Reports

The VA Office of Inspector General (OIG) conducted a review of the Veterans Health Administration’s response to anticipated demand and use of emergency department and urgent care center services when faced with the possibility of an influx of patients needing evaluation during the COVID-19 pandemic. A survey was deployed and 63 emergency department and urgent care center directors were interviewed. The OIG learned there was a decreased number of patient visits to the emergency departments (19.8 percent decline) and to the urgent care centers (28.6 percent decline) for January–June 2020 when compared with the same time frame in 2019. Other issues described by interviewees included a small number of rooms with negative pressure and small waiting rooms that made it difficult to isolate or separate patients with known or suspected COVID-19. Twenty-three emergency department and urgent care center directors reported a loss of staff due to providers testing positive for the virus, transfers, resignations, or retirements. COVID-19 testing was generally available at the selected facilities. Some directors reported a lack of or need to ration certain items of personal protective equipment. Regular communications with leaders that addressed the most recent COVID-19 topics were informative and helpful. Data related to supplies, clinical treatment, COVID-19 epidemiology, and hospital utilization were deemed critical and helpful for decision making. Virtually all respondents stated that they closely monitored staff for signs of fatigue and burnout. Lessons learned included patient and provider COVID-19 education, rethinking how emergency or urgent care can be delivered in a pandemic, and redesigning the day-to-day operations of the work place. The directors also noted the need to preserve the capability to provide emergency or urgent care for non-COVID-19 patients while attending to the special care needs of patients with COVID-19.

The objective of our inspection was to assess the U.S. Department of Education’s (Department) plans and procedures for returning employees to the federal office in the wake of the coronavirus pandemic, including what existing guidance the Department considered when developing its plans and procedures. We found that the Department generally incorporated available guidance, which was intended to provide for a safe and gradual return to federal offices, in its Workplace Reconstitution Transition Plan (Reconstitution Plan). However, we noted that the Department’s Reconstitution Plan does not address anti-retaliation as recommended in OSHA guidance. In addition, we found that the Department did not periodically reassess and update self-screening questions as necessary in its Reconstitution Plan as suggested by OMB.

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To lead its pandemic response, the Postal Service created the COVID-19 Command Response Team at headquarters to ensure the agency followed directives and guidance from the CDC. The Postal Service implemented changes to slow the spread of the virus, manage and support affected employees, and ensure that recovered employees returned to work safely. Our objective was to assess the Postal Service’s response to the novel coronavirus disease (COVID-19) outbreak regarding the safety of its employees.

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The Coronavirus Aid, Relief, and Economic Security (CARES) Act requires the Office of Management and Budget, in consultation with Department of the Treasury, the Council of Economic Advisers, and the Small Business Administration, to issue quarterly reports to Congress and the public on the economic impact of certain coronavirus funds. This is the second quarterly report issued.