Miami VA coronavirus numbers low so far, but mask policy remains a staff concern

When federal inspectors dropped in unannounced at the Miami VA hospital as the coronavirus began spreading last month, they discovered the facility lacked adequate supplies and equipment, including critical N95 masks for healthcare staff and other employees.

So far, a relatively low number of patients at the Miami VA have tested positive for COVID-19, the dangerous respiratory disease caused by the virus, but the facility’s directors have enacted a policy to avert a potential shortage — and some staffers worry it could compromise their own health.

On Monday, Miami VA officials started requiring employees to use surgical masks for one week, unless they are treating patients with COVID-19 or their masks become soiled. In those instances, they can ask supervisors for a replacement.

“These masks are expected to be used for a week at a time, longer if possible,” Miami VA Healthcare System Director Kalautie JangDhari told staff in an email Sunday that was updated with the same message Wednesday. “Masks may be removed while eating or drinking, but must be immediately put back on.”

Despite the new policy, Miami VA healthcare workers say surgical masks are not as thick or effective as the N95 masks that were found to be in short supply at the hospital by federal inspectors. The director’s emails did not address that shortage issue, nor did a VA hospital spokesperson respond to a Miami Herald request to comment about it.

“We’re doing the best we can — what’s going on in New York is certainly not going on down here,” said one Miami VA employee on the front lines of treating patients at the Bruce W. Carter VA Medical Center in downtown Miami. “I feel we’re prepared, but there are some employees who have children at home with asthma who might not feel the same way.

“They want a new mask every day,” said the employee, who wished to remain anonymous because the person is not authorized to speak on behalf of the Miami VA. “It’s a fear factor.”

Another Miami VA employee, who also wanted to remain anonymous, said the hospital’s coronavirus mask policy is flawed, contributing to potential exposure among both staff and patients.

“We were told across the board that it was one mask per week, and that we had to check with a supervisor to get a replacement,” the employee said. “These masks are meant for single use only, but they’re being used multiple times.”

That employee and others question the Miami VA’s readiness to confront the threat of COVD-19. Some say only veterans with flu-like symptoms are being tested for the viral infection, excluding other patients without symptoms as well as nurses, doctors and healthcare personnel. Also, workers say that screenings at the west entrance to the VA facility at 1201 NW 16th St. are a daily routine, but that staffers only started taking the temperature of employees for possible fever on Monday. The slow process led to a bottleneck of employees at the entrance.

While confirmed cases of veterans infected with the coronavirus at the Miami VA hospital have been gradually rising since the pandemic struck Florida last month, they represent only a tiny fraction of all people who have tested positive for COVID-19 in Miami-Dade, Broward and Monroe counties.

Since early March, the Miami VA serving that area has reported a total of 17 veterans who tested positive for COVID-19 — including the death of one patient in his 90s last week. That figure — relatively low perhaps because of the lack of universal VA patient testing — pales compared with more than 3,500 confirmed cases in those three South Florida counties, or roughly half of all such cases statewide as of Wednesday, according to records. There have been more than 100 deaths in Florida due to COVID-19, the highly contagious respiratory disease..

The Miami VA’s confirmed coronavirus cases represent one-quarter of the 70 veterans who have tested positive for the disease in Florida, according to records. The Orlando VA hospital has the greatest number of confirmed COVID-19 cases, with nearly twice the total at the Miami VA.

In addition, four staff members at the Miami VA have tested positive for the viral infection, according to U.S. Department of Veterans Affairs spokeswoman Mary Kay Rutan in Florida. But, citing privacy concerns, she declined to break down which type or types of staff — doctors, nurses or other healthcare personnel — have been infected with the virus.

Rutan said that “the employees are all in isolation, mitigating further risk of transmission to other patients and staff.”

Rutan issued a statement asserting that the veterans’ healthcare system has been preparing for the coronavirus outbreak since late January and is gearing up to meet the escalating threat on all fronts, from medical supplies to testing to screenings.

“The VA has robust procurement and inventory processes in place to ensure medical center needs are met,” the statement said.

The 372-bed Miami VA hospital cares for about 58,000 patients annually, while the veterans population in South Florida is estimated to be about 150,000.

On Monday, Miami VA officials issued the one-mask-a-week policy after a federal report on VA hospital preparedness for the coronavirus pandemic found the local facility had shortages of personal protective equipment during a visit between March 19 and March 24.

Administration officials at the Miami VA told employees to check out a surgical mask and return it at the end of each week in order to receive a new one. Shane Suzuki, the spokesperson for the facility, confirmed the guidance on Sunday but said it applied only to employees who are not dealing directly with patients suspected of having COVID-19.

Suzuki said the guidance was issued out of “an abundance of caution.”

“Staff who need replacement masks are instructed to contact their supervisor,” he said.

A report by the Veterans Affairs Office of Inspector General, released a week ago, examined all VA facilities for their preparedness to combat COVID-19. The Miami VA had “inadequate supplies” of N95 masks, air-purifying respirators, gloves, gowns, as well as face and eye protection, the report said. The local facility was among 33 out of 54 VA hospitals visited by federal inspectors that were found to have shortages of medical supplies and equipment.

The report also found that the Miami VA facility could improve upon its staff screening process and had inadequate staffing levels for its police and janitorial services, though the inspector general found no issues with staffing for nurses and other practitioners.

In a related VA matter, two men living at a nursing home for veterans in Pembroke Pines were hospitalized in mid-March after they tested presumptive positive for the coronavirus, according to the Florida Department of Veterans Affairs.

The two residents at the Alexander Nininger State Veterans Nursing Home were tested after they showed signs of a low-grade fever, according to officials. They remain at a local hospital..

“We’re awaiting a second round of test results from the CDC [Centers for Disease Control and Prevention],” said Steve Murray, spokesman for the state Department of Veterans Affairs. “There are currently no other residents or staff members within this home exhibiting signs or symptoms of COVID-19.”

Murray also said there are no other confirmed coronavirus cases among veterans residing in the state VA’s network of six nursing homes and one domiciliary in Florida.

This story was originally published April 1, 2020 at 5:22 PM.