WASHINGTON, DC — Veterans for Common Sense is among seven veterans advocacy and service organizations that this week wrote Department of Veterans Affairs (VA) Secretary Robert Wilkie regarding testing, screening, and communications related to the COVID-19 virus.
In the letter, the organizations wrote,
“While we recognize the unique challenges VA faces with this pandemic, these and related issues are deeply concerning given that millions of our nation’s veterans rely on VA medical care – including and even more so during these difficult times. We therefore encourage you to take the steps necessary to quickly ensure a more unified national approach by VA that addresses these and related issues. Most especially, we encourage you to quickly take the necessary steps to ensure VA provides a clearly articulated and viable path for every veteran who needs testing for the COVID-19 virus, a clear response regarding those veterans who are turned away, and what specific actions VA will take to ensure that veterans who present with symptoms are immediately tested rather than turned away. We appreciate your leadership during these difficult times and look forward to hearing the results of these necessary changes from the veterans we represent.“
The letter came after a report released last week by the VA Inspector General that found only one VA facility in the U.S. had the capacity to process COVID-19 tests and that expanding that capacity would help flatten VA’s curve.
A story published today by Fox News (“VA hospitals lack adequate coronavirus testing, protocol…“) reported:
The specialized division within the Department of Veterans Affairs launched an investigation at the start of the coronavirus outbreak in the U.S. in which their officials went undercover as they looked into the preparedness throughout hundreds of VA hospitals and other health care facilities.
They alleged in their report, “OIG Inspection of Veterans Health Administration’s COVID-19 Screening Processes and Pandemic Readiness”, that while a majority of the facilities were able to conduct swab tests for the virus, they were not able to screen the samples on-site. In fact, only one facility, VA Palo Alto in California, is able to get test results processed on the premises.
One facility leader told OIG investigators that having the ability to test samples on-site would shorten result times. It’s believed that the short turn around in time would help in flattening the curve of infected veterans.
“One Facility estimated that specimen processing time could be reduced from several days down to four hours by processing at an on-site laboratory,” reads a line from the report.
Out of the 125 outpatient facilities visited by investigators, a robust 97 percent were able to screen for COVID-19, but only 71 percent were found to be adequate. Four facilities were found to have no readiness plan in place and did not screen patients or ask them if they were feeling any of the symptoms associated with the coronavirus. ….
Our concern is the lack of action, these are procedural concerns that can save the lives of our Veterans,” Rosie Torres, founder of veteran advocacy group Burn Pits 360 said to Fox News. “Our overarching concern is that actual testing was given short shrift coverage in this report.” ….
Burn Pits 360 along with several other veterans’ organizations like Veterans for Common Sense, recently sent a letter to VA Secretary Robert Wilkie in which they addressed their concerns regarding the OIG’s findings. They also underscored how the lack of preparedness has already affected veterans across the country, including a former drill sergeant in Oklahoma City who verbally screened positive on his phone call with VA but was unable to get tested for three days. He remains ill and is self-treating with a wife at home who is battling cancer. He fears that he could infect her due to her compromised immune system.
It also includes one veteran in Gainesville, Fla., who was screened and to date, has been refused treatment; and a Gulf War veteran in Portland, Oregon who was refused entry to the VA emergency room due to having ADI-trained service dog.
“The report indicates an inadequate communication system, a lack of a unified national VA outreach guidance campaign addressing symptoms, concerns, and screening procedures such as how to get tested,” Torres says adding that the OIG report does not address the VA’s outmoded screening questions.
“They have been asking, ‘Have you traveled to China or Iran,’ rather than, ‘Have you traveled to a U.S. city that’s a known coronavirus hotspot,’” she said.
“They are only adapting it now that it widespread across the U.S.”
