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V.A. Health Care Workers Balk at Safety Practices V.A. Health Care Workers Balk at Safety Practices
(about 11 hours later)
WASHINGTON — The Department of Veterans Affairs had a problem: Some of its workers appeared to be taking home extra masks and other protective gear, most likely fearing that they might not have enough supplies to do their jobs. So the department decided it would start checking everyone’s bags before they left for the day, and officials drafted a memo to explain the new policy.WASHINGTON — The Department of Veterans Affairs had a problem: Some of its workers appeared to be taking home extra masks and other protective gear, most likely fearing that they might not have enough supplies to do their jobs. So the department decided it would start checking everyone’s bags before they left for the day, and officials drafted a memo to explain the new policy.
But White House officials, not wishing to draw attention to shortages of protective gear at the V.A., the nation’s largest health care system, balked at the memo’s language, which was ultimately rescinded, officials said.But White House officials, not wishing to draw attention to shortages of protective gear at the V.A., the nation’s largest health care system, balked at the memo’s language, which was ultimately rescinded, officials said.
Since the moment the coronavirus arrived in the United States, doctors, nurses and other medical workers have been faced with a dangerous shortage of masks and other protective gear.Since the moment the coronavirus arrived in the United States, doctors, nurses and other medical workers have been faced with a dangerous shortage of masks and other protective gear.
In response, the Centers for Disease Control and Prevention loosened many of its health care safety guidelines, permitting the frequent reuse of masks. These amended guidelines have raised alarms during internal meetings for health care experts within the Department of Veterans Affairs, and have caused fear and anger among workers.In response, the Centers for Disease Control and Prevention loosened many of its health care safety guidelines, permitting the frequent reuse of masks. These amended guidelines have raised alarms during internal meetings for health care experts within the Department of Veterans Affairs, and have caused fear and anger among workers.
Department officials have repeatedly denied that workers across their health care system — which serves nine million veterans and has 390,000 employees — have inadequate gear, even as complaints against the department have been rising.Department officials have repeatedly denied that workers across their health care system — which serves nine million veterans and has 390,000 employees — have inadequate gear, even as complaints against the department have been rising.
Over all, at least 1,604 workers have become sick with the coronavirus, and 14 have died. The department until recently had been recommending that health care workers who tested positive for the virus return to work if they did not have symptoms, the opposite of advice the federal government has given the rest of the nation. (The department now says people who are under investigation for possibly having the virus may come to work, not those tested positive.)Over all, at least 1,604 workers have become sick with the coronavirus, and 14 have died. The department until recently had been recommending that health care workers who tested positive for the virus return to work if they did not have symptoms, the opposite of advice the federal government has given the rest of the nation. (The department now says people who are under investigation for possibly having the virus may come to work, not those tested positive.)
In recent weeks, hundreds of workers have called in sick, stretching the department’s work force even as it commits to making 1,500 beds available for use by nonveterans, hospital workers say, though department officials say they have been able to manage the labor force well. This could exacerbate a staffing problem that has drawn the attention of its inspector general.In recent weeks, hundreds of workers have called in sick, stretching the department’s work force even as it commits to making 1,500 beds available for use by nonveterans, hospital workers say, though department officials say they have been able to manage the labor force well. This could exacerbate a staffing problem that has drawn the attention of its inspector general.
Guidance concerning the virus that is sent to the department’s 170 hospital centers now has to be cleared by the White House, which sometimes slows communications, according to officials.Guidance concerning the virus that is sent to the department’s 170 hospital centers now has to be cleared by the White House, which sometimes slows communications, according to officials.
“Everyone is extremely anxious,” said Jason Gearhart, a nursing assistant at the Pittsburgh V.A. Medical Center. “People keep using the same mask they have had forever.”“Everyone is extremely anxious,” said Jason Gearhart, a nursing assistant at the Pittsburgh V.A. Medical Center. “People keep using the same mask they have had forever.”
He noted that, like workers in many health care centers, those in veterans’ facilities are using their N95 masks for days at a time, storing them in paper bags when they are not working. “They say they are working on refurbishing them,” Mr. Gearhart said.He noted that, like workers in many health care centers, those in veterans’ facilities are using their N95 masks for days at a time, storing them in paper bags when they are not working. “They say they are working on refurbishing them,” Mr. Gearhart said.
Workers have no access to coronavirus tests and are not called when a colleague becomes sick to try to ascertain if they have been exposed, he said. “It feels like our lives and our families lives and veterans lives don’t matter here,” Mr. Gearhart added.Workers have no access to coronavirus tests and are not called when a colleague becomes sick to try to ascertain if they have been exposed, he said. “It feels like our lives and our families lives and veterans lives don’t matter here,” Mr. Gearhart added.
