Coronavirus isolation stresses Vietnam War veterans in Sonoma County

Richard Jones, a gravel-voiced Vietnam War veteran from Santa Rosa, is worried about the price his cohort of aging men and women may be paying nearly 50 years since the last U.S. forces left the Southeast Asian battlefields that claimed 58,220 American lives.

In the campaign against the coronavirus - which has now killed more than 97,000 Americans - social distancing and self-isolation are critical strategies. But they are demoralizing to Vietnam veterans, who refer to one another as brothers and sisters and thrive on lending a hand to those in need.

“We can’t hold meetings. We can’t get together,” said Jones, 75, who co-founded a local nonprofit, Sonoma County Vet Connect, a dozen years ago. The group’s Tuesday meetings at the Santa Rosa Veterans Memorial Building, held to connect veterans with a host of services, are on hold, along with all other gatherings.

“We don’t know when we’ll be able to do it again,” Jones said. “It’s been really tough.”

Jones, who was aboard a Navy landing craft in the Gulf of Tonkin in 1964 when a controversial incident ignited the Vietnam War, senses depression mounting among his fellow veterans and is worried it could result in suicides, especially for those who cannot shake post-traumatic stress disorder.

“That’s what I’m worried about,” he said.

Suicide stalks female and male veterans, exceeding 6,000 a year from 2008 to 2017 - 1.5 times the rate of suicides for nonveteran adults. Nearly 79,000 veterans died by suicide between 2005 and 2017, compared with about 7,000 troops killed during two decades of the wars in Afghanistan and Iraq.

“Suicide prevention is a national priority and the VA (Veterans Administration) is dedicated to this mission,” said a report last year from the Department of Veterans Affairs, noting that a cabinet-level task force had been formed to develop a plan.

Loneliness looms as a risk factor because it is tied to the highest levels of depression and suicidal thoughts among former service members, according to a study by Dr. Alan Teo, a psychiatrist at the VA Portland Health Care System.

“I am worried that there will be serious mental health consequences from COVID-19 that we have not paid enough attention to,” Teo said in an email. “That could include more suicides in veterans, not necessarily this month but in the coming months or even years.”

Teo believes the dangers of loneliness also accrue over time, and the mindset is “especially dangerous when it is sustained and persistent.”

The condition afflicts people living alone and with others, he said.

“Loneliness is the feeling of being alone, but not at all necessarily being physically alone,” Teo said.

Dr. Somnath Saha, a Portland VA physician, said: “Humans are social beings and connection to others is part of what buoys us in a stressful world.”

Jones, who said he was exposed to Agent Orange, the toxic defoliant sprayed over Vietnam for 10 years, checks in with a therapist about once a year for PTSD.

“It won’t go away,” he said.

Kate O’Hare-Palmer of Petaluma, who served as an Army emergency room nurse in Vietnam, said the coronavirus onslaught “comes across as a war zone to us (veterans). It’s overwhelming. There’s no end.”

It took her 25 years to accept the fact she had PTSD, sublimating the pain through steady work. “When you’re busy you don’t think and you don’t feel,” she said.

Many veterans are, by nature, driven to help others, an impulse that was crushed by stay-at-home orders imposed by the county more than two months ago, said O’Hare-Palmer, 73, who chairs the Vietnam Veterans of America’s Women Veterans Committee. The rules against social gatherings spelled a temporary end to the coffee cart she and others operated for five years outside the Santa Rosa VA Outpatient Clinic on Brickway Boulevard, serving doughnuts, fruit and coffee to veterans who had come from as far away as Eureka to catch a bus to the San Francisco VA Medical Center.

“It turned into a very social thing,” O’Hare-Palmer said.

Vietnam veterans may be seen as rugged and potentially gruff, but O’Hare-Palmer said the vast majority - about eight out of 10 - are “everyday people” going about their lives with jobs and families. With a median age of 68, most are now retired, but they are marked men and women in several ways.

Of the 2.7 million American troops who served in Vietnam, about 774,000 are living today.

The VA’s National Center for PTSD says about 15% of Vietnam veterans were diagnosed with the condition in a late 1980s study, possibly due to horrible and life-threatening experiences in combat. In 2015, a study found about 11% - some 271,000 veterans - still had the “psychological nightmare” of PTSD, many with conditions that were “only getting worse with time,” according to Smithsonian magazine.

