Veterans Facilities in the COVID19 Firing Line in AZ and Around the Nation

Just one month ago, VA officials were warning that they faced staffing shortages and lack of PPE for safe operations in their veterans’ facilities across the country. As of March 27th, they had confirmed 571 cases of COVID19 among their patients, and 185 among staff.

As I write now, one month later on April 28th, there are 7,001 total confirmed cases, and 434 patient deaths in VA facilities across America. Those numbers do not argue that the VA is in any more control than they were a month ago when they admitted they faced serious problems. Those numbers don’t even include infections among staff – just in-patients and out-patients. This represents a major outbreak, no matter how you parse it, especially in the North Eastern corridor and New Orleans, but also widely distributed around the nation.

Unlike most states’ medical facility systems, like hospitals and nursing homes, the VA has a great real time reporting system, so you can see exactly how many cases have been identified, and what facilities they are in. If the Federal Government had it’s act together, it could certainly expand such a public information system nationally, so that every community could see, in near real time, at what facilities infections are being diagnosed in their localities. That could inform decisions about whether to withdraw family from Long Term Care (LTC) facilities and bring them home, or where to most safely seek elective procedures in local hospitals.

But I digress, my main concern in this post is VA facilities in Arizona. There are three main vet medical centers in Arizona: Phoenix, Tucson, and Prescott. Among the three, there have been 52 confirmed cases and 4 deaths, so far (2 in the Phoenix facility, and 2 in Tucson’s). Of course, this total does not include the dozens of rehabilitation centers and nursing homes for vets across the state, nor does it include any of the facilities’ staff. I don’t know, and can’t find out, whether those facilities, or other civilian facilities are testing for COVID19, are taking special infection control measures, are getting the support, PPE, testing, and personnel they need, or are reporting cases to anyone. That’s the problem.

We need to test everyone working and living in these types of congregate living facilities. They are the most likely to be unable to contain the spread of infection because of their collective living situations; and also the most likely to have serious complications or death result from an infection, due to co-morbidities and age.

Yet, still, there is no apparent effort by AZ DHS or Governor Ducey to target our testing resources to where they are most needed. Instead, the Administration seems intent to merely give the public empty reassurances that they may be tested if they wish, rather than focusing testing resources where they will save the most lives. It’s a lie to begin with – there are still serious constraints on testing availability – and a misallocation of critical resources, to boot.

I still see no evidence of a real plan to rebuild and expand the public health infrastructure we will need to control this epidemic and re-open our economy safely and sustainably, from either the Trump or Ducey Administration. It seems they think that if they merely wait for the first wave to plateau, that we can then simply re-open and be safe. That is a naive hope, not a plan, and not consistent with everything we know about community transmission of this virus, as I have explained at length in a series of other posts.

The “invisible enemy” is loose among our most medically vulnerable veterans and seniors in LTC facilities. We owe them better than to do nothing and let them live or die according to chance. We must test, trace, and isolate infections for everyone in those facilities as our FIRST priority. We have to do better. Ducey needs to do better.

Step up, Governor Ducey. Save lives.