By Zachary Cohen, CNN
Updated: Wed, 22 Apr 2020 22:07:42 GMT
A recent Department of Veterans Affairs memo warns that current protective medical gear supply levels "do not support providing a mask" to all staff at its hospitals and urges facility directors around the country to take steps toward conserving personal protective equipment (PPE) amid the coronavirus pandemic, according to a copy of the internal document obtained by CNN.
The April 16 memo sent to network directors by the VA's deputy under secretary for health for operations and management shows how the agency was implementing conservation procedures in order to stretch supplies.
"(Veterans Health Administration) staff providing direct patient care to COVID-19 patients should use a N95 respirator. When N95 respirators are in short supply, VHA staff performing low-risk care on suspected or confirmed COVID-19 patients may use surgical masks," the memo states.
It also asserts that VA PPE levels are consistent with Centers for Disease Control and Prevention (CDC) guidelines, but makes clear the department was continuing to work toward securing additional equipment like masks in order to avoid more serious shortfalls.
The memo undercuts public denials made by the VA just days earlier when agency communications officials called reports that the department was telling hospitals to decide which staff will receive face masks amid a shortage of PPE "extremely misleading."
"All VA employees who need PPE have it," a department spokesperson said on April 11, noting that the department was following CDC guidelines.
Asked about the memo CNN has obtained, the VA now acknowledges that it has needed to conserve supplies and says it is doing so in accordance with CDC guidelines.
"As America responds to a national emergency the likes of which the nation hasn't seen since 1918, every health care system is taking steps to conserve PPE. VA is no different," department spokesperson Christina Noel told CNN Tuesday. "CDC guidance states that 'All U.S. healthcare facilities should begin using PPE contingency strategies now,' and VA is currently adhering to CDC's contingency capacity posture for PPE use."
"VA's PPE conservation posture is precisely why the department has not encountered any PPE shortages that have negatively impacted patient care or employee safety," Noel continued. "VA is monitoring the supply levels at every facility every day to make sure facilities have adequate PPE for the number and types of patients they are seeing. And if a facility were to fall below stock levels, the facility could be cross-leveled by another VA facility or region."
VA staff from around the country have continued to raise concerns about limited access to PPE, prompting lawmakers to demand information related to the department's supply levels.
Staff at several VA facilities across the country have told CNN they have continued to experience PPE shortages in the days since the memo was sent, with some saying as recently as this weekend that the problem persists. The staffers requested anonymity because they are not authorized to speak to the media.
The memo backs up the claims.
"VHA staff directly involved with the care of Community Living Center (CLC), Spinal Cord Injury and Disorders (SCI/D), and inpatient mental health patients will be provided with one facemask or surgical mask a day to protect the residents. Current supply levels do not support providing a mask to all VHA staff," it states.
The memo also acknowledges the challenge of obtaining additional supplies due to the "disrupted global supply chain" and urges directors to plan accordingly.
"Plans should include scenarios that permit extended mask use, permit limited re-use, permit staff to bring in their own facemasks and N95 respirators, and allow decontamination of used N95 respirators," it says. "The re-use of decontaminated masks should only be used under crisis scenarios."
Nineteen VA employees have died so far from Covid-19 and more than 1,500 have tested positive.
The department is also working to procure additional PPE from other agencies and commercial producers -- an effort that has ramped up since the April 16 memo was sent.
Noel told CNN that FEMA provided the VA with 500,000 masks this week. On April 16, the department also awarded a $74,000 contract to the company MyPillow to produce additional cloth masks, according to a purchase order first reported by Politico. MyPillow CEO Mike Lindell is a close ally of President Donald Trump.