When she contracted the novel coronavirus, Elana Duffy remembered the acrid smoke she breathed in from her Army tours in Iraq and Afghanistan, where jet fuel burned everything from broken furniture to human feces in toxic pits.
“I actually was saying prior to getting [the virus], I wonder if I would get it because I feel like my lungs don't work the same way everyone else’s do,” Duffy said.
That’s because of the U.S. military’s tendency in the Afghanistan and Iraq wars to incinerate the immense detritus of war. Deployed servicemembers were frequently exposed on their bases to rancid fumes. At the burn pit near the entry control point of the massive Balad airbase in Iraq, Duffy said, “you’d sit there an hour sometimes waiting to be let in and out, and they’re burning everything from tires to medical waste.”
The military hasn’t formally admitted that the burn pits jeopardized troops’ health, much as it took the Defense Department decades to acknowledge the damage the chemical Agent Orange inflicted on Vietnam veterans. But leaked Army documents from 2011 warned of the pits’ “long term health risk.” Servicemembers were likely to experience "reduced lung function or exacerbated chronic bronchitis, chronic obstructive pulmonary disease (COPD), asthma, atherosclerosis, or other cardiopulmonary diseases. It’s the sort of respiratory damage that might turn a case of coronavirus severe or deadly—and a specific way that the war on terror left people vulnerable to the pandemic.
To track veterans’ exposure to the burn pits, something the government failed to do for Agent Orange, Congress in 2013 created a registry for troops who inhaled the gnarly fumes. Maintained by the Department of Veterans Affairs (VA), it’s a storehouse of data for further study about the effects of the pits. Over 200,000 veterans have signed up for it, though nearly three million have served in the war on terror.
Duffy is one of more than half a dozen veterans contacted by The Daily Beast who enrolled in the registry but haven’t received any guidance at all warning them that their exposure to the pits puts them at greater risk of developing dangerous coronavirus symptoms—let alone specific precautions they ought to take. “I don’t think that they’re doing anything with the burn pit registry, quite frankly,” Duffy said.
Since COVID-19 prompted a nationwide lockdown, the VA has sent out multiple text alerts to veterans about the virus, precautions to take against it, and resources should they fall ill. VA press secretary Stephanie Noel estimated that the texts have reached some 8.8 million veterans. The VA website has additional material, including a notice about the burn pit registry updated with a warning on COVID-19.
Some veterans contacted by The Daily Beast found the VA texts helpful. One who was exposed to the pits—though is not in the registry—said the texts were specifically useful in identifying symptoms of COVID-19 and distinguishing it from the seasonal flu. In general, the Wounded Warrior Project, a post-9/11 veterans-service organization, considers the VA to be doing a good job.
But those VA resources don’t provide specific guidance for those in the burn pit registry. Nor do they warn burn pit-exposed veterans that their exposure to the pits may increase the severity of COVID-19. While the coronavirus warning on the burn pit registry warns that immuno-compromised veterans may experience more virulent symptoms, it does not state that exposure to the pits itself represents an immuno-compromise.
“It would be helpful for VA to proactively contact those veterans in its care, like me, based on what's in their health records, and give them individualized advice about what they should do to stay healthy in the face of COVID-19,” said Phil Carter, an Iraq veteran who studies veterans’ health issues for the RAND Corporation. “That kind of preventive medicine could make a difference, especially if it came backed up by VA's ability to deliver telemedicine, deliver medications by mail, and help veterans in other ways.”
But “we’re not seeing that kind of action from the VA,” said Jeremy Butler, CEO of Iraq and Afghanistan Veterans of America.” Julie Tomaska of the advocacy group Burn Pits 360 said it was “concerning” wasn’t giving veterans with “compromised immune systems... information and access to the care they need.”
The VA’s Noel didn’t respond to follow-up questions about directing burn pit registrants to specifically tailored information.
“Ever since coming back from Iraq in 2004, I’ve suffered from shortness of breath,” said Raf Noboa y Rivera, a 43-year old veteran who signed up for the burn pit registry. “You’d think that registry would be a useful tool for VA personnel to contact immunocompromised people like me in the event of a lethal respiratory pandemic like COVID-19. You’d be mistaken. Since March 17th, I’ve only gotten three generic text messages from them. None of them addressed people like me specifically.”
“The VA hasn’t told me anything other than recently upping my disability paycheck due to recent studies, which doesn’t make me feel great,” added Joe Kassabian, an Afghanistan veteran and author of The Hooligans of Kandahar. Kassabian signed up for the burn pit registry in the past year, he said, “so it wouldn’t shock me if it takes them three years to catch up.”
The impact of the burn pits varies. Some veterans said they don’t show symptoms of reduced cardiopulmonary heath, though several expected to see those symptoms later in life. Emma Moore, a veterans-focused research associate at the Center for a New American Security, cautioned that definitive research on burn-pit impact still hasn’t occurred. “But you have a resource available,” she said of the registry. “Why not use it?”
Mike Jason, a recently retired Army colonel who served multiple tours proximate to burn pits in Iraq, Afghanistan and Kuwait, said it took him “years” to sign up online for the registry owing to technical glitches. After not receiving any COVID-19 information, Jason questioned the registry’s purpose.
“I’m not seeing anything that shows me what this is for, what the program does in terms of deliverables for me and the community,” said Jason, who likened the military’s burn-pit understanding to the “early days of Agent Orange.”
Jason said the uncertainty around coronavirus and the burn pits frightened him: “I don’t understand the impact. How compromised am I?”
A different spokesperson for the VA, who interacts with the New Jersey-based medical center that conducts burn-pit study for the department, acknowledged the burn-pit-exposed veterans’ concerns and urged them to follow CDC guidelines.
“While it may not seem like those general preventive measures are unique to individuals who may have had burn pit exposures, we know that those with respiratory conditions are more susceptible and experience more severe symptoms if infected with the coronavirus as is seen in the general population,” said the VA spokesperson, Christine Betros Farrell. “Given that the COVID-19 pandemic started only a few months ago, it is nearly impossible to assess any data that might indicate whether those exposed to deployment related airborne hazards have a higher risk than those of the general population. It is going to take time and that is what we are working on.”
Military Times reported on Monday that veterans’ deaths from COVID-19 are spiking. (Though that’s not just post-9/11 veterans.) According to VA statistics, as of Tuesday, 257 veterans have now died from the virus out of 4,261 known veteran cases.
Duffy said she began feeling fatigued around March 18. She developed a headache notably different than those she suffers as a result of a traumatic brain injury. Breathing problems rapidly followed, as did a high fever. While the VA didn’t give Duffy a COVID-19 test or require hospitalization, “largely because the VA is slammed,” her doctors told her that her symptoms added up to the virus. They told her they’d like to have her back in for a lung x-ray—when her VA hospital has the capacity to administer one.
Duffy only started feeling better last week, although she’s not back to 100 percent. “I haven’t tried working out or anything because I'm not able to breathe as deep as I could,” she said.
The lack of definitive correlation between burn pit exposure and coronavirus virulence shouldn’t stop the VA from alerting post-9/11 veterans about the danger, Duffy said. “They should have sent out something in the very beginning, not just posted something on their website, because, I’m sorry, who checks that?” she said. “Like, ‘hey, burn pit registry people, make sure to take some extra precautions, keep your face covered.”