The full text of the letter is below:
(Download PDF) – SecVA CV-19 Letter
March 31, 2020
The Honorable Robert Wilkie
Secretary of Veterans Affairs
U.S. Department of Veterans Affairs
810 Vermont Avenue, N.W.
Washington, D.C. 20420
SUBJECT: COVID-19 Testing, Screening, and Communications
Dear Secretary Wilkie,
We are writing to express our grave concerns regarding what appear to be continued inadequate testing and communications related to testing for the COVID-19 virus at Department of Veterans Affairs (VA) medical facilities. These issues are above and beyond those of serious concern identified in the recent report, OIG Inspection of Veterans Health Administration’s COVID-19 Screening Processes and Pandemic Readiness: March 19-24, 2020.
From contacts with veterans around the country, we are aware that some VA medical centers are proactively communicating about COVID-19 issues with veterans in their catchment areas via emails. Others are only providing the lone or occasional tersely worded text message. However, few – if any – are providing clear information to veterans on how to get tested for the COVID-19 virus. Please see the attachment for examples.
Most serious of all, we are deeply concerned that at least some veterans screened by VA, identified as having symptoms presumed to be COVID-19, and told by VA screeners their symptoms are most likely COVID-19 are then being denied or otherwise prevented from receiving testing for the COVID-19 virus. The attachment also includes examples.
Furthermore, it is unclear why current VA outreach on COVID-19 varies wildly from VAMC to VAMC, why verbal screening questions are out of step with the current medical understanding of COVID-19, and why there is not a coordinated, clear VA message to veterans across the country that provides a clear path to COVID-19 virus testing – particularly for those whom VA screens and determines to likely be either positive for the virus or having been exposed to it.
With regards to screening, for example, veterans across the country report being asked screening questions that do not correspond with the rapidly evolving state of medical knowledge about COVID-19. One of these is a symptom-related question that is severely limited and does not correspond with current medical knowledge of multiple COVID-19 symptoms. Another is a foreign travel-related question that fails to account for the current reality of community-spread throughout much of the United States, now the epicenter of the global COVID-19 pandemic. Both questions seem likely to miss many COVID-19 cases.
While we recognize the unique challenges VA faces with this pandemic, these and related issues are deeply concerning given that millions of our nation’s veterans rely on VA medical care – including and even more so during these difficult times. We therefore encourage you to take the steps necessary to quickly ensure a more unified national approach by VA that addresses these and related issues. Most especially, we encourage you to quickly take the necessary steps to ensure VA provides a clearly articulated and viable path for every veteran who needs testing for the COVID-19 virus, a clear response regarding those veterans who are turned away, and what specific actions VA will take to ensure that veterans who present with symptoms are immediately tested rather than turned away.
We appreciate your leadership during these difficult times and look forward to hearing the results of these necessary changes from the veterans we represent.
Association of the United States Navy
Burn Pits 360
National Vietnam & Gulf War Veterans Coalition
Non Commissioned Officers Association
Sergeant Sullivan Circle
Veterans for Common Sense
Examples of Concerns related to VA’s COVID-19 Testing, Screening, and Communications
Senator Jerry Moran, Chair, Senate Committee on Veterans’ Affairs
Senator Jon Tester, Ranking Member, Senate Committee on Veterans’ Affairs
Representative Mark Takano, Chair, House Committee on Veterans’ Affairs
Representative Phil Roe, M.D., Ranking Member, House Committee on Veterans’ Affairs
ATTACHMENT: Examples of Concerns related to VA’s COVID-19 Testing, Screening, and Communications
Veterans from across the country are reporting that they have been unable to obtain VA testing for the COVID-19 virus. Following are several examples informing these concerns.
In all the locations noted below, public communications from numerous VA medical centers across numerous VISN’s persist in failing to provide clear, viable direction on how veterans can in fact be tested for the COVID-19 virus.
VISN-2. Veterans in the VA New York Harbor Healthcare System (Jamaica, Queens, New York) catchment area report receiving only brief text messages with no email updates – and no clear direction on how veterans can be tested for the COVID-19 virus.
