The Things They Carry: Veterans and the COVID-19 Pandemic

Gerber, Megan R.

doi:10.1007/s11606-020-06048-x

Cited by 9 publications

(14 citation statements)

References 5 publications

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“…The absence of significant differences across combat categories in the qualitative responses supports the contention that the military experience itself provides veterans with positive life experience that can help them through potential adversity and challenges in their post-military lives. By contrast, the magnitude of difference in PTSD between those providing responses and those who did not fill in a response, and the fact that nearly 20% of responses to the open-ended coping question dealt with the veterans' own emotional health and not with their military experiences, as queried, provides strong support for the negative aspects of the military experience that as Gerber noted, are still powerfully present in many veterans ( 1 ). The few men who offered no effect comments (their military neither helped nor hindered them in the COVID situation) did not differ significantly from those who did not provide a comment.…”

Section: Discussionmentioning

confidence: 99%

“…This is also consistent with our work on the importance of social ties during physical distancing ( 22 ). As Gerber posits, perhaps “unit cohesion” (transmuting support from one's military unit onto one's family unit) could also help with trauma-related symptoms ( 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…Early in the COVID-19 pandemic, Gerber ( 1 ), an internist and expert in veterans' health and trauma-informed care, warned of the special burden many Vietnam veterans who had experienced military trauma could face as members of an aging population. (In 2020, the median age of Vietnam veterans was 71) ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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Impact of Military Service in Vietnam on Coping and Health Behaviors of Aging Veterans During the COVID-19 Pandemic

Stellman

Spiro

et al. 2022

Front. Public Health

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Many Vietnam War veterans who experienced military trauma still exhibit PTSD symptomatology. Little is known about how new stressful situations, like the COVID-19 pandemic, affect previously traumatized people or whether they will react differently to them. We explore whether military combat experiences in Vietnam affect veterans' perceived abilities to cope with COVID-19 and whether current PTSD symptoms and later-adulthood reengagement with trauma memories are related to coping. We examine the extent that current PTSD symptoms and trauma reengagement relate to preventive practices. Participants were part of a randomly sampled cohort of American Legionnaires who responded to two previous surveys (1984, 1998), were born 1945-1953 and deployed to Vietnam 1963-1973, thus representing an aging veteran population. A survey supplement assessed coping with the pandemic and adherence to public health guidelines. The response rate was 74% (N = 507); 422 (61.6%) completed the COVID-19 supplement. Military experiences were found to affect coping with 41.4% reporting they affected ability to cope with COVID-19. Medium- and high-combat veterans were more likely to report that military experience affected coping than low-combat (OR 2.4, 95% CI 1.51–3.96; 2.6, 95% CI 1.41–4.61, respectively). Those with high PTSD scores had 7.7-fold (95% CI 4.3–13.17) increased likelihood of reporting that their coping was affected, compared to low-PTSD scorers. Few adopted social distancing (4%), staying at home (17%), or ceasing usual activities (32%); high-combat veterans were least likely to stay home. Veterans who practiced handwashing, sanitizer use, mask-wearing, and surface disinfection had significantly higher PTSD scores than those who did not. Veterans with higher scores on the LOSS-SF scale associated more reengagement with trauma memories and were more likely to engage in personal preventive strategies. Analysis of open-ended responses supported these findings. We conclude that fifty years after returning from Vietnam, PTSD scores were high for high-combat veterans, suggestive of PTSD diagnosis. Military experiences affected coping with COVID both positively and negatively, and may have helped instill useful personal health behaviors. Veterans, especially those with PTSD symptomatology, may have special needs during stressful times, like the COVID-19 pandemic, affecting compliance with recommended practices, as well as their overall health and well-being.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of Military Service in Vietnam on Coping and Health Behaviors of Aging Veterans During the COVID-19 Pandemic

Stellman

Spiro

et al. 2022

Front. Public Health

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“…The pandemic quickly created an environment that stoked fear among employees, amplifying their feelings of stress, anxiety, and isolation, 19 , 28 and highlighting the need for healthcare organizations to develop a “proactive, comprehensive wellness strategy” for their employees. 10 Similarly, the general public also faced significant stress and uncertainty during the pandemic 29 , 30 with Veterans in particular facing a high risk of increased anxiety and stress due to pre-existing trauma 31 – 34 and greater economic insecurity. 35 Given the inherent alignment between the principles of WH and the needs of Veterans and employees whose lives had been deeply affected by the pandemic, sites in our study found that the pandemic presented a unique opportunity to showcase the value of a proactive WH approach to care.…”

Section: Discussionmentioning

confidence: 99%

Leaning Into Whole Health: Sustaining System Transformation While Supporting Patients and Employees During COVID-19

Dryden

Bolton

Bokhour

et al. 2021

Glob Adv Health Med

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Background The US Veterans Health Administration (VA) is transforming its healthcare system to create a Whole Health System (WHS) of care. Akin to such reorganization efforts as creating patient-centered medical homes and primary care behavioral health integration, the WHS goes beyond by transforming the entire system to one that takes a proactive approach to support patient and employee health and wellness. The SARS-CoV-2 pandemic disrupted the VA’s healthcare system and added stress for staff and patients, creating an exogenous shock for this transformation towards a WHS. Objective We examined the relationship between VA’s WHS transformation and the pandemic to understand if transformation was sustained during crisis and contributed to VA’s response. Methods Qualitative interviews were conducted as part of a multi-year study of WHS transformation. A single multi-person interview was conducted with 61 WHS leaders at 18 VA Medical Centers, examining WH transformation and use during the pandemic. Data were analyzed using rapid directed content analysis. Results While the pandemic initially slowed transformation efforts, sites intentionally embraced a WH approach to support patients and employees during this crisis. Efforts included conducting patient wellness calls, and, for patients and employees, promoting complementary and integrative health therapies, self-care, and WH concepts to combat stress and support wellbeing. A surge in virtual technology use facilitated innovative delivery of complementary and integrative therapies and promoted continued use of WH activities. Conclusion The pandemic called attention to the need for healthcare systems to address the wellbeing of both patients and providers to sustain high quality care delivery. At a time of crisis, VA sites sustained WH transformation efforts, recognizing WH as one strategy to support patients and employees. This response indicates cultural transformation is taking hold, with WH serving as a promising approach for promoting wellbeing among patients and employees alike.

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“…These individuals include a large population in different countries such as Iran, the United Kingdom, Iraq, Afghanistan, and the United States of America 2 . People with chemical war injury may suffer from serious consequences, such as respiratory disease, heart failure, and immunodeficiency, due to the exposure to chemical gas warfare (e.g., mustard gas) 3 . Based on the WHO reports, chemical warfare agents have affected thousands of people worldwide and these individuals often have a poor health status 4,5. During the years 1980 to 1988, Iraq used chemical weapons against Iran (both against the army and the general population) almost 260 times and victimized more than 100,000 people 6. The aim of the current study was to determine whether COVID-19 is associated with a different presenting clinical picture or a more severe course of illness (e.g., intubation and death) in people with a past history of chemical war injury; this information might help us understand the severity and the gravity of COVID-19 in these people.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in Patients With a Past History of Chemical War Injury: A Cross-Sectional Study in Southern Iran

Emami

Pezeshkian

Javanmardi

et al. 2021

Disaster med. public health prep.

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OBJECTIVES: This study aimed to determine whether COVID-19 is associated with a different presenting clinical picture or a more severe course of illness in people with a past history of chemical war injury. METHODS: This is a multicenter retrospective study in Fars province, Iran, from 22 August to 4 October 2020. People with a past history of chemical war injury and COVID-19 were studied. Two age- and sex-matched control groups, double the size of the patient group each, from the same database of patients with COVID-19 who were hospitalized at the same time [i.e., healthy controls and pseudocontrols]. RESULTS: 46 people with a past history of chemical war injury, 92 healthy controls, and 92 pseudocontrols were studied. People with COVID-19 and a past history of chemical war injury had a significantly higher rate of chest pain compared to others. There were no other clinical differences between the groups. Mortality rate was 17.39%, 15.21%, and 27.17% in people with a past history of chemical war injury, the control group, and the pseudocontrol group, respectively. CONCLUSION: A past history of a chemical war injury does not add to the risk of COVID-19 and does not significantly modify its clinical picture either.

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The Things They Carry: Veterans and the COVID-19 Pandemic

Cited by 9 publications

References 5 publications

Impact of Military Service in Vietnam on Coping and Health Behaviors of Aging Veterans During the COVID-19 Pandemic

Impact of Military Service in Vietnam on Coping and Health Behaviors of Aging Veterans During the COVID-19 Pandemic

Leaning Into Whole Health: Sustaining System Transformation While Supporting Patients and Employees During COVID-19

COVID-19 in Patients With a Past History of Chemical War Injury: A Cross-Sectional Study in Southern Iran

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