John Mechanic, a union representative in Mississippi, received masks from a friend who has a lawn care business, and he delivered them to a V.A. community clinic in Mobile, Ala., where at least one worker had gotten sick after screening patients.John Mechanic, a union representative in Mississippi, received masks from a friend who has a lawn care business, and he delivered them to a V.A. community clinic in Mobile, Ala., where at least one worker had gotten sick after screening patients.
“We begged for P.P.E., and they said they didn’t have any to give us,” said Myoshi North, who worked at the front desk of the clinic, referring to personal protective equipment. She said that she was now ill.“We begged for P.P.E., and they said they didn’t have any to give us,” said Myoshi North, who worked at the front desk of the clinic, referring to personal protective equipment. She said that she was now ill.
In Georgia, a man was arrested last week for trying to defraud the Department of Veterans Affairs by offering to sell $750 million in nonexistent protective gear. In Oregon, a radiology technician filed a whistle-blower complaint after he said he was exposed to a patient that he was not told had the virus.In Georgia, a man was arrested last week for trying to defraud the Department of Veterans Affairs by offering to sell $750 million in nonexistent protective gear. In Oregon, a radiology technician filed a whistle-blower complaint after he said he was exposed to a patient that he was not told had the virus.
The hotline for the department’s inspector general has been receiving dozens of calls from health care workers complaining about a lack of protective gear, officials said.The hotline for the department’s inspector general has been receiving dozens of calls from health care workers complaining about a lack of protective gear, officials said.
“What the V.A. Administration is saying to the public about safety is, quite frankly, not true,” said Alma Lee, the president of the American Federation of Government Employees National Veterans Affairs Council, which represents 260,000 department employees. “Our members don’t have adequate P.P.E., appropriate leave policies, hazard pay or widespread telework. This has to change.”“What the V.A. Administration is saying to the public about safety is, quite frankly, not true,” said Alma Lee, the president of the American Federation of Government Employees National Veterans Affairs Council, which represents 260,000 department employees. “Our members don’t have adequate P.P.E., appropriate leave policies, hazard pay or widespread telework. This has to change.”
Even administrative employees who work at department offices outside of its health care facilities have complained that they have often not been permitted to work from home. Dr. Richard Stone, who runs the department’s Veterans Health Administration, has told employees by phone that they need to go the extra mile for veterans.Even administrative employees who work at department offices outside of its health care facilities have complained that they have often not been permitted to work from home. Dr. Richard Stone, who runs the department’s Veterans Health Administration, has told employees by phone that they need to go the extra mile for veterans.
Updated June 12, 2020 Updated June 16, 2020
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“Currently, every health care system is taking steps to conserve P.P.E.,” said Christina Mandreucci, a spokeswoman for the Department of Veterans Affairs. “All V.A. facilities are equipped with essential items and supplies to handle coronavirus cases, and all V.A. employees have the appropriate personal protective equipment, as per C.D.C. guidelines.”“Currently, every health care system is taking steps to conserve P.P.E.,” said Christina Mandreucci, a spokeswoman for the Department of Veterans Affairs. “All V.A. facilities are equipped with essential items and supplies to handle coronavirus cases, and all V.A. employees have the appropriate personal protective equipment, as per C.D.C. guidelines.”
She said the department was “monitoring the supply levels at every facility every day to make sure facilities have adequate P.P.E. for the number and types of patients they are seeing.” As for staffing, Ms. Mandreucci said, “The vast majority of our facilities has been able to reallocate personnel to areas experiencing a surge in Covid-19 demands for care.”She said the department was “monitoring the supply levels at every facility every day to make sure facilities have adequate P.P.E. for the number and types of patients they are seeing.” As for staffing, Ms. Mandreucci said, “The vast majority of our facilities has been able to reallocate personnel to areas experiencing a surge in Covid-19 demands for care.”
Under the V.A.’s guidelines, employees treating coronavirus patients get one face mask a day, and N95 respirators are given as needed. But workers are encouraged to reuse them, Ms. Mandreucci said.Under the V.A.’s guidelines, employees treating coronavirus patients get one face mask a day, and N95 respirators are given as needed. But workers are encouraged to reuse them, Ms. Mandreucci said.
Numerous health care workers said they were instructed to keep their masks in a paper bag to reuse the next day. One official at the department noted in a meeting that the situation with masks seemed “dire” and that they feared there would not be proper filtration with old masks.Numerous health care workers said they were instructed to keep their masks in a paper bag to reuse the next day. One official at the department noted in a meeting that the situation with masks seemed “dire” and that they feared there would not be proper filtration with old masks.