San Diego VA Faces Nursing Shortage And Lapses In COVID-19 Readiness, Report Finds
Saturday, March 28, 2020
Photo by Zoë Meyers/inewsource
A new report by the VA inspector general’s office reveals shortcomings at the San Diego VA in its efforts to combat the novel coronavirus, including a failure to screen all patients for virus symptoms, a shortage of nurses on staff, and a limited supply of masks and gowns to protect medical workers.
Out of 125 VA clinics across the U.S. that inspectors visited in mid-March, the report found that only four were not following guidelines to screen patients for symptoms of COVID-19, the disease caused by the new coronavirus. The San Diego VA runs two of those clinics.
The report, released Thursday, assessed the preparedness of VA medical facilities across the country to tackle the surging coronavirus pandemic.
In early March, the VA asked its medical centers to begin using questionnaires to detect patients with COVID-19 symptoms before letting them inside any buildings. The Centers for Disease Control and Prevention has encouraged these kinds of screenings, which serve as a chance to quickly identify and isolate COVID-19 patients in order to slow the spread of the virus.
Inspectors tested which VA facilities around the country had implemented the new guidelines by visiting VA clinics and hospitals unannounced between March 19 and March 24, without explaining who they were, and observing whether medical staff screened them for possible COVID-19 symptoms. They also surveyed officials at the healthcare centers about equipment and staffing needs.
While the San Diego VA hospital in La Jolla was properly screening people, the report said, two of its outpatient clinics weren’t.
When inspectors visited a San Diego VA clinic in El Centro, “patients and visitors were permitted to freely enter the waiting room,” the report said, then “stood in the waiting room for 10 minutes, and were not greeted or screened by (VA) staff.”
At a mental health clinic in Chula Vista, the inspectors were “politely greeted but not asked any COVID-19 screening questions.”
The San Diego VA had not provided inewsource a comment by Saturday afternoon.
As of Friday, 571 patients at VA healthcare centers and 185 VA employees across the U.S. have tested positive for the coronavirus.
At the San Diego VA, five veterans have tested positive, according to a March 24 email sent to staff, and 12 patients in its ICU have tests pending. Another 126 patients are “under investigation” and waiting test results.
The email also said five staff at the San Diego Counseling Center tested positive, and all employees at the counseling center have been sent home to self-isolate.
San Diego VA officials told the inspector general’s office that they currently don’t have enough nurses to “optimize care” in medical wards and ICUs. They also said their facilities need a bigger supply of disposable gowns, disinfecting wipes, hand sanitizer, N95 respirator masks and surgical masks.
VA spokeswoman Cindy Butler told inewsource on March 20 that the San Diego VA is “equipped with essential items and supplies to handle an influx of coronavirus cases,” and protect its healthcare workers. She also confirmed its facilities are following new CDC guidelines to restrict the use of highly protective respirator masks so they can maintain stockpile in case COVID-19 cases spike.
An email to VA medical staff on Feb. 28 obtained by inewsource encouraged healthcare workers to re-wear the same N95 mask when treating the same patient more than once and store them in “zip lock bags” in between uses, even though the standard policy is to discard them after they are worn.
More than a quarter million veterans in San Diego and Imperial counties are eligible to receive care from the San Diego VA healthcare system. During emergencies when other local hospitals become overwhelmed, the San Diego VA can also offer treatment to people in the region who are normally not eligible for VA care, stretching the system’s resources even thinner.
In a statement, Democratic Congressman Mike Levin said he was “troubled” by the inspector general’s findings about the San Diego VA.
“We must ensure that VA medical facilities are prepared to provide high quality care for our nation’s heroes,” he said.
Levin, whose district runs from Dana Point to La Jolla, is a member of the House Committee on Veterans Affairs and its subcommittee on health. He said he is “in constant contact with our local VA medical facilities, and will continue to closely monitor their needs.”
A bill signed into law Friday by President Donald Trump offers $2 trillion in support to individuals and businesses to provide relief during the pandemic. That funding includes nearly $20 billion for the VA, which will help purchase more medical supplies, testing kits and protective gear, as well as build up bed capacity in VA hospitals and support homeless and elderly veterans in community living centers.
“We know that the magnitude of this public health emergency and the number of veterans sickened by this deadly virus are underreported,” said Rep. Mark Takano, chairman of the House VA committee, in a news release advocating for the bill’s passage.
“It will only become more severe in the weeks to come,” said Takano, a Riverside Democrat.
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