Veterans, VA brace for COVID-19 impact

A car drives near a road sign that reads "No appt? Call 1st"
All traffic coming into the VA Medical Center in St. Cloud, Minn., is being routed into one entrance along Veterans Drive Saturday. The St. Cloud VA is screening patients at a checkpoint before they enter and restricting visitors in an effort to prevent the spread of the coronavirus.
Paul Middlestaedt for MPR News

As more cases of COVID-19 develop across the U.S., military veterans are among those most at risk for falling seriously ill from the disease. They’re also bearing the brunt of many measures aimed at stopping the virus’ rapid spread.

About half of U.S. veterans are over the age of 65, and many have underlying health complications, making them especially vulnerable to the new coronavirus, which often causes respiratory illness in people who are infected.

Those statistics have led to concerns about whether the federal agency that serves them, the U.S. Department of Veterans Affairs, is ready with enough hospital beds, staff and medical equipment to handle a widespread outbreak.

State and federal VA officials say early action and experience caring for the very sick — including patients in intensive care and on ventilators — mean the sprawling agency is prepared for a worst-case scenario.

That’s in part because the VA also serves as a backstop to the civilian U.S. health care system for major events — not only war, said VA Secretary Robert Wilkie.

“For natural disasters and epidemics, we provide a backup force for the country, and we rehearse and exercise these scenarios throughout the year,” he said.

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Wilkie said the VA has access to federal stockpiles of medical supplies and has a reserve force of 3,000 staff around the country that can be deployed in an emergency. The VA hasn’t received requests from states yet to provide large-scale support, he said.

As of Wednesday, the VA had reported that 365 veterans across the U.S. have tested positive for COVID-19, and four have died.

Meanwhile, VA medical facilities have taken steps to screen patients and restrict visitors. As with other health care facilities, elective surgeries and procedures have been postponed, and nonurgent medical appointments are being rescheduled.

“That stopped the wear and tear on our people and the wear and tear on our supplies,” Wilkie said. “It stabilized our blood supply as well."

At Minnesota’s VA hospitals in Minneapolis and St. Cloud, patients are asked a series of questions at a screening checkpoint about their travel history and whether they have any possible symptoms of COVID-19, such as cough, fever or shortness of breath. Patients who don’t have an appointment are being asked to call before coming in.

Cars drive past a road sign that reads "VA entry closed. Bus only."
Temporary signs warn drivers along 44th Avenue that the entrance to the St. Cloud VA Medical Center is being rerouted to one access point along Veterans Drive.
Paul Middlestaedt for MPR News

Visitors to both hospitals’ community living centers — facilities similar to nursing homes, reserved for the most medically fragile patients — are restricted. Some exceptions are being made to allow people to visit patients at the end of life or in hospice care.

“We very actively try to limit and minimize [visitors], but to be compassionate about it,” said Patrick Kelly, director of the Minneapolis VA Health Care System. “Because in some cases, these veterans are dying, and it’s very challenging for them to be without their family during what is a very, very vulnerable time.”

Despite the changes, VA officials say veterans still can receive a broad range of care, including urgent procedures and prescription renewals. The VA has been shifting toward telehealth, or appointments done over video conference calls, in recent years. Those efforts are now being ramped up, Kelly said.

That includes mental health appointments, which are critically important for veterans dealing with anxiety, post-traumatic stress or other mental health issues — particularly in a time of such uncertainty.

Telehealth visits can help reduce exposure and the need for veterans to travel to hospitals or clinics, so some veterans are more comfortable doing video visits during the pandemic, Kelly said.

However, not all veterans may be comfortable with the technology or have access to the internet, especially those who are older or live in rural areas. Those patients may be transferred to a phone call, or they may be asked to come into the VA for a visit, said Scott Bartley, chief of staff at the St. Cloud VA Health Care System.

For veterans, the uncertainty and stay-at-home recommendations during the COVID-19 outbreak can be difficult to cope with. Many older veterans have health complications and may rely on others for care and support.

Isolation also can be difficult. Many veterans rely on VA centers and organizations such as the American Legion and VFW for social interaction. But many of those clubs have had to close due to the outbreak.

“We are mindful of that, and thinking that we need to stay in touch with our veterans, even if they don’t come to our hospital, because these are and will continue to be challenging times,” Kelly said.

At the same time, veterans — especially those who’ve experienced combat — tend to be resilient, said Chris Belfield, a retired U.S. Air Force officer and current chaplain for the American Legion Post 109 in Two Harbors, because they’ve been through difficult situations, are trained to deal with stress.

“They have seen it,” Belfield said. “They do know what it takes in order to get through something like this — which is a lot of good information, training, relying on your friends, your family and also looking deep down inside. What strengths do I have that I can share with somebody else?”

Efforts are underway to make sure veterans are still getting the support they need, whether financial, mental or emotional.

“There’s so much that we can still do for vets,” said Dan Tengwall, a Carver County veteran service officer. “We’ve had the regular calls of, ‘What’s the status of my claim? How do I utilize this benefit?’ And so we’re having a lot of those conversations with veterans and their surviving spouses right now.”

Many of those questions relate to the GI Bill, which provides education assistance to veterans and their dependents. Many want to know whether those benefits will continue if their college or university switches to online classes, Tengwall said. The answer is yes, he said.

Jennifer Havlick, membership chair with the American Legion in northeast Minnesota, has been working to expand a “buddy check” system, where volunteers periodically call and check on veterans who haven’t been seen or heard from in a while.

“We want to make sure they’re OK, and maybe inquire why we haven’t seen them, in case they need assistance of some kind,” Havlick said.

She and other advocates encourage people who know a veteran to reach out and check on them.

“Social distancing doesn’t necessarily mean that you isolate. You reach out,” Havlick said. “If you haven’t heard from somebody, give them a call.”