19 emergency exercises, she said, “began weeks before the first case was confirmed in the U.S., and VA facilities are equipped with essential items and supplies to handle an influx of corona cases and are operating normally with additional safeguards.”

The VA, she said, “has plans in place to protect everyone who gets care, visits, or works at one of our facilities.”

This might be the message the VA Central Office wanted to put out. Unfortunately, it flouts reality. In most VA medical centers and community-based outpatient clinics training has been a joke. Personal protective equipment for VA staff on the front lines is still severely lacking, particularly masks. 

When we spoke with local VA staff early in April—most of them nurses involved in direct patient care—we were told that a single mask had to be worn up to a week in some medical centers because enough weren’t on hand to meet the need.

In Minneapolis, we were informed, “managers locked up all the personal protective equipment” because of fears they’d run out. Hospital staff, it turned out, didn’t have sufficient supplies to protect themselves. At least some of the nurses handling COVID-19 cases, which were confined to one ward, had to buy their own scrubs.

In any organization, the most important elements are the employees. In the VAMCs, said Barbara Galle, an ICU nurse and 29-year VA veteran, “staff are not expendable, although it seems they’re treated as if they are.

“We have really, really dedicated frontline staff,” Galle, who is president of the union local, said, “but they feel disrespected and not cared for by the agency. What frontline staff can bring [in a crisis] is more realistic than all the mandates coming out of Central Office. But they refuse to have staff input; they’re not interested in our ideas as to what will work or what might work better.

“Supervisors who don’t work with patients make the decisions. Yet those of us who do interact with our patients are more the common-sense piece of the planning, but they won’t use us. I don’t know if they feel they’ll be one-upped” by some nursing assistant.

There was the opportunity to form a hospital-wide planning group or even a regional task force comprising managers and workers, like Galle, who had been deployed to Waco in the wake of Hurricane Katrina.

For Galle, that event made for intense, on-the-job training. “Social workers, nurses, housekeepers, we all worked in unison; then, when Homeland Security took over, it became a real [mess],” she said. 

In Vietnam, savvy second lieutenants new to the bush listened to their first sergeants and squad leaders, troops who had survived months fighting Charlie. Those who came with a know-it-all attitude were usually either quickly disabused of their mindset or wound up with a disabling or fatal wound.

The situation at the Minneapolis VAMC is typical. In Las Vegas, reports 13-year nurse Linda Ward Smith, “it’s chaos. To say staff is concerned or afraid would be an understatement.” 

As president of the union local, she is the recipient of staff complaints “daily—oh my goodness, hourly, actually. Yet management blows off our complaints. Surgical masks have to be used three or four days for staff not involved in direct care. Still, we may see patients, and will they want me to [wear] the same mask in to see another patient and possibly infect him?

“Look, we signed up for this. But give us the tools, the safety equipment that we need.” That complaint echoes throughout the VA’s 170 hospitals.

The VA has provided a running count of the number of veterans stricken with the coronavirus—2,866 as of Monday, April 6; 3,265 two days later—and those who have died—125, 22 more than the day before.

As seems to be the policy in most public and private hospitals, the VA does not post the number of staff who test positive. As of the April 6, 776 VA workers had been infected; three died. The New Orleans VAMC had by far the largest number of cases, 82, followed by Montrose, N.Y., with half that number; followed by East Orange, N.J.; Houston; Indianapolis; Aurora, Colo.; Kansas City, Mo.; and Washington, D.C.

Why was the VA so ill-prepared for the oncoming flood of cases? Did they follow the lead of the President, who initially pooh-poohed the probability that the coronavirus pandemic would reach our shores and breach our defenses? According to PIO Mandreucci, the VA was prepared, despite the fact that 44,000 frontline health positions remain unfilled, including 2,700 physicians and 11,300 nurses and nursing assistants, according to a September 2019 Government Accountability Office report; despite the finding of the VA’s own Inspector General that the department’s emergency cache of medicines was in disarray.