The Department of Veterans Affairs is sending a team of infection control experts to the Yukio Okutsu State Veterans Home, Hawaii's only state nursing home for veterans, which has been hit hard in the past month by the coronavirus pandemic.
A "Tiger Team" -- including an infectious disease physician and nurse, in addition to nurse managers, safety officers, industrial hygienists and engineers -- is traveling to the Big Island to manage an outbreak that has killed 14 residents and infected an additional 68 veterans and staff members.
According to VA Secretary Robert Wilkie, the team has deployed at the request of Hawaii Gov. David Ige as part of the VA's "Fourth Mission," supporting the nation's public health response in a national emergency.
Since the pandemic was first detected in the U.S. in February, the VA has issued more than 800,000 pieces of personal protective equipment, including masks, gowns, gloves and more, to state and local facilities and sent personnel to 45 states to assist in state veterans and community nursing homes, non-VA hospitals and on Native American reservations.
The Hawaii effort is just one example of what's happened "all across the country," Wilkie said.
"It's one of the best stories about the government out there, that VA employees -- and they're all volunteers -- went out beyond their foundational mission to help," he said Friday.
The COVID-19 outbreak at the Hawaii state veterans home began Aug. 22, about the time the state began seeing a surge of cases. The facility is run by Avalon Health Systems.
According to a statement from the company, health officials believe that the virus entered the facility via a staff member who had no symptoms, as well as a resident who was exposed during an off-campus dialysis appointment.
"We are deeply saddened to report that 14 of our beloved Veterans who tested positive for COVID-19 have passed away. We are heartbroken over this and express our condolences to the family and friends of these residents," officials said in a written statement.
The VA is responsible for annual inspections and ensuring that state veterans homes are operated up to department standards. It also provides roughly $1 billion in funding to homes across the U.S. But by law, their operations fall under the state governments.
Since the beginning of the pandemic, state veterans homes have suffered some of the biggest outbreaks. But just how many veterans in these homes who have been infected or died is not known: Some homes are not required to report their rates of infection or deaths, and neither the VA nor the National Association of State Veterans Homes maintains the data.
A report by an ad hoc committee at Vietnam Veterans of America (VVA) found that, from late April to July 17, 2020, 1,011 residents at 47 homes in 34 states had died. The group could not obtain data for the remaining 115 state veterans homes.
State veterans homes with the highest numbers of cases and deaths include the Soldier's Home in Holyoke, Massachusetts, which had at least 76 deaths, and the New Jersey Veterans Home in Paramus, with 81 deaths.
Wilkie said in May that, while he can assist states with their response, the VA does not control the state veterans homes.
"What I told the governors is, if they need us, call us -- since the national emergency was declared. The process is that the governors have to go through the [Federal Emergency Management Agency], but I can help," Wilkie told Military.com.
Last year, the Government Accountability Office faulted the VA for failing to adequately monitor the contractor it hired to run inspections at state veterans homes. The GAO said the VA had not been transparent in its assessments of the quality of care available at these homes.
After so many veterans died this year of COVID-19 at these homes, senators asked the GAO to renew its investigation of VA oversight and determine whether the department followed the office's recommendations for stricter oversight.
In their report, members of the VVA's Subcommittee on the Aging Veteran Experience, or SAVE, made several recommendations to the VA about state veterans homes, to include recommending that VA medical center, or VAMC, staff designate an official to act as liaison with their local veterans homes; track each state's use of VA funding for the homes; conduct training with veterans homes staff; and evaluate the quality of care at these homes.
"We found that state veteran homes with strong ties to the VAMC of jurisdiction fared better than those without this tie," they wrote. "Going forward, we highly recommend that the local VAMCs and state veterans homes collaborate for the mutual benefit of both systems and for the welfare of the veterans entrusted to their care."
The Yukio Okutsu Veterans Home provides 95 beds for veterans. Hawaii Democratic Rep. Tulsi Gabbard, an Army Reserve officer, on Monday called the deaths of fellow veterans "unconscionable," a consequence of a lack of testing and contract tracing in the state.
"Not only is urgent action needed to protect our veterans, urgent action is needed to protect every person in our state," Gabbard said in a statement.
Throughout most of the pandemic, Hawaii avoided spikes in coronavirus cases by instituting a strict mandatory quarantine for any incoming visitors. Cases began surging at the beginning of August -- the result, state officials say, of summer celebrations and protests.
Across the VA, more than 56,400 veterans have been diagnosed with COVID-19 and 3,219 have died, according to department statistics released Tuesday.