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Stories and information in our region on the COVID-19 pandemic.

Interview: VA Secretary Robert Wilkie On Fighting COVID, Protecting Seniors

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Gene Russell
/
U.S. Department of Veterans Affairs

The number of coronavirus cases among veterans is on the rise, but hospitalizations remain lower. Connecticut has seen over 400 veterans’ cases and nearly 300 cases on Long Island since March. The death toll is below 40 in each state. That’s because many veterans who are infected with COVID-19 don’t necessarily require intensive care, according to data from the U.S. Department of Veterans Affairs.

The Trump administration credits an expansion of telemedicine and increased testing for keeping serious cases among veterans low.

Robert Wilkie, U.S. Secretary of Veterans Affairs, recently spoke with All Things Considered host Bill Buchner about coronavirus among veterans.

Below is a transcript of their conversation.

The hardest hit veterans during this crisis have been those that are in long-term care facilities. Could you tell us what went wrong there?

Well, let me talk about the two different systems at VA. We have 134 assisted living facilities. And as of this morning, of our 7,500 patients, we have two patients who are positive. We took drastic measures at the beginning of this crisis to lock our facilities down. And sadly, we had to prevent our veterans in those facilities, most of whom are from Korea and World War II, for getting the sustenance of their families. So in that sense, we were ahead of the rest of the country. The state veterans homes were the ones that were hard hit. And we have moved into those veterans homes, even though by statute we have no ability to control or manage those state veterans homes, and we've tried to impart best practices.

We're in New Jersey, and we are in Massachusetts, we're in Rhode Island. So we're all over the country. And we are imparting the ways that we protected our veterans to those state nursing homes. There's a problem in each one. And I think in some cases, they were just overwhelmed by numbers. And we treat our nursing home patients differently. We treat each nursing home patient as if that patient is in an acute care bed. We have more doctors, we have more gerontologists, we have more nurses on duty. And that really has helped us, and we tested everyone. We tested all of our employees and continue to do so. And we test all of our patients, which is why our numbers are so low.

How has the VA tackled suicide prevention because of increased social isolation felt among veterans and the potential for substance use?

Well, remarkably, and I think this is partly because of the natural human reaction during crises, to look in on neighbors, we see it mostly in natural disasters. But we've had a dramatic drop in terms of death by suicide on our campuses. We had an epidemic last year and the year before. But that has been in part because we have really saturated the market. In terms of outreach, we've sent out tens of millions of communications. We have taken telehealth for mental health from about 40,000 calls a month to over 900,000. So we have increased our ability to communicate and to increase our footprint in remote areas of the country.

We just launched the President's national task force on suicide a month or so ago. So we will be distributing resources to the states and localities to help us find those veterans We don't see the vast majority, 70% of veterans who take their lives by suicide are not in the VA system. And that majority is actually from my father's generation in Vietnam. So the national task force is the first whole-of-government approach to prevent veteran suicide. We think we've actually benefited from this epidemic by stressing our system and increasing the viability of mental health telehealth services throughout the country.

Your agency is handling a surge in cases nationwide and some major VA medical centers are moving patients to make room. How are you guiding New York and Connecticut VA centers for the potential second wave of the virus?

Well, that is the threshold question. What happens in the fall and winter in the event that there is a convergence of flu and Covid? I'm here in Northport. I was in East Orange, New Jersey, yesterday. I'll be in Manhattan tomorrow. And what the facilities are doing is they are expanding their ICU potential. They are making available more rooms within the hospital.

Now here at Northport Long Island, there's only one veteran in the hospital who has tested positive for Covid. But they are making plans should they be needed in the fall and winter and the beauty of our VA system, and you've seen it in the metropolitan area, is that we were the first to open our doors to people who are not veterans. If you look at Manhattan, you look at Brooklyn, look at East Orange, New Jersey, those doors were open to fellow citizens. So I've been in contact with most of the state governors in the area. Making sure they know we are working toward building our supplies and building our capacity. Should this thing boomerang back on us here in Northport? I just visited the ICU unit and talk with the engineers and the nurses who are preparing the facility in the event that we have another outbreak.

The pandemic delayed crucial upgrades for the VA digital healthcare infrastructure. Have those resumed?

Well, yes. I give you an example. The electronic health record, which is the largest, most expensive electronic project IT project the federal government has. We've continued to work on it during this epidemic. It works. We're going to start fielding it in the Pacific Northwest, and it will move to the east. What it does is it allows us to reach into the Department of Defense. It allows the private sector to add information to a veteran's health record, so that we finally have after decades and decades of talking about it, a complete, holistic picture of a veteran's health.

From the minute that veteran walked into the military entrance processing station to the minute  that veteran was turned over to VA. So we have, we have moved forward on that. But more importantly, and this is important for this part of the country, where there are so many Vietnam veterans. In the fall, we will finally begin giving support to the families of Vietnam veterans who are caregivers. We are closing one of the last circles left from Vietnam. Those caregivers were left out of this system. I don't know why it was done that way many years ago, but in the fall, they will have access to financial and material resources to help those veterans from Vietnam that they care for. We have moved ahead with the preparation for that during this epidemic.

Earlier this month, you said you want to get “veterans back into their normal routine as soon as possible” after months of delayed and canceled medical appointments. Is that still the goal?

Yes. So here in Long Island, Long Island is in Phase Four. And we are slowly returning our system back to normal, we never closed. But we are telling veterans depending on the service, when they can come in and start back in their routines, the routine that they had before for face-to-face encounters, and that means everything from wellness visits to physicals to things like dermatology, cardiology, we're going to get back to that normal rhythm, and we'll be doing that across the country, but it depends on what the situation is on the ground, surrounding the VA facility. There are many places in the country that are not as advanced in the recovery as Long Island is, so we evaluate that on a case-by-case basis.

You sound very confident as we go forward with this pandemic.

Well, I'm confident because of what I've seen. And I will give you an example. I'm here in the metropolitan area to do one thing. And that is to thank the thousands of VA employees here for what they've done not just for veterans, but for their fellow citizens. This is an area of the country that has been rocked in the last 20 years by a succession of things that nobody had could have planned for.

Certainly the attacks in 2001, Sandy, and the natural disasters and now this, VA employees put themselves on the line. They put themselves in danger to help their fellow citizens as I've mentioned, we opened in Manhattan and Brooklyn and East Orange, not just to veterans, but to citizens. Our nurses are in 46 states right now, helping people who are not veterans. That's our special mission. That's our fourth mission.

And I will also say, because the system has been stressed, the lessons learned by these wonderful people will be needed if this thing rebounds. We’re in a new day at VA, we have a 90% trust and approval score from our veterans. Four years ago it was at 52%. We just set a record for the number of appointments within VA last year at 59.9 million. So we are all as prepared as anyone in America could have been for this. And I'm confident that if it comes back that we will respond not just for veterans but also for the nation.

Robert Wilkie, thank you for joining All Things Considered.

It's always a pleasure and have me back another time.

Bill began his radio journey on Long Island, followed by stops in Schenectady, Bridgeport, Boston and New York City. He’s glad to be back on the air in Fairfield County, where he has lived with his wife and two sons for more than 20 years.
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