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Keeping The COVID Plague At Bay: How California Is Protecting Older Veterans

Dr. Vito Imbasciani, secretary of the California Department of Veterans Affairs, stands outside the Veterans Home of California on April 30, in Los Angeles. Imbasciani, who served 27 years in the Army Medical Corps, and his staff are responsible for keeping the novel coronavirus away from the state鈥檚 eight veterans homes. (Gary Coronado/Los Angeles Times)

Dr. Vito Imbasciani has been at war with viruses since he was 5.

Growing up near the U.S. Military Academy at West Point in New York, he contracted polio in 1952 and couldn鈥檛 walk for two months. In medical school in Vermont 30 years later, he witnessed AIDS steal the lives of otherwise healthy gay men.

Now, Imbasciani, secretary of California鈥檚 Department of Veterans Affairs, and his staff are responsible for keeping the novel coronavirus away from the state鈥檚 eight veterans homes. California鈥檚 defenses are holding.

The explanation, many say, lies in CalVet鈥檚 intense preparation, quick response, attention to hygiene and leadership, starting with Imbasciani, a physician and retired colonel who not too many years ago could have been discharged from the military because he is gay.

鈥淲e created our own fortune,鈥 Imbasciani said, looking to knock on wood.

Deaths are part of life in the state-run veterans homes. The homes are populated largely by frail men and women, some of them veterans of World War II and Korea, and many from the Vietnam War era. A quarter of the vets admitted to California鈥檚 homes in recent years had been living homeless.

COVID-19 has hastened the end for scores of retired soldiers in veterans homes in other states: have died of the disease at a 鈥渟oldiers鈥 home鈥 in Massachusetts; more than in New Jersey鈥檚 three homes; more than 60 residents of an Alabama and eight have died.

The California Department of Veteran Affairs, by contrast, is holding the beastly infection at bay. In its eight homes, where 2,100 veterans reside, three residents have contracted the disease, and two have died of it, one in his 90s and one in his late 80s.

鈥淚t鈥檚 all hands on deck,鈥 state Sen. Bob Archuleta, a Los Angeles-area Democrat who chairs the Senate Veterans Affairs Committee, said of CalVet鈥檚 response. 鈥淚t goes back to the staff. We have people who care about their veterans, and they will go the extra mile.鈥

Like Archuleta, Imbasciani credits the work of the front-line staff of nurses, nursing assistants and doctors who provide direct care. But leadership matters, and Archuleta and others also point to Imbasciani.

CalVet鈥檚 leader is a 73-year-old urologic surgeon who speaks six languages and has a master鈥檚 degree in musicology and a doctorate in philosophy. The son of a World War II tail gunner and grandson of a World War I vet, Imbasciani served 27 years in the Army Medical Corps. He deployed to war zones four times before retiring as a colonel in 2014.

For most of those years, Imbasciani had to hide his personal life because of President Bill Clinton鈥檚 鈥渄on鈥檛 ask, don鈥檛 tell鈥 policy that sought to keep LGBTQ service people serving in the closet.

That changed when President Barack Obama signed . Two years later, Imbasciani introduced Obama at a fundraiser hosted by LGBTQ community leaders in Beverly Hills.

鈥淭he price of my service was to live a lie,鈥 Imbasciani told the crowd of 600 when introducing the president, as quoted by . 鈥淏ut not anymore.鈥

Imbasciani was director of government relations at the Southern California Permanente Medical Group in September 2015 when Gov. Jerry Brown appointed him secretary of the California Department of Veterans Affairs. Gov. Gavin Newsom reappointed him in January, even as the novel coronavirus was starting its global spread.

Over the years, Imbasciani has tracked SARS (severe acute respiratory syndrome), Ebola and Zika, among other viral threats. In January, when scientists in China sequenced the DNA of a mysterious new coronavirus that had emerged in Wuhan, Imbasciani thought, 鈥淗ere we go again.鈥

He assumed the virus would storm the West Coast, as did CalVet鈥檚 director of long-term care, Thomas Bucci. Based on the devastating events unfolding in Wuhan, they quickly recognized COVID-19 as a disease far worse than the flu.

Bucci, an Air Force veteran, spent 38 years as a health care administrator before going to work for the state in 2015. Knowing that older and immunosuppressed people are particularly vulnerable, Bucci said: 鈥淲e had a big bull鈥檚-eye on ourselves.鈥

By mid-February, a month before the World Health Organization declared COVID-19 to be a pandemic, Bucci was regularly communicating with directors of the eight homes about the threat, and, along with Imbasciani, implementing a 38-step plan.

The protocol began with the basics. Directors of each home updated their emergency operations plans. They ensured they had enough surgical and N95 masks, gloves and gowns for the staff, and even disposable dinnerware, to minimize the chance of spread.

As of Feb. 26, all visitors were directed to sanitize their hands before entry, and staff began disinfecting common surfaces every 30 minutes. On March 4, as the infection killed the first of dozens of residents at the Life Care Center in Kirkland, Washington, Imbasciani discussed the coming onslaught at an executive team meeting. And by March 15 鈥 four days before Newsom issued the 鈥 all visitors were barred, with the exception of family members paying respects to veterans in hospice.

The Veterans Home of California, on April 30, in Los Angeles. California has managed to keep COVID-19 at bay at its eight state-run homes for frail and older veterans, despite the virus’s persistent march through nursing homes around the country.(Gary Coronado/Los Angeles Times)

Now, all staffers have their temperatures taken when they arrive for work and are sent home if they show symptoms. At four of the homes, all workers are encouraged to take tests for the virus, and all residents are tested. At the other four, employees who have been exposed to a known or suspected COVID-19 case are being tested, as are any residents who show symptoms.

All staffers wear masks, as do residents when not in their rooms. Residents are required to social-distance, meaning no congregating closely for conversation or card games. Meals are delivered to residents鈥 rooms.

The Veterans Home of California-Yountville opened in Napa Valley in 1884. How it withstood the 1918-19 influenza pandemic is for the most part . A century later, however, not a single COVID-19 case has been recorded among its nearly 1,000 residents.

Muriel Zimmer, 85, a Korean War-era Air Force veteran, has been living at the Yountville home for nine years with her husband, Dick. He needs more care and lives in the skilled nursing section of the facility, limiting her ability to see him. They鈥檙e allowed only brief conversations, and from a safe distance.

鈥淚 miss him,鈥 she said.

She also misses seeing friends in the dining hall. But she remembers rationing during World War II, and knows others have it much harder. She is able to walk across the Yountville grounds, with its sweeping views of the Napa vineyards below, and notices small things, like the monarch butterfly that flitted by the other day.

鈥淚 almost get teary-eyed when I think about the staff,鈥 she said. 鈥淲e are blessed.鈥

At the Redding Veterans Home in Shasta County, Michael Vancleemput, a Vietnam-era Army veteran, spoke by phone through a mask, as a worker walked past disinfecting surfaces. 鈥淭hey鈥檙e personally motivated to serve us. It鈥檚 not like they鈥檙e doing a job,鈥 said Vancleemput, 79.

He has to socially distance from his friends, not that it鈥檚 a problem. He lived alone for years in the small town of McCloud at the base of Mount Shasta before moving to the veterans home five years ago. A ham radio operator, he said he keeps in touch with other members of the home鈥檚 amateur radio operators club.

鈥淚 would invite you to visit our institution,鈥 Vancleemput said, then paused. 鈥淣ot now.鈥 No visitors allowed.

The bulwark that CalVet has erected against COVID-19 builds on a series of improvements. When Imbasciani and Bucci arrived, the state-run homes used paper records. Now, medical records are tracked electronically. Each home once operated independently. Now, they are part of a system with standardized procedures.

CalVet鈥檚 nurses, nursing assistants and physicians are state civil servants with union representation and paid sick leave. One nursing assistant might be responsible for six or eight residents. At a private nursing home, an aide more typically handles 10 or 12. CalVet also has staff physicians on-site every day.

For many years, the federal government, which rates nursing homes, gave CalVet鈥檚 homes dismal marks. Now, among the homes that have been rated, four have the highest designation of five stars, and one has four stars.

鈥淚t does show that when there is strong and visionary leadership, it can make a big difference,鈥 said Charlene Harrington, an expert on nursing home care and professor emerita at the University of California-San Francisco.

In the military, superiors give what are known as challenge coins to soldiers as an attaboy. The coins have a hierarchy. One bestowed by a two-star general carries greater bragging rights than, say, one given by a one-star general.

Imbasciani鈥檚 challenge coin is one of his most prized possessions. It鈥檚 a little larger than a silver dollar and is stamped with the presidential seal and the name of the 44th president. Obama gave it to him, and no one outranks the commander in chief, Imbasciani noted.

At California鈥檚 eight veterans homes, the walls are holding, so far. But Imbasciani knows an asymptomatic carrier could cause a breach any day. He is, after all, someone who has been battling viruses since he was a boy. He can even imagine the epitaph on his tombstone:

鈥淗ere lies Vito. He hated viruses.鈥

This story was produced by聽, which publishes聽, an editorially independent service of the聽.

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