The Department of Veterans Affairs is bracing for a potential surge of 1 million veterans infected by coronavirus and at the same time is preparing for the possibility it may have to absorb overflow civilian patients if private hospitals are overrun by the pandemic.
Based on a "worst case" scenario that up to 1 in 5 of its mostly elderly population of veterans will need coronavirus care, the government-run hospital system is seeking $16.6 billion in emergency money, according to a VA document submitted to Congress and obtained by The Associated Press.
The money would be used over six months to ramp up COVID-19 testing, cover hospital care and protective masks for 4,500 more veterans, add medical ventilators, boost online telehealth options as Americans continue to hunker at home and pay for 40,000 more urgent care visits. About $170.74 would be allocated per VA employee in certain divisions for hand sanitizer, disinfecting wipes and antiviral face tissue for the rest of the budget year that ends Sept. 30.
"All that gives is an added safety boost," Dr. Richard Stone, the agency's top health official, said in an AP interview.
During national emergencies such as the one declared by President Donald Trump last week, the VA not only serves 9 million veterans but also acts as a backup health care system to the broader public.
If called upon by states and HHS, the VA network of 170 hospitals, 1,074 outpatient sites and more than 350,000 employees could provide care to first responders and civilians in hard-hit communities.
It could be an unprecedented task for the VA, which has faced past criticism for staff shortages, management disarray and long patient wait times.
Since January, the department has run drills and checked stockpiles of medical equipment. As coronavirus spread in the U.S., the VA locked down visitation at its 134 nursing homes and 24 spinal cord injury centers to protect elderly and vulnerable patients and screened patients for symptoms of the virus before they entered facilities.
To increase capacity, the VA has cut back on routine appointments, limiting dental work and canceling elective surgeries, according to Secretary Robert Wilkie, who was belatedly added to the White House coronavirus task force this month.
In the U.S., there are more than 10,000 confirmed coronavirus cases.
For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. The vast majority of people recover from the new virus.
At the VA, officials said they were tracking at least 83 cases of veterans who showed signs of the virus. One patient in their 70s died late last week at a VA facility in Portland, Oregon, of complications from COVID-19. The department currently has 1,200 coronavirus test kits from the Centers for Disease Control and Prevention and 2,000 VA-developed tests. More than 800 veterans have been tested so far.
A group of Democratic senators and the House Veterans' Affairs Committee have pressed the VA to provide regular updates on its preparedness and available resources to address the pandemic.
"VA must be properly prepared to respond to the unique needs of our nation's veterans, and ready to activate its critical Fourth Mission to support all Americans if it becomes necessary," said Montana Sen. Jon Tester, the top Democrat on the Senate Veterans' Affairs Committee.
He urged the agency, which currently has more than 44,000 vacancies, to work aggressively "to determine both immediate and projected needs for health care workers and first responders on the frontlines — including beds and personal protective equipment."
Joe Chenelly, executive director of American Veterans, or AMVETS, said veterans were anxious and uncertain about their health care amid the outbreak, with information from the VA often slow in coming.
"We understand that the VA has a crucial role in a public health crisis, and we're ready for whatever that means," he said.
At the same time, Chenelly said, more than half of veterans are older and face a higher risk from the virus and younger veterans have chronic health conditions related to their military work. "There is perhaps no segment of the American population more at risk of being decimated," he said.
Asked this week at what point VA hospitals or Defense Department medical facilities might be tapped by federal health officials to help relieve an overburdened private health care system, Trump pointed to pockets of the U.S. where medical personnel are showing strain.
"Some areas—like New York, California, State of Washington—they're going to have some difficulty. And when we see that coming, we're going to be in there," Trump said.
The VA has played a role in national emergencies before, such as the 2017 hurricane in Puerto Rico.
The VA system currently has 13,000 acute care beds, including 1,800 intensive care beds and 1,100 negative air flow rooms, which control the air flow around patients with airborne contagious diseases to protect other patients and medical personnel.
Over the past two weeks, the VA has expanded hospital capacity, dropping occupancy in acute care beds from about 80% to over 60% to make room for possible civilian patients, Stone said. He added that VA also is working to add negative air flow beds should they be needed to help treat the civilian population.
"We are the buttress force in case'' HHS or the Federal Emergency Management Agency "calls upon us to deploy medical professionals across the country to meet crises," Wilkie said this week at a White House briefing of the coronavirus task force. "We are gaming out emergency preparedness scenarios. And we stand ready, when the president needs us, to expand our mission."