WASHINGTON — Yvonne Evans, a longtime nurse at Detroit’s veterans hospital, has spent the last two months at home recovering from COVID-19, “the worst thing” she said she’s ever contracted.
“I honestly thought I was going to die,” she said, her voice trembling. “It brings tears to my eyes to even think about it. It’s like putting your head in water and you can’t hardly breathe sometimes.” Her husband, a veteran himself, got the disease after she did.
Evans, who also serves as a representative with the American Federation of Government Employees, said she believes she contracted the virus at work.
But getting the department to take her illness seriously was a challenge, she said. After she started showing symptoms, she said, she was told to keep working for two days, possibly infecting even more people at the John D. Dingell VA Medical Center, where she helps run a surgical clinic.
Now, as the VA begins to reintroduce some of its healthcare services that were suspended to help stop the spread of the novel coronavirus, Evans and other union officials are worried that the department is destined to face the same problems they’ve seen since the pandemic began.
The virus caught the US healthcare system by surprise, leading to widespread shortages of protective equipment for frontline staff — including within the VA, which cares for the nation’s veterans and serves as a backstop to civilian healthcare facilities during national crises.
So far, 67 employees at the Detroit VA Medical Center have tested positive for the coronavirus, a spokesperson said; 51 of those are feeling better and back at work. One nurse at the center has died from COVID-19, prompting an inquiry from a government regulator, which is ongoing.
More than 700 patients in VA hospitals have died from COVID-19, according to the department’s tracking tool.
Throughout the pandemic, the department’s leadership has countered criticism by saying that frontline medical staff have been provided the equipment they need.
VA Secretary Robert Wilkie told Congress on Thursday that veterans hospitals “have never run out of equipment,” echoing similar comments in April. Still, he said, the VA is making plans to stock up on equipment should there be more disruptions in the supply chain, as occurred when the virus first hit the US.
Dr. Jennifer MacDonald, a senior VA official who testified alongside Wilkie on Thursday, said the department’s healthcare facilities had moved to a “universal masking” policy.
But Florida Rep. Debbie Wasserman Schultz, chair of the Appropriations subcommittee that oversees the VA and hosted the hearing, replied that she has received “whistleblower, anonymous complaints” saying employees are still having to reuse masks.
MacDonald said equipment rationing was limited to early April, when the virus was at its most severe. “We made a strategic decision for a very brief period of time to make sure that our supplies would reach until we could be re-supplied,” she said. “At each point and each day across that time, our employees had what they needed.”
The director of the Detroit VA Medical Center has said the hospital never faced any shortages of protective gear.
However, VA employees often have provided a contrasting picture of what’s happening. In April, BuzzFeed News reported that the Los Angeles VA hospital system was rationing supplies even as senior officials were saying that the department’s facilities had enough personal protective equipment.
With experts warning of a likely second spike in COVID-19 cases this fall, Evans and other union officials want the VA to have a rigorous plan in place to protect employees and patients.
“VA keeps saying that we have enough PPE,” Alma Lee, the national VA council president for the American Federation of Government Employees, said in a statement to BuzzFeed News. “The VA has not done anything to show that they have a better plan to protect employees during a reopening than they did for the closures.”
“The bleach wipes, we have one-day supply. Hand sanitizer, we have a one-day supply. That is unheard of in any medical facility and there’s no excuse for it.”
Barbara Galle, an intensive care nurse at the Minneapolis VA Medical Center and local AFGE representative, said in early May that her facility still didn’t have the supplies it needed.
“The bleach wipes, we have one-day supply,” she said during a union press call. “Hand sanitizer, we have a one-day supply. That is unheard of in any medical facility and there’s no excuse for it.”
“I think that we could be looking into a lot of trouble if they don’t do some serious planning,” she said of a possible reopening.
Evans, who has worked in Detroit-area hospitals for more than three decades, said that while she believes the Dingell VA facility was not prepared when the pandemic first hit, the situation has improved since then.
“I’m not trying to bash them, by no means,” she said. “But what I don’t want is to be caught off guard when this happens again.”
At least two VA healthcare facilities are experiencing shortages of surgical masks, according to the results of a survey the union sent its members on May 20, a spokesperson said. Staff at the St. Cloud VA Health Care System in Minnesota reported having to supply their own masks, the spokesperson said, and employees at the Carl Vinson VA Medical Center in Georgia are only receiving one mask per week.
