Beware the Fog of War in the Fight Against Coronavirus

Dr. Richard Stone serves as the executive in charge of the Veterans Health Administration. He is a retired Army major general and veteran of the war in Afghanistan.

Today, our nation faces an unprecedented challenge, with no comparison in modern medicine or economics. I don't have to tell you all the ways that this moment in history is unique but, as the physician in charge of leading the nation's largest integrated health care system, the Veterans Health Administration that is part of the Department of Veterans Affairs, I wanted to take a moment to talk to my fellow veterans about what we are doing to rise to the occasion.

The comparisons between war and the fight being undertaken against COVID-19 seem to be everywhere today and, while they are most often made by those who never served in uniform, some of the parallels still apply. As a combat veteran and physician who has treated casualties overseas, I can tell you firsthand that the trust and friendships that one develops in the fight of your life are all around us.

The outpouring of support for those on the frontlines, albeit much closer than we are used to, is here too. The stories of men and women, unsung and unlikely heroes, raising their hands and saying "send me" to support their fellow citizens of the world, abound. Here at the VA, like in combat units, we are blessed to have all of that, with incredible people volunteering to put their lives on the line to care for extremely sick patients, even leaving their families for weeks at a time to go to the hottest of hot spots like New York and New Orleans.

Like combat, the enemy gets a vote, and no plan survives first contact. The enemy strikes in unexpected places, at unexpected times, and you grab what you have nearby to fight back in those first few chaotic minutes, hours and days until you can level-set and readjust your plans to shape the battlefield more effectively.

In our case, we were watching this enemy move stealthily across the planet since January and began preparing as best we could. Under President Donald Trump's leadership, we activated emergency plans in every state within days and began assessing our capabilities, both as a system and at individual facilities, to ensure we were as ready as we could be.

We began distributing resources, canceling non-emergent operations, increasing telehealth appointments, and learning as much as we could from our peers overseas already in the fight about how to protect our people, treat our patients and ultimately win. As of today, with those lessons learned, we have tested more than 78,000 veterans and are currently managing the treatment of several thousand COVID-19-positive veterans, as well as almost 200 non-veterans.

Unlike combat, however, there are no reserve forces sitting safely in another theater, gearing up to reinforce those on the frontlines. Never in the history of warfare was every unit on the planet hit at almost the same time, forcing like formations to compete for the same limited supply of bullets and armor -- in our case, ventilators and personal protective equipment. We are fortunately much more capable than smaller systems to redistribute needed personnel and equipment between our formations, but we all know that there is only so much production capability to handle this global demand. At this moment, however, I can say with confidence that our people are properly protected per the Centers for Disease Control guidelines for health care workers and, while we are taking necessary measures to be conservative in our use of PPE and other equipment, like our peers, no one on the frontlines at the VA needs to make homemade PPE or go without.

In battle, at every level, there is inevitably the "fog of war," which blinds us to some of the elements of the world around us that, looking back, we wished we could have seen. This fight will be no different, and there are certainly the "armchair generals" popping off on TV and in newspapers about things that those of us on the frontlines could be doing better. Unlike battle, however, this fight has room for everyone who can help, and we have seen an inspiring number of our retired medical providers return to the workforce in recent weeks, including two former chief nursing officers, scrubbing up and lending a hand to those who need it most.

I want those who have earned our care, my fellow veterans, to know that the VA is here for you. We are ready to fight this fight because, quite frankly, you deserve nothing less. You can come to us if you are showing symptoms of infection, and we will treat you with the excellent care, dignity and resolve that you expect from those who have fought on the frontlines. We are all in this together, and I hope you will consider the VA your brothers and sisters in this fight, just like those you fought with during your service.

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