“America will again, and soon, be open for business,” President Trump had said. “We cannot let the cure be worse than the problem itself.” That was on March 23, the same day that the Norfolk-based Virginian-Pilot published a letter from Sheila Elliott, a long-time pharmacist at the nearby Hampton Veterans Affairs hospital, criticizing the Department of Veterans Affairs for “the haphazard way in which COVID-19 is being handled.” The VA, she wrote, “was at the front lines of providing invaluable assistance” to victims of Hurricane Katrina and the Ebola epidemic, but “this time, VA workers are facing a scarcity of everything from masks to hand sanitizer to test kits.”
As the coronavirus pandemic rips through America, the VA is preparing to fulfill its statutory role as a backup civilian healthcare system when the private sector becomes overloaded. Veterans Affairs Secretary Robert Wilkie announced last week that the department would open up 1,500 hospital beds across the country for civilians diagnosed with Covid-19. But as the VA ramps up this critical support, its clinicians must also continue treating more than nine million veterans, many of whom are particularly susceptible to the coronavirus due to their age and underlying conditions, including respiratory illnesses brought on by exposure to Agent Orange or burn pits.
There’s reason to be hopeful that the VA can meet these challenges. Contrary to popular belief, the department generally delivers care that’s as good or better than the private sector’s. As for-private hospitals continue to schedule lucrative tummy tucks and other non-essential services, the VA has swiftly canceled elective procedures in order to free up staff and resources for emergency care. While the private sector system is furloughing staff, the VA is expediting hiring practices and ramping up compensation. New York Governor Andrew Cuomo had to strong-arm private hospitals to coordinate on care and equipment, but the VA has long run a highly integrated national network where staff and supplies can be shifted quickly to help quell the virus.
But the VA’s many strengths are being undercut by the Trump administration’s attacks on federal workers’ rights. Elliott—who, in addition to having worked at the VA for 30 years, is the daughter of a World War II Navy veteran and president of the American Federation of Government Employees (AFGE) Local 2328—told me that VA leaders were ignoring labor leaders’ concerns and recommendations for workplace safety. As a result, decisions were being made seemingly arbitrarily, some staff assigned to Elliott’s hospital’s Covid-19 unit were not properly trained, and safety protections had not been ensured.
“If you’re going to roll right over the union, roll right over the staff, and push whatever you want, that doesn’t increase morale,” she said, “and ultimately it ends up causing safety problems for the staff and the veterans.”
In early April, the VA distributed “CDC crisis capacity strategies” by email that “permit extended use and permit limited reuse” of coveted N-95 respirators. Union sources say hospital managers are locking away and rationing their stockpiles of personal protective equipment. Supplies and and staffing concerns seem most stark at the Brooklyn VA medical center, which is hitting a breaking point.
The VA reported Monday that at least 4,000 patients and 1,500 workers in its medical system had tested positive for the coronavirus; 241 patients and nine employees have died from it. At the Indianapolis medical center, where the number of sick employees is now second in the nation, staffers have complained to union reps that they were threatened by management for bringing in their own protective masks, and that at least two staff have been kept on the job after exposure to Covid-19, even after showing clear symptoms of the illness.
Emails shared with The New Republic also show that in late March, VA workers in Iowa were also told, without any explanation, that the Centers for Disease Control’s 14-day self-quarantine requirement for staff who had recent international travel was “being modified to 11 days,” and in the future “the travel question for staff entering the facility will not be asked.”
M.J. Burke, who works out of the Indianapolis medical center and serves on AFGE’s National Veterans Affairs Council, received an email informing her that a VA nurse exposed to Covid-19 continued to be scheduled on shifts. “She continued to work, unbelievable, I know,” a staffer with knowledge of the situation wrote Burke in the email. “She’s sick now, called in today, these are safety violations.” Representatives of the Indianapolis VA medical center and the office that sent the quarantine-shortening email did not respond to requests for comment.
“When you’re a union person, your job is to make people safe and secure,” Burke told me, on the edge of tears. “And I feel very hopeless. Everything’s out of control. My people should be quarantined if they are exposed at a low or high level.”
In response to a list of questions about these and other labor issues, Washington-based VA spokeswoman Christina Noel emailed my editor at The New Republic. “Judging by his previous work, he appears to be an opinion writer with a clear agenda,” she wrote, including a link to the reporter’s 2018 investigation for The Nation into the VA whistleblower-protection office’s targeting of low-level employees and labor organizers. “Given his track record, it’s hard to imagine that his intent is merely to report objectively.” When asked by the editor if she would respond to my questions or give additional context to her email, Noel wrote back: “We respectfully decline to comment.”