VA press secretary Christina Noel said it’s “not exactly true” that staff at the VA facility in Georgia only receive one mask each week.
“Staff that provide direct patient care . . . receive masks daily while other staff typically receive one mask per week, in accordance with CDC guidelines,” Noel wrote by email.
The CDC says that medical personnel should throw away facemasks after each usage but that masks can be reused “temporarily during periods of expected facemask shortages.” Noel said that if an employee’s mask “becomes visibly soiled,” the employee receives a new one.
Noel said employees at the Minnesota facility have been using cloth masks, which the CDC only recommends to medical personnel who are “not engaged in direct patient care activities,” but said it’s “not true” that employees at the Minnesota facility have to supply their own.
“Non-clinical employees were provided reusable cloth masks on April 20,” Noel wrote. “Employees without a reusable cloth mask or those unable to obtain one can request one from their supervisor. Every employee, including those unable to wear a cloth mask, was also provided a reusable face shield.”
Noel said that the infection rate for VA employees is below 1%, “which is much lower than other health care systems.”
Last week, Wilkie announced that 23 of the department’s healthcare facilities were beginning to offer “select health care services” again, in addition to the urgent care they have provided during the crisis. Though the VA didn’t say which services it was offering again, he said that “patient health, staff safety and resource considerations” would help determine which services are reintroduced, and where.
“The lessons learned from these initial sites will help to inform how other facilities plan for expanding services in their facilities,” the statement read.
"Rigorous safety measures including employee and Veteran COVID-19 screening, physical distancing and appropriate personal protective attire such as face coverings, will remain in place at all facilities," the statement added.
The department chose the 23 locations because they met government guidelines for reopening, a VA spokesperson told BuzzFeed News. The Detroit and Minneapolis medical centers were not among them. The safety measures will include limiting the number of patients inside the medical centers, expanding telehealth services, maintaining social distancing, requiring that everyone who enters a facility wear a mask, and screening employees and veterans for symptoms of COVID-19, according to Noel.
Past deficiencies have prompted several Democratic senators to seek answers from the VA secretary. In April, Sens. Mark Warner, Tim Kaine, Michael Bennet, Sherrod Brown, and Jack Reed wrote to Wilkie with nearly a dozen questions about equipment shortages and how often staff have to reuse masks.
“As of today, we are still waiting on a response to our letter of April 20,” said Rachel Cohen, a spokesperson for Warner, in a statement to BuzzFeed News. “The VA has indicated that the Department continues to work on the answers. Senator Warner is also seeking a meeting with Secretary Wilkie specifically to discuss this issue.”
More recently, the issues in Detroit have caught the eye of Michigan Sen. Gary Peters, who wrote to Wilkie with questions about shortages of protective equipment at the Detroit VA Medical Center and other VA facilities.
“Staff at VAMC Detroit report shortages of critical medical supplies necessary to perform their duties in light of COVID-19,” Peters wrote on May 11. “This comes as VA health care workers nationwide have also expressed inadequate access to essential equipment and in some cases being forced to ration PPE. Clearly more needs to be done to ensure all VA medical providers have a safe work environment.”
Peters, whose office provided the letter, cited a March report from the VA inspector general that revealed more than 30 VA healthcare facilities had inadequate supplies to treat COVID-19, including Detroit.
The report, which was based on in-person inspections and data provided by the facilities, found that the Detroit VA Medical Center lacked adequate supplies of ventilators, testing swabs, masks, and face shields, among other things. The report, compiled to assess the VA’s ability to respond to the pandemic, did not include all of the department’s healthcare facilities.
Bill Browning, a spokesperson for the Detroit VA Medical Center, said by email that the inspector general’s report “was dated the day it was released” and “doesn’t represent the rapidly changing situations at VA medical centers, where our employees continue to perform amazingly well as they implement the department’s comprehensive COVID-19 response plan.”
Responding to Evans’ description of how she was treated, Browning said: “The VA will not comment on an individual’s health condition in order to protect his or her privacy. Per CDC guidance and VA protocols, employees exhibiting COVID-19 symptoms are immediately isolated to prevent potential spread to others.”
Browning also commented on the letters from the senators, saying that the “VA is monitoring the supply levels at every facility every day to make sure facilities have adequate PPE for the number and types of patients they are seeing.”
