In the more than eight months since the Department of Veterans Affairs recorded its first veteran lost to the coronavirus pandemic, more than 5,000 have died because of the fast-spreading virus -- an average of about 19 each day.
That number has increased significantly since mid-October, when VA averaged about 17 patients lost per day to complications of COVID-19 since March, roughly equaling the number of veterans who die by suicide each day on average, according to VA data. Now, at 19, the rate exceeds the number of those lost to suicide.
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That change is due largely to a surge in COVID-19 cases and deaths at VA hospitals across the country. In November, VA more than doubled its previous record for the number of patients actively sick from the virus and over the course of the month reached another grim milestone. VA recorded more than 1,000 patient deaths in November, making it the deadliest month for VA patients so far. In August, VA recorded 825 deaths, the previous high, followed by more than 730 in May.
On Nov. 1, VA recorded 4,000 patient deaths from complications caused by the virus. On Dec. 1, the department recorded 5,022.
VA said previously that the number of deaths recorded in a given month may not be a fully accurate account of those who died that month, since data may lag behind, sometimes by weeks.
While VA has recorded a significant spike in total number of patients who have died because of the virus, VA's mortality rate continues to decrease. In October, it was about 5.5%. By the end of November, it reached about 4.4%, which is still significantly higher than the about 2% for Americans overall, according to the most recent Centers for Disease Control and Prevention data. Earlier during the pandemic, VA's mortality rate reached a high of nearly 6.8%.
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. 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.
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 publicly available data also includes its staff and some non-veteran patients the department treated as part of its Fourth Mission. VA recorded 12 staff deaths in November, for a total of 74 during the pandemic and making November the deadliest month for staff, too.
15,000 sick
The last major spike in VA patient deaths in August followed a sharp surge in COVID-19 cases beginning in June and continuing through July. Then, cases began to fall steadily until they began trending up again in September.
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Those surge patterns appear to generally reflect similar increases in active cases across the country, and VA Press Secretary Christina Noel said trends in new cases at the department typically follow those nationally and in local communities.
In November, VA reached more than 15,000 patients actively sick with the virus, and has remained relatively steady at that level for about a week straight. VA's previous record for active cases was 6,424 in July. VA broke that record on Nov. 2, and cases have continued to rise since. Active cases jumped more than 147% from Nov. 1 to Nov. 30 and more than 356% from Oct. 1 until the end of November. The vast majority of those active cases are veteran patients.
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 12% in November, 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. 24-30, the department recorded 1,055 COVID-19 inpatients, up 74% from the beginning of the month.
VA surpassed 110,000 total cases of the coronavirus among patients and staff on Nov. 30, adding more than 11,000 in the final seven days.
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The top 10 VA health systems with the most active cases remain largely those in the Midwest: Cleveland (476); Minneapolis (401); North Chicago (284); Aurora, Colorado (245); Columbia, Missouri (229); Kansas City, Missouri (221); Milwaukee (217); Nebraska-Western Iowa (211); Loma Linda, California (210); Phoenix (209); Indianapolis (209).
The North Chicago VA Healthcare System has recorded more than 2,700 confirmed COVID-19 cases during the pandemic. Of the 140 VA health systems the department is tracking in its publicly available data, at least 38 have recorded more than 1,000 confirmed cases, up from 21 in early November.
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; Minneapolis; Columbia, South Carolina; Cleveland; Phoenix; the Bronx; and San Antonio. Areas such as Columbia and Minneapolis have seen significant increases in the number of patient deaths in the last month.
In November, some VA healthcare systems and medical centers began sending out advisories for veterans asking that they abide by new COVID-19 restrictions in their states and new limitations on visitors and other policies at VA.
By the end of November, VA recorded more than 1 million total COVID-19 tests administered nationwide during the pandemic. 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.
VA averaged about 4,800 COVID-19 tests per day in November, on par with September's average, but significantly higher than the October average of 3,800 tests per day.
As cases surge at VA facilities and in communities nationwide, Noel said all VA medical centers have "adequate capacity, PPE and supplies to meet current demand" and said no facilities were experiencing issues with staffing.
Vaccine trials at VA
VA announced in November that several of its medical centers were among those selected to participate in a new COVID-19 vaccine trial, the fourth large-scale trial in the United States.
In a message to veterans on Nov. 30, VA outlined the 17 locations participating in the trial:
- New Mexico Veteran Administration Health Care System
- Atlanta VA Medical CenterRocky Mountain Regional VAMC/ECHCS
- Baltimore VA Medical Center
- Birmingham BA Medical Center
- James J. Peters VA Medical Center
- Jesse Brown VA Medical Center
- Columbia VA Health Care System, WJB Corn VA Medical Center
- VA North Texas Health Care System, Dallas VA Medical Center
- Durham VA Medical Center
- North Florida/South Georgia VA Health Care System
- Central Arkansas Veterans Health Care System
- Southeast Louisiana Veterans Health Care System
- Phoenix VA Health Care System
- Reno VA Medical Center
- San Francisco Medical Center
- James A. Haley Veterans Hospital
VA is asking for veterans to volunteer for the vaccine trial, especially veterans of color, "because Black, Hispanic and Native Americans are several times more likely to get sick, have complications and die from COVID-19 than White Americans. But few are participating in clinical trials for vaccines and treatments," the department said in emails to veterans.
VA and national studies and data suggest Black, Hispanic and Native Americans may be disproportionately affected by the pandemic. VA began publicly sharing COVID-19 data broken down by race and ethnicity in November, after months of declining to make that information available. That data reflects VA research showing that veterans of color are typically disproportionately affected by the virus.
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Veterans can join VA’s coronavirus research volunteer list, but signing up doesn't mean you'll be enrolled, only that you may be contacted if you're a good fit for the trial or other VA research, according to the department.
The trial does not involve infecting veteran participants with the virus.
"You cannot get COVID-19 from the investigational vaccine or the placebo used as part of the study," the department said in an email to veterans this week. "The investigational vaccine will not increase your risk of COVID-19."
Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett.
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