As the U.S. nears 100,000 COVID19- related deaths, the level of unease among medical professionals and the public continues to grow. This is due to what we don’t know about the spread of the disease and how this will impact the healthcare system in the U.S.
This situation is even more uncertain for those who rely on the Veterans Administration (VA) for their healthcare and other services. Part of the reason is that the VA has been pushed to the limit in recent years due to budget cuts, aging Vietnam-era veterans, and the influx of post-9/11 vets. Another reason is that the rapid spread of the virus in a country as large as the U.S. has the potential to overwhelm existing healthcare systems.
Add to this, the cost of getting treatment in the U.S., and there is the potential for a disaster reaches well beyond the human cost of the virus itself. However, one thing that gets overlooked in the discussion is how the coronavirus could affect VA home care.
According to recent reports, the Department of Veterans Affairs has started to put in place an emergency team to prepare for the continued spread of the outbreak. While this is a step in the right direction, little is known at this point what efforts the emergency team is making to ensure the VA-system is up to the challenge.
There are rampant questions about testing which the Centers for Disease Control (CDC) have been tackling. These questions focus on the processes and the time required to perform the tests.
According to the National Cancer Institute (NCI), these tests “check for RNA (genetic material) from the virus in a [patient] sample.” While this approach works in suspected cancer and HIV cases, it is not an excellent fit for a fact spreading and reportedly mutating, a virus such as the one which causes COVID19.
Also, RNA tests either require trained specialists who can perform manual extraction of the genetic material or costly machines to perform the tests automatically. Neither is an ideal situation in a population as large as the U.S. Then there are questions about the ability to scale up – even to meet the demands of the more than 18 million veterans alive today.
Adding to these challenges are serious questions of how the continued spread of the virus will impact VA home care. This is already being brought to attention as cases such as the COVID19 outbreak in a Washington state nursing home have the potential to affect those who qualify for VA aid and attendance pensions. This is an additional coverage package meant for veterans who do not have a service-related disability, but they do require additional support in some way – for example, home care.
According to observers, there are three potential challenges which the VA might face in the coming months. The first is that the system will become overwhelmed. At the same time, this concern also impacts the civilian healthcare system; it could have a more significant impact on those who rely on the VA as the order is already overextended.
The second challenge is that administrative backlogs could further impact enrollment of veterans for coverage, or even delay payment to third-party service providers. The latter could have a tremendous impact on reimbursement for those relying on home care.
Another challenge is that most healthcare systems, including the VA, are unprepared for how to stop the spread of the virus from patient to patient. This is because healthcare workers, even though they try, can sometimes unwittingly cross-infect patients. While hygiene standards are extremely high in the industry, accidents happen.
What does this mean for veterans who rely on home care? First, they should contact their service providers to find out what are the contingencies. Second, they should make sure that needed supplies are available – especially as some observers believe acute shortages could start to impact healthcare in the U.S. in the coming months.
Beyond this, veterans, like everyone else, should use an abundance of caution. This includes proper hand hygiene, social distancing, and the use of masks when needed. While it is still possible to limit the impact of the COVID19 virus, the best course of action is to prepare for the worst and hope for the best.