In his letter, Peters expressed concern about “the disparity between experiences shared by frontline workers and statements from VA leadership.” Peters asked Wilkie what the VA has “done to address the deficiencies” that the inspector general identified in Detroit, but he has yet to hear back.
In late March, as the coronavirus outbreak began to batter Detroit, the medical center made a request for help, asking the public to donate protective equipment for its staff. The facility at the time said the callout was only to address any future shortages and that “health care workers at the Detroit VA Healthcare System have the gear they need to protect themselves and others.’’
But an employee complaint the day before to the federal Occupational Safety and Health Administration tells a different story. On March 23, a staff member told the agency that personnel in the medical center’s hospital wing and extended care facility weren’t being given the protective gear needed to treat COVID-19.
"Employees in unit A5 South as well as the blue wing, are not being provided with N-95 masks, surgical masks, and protective gowns," read the complaint, obtained by BuzzFeed News through a Freedom of Information Act request.
OSHA launched an inquiry and found the complaint to be “valid,” a spokesperson for the Department of Labor told BuzzFeed News. The Detroit VA Medical Center provided OSHA with a “satisfactory” response that addressed the problems, the spokesperson said, but did not provide any further information on the case or the VA’s response.
Asked about the OSHA complaint, Browning said: “Complaints are not facts, they are merely allegations.”
He said the facility followed guidelines from the Centers for Disease Control and Prevention at the time. Those guidelines instructed medical facilities that were short on protective gear to save it for staff who were performing “aerosolizing” procedures on COVID-19 patients, which put medical personnel at a higher risk of contracting the virus.
“The Detroit VAMC has maintained sufficient PPE for its employees, and is currently adhering to the same CDC contingency capacity PPE postures the CDC recommends all health care facilities use,” Browning wrote in response to questions from BuzzFeed News. “The community call for PPE and cleaning supply donations was precautionary.”
The Detroit VA Medical Center has been the subject of two more coronavirus-related OSHA investigations since March, the Department of Labor spokesperson said. One was an April 2 inquiry into an employee death, which remains open.
The spokesperson didn’t provide additional details about the death. Only one staff member, a 72-year-old nurse, is known to have died, and the VA announced the death on April 2.
Days later, OSHA launched a third inquiry, based on another employee complaint about protective equipment filed on April 6, the spokesperson said.
The agency has closed both inquiries about protective gear, the spokesperson said.
The Labor Department spokesperson did not say whether the second complaint, filed April 6, was deemed valid. The Detroit VA Medical Center “thoroughly investigated” that complaint on its own and found it “to have no merit,” Browning wrote.
Browning said OSHA officials “confirmed they were closing the complaint in a letter to the facility on April 13.”
Evans, who serves as a national affirmative action coordinator for the American Federation of Government Employees as well as the recording secretary for her local branch, wants the VA to have a better screening process now that healthcare centers are reopening.
There should be multiple screening areas at the VA medical centers, not just at the front door, she said, and employees who have tested positive should get retested before returning to work. The VA is following current CDC guidelines, which say healthcare workers can return to work once they’ve quarantined for 14 days and been fever-free for three.
But Evans said she still felt sick after that period passed, so she visited her doctor again. “I didn’t feel right, and not only did I test positive, I had a X-ray to show I had viral pneumonia,” she said.
Peters cited Evans’ story in his letter to Wilkie, saying he was “deeply troubled” by it. He asked the VA to provide its plan for making sure employees are virus-free before going back to work and whether the department is providing employees who get COVID-19 enough paid sick leave.
Evans and Galle said staff who fall ill with the disease — from which it often takes weeks to recover — have not received any additional paid leave and are left to use their own sick days, which are limited to 13 days per year.
“That’s absurd,” Galle said.
Evans, whose infection was likely worsened by her asthma, said she’s gone on workers’ compensation instead. She’s been slowly feeling better and is eager to get back to work.
“I want to be with my coworkers and I want to help serve my vets, because I love my vets unconditionally,” she said. “They served this country for me and I want to serve them.”
But she’s scared to get sick again. “I was blessed; I was one of the lucky ones,” she said. “If I get it again, will I be as lucky?’’
Brianna Sacks and Caroline O’Donovan contributed reporting.
This story was updated with additional comment from the VA.