VISN-6. Veterans in the Salem VA Medical Center (Salem, Virginia) catchment area report receiving only brief text messages with no email updates – and no clear direction on how veterans can be tested for the COVID-19 virus.
Veterans in the Durham VA Medical Center (Durham, North Carolina) catchment area report receiving many email updates and communications related to CORVID-19 – but no specifics on how to get tested.
VISN-8. Veterans in multiple instances across Veterans Integrated Service Network Eight (VISN-8) have shared their experiences that they have screened positive for COVID-19 at VISN-8 facilities but have subsequently been turned away without testing.
Information on how to get tested has been absent from public email communications, including in a March 30 email, “An Open Letter from the Directors of the Bay Pines VA Healthcare System in Bay Pines and the James A. Haley Veterans’ Hospital in Tampa” (Bay Pines/St. Petersburg and Tampa, Florida).
Public communications from the Bay Pines VA Health Care System (Bay Pines/St. Petersburg, Florida) persist in their failure to clearly explain, if at all, how veterans can be tested for the COVID-19 virus. In another March 30 email, “Bay Pines VA Healthcare System Update,” veterans were told, “Veterans who are concerned they may have symptoms of COVID-19 (Coronavirus), flu or cold should contact the VISN 8 Clinical Contact Center at 1-877-741-3400 (toll free) before coming to a VA facility. Clinical staff are available to provide 24/7 virtualcare and support… [emphasis added].”
VISN-16. Veterans in the Central Arkansas Veterans Healthcare System (Little Rock, AR) catchment area report receiving only brief text messages with no email updates – and no clear direction on how veterans can be tested for the COVID-19 virus.
VISN-19. In a particularly egregious example, a very ill veteran reports having contacted the national COVID-19 call-in number on March 28, based on the veteran’s responses was told COVID-19 was presumed, and was referred to the Oklahoma City VA Health Care System (Oklahoma City, Oklahoma), which did not result in providing a path for the veteran to get tested; as of the writing of this letter, the veteran remains severely ill at home, is self-treating, and was finally tested this afternoon.
Veterans in the VA Eastern Colorado Health Care System (ECHCS) (Aurora/Denver, Colorado) catchment area report receiving no email updates relative to COVID-19 and no proactive communications on how to get tested.
Veterans in the Oklahoma City VA Health Care System (Oklahoma City, Oklahoma) catchment area report receiving no email updates relative to COVID-19 and no proactive communications on how to get tested.
VISN-20. In another especially egregious case, a veteran with severe shortness of breath and other unremitting respiratory and other symptoms was turned away from the Portland VA Health Care System (Portland, Oregon) without being provided needed medical care on the basis that the veteran has a service dog and irrespective of the fact the service dog meets ADA service dog requirements. VA-Portland’s unacceptable refusal of this Gulf War veteran’s care persisted despite valiant efforts to engage VA-Portland leadership by the Director, Pre-9/11 Era Environmental Health Program, Office of Patient Care Services/Public Health, Veterans Health Administration. Ultimately, a veteran advocate was able to help this veteran secure care outside the VA at a MISSION Act-approved private sector urgent care facility, where the veteran was promptly given appropriate medical care including testing for the COVID-19 virus, reportedly at the private medical provider’s urging.
VISN-21. Veterans were informed in a March 30, 2020 email update from the San Francisco VA Medical Center (San Francisco, California), in a paragraph encompassing COVID-19 and entitled “Stay Home and Phone”: “VA’s telehealth providers can evaluate your symptoms and provide a diagnosis and comprehensive care, so you do not have to leave your home or office.” No clear guidance on how to actually get tested for the COVID-19 virus was provided.
VISN-23. Veterans in the Minneapolis VA Health Care System (Minneapolis, Minnesota) report being asked outdated questions on screening, including a single symptom-related question that does not correspond with current medical knowledge of COVID-19 symptoms, and a foreign travel-related question not reflective of the current state of understanding of widely dispersed community-spread throughout much of the United States, now the epicenter of the global pandemic.