• Tue. Sep 27th, 2022

Pentagon plans for next pandemic battle – JEMS: EMS, Emergency Medical Services

ByMadeleine J. Pierce

Apr 11, 2022
In this image provided by the U.S. Army, University of Utah health care personnel talk to U.S. Army North personnel in Salt Lake City, Utah, March 2, 2022, during a visit to the University of Utah Hospital. (Pfc. Duke Edwards/US Army via AP)

By LOLITA C. BALDOR Associated Press

WASHINGTON (AP) — A COVID-19 patient was in respiratory distress. 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. Regular patient beds were full. Intensive care too. But the nurse heard of a vacant spot in an overflow treatment area, so she and another team member raced on the stretcher through the hospital to claim the space first, denting a wall in their haste.

When she saw the bump, Army team leader Lt. Col. Suzanne Cobleigh knew the nurse had done her job. “She’s going to damage the wall on the way because he’s going to have that bed,” Cobleigh said. “He will get the treatment he needs. This was the mission. »

This nurse’s mission was to provide urgent care to her patient. Now, the US military mission is to use the experiences of the Cobleigh team and other units fielded against the coronavirus pandemic to prepare for the next crisis threatening a large population, whatever its nature.

Their experiences, Gen. Glen VanHerck said, will help shape the size and staffing of the Army’s medical response so the Pentagon can provide the right types and numbers of forces needed for another pandemic, global crisis, or conflict.

One of the key lessons learned has been the value of small military teams versus massive movements of personnel and facilities in a crisis like the one caused by COVID-19.

At the start of the pandemic, the Pentagon flew hospital ships to New York and Los Angeles and set up huge hospital facilities in convention centers and parking lots, in response to pleas from state government leaders . The idea was to use them to treat non-COVID-19 patients, allowing hospitals to focus on the most acute pandemic cases. But while the images of military ships were powerful, too often many beds remained unused. Fewer patients needed non-coronavirus care than expected, and hospitals were still overwhelmed by the pandemic.

A more agile approach has emerged: bringing in military medical personnel for exhausted hospital staff members or working alongside them or in additional treatment