Masks, Other Protective Equipment Went Into Federal Stockpile
A photo from the Central Arkansas Veterans Health Care System’s Facebook page. Many VAMCs are using homemade masks and covers to preserve scare personal protective equipment. The Central Arkansas VA even holds a contest for most creative mask.
WASHINGTON—While early in the pandemic VA leaders repeatedly said that their facilities had enough personal protective equipment for its staff to weather the crisis, reports began circulating last month of VA staff running short.
Only after VA healthcare workers began going public with stories of having to reuse old masks, being refused new masks and going without PPE entirely did VA officials admit that there was a significant shortage.
In an interview with The Washington Post, VHA’s executive-in-charge, Richard Stone, MD, said that not only was VA running out of PPE but that new supplies were being diverted by the Federal Emergency Management Agency, causing delays in materials reaching VA facilities.
Stone said that VA’s four-week supply of PPE was nearly gone and that medical centers across the country were rationing PPE. FEMA, he said, had directed VA suppliers to send PPE supplies to the federal stockpile rather than to VA facilities.
Stone’s admission was not news to legislators, who had been pressing VA for weeks to be transparent with their PPE shortages.
VA Secretary Robert Wilkie had been holding weekly calls with overseers from the House Committee on Veterans’ Affairs, the overall tone being one of an agency that was prepared for the pandemic.
By late March, however, legislators said they were becoming concerned about the disconnect between what they were hearing from VA and what they were hearing elsewhere. According to committee members, they were getting reports from constituents who were employees at VA facilities where drastic actions to conserve PPE have been taken. Those measures included issuing only one facemask or N95 respirator per week to staff caring for veterans in nursing homes and spinal cord injury units and to staff screening patients and visitors at facility entrances.
Starting March 23, the committee began asking for hard numbers. They requested VA provide them with “relevant memoranda, policy guidance, emails, and other written instructions that VHA has sent to its medical facilities pertaining to operational changes.”
Their requests were repeatedly stymied. The committee was told by VA officials that release of the documents needed to be cleared by the Office of Management and Budget, a procedure that has not been a common practice in the past.
“These additional bureaucratic delays have created a logjam in which the documentation we have repeatedly requested has not been provided,” committee leaders wrote in a letter to Vice President Mike Pence and Russell Vought, acting director of the Office of Management and Budget, on April 15. “The lack of specificity in VA’s ongoing briefings for the committee not only poses risks of potential harm to veterans but also leads us to a simple conclusion—your administration has hamstrung VA’s ability to ensure Congress is fully informed of the full extent to which it is prepared to care for veterans and fulfill VA’s fourth mission of augmenting the civilian healthcare system.”
At the time the letter was sent, over 5,000 VA patients and 1,600 VA staff had tested positive for the novel coronavirus.
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The updated ICD-10 2020 year – International Classification of Diseases provides assistance in the organization of health care and regulates the general rules of medicine. Unification of pathologies is necessary for system workers to designate a disease code. This simplifies the maintenance of statistics both inside clinics and in the state. It is also more convenient to keep track of the documentation and sort it into electronic data. For the first time the regulatory document was approved in 1893, and since then it has been repeatedly revised and updated with new clarifying data.
ICD 10 was adopted in 2007, when the tenth revision of the World Health Organization was conducted. New rules allowed not only to classify, but also to encode medical diagnoses. Total list includes 21 sections (class), each of which is divided into headings. They contain codes of medical pathologies (diseases and conditions).
Numbers are denoted by a letter of the Latin alphabet from A to Z and two digits after. The letters D and H are used for several diagnoses in different classes. U symbol left in reserve. Blocks of rubrics in a class describe diseases that are conditionally considered homogeneous. The block is divided into three-digit headings, which may contain subheadings with four-digit designation.
icd 10 codes 2020