Veterans Affairs reaches more than 100,000 COVID-19 cases since pandemic began

As active cases continue to surge at record levels at VA, lawmakers concerned over vaccine distribution plans.
U.S. Army Spc. Jabari Ashanti, a Combat Medic with the 1st Battalion, 114th Infantry Regiment, New Jersey Army National Guard (NJARNG), checks a resident’s temperature at the New Jersey Veterans Memorial Home at Menlo Park in Edison, N.J., April 17, 2020.
U.S. Army Spc. Jabari Ashanti, a Combat Medic with the 1st Battalion, 114th Infantry Regiment, New Jersey Army National Guard (NJARNG), checks a resident’s temperature at the New Jersey Veterans Memorial Home at Menlo Park in Edison, N.J., April 17, 2020. Photo credit U.S. Air National Guard photo by Senior Master Sgt. Andrew J. Moseley
By Connecting Vets

The number of Department of Veterans Affairs patients sick from the coronavirus has doubled the previous record high from July as the total number of cases at VA reaches more than 100,000.

VA has reached or exceeded record numbers of patients sick because of the virus for weeks, since first breaking July's record high of 6,424 on Nov. 2. As of Tuesday, VA recorded more than 13,000 patients sick with the virus.

The increase in active cases as of this week represents a nearly 115% increase from the beginning of this month. October began with 3,331 active cases and ended by recording more than 5,800. Active cases at VA have jumped more than 20% in the last seven days alone and continue to grow.

Active increased more than 173% since this time last month and could triple if the trend continues. The vast majority of those active cases are veteran patients.

On Nov. 1, VA recorded 4,000 deaths from complications caused by the virus, and since then has added more than 680, putting the department on track to reach more than 800 deaths by the end of November, putting it near the top of the deadliest months of the pandemic for VA patients. In August, VA recorded 825 deaths, the highest so far, followed by more than 730 in May.

Since VA cares for about half of the roughly 18 million veterans in America, its numbers are representative only of those in its care and do not include veterans who receive care elsewhere or who do not qualify for VA health care.

VA's overall mortality rate is about 4.65% is still significantly higher than the about 2.1% mortality rate for Americans overall, according to the most recently available Centers for Disease Control and Prevention data, though both of those rates have fallen slightly from previous months.

More than eight months since VA recorded its first veteran lost to the virus the department has averaged about 18 deaths per day up from 17, and higher than the estimated rate of veteran suicide, according to the most recently available VA data.

VA's mortality rate is influenced by the age and overall health of its patients, who tend to be older and less healthy than the overall American population. VA's data also includes its staff and some non-veteran patients the department treated as part of its Fourth Mission. As of Nov. 24, VA recorded 70 staff deaths, adding eight deaths so far this month.

Increases in the overall number of deaths at the department appear to generally follow in the wake of trends in active cases increasing both at VA and across the United States overall.

Active cases at the department fell steadily for about two months before they began to rise again in late September. The surge in active cases at VA which began in late September appears to reflect a similar increase in active cases across the country, with cases rising in the majority of states.

"Trends in new cases generally reflect what is going on in the country and local communities," VA Press Secretary Christina Noel said.

The number of patients at the department who require hospitalization -- the statistic VA cites as the most reliable judge of how it's patients are faring amid the pandemic -- has consistently fallen since a height of 38% in March, to about 15% in October and now about 13% so far this month, Christina Noel said.

But the number of patients hospitalized also appears to be rising. In the latest of VA's weekly pandemic response reports for Nov. 17-23, the department recorded 944 COVID-19 inpatients, more than doubling since this time last month.

As VA deals with growing COVID-19 counts, Noel said all department medical centers "have adequate capacity, PPE and supplies to meet current demand."

VA surpassed 100,000 total cases of the virus this week, adding more than 24,000 so far in November. Of VA's more than 100,000 total cases, about 82% are considered convalescent, meaning they have either recovered or passed the 14-day mark since their last positive test, and that number has continued to drop as the number of active cases has increased.

The department's total case count exceeds the total number of cases confirmed in several states, such as Connecticut (99,313) and Idaho (79,410), according to CDC data. VA's total number of cases exceeds those confirmed in at least eight states. The department cares for a total of more than 9 million veterans, roughly half of the veterans in the United States, and has nearly 400,000 employees.

The top 10 VA health systems with the most active cases have changed slightly since earlier this month. The Cleveland VA is now the facility with the most active cases (436) followed by Minneapolis (420); Aurora, Colorado (292); Milwaukee (274); Kansas City, Missouri (244); North Chicago (223); Nebraska-Western Iowa (218); Hines, Illinois (217); Columbia, Missouri (200); and Las Vegas (199).

The North Chicago VA Healthcare System has recorded more than 2,600 confirmed COVID-19 cases during the pandemic. Of the 140 VA health systems the department is tracking in its publicly available data, at least 33 have recorded more than 1,000 confirmed cases, up from 21 earlier this month.

The VA systems with the most deaths remain primarily areas hit hardest early in the pandemic, including New Jersey, New York, Texas Valley Coastal bend, Boston, Bronx, Phoenix, San Antonio, Cleveland, New Orleans and Columbia, South Carolina, though Minneapolis is now in the top 10 VA systems for most coronavirus-related deaths.

Some VA systems have sent out advisories asking veterans to abide by new, tightening COVID-19 restrictions in their states, and others are again beginning to limit visitors and reactivate previous policies intended to prevent the spread of infection.

Noel said each VA medical center is taking precautions and considering unique circumstances in its area as the facilities make decisions about what services to provide.

VA recorded 989,636 total COVID-19 tests administered nationwide during the pandemic as of Nov. 23. That total number of tests does not necessarily reflect how many individual people have been tested at VA, but rather how many tests have been administered -- some people may receive multiple tests.

In October, VA averaged more than 3,800 COVID-19 tests per day, lower than the September average of more than 4,700 per day.

New vaccine trials and distribution plan

VA Medical Centers in Maryland, Louisiana, New York, New Mexico, Texas, Arkansas, North Carolina, Colorado, Illinois, Nevada, Florida, Georgia are among those selected to participate in a new COVID-19 vaccine trial, the fourth large-scale trial in the United States, according to department news releases.

Veterans can volunteer for the studies, but researchers are asking especially for frontline and essential workers as well as Black, Hispanic and Native American volunteers. Veterans can sign up to participate here. VA and national data suggest Black, Hispanic and Native Americans may be disproportionately affected by the pandemic.

But some lawmakers are concerned about VA's distribution plan. In a letter to Secretary Robert Wilkie on Monday, Senate Veterans Affairs ranking member Jon Tester, D-Montana, and fellow Democrat senators Richard Blumenthal, Mazie Hirono and Sherrod Brown, said they were concerned the department had not yet shared its plans for how to distribute vaccines once they are approved.

“For COVID-19 vaccine distribution to succeed there must be a well-organized plan to meet the needs of all veterans and their providers,” the senators wrote, adding that all 50 states and the CDC have already released their plans and VA may be "behind the curve."

"Why is VA lagging behind?" the lawmakers asked in their letter. "When will VA's COVID-19 vaccine plan be available and released to Congress and the public?"

VA announced last week it was working with federal partners to plan for massive vaccine distribution once they are approved, but shared few details.

The plan will follow a phased approach and "lessons learned from past pandemic vaccine plans," VA said in its announcement. The initial phase will be a limited supply, followed by a "general implementation phase" when VA said larger supplies of the vaccine will be available for veterans if they want to receive one.

“In October, staff at VA medical facilities conducted important planning exercises in preparation for the vaccine,” VA Secretary Robert Wilkie said in a statement. “These exercises help us to address vaccine distribution, allocation, safety monitoring and supply tracking.”

The senators were not satisfied with the information VA had shared so far.

"Veterans and staff need to feel safe receiving any future COVID-19 vaccine, and this vaccine should be administered at no-cost to them," they wrote. "Veterans and VA staff can’t afford to wait until January 20 for a COVID-19 vaccine plan. The Department needs to take action now to ensure the health and safety of veterans, staff, and their families during this pandemic.”

Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett.

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