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 New York state has become the epicenter of the U.S. coronavirus
epidemic with more than 37,000 cases and 385 deaths, sending local
and state leaders scrambling to increase hospital capacity.
The VA has a legal mandate to provide civilian care in an emergency.
But the agency is facing the same surge in COVID-19 patients as
other hospitals throughout New York, raising serious questions about
whether it can expand it services, said Corey Lanham, VA Division
Director for National Nurses United (NNU).
"I don't know where the staff to cover all these patients is going
to come from, and I don't think they know either," Lanham said.
The Trump administration has pledged to send a 1,000-bed Navy
hospital ship to the city, and construct military field hospitals.
But the ship and makeshift hospitals will not be ready for some time
and the infection rate in New York is accelerating fast. New York
Governor Andrew Cuomo has said the state needs tens of thousands
more ventilators than it currently has, among other shortages.
All U.S. veterans in the city's five boroughs who need inpatient
hospital treatment are being routed to the Veterans Affairs Medical
Center in Brooklyn.
NNU represents 270 registered nurses at the Brooklyn facility. At
least three have tested positive for the virus and are quarantined,
the union said. One licensed practical nurse, who assist RNs, has
also been infected with the highly contagious respiratory illness.
Two doctors there also tested positive and were quarantined, the VA
told the Military Times newspaper. VA spokesman Steve Piork did not
say whether additional staff are quarantined due to contact with
infected doctors and nurses.
A shortage of protective equipment is further exacerbating the risk
to healthcare workers on the front lines of the pandemic.
Maria Lobifaro, a New York intensive care unit (ICU) nurse treating
veterans with COVID-19, said they normally change masks after every
patient interaction. Now, they are getting one surgical mask to use
for an entire 12-hour shift. The ratio of patients to nurses in the
ICU is usually two-to-one. As of Monday it was already four-to-one,
she said.
"Right now we can barely handle the veterans that we have," Lobifaro
added.
'A MATTER OF WHEN, NOT IF'
Piork said earlier this week that the New York VA system stands
ready to "surge capabilities into civilian health care systems in
the event those systems encounter capacity issues."
The VA did not answer questions about its current capacity in
Brooklyn, including how many ICU beds were filled or available.
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The VA operated 517 total hospital beds at facilities in the New York City
boroughs of Brooklyn, Manhattan and Queens in fiscal year 2014, according to
federal data. The Brooklyn facility contains about 150 of them.
The VA did not respond when asked if its other facilities in New York would be
prepared to handle civilian COVID-19 patients.
New York Congressman Max Rose, a Democrat whose district includes the Brooklyn
facility, wrote to VA Secretary Robert Wilkie on Monday asking that a mobile
hospital unit be set up in the VA Medical Center's parking lot to handle
civilians. He said expanding VA care to civilians "seems more a matter of when,
not if."
"My office has learned that there is limited capacity for additional
COVID-19-positive patients at the Brooklyn VAMC," he wrote, "and absent an
increase in staff, ventilators, and other equipment, the facility is unable to
scale up."
The VA's mission is to provide healthcare and benefits to veterans, and run the
national cemeteries. In 1982, Congress authorized a so-called fourth mission to
support the nation in the event of a disaster or pandemic.
Earlier this month, Wilkie said in a White House press briefing that the VA was
a "buttress force," ready to aid the Federal Emergency Management Agency (FEMA)
or the Department of Health and Human Services if needed.
"We stand ready when the President needs us to expand our mission," Wilkie said.
James Fitzgerald, deputy director of the New York City Veterans Alliance, said
veterans are particularly susceptible to upper respiratory conditions.
The positive test results among Brooklyn staff underscore the need for the VA to
be transparent about its capacity, staffing, and steps to protect doctors and
nurses.
"The veterans' community deserves more," Fitzgerald said.
Amid the frenzy of activity at the VA this week, Lobifaro described a "weird
energy" pervading the ICU unit driven by uncertainty.
"These patients are so sick and require so much care," she said. "One minute
they can seem fine, and the next minute they're on a ventilator."
(Reporting by Dan Levine in Oakland California and Robin Respaut in San
Francisco; Additional reporting by Chad Terhune in Los Angeles; Editing by Bill
Berkrot)
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