Reports highlight failures of the VA’s health system during the pandemic

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• Judy Woodruff:

  One of the key parts of our health care system that typically gets a lot less attention is the Veterans Affairs, or the VA, system. That has also been true during the pandemic.

  As we start a new year, we wanted to look at the challenges and problems that the VA has faced over the past year as well.

  William Brangham has our conversation.

• William Brangham:

  The Department of Veterans Affairs operates the nation's biggest hospital system, serving millions of former service members around the country.

  But, according to a series of investigative reports in ProPublica, that system not only has suffered badly during the pandemic, but it's also failing to provide adequate protection for its own medical staff, particularly the crucial N95 face masks.

  It's a response, according to ProPublica, that's been plagued by — quote — "incompetence and greed, poor planning and judgment failures."

  J. David McSwane wrote those stories, and he joins me now.

  David, great to have you on the "NewsHour."

  You start your most recent story with the vignette about a nurse at a hospital, a VA Center, in South Dakota. Kristen Cline is her name.

  Can you tell us about her and why she's so emblematic?

• J. David McSwane:

  Sure.

  She's a senior nurse at a smallish hospital in Sioux Falls, South Dakota. And we got to talking somewhere in early May, when her area and her facility had largely been untouched by COVID, while other major cities were overrun. And she told me then that: We're being asked to ration masks. There are no masks. There's an extreme shortage. We're really worried.

  And we just sort of kept in touch. And slowly, but surely, she watched sort of in slow motion as the — as COVID sort of swept over the country. And, suddenly, her small hospital and the small community was really at the epicenter.

  And, for me, her journey and just sort of what she was watching as a health care provider was an interesting lens to help us understand just the stress health care workers are under and what it means to just worry each day you come in, are you going to have the mask you need, so you don't get sick or get your family sick?

• William Brangham:

  I mean, this far into the pandemic, nurses at government-run facilities — I mean, that's what the VA is — are still struggling to get the protective gear they need?

• J. David McSwane:

  Right.

  Yes, in this facility, the nurses I spoke with do have access to N95s, but they're being asked to use what was once a disposable mask that you toss after each patient. They're being asked to keep them in paper bags and reuse them for as many as five shifts, which really just — it just signifies and shows that there's a supply issue within the VA.

• William Brangham:

  You quote the VA in your story talking specifically about the situation in the South Dakota facility, and they say the issues you're reporting are not a problem anymore, there's no rationing going on, everyone's got enough gear.

  Is that — how true is that?

• J. David McSwane:

  Well, it's just not true, from what I'm hearing.

  I mean, the definition of asking a nurse to hold onto a disposable item for five shifts is rationing. You're asking them to ration. And the VA has really sent — had sort of had this line from the outset of the pandemic, when health care workers were saying, we don't have enough, we're being stretched thin, we're reusing items.

  The VA has tried to say, everything's fine, we have the supplies.

  But, at the same time, you see this massive buying spree, where they're hiring anyone — anyone who says they can get masks. They're obviously very desperate for the masks, just like everybody else. And it's just not what I'm hearing from nurses on the front line.

• William Brangham:

  So, how typical is this? I mean, we know that hospital systems, and state governments, for that matter, were faced with the similar surprise.

  When the virus emerged, we suddenly were scrambling to develop tests and to find enough protective gear for everyone. How different is the VA's experience compared to different states, compared to different hospital systems around the country?

• J. David McSwane:

  What distinguishes the VA, aside from being the largest hospital system, is that it had this really antiquated approach to getting supplies.

  It had been dinged by the Government Accountability Office for years for this old system that really wasn't built to respond to really any disruption in the supply chain. And that just hadn't been fixed.

  And so what you have is, you had this sort of perfect storm of a really bad, antiquated system, where individuals are updating spreadsheets manually, and, all of a sudden, a global shortage, and you need masks, you need them now. You don't even know what you have or how to — who needs more supplies to be shipped in.

  And that was a real mess. So, to compensate for that, the VA just went on a crazy buying spree, just awarding contracts to really anyone who said they could deliver. I mean, we found companies that hadn't existed just days before. We companies that…

• William Brangham:

  Hadn't existed days before, and then they were getting million-dollar contracts?

• J. David McSwane:

  Right, yes, or companies that simply — there were companies that were created, obviously, to profit as a result of COVID, but there were also just companies that hadn't been tested. They had no experience getting medical supplies, which, medical supplies and understanding a supply chain that really involves relationships with China is complicated stuff.

• William Brangham:

  As you reported, this all came at a time when the Trump administration was going through this very substantive reorganization of the VA's leadership.

  How much of it does — this sort of chaotic, haphazard buying spree, as you describe it, how much of it had to do with that leadership turnover?

• J. David McSwane:

  You know, it's really hard to say.

  You know, I couldn't put a specific number on it. I mean, what we know is, you have an agency that just had a really bad system. And…

• William Brangham:

  Prior to the pandemic?

• J. David McSwane:

  Right, prior to the pandemic. They just weren't very good at their inventory, at getting supplies.

  And then you have — you take people out of that system. So, now you have got sort of a broken ship, and now you have got fewer sailors to steer the ships.

• William Brangham:

  All right, J. David McSwane of ProPublica, great reporting. Thank you very much for joining us.

• J. David McSwane:

  Thank you.