The VA’s labor conditions deteriorated further in 2017, when the White House created the Office of Accountability and Whistleblower Protection, which has targeted labor leaders and thousands of front-line workers with “threats, intimidation, and retaliation,” as one nonpartisan watchdog puts it. The administration has also instituted a series of picayune anti-union rules, including a November order that revoked official time, computers, office space, and even designated parking spots from VA union representatives across the country.
Perhaps most consequentially, the VA has enlisted a cadre of conservative lawyers to gut AFGE’s master agreement with the department. According to a national grievance filed by the union last year, this ongoing work has been marked by “bad faith bargaining” and a series of violations of labor regulations. Ahead of the first negotiating session, the VA failed to approve travel expenses for two senior union members, then went silent when asked where the first meeting was to take place. When negotiations eventually kicked off, the VA proposed striking 28 articles from the agreement and inserting new onerous language, including a measure that would allow management to change the agreement unilaterally. That behavior last year caused a bipartisan group of 128 lawmakers to send a letter to the VA accusing its leaders of engaging in “anti-labor policies” that could have “a detrimental effect on veterans.”
While public sector unions fight for better pay and conditions for their members, they also operate as a key bureaucratic check on the system, helping ensure that the VA stays staffed up and safe in its practices. For years, they’ve demanded the Trump administration fill the department’s nearly 50,000 vacancies, an enormous number that encompasses thousands of nurses and doctors, as well as other critical roles for the Covid-19 response, including cleaners, custodians, and emergency management staff.
Labor representatives also bring malfeasance to light. They draft and file EEO complaints and tip off OSHA and the inspector general to safety concerns and managerial corruption. In interviews, a dozen labor leaders at VA facilities across the country told me that their sensitive oversight responsibilities have been hampered because they no longer have onsite offices or designated time in which to do the sensitive work. Some acknowledged they often can’t show up to their hospital’s patient-safety committee or attend resource-management meetings where staffing decisions are made. Health and safety refresher courses run by the unions are also poorly attended due to the crackdown on official time.
Now, as the department rushes to care for thousands of new COVID-19 patients, the VA’s Central Office in Washington and many regional hospital leaders are treating labor representatives as opponents, not partners. This has hampered communication on critical matters and resulted in procedures and protocols out of step with best clinical practices. Because these plans are being rolled out without advance notice or union consultation, many clinical staff are experiencing sudden shifts in their schedules, which has disrupted childcare and home situations.
“We have leadership that has never been involved in patient care coming up with plans without any input from the frontline staff,” said Barb Galle, a trained nurse out of Minneapolis and a representative for AFGE’s National VA Council. “We know how to improve care during this situation, and they refuse to listen.”
Rhonda Risner, a registered nurse from Dayton, Ohio, and a National Nurses United union leader, said this approach contrasts significantly with the VA’s work around the 2014 Ebola outbreak, when union staff were briefed frequently by national officials on contingency plans and the status of the equipment stockpile. “I will take care of any patient, and I’ve suited up multiple times for people who were presumed or been diagnosed with COVID-19,” said Risner. “I’m not scared so long as I have the proper equipment. But we don’t seem to have enough of the right equipment. And that’s frightening.”
Labor leaders are ratcheting up pressure on the department in hopes of regaining their seat at the table. In mid-March, six unions representing nearly 350,000 VA employees demanded the department incorporate labor input into its Covid-19 plans. A week later, National Nurses United filed a national grievance–thus far unanswered–demanding more equipment and better safety and training protocols. On March 27, AFGE filed suit demanding hazard pay for federal workers. The union’s complaint alleges, among other things, that a VA employee in Portland, Oregon, wasn’t told of a patient’s coronavirus diagnosis or given the proper protective equipment while caring for him.
The VA now estimates that 40 percent of department employees may become sick or unable to work due to family limitations in the course of fighting the coronavirus.* As Elliott tells it, that’s part and parcel of the White House’s antipathy to rank-and-file VA workers. Those who are still coming to work at the VA are doing so in spite of any fears they may have about the virus—or their management.
“I’ve started hearing rumors about how people at the hospital are angry with me and think I should be disciplined or terminate. At this point, I’m pissed off,” she said. “I will not be silenced, and I will not be threatened.”
* A previous version of this story incorrectly attributed this estimate to the VA inspector general.