By LOLITA C. BALDOR – Associated Press
WASHINGTON (AP) — A COVID-19 patient experienced shortness of breath. The Army nurse knew she had to act quickly.
It was the peak of this year’s Omicron surge, and an Army medical team was helping at a Michigan hospital. Normal patient beds were full. Likewise the intensive care. But the nurse heard of an opening in a spill treatment area, so she and another team member raced through the hospital with the stretcher to claim the space first, denting a wall in their haste.
When she saw the dent, Lt. Col. Suzanne Cobleigh, the army team leader, knew the nurse had done her job. “She’s going to damage the wall on the way there because he’s going to get that bed,” Cobleigh said. “He will get the treatment he needs. That was the mission.”
This nurse’s mission was to provide urgent care to her patient. Now the US military mission is to use the experience of Cobleigh’s team and other units deployed against the pandemic to prepare for the next crisis that threatens a large population of whatever kind.
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Their experiences, Gen. Glen VanHerck said, will help shape the size and staffing of the military’s medical response so the Pentagon can deploy the right type and number of forces needed to combat another pandemic, global crisis, or other conflict will.
One of the key lessons we learned was the value of small military teams versus mass movements of personnel and facilities in a crisis like the one caused by COVID-19.
In the early days of the pandemic, the Pentagon steamed hospital ships to New York City and Los Angeles, erecting massive hospital facilities in convention centers and parking lots at the request of state leaders. The idea was to use them to treat non-COVID-19 patients so hospitals could focus on the more acute pandemic cases. But while the images of the military ships were impressive, too often many beds remained unused. Fewer patients required non-coronavirus care than expected and hospitals were still overwhelmed by the pandemic.
A more agile approach evolved: military medical personnel should fill in for exhausted hospital workers or work alongside them or in additional treatment areas in unused spaces.
“It’s changed over time,” said VanHerck, who heads U.S. Northern Command and is responsible for homeland defense, of the response.
In all, about 24,000 U.S. troops have been deployed to deal with the pandemic, including nearly 6,000 medical workers in hospitals and 5,000 to help administer vaccines. Many have done multiple tours. That mission is over, at least for now.
Cobleigh and her team members were deployed to two Grand Rapids hospitals from December to February as part of the US military’s effort to relieve civilian medical workers. And just last week, the last military medical team deployed for the pandemic completed its stay at the University of Utah Hospital and made its way home.
VanHerck told The Associated Press his command is overriding plans for pandemics and infectious diseases and planning war games and other drills to determine if the U.S. has the right balance of active-duty military medical personnel and those in the reserves.
During the pandemic, he said, teams’ makeup and equipment requirements have evolved. Now he has about 10 teams of doctors, nurses and other personnel — or about 200 soldiers — on orders to be ready by the end of May if infections pick up again. The size of the teams ranges from small to medium.
dr Kencee Graves, inpatient chief medical officer at the University of Utah Hospital, said the facility finally decided to seek help this year because it was postponing surgeries to care for all COVID-19 patients and closing beds due to staff shortages .
For some patients, surgery has been postponed more than once, Graves said, because of critically ill patients or the critical needs of others. “Before the military came, we were looking at a surgical backlog of hundreds of cases and we were short on staff. We had tired staff.”
Her mantra was, “All I can do is show up and hope it helps.” She added, “And I’ve been doing that, day after day, day after day, for two years.”
Then came a 25-strong Navy medical team.
“Some employees were overwhelmed,” said Cdr. Arriel Atienza, Navy team chief medical officer. “They were burned out. They couldn’t call in sick. We are able to fill some gaps and require shifts that would otherwise have gone unmanned and the patient burden would have been very demanding on the existing staff.”
Atienza, a family doctor who has been in the military for 21 years, spent the Christmas break on duty at a New Mexico hospital and then headed to Salt Lake City in March. Over time, he said, the military has “evolved from things like pop-up hospitals” and now knows how to seamlessly integrate with local healthcare facilities in just days.
This integration helped hospital staff to recover and catch up.
“We’ve cleared about a quarter of our surgical backlog,” Graves said. “We did not call in a backup doctor for the hospital team this month… this is the first time that has happened in several months. And then for most of the last few weeks we haven’t called any patient and asked them to postpone their surgery.”
VanHerck said the pandemic also underscores the need to scrutinize the country’s supply chain to ensure the right equipment and medicines are being stocked, or to see if they came from foreign distributors.
“If we rely on getting these from a foreign manufacturer and supplier, then that could be a national security vulnerability that we need to address,” he said.
VanHerck said the US is also working to better analyze trends to predict needs for personnel, equipment and protective gear. Military and other government experts monitored the progress of COVID-19 infections spreading across the country and used that data to predict where the next outbreak might take place so employees could be prepared to go there.
The need for psychiatric care for military personnel also became apparent. Team members coming from difficult shifts often needed someone to talk to.
Cobleigh said military medical personnel are not used to caring for so many people with multiple health conditions, as they are more likely to be found in civilian populations than in the military ranks. “The level of sickness and death in the civilian sector was many times greater than what anyone in the Army had experienced,” said Cobleigh, who is now stationed at Fort Riley, Kansas, but will soon be transferred to the Aberdeen Proving Ground in Maryland will move.
She said she realized her co-workers needed her and wanted to “talk about their stress and strains before they go back into shift.”
For civilian hospitals, the lesson was knowing when to call for help.
“It was the bridge that helped us get out of omicron and put us in a position where we can take good care of our patients,” Graves said. “I’m not sure how we would have managed without her.”
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