There were about 20 million veterans of all ages in the United States and 1.7 million in California in 2017, comprising about 6% of the adult population in both cases, the VA says. Sonoma County had 25,307 veterans last September, with 3,532 age 17-44, 6,788 age 45-64 and 14,986 age 65 and up, placing them in the Vietnam War era.

Patients in the VA system are faring worse with coronavirus infections than the general public, according to the agency’s ongoing count of infections and deaths.

The VA system, which serves 9.5 million people, reported 13,240 COVID-19 cases on Sunday, with 1,116 deaths for an 8.4% case fatality rate. There were 1,619,482 cases nationwide, with 95,903 deaths and a rate more than two points lower at 6%, the VA’s Access to Care website said.

In California, the gap was smaller with 496 cases and a 5% death rate in the VA system, compared with 62,622 cases and a 4.4% rate for all patients.

Dr. Gary Green, an infectious disease specialist at Sutter Santa Rosa Medical Center, said a higher case fatality rate for veterans was to be expected, as vets are an older population with a high percentage of heavy smokers combined with medical conditions such as heart and lung disease. He describes veterans as a “moderately vulnerable” population, but less so than nursing home patients.

Eighty percent of the people infected by the coronavirus need no medical attention, Green noted.

But Suzanne Gordon, an author and senior policy analyst at the Veterans Healthcare Policy Institute, said veterans are “hugely at risk of hospitalization or death from COVID-19.”

The average patient over age 65 has three to five health problems, while the average Vietnam War veteran has nine to 12 problems, she said.

Gordon, an East Bay resident, acknowledged that isolation can have serious consequences for veterans. But, she said, that consideration must be balanced against the alternative: “If you don’t isolate them you get death.”

“This is a high-risk situation for humanity,” she said.

Gordon gave the VA health care system high marks, saying it had done much better than the private sector in responding to the pandemic. As the shutdown orders came in March, the VA system quickly pivoted to an extensive nationwide telemedicine capacity.

At the San Francisco hospital and the Santa Rosa clinic, outpatient care appointments not requiring face-to-face contact were moved to virtual and telephone appointments.

In February, when COVID-19 claimed its first American victim, the local clinic had completed 3,820 in-person appointments along with 35 video and 399 phone appointments. In March, the clinic completed 2,164 in-person, 75 video and 1,090 phone appointments.

The shift allows veterans to receive care “through minimal contact with our staff … while saving them time and reducing the potential for harmful exposures,” said Jason Dominguez, a spokesman for the San Francisco VA Health Care System.

The hospital and its network of six community clinics, including Santa Rosa, also completed 2,003 virtual mental health appointments from early February to early March, and in the following month the number nearly quadrupled to a total of 7,959 online appointments.

Richard Jones said the VA system is okay, but there’s almost no way to get hands-on care. Told that much of American health care has shifted to telemedicine, he grumbled, “We veterans have a different outlook. We take it personal.”

Rep. Mike Thompson, the St. Helena Democrat who is a Vietnam combat veteran, said the VA seems to be “doing better than other health care systems.”

Congress has appropriated more than $23.6 billion to bolster care for veterans. In response to the pandemic, the VA has added 3,000 new hospital beds, hired 11,000 new employees and acquired enough equipment and supplies to process tens of thousands of COVID-19 tests every day, he said.

But Thompson also seconded the concern over isolated veterans.

“We need to be with people. We need to be able to socialize,” he said.

At a group home for seven veterans on a Sebastopol hilltop that’s absolutely no problem.

“We all get along really well together,” said Dana Henry, 73, a Vietnam veteran who is the house manager. “We’re all pretty upbeat.”

Lacking a television, the residents play cards, work in the garden on their one-acre lot and get three meals a day provided by the Veterans Resource Center of Santa Rosa, a nonprofit that operates another transitional home for veterans on Hearn Avenue.

Both houses are at half capacity for now to ensure social distancing, and the men in Sebastopol have ample space. “We’re not running into each other at all,” Henry said.

You can reach Staff Writer Guy Kovner at 707-521-5457 or guy.kovner@pressdemocrat.com. On Twitter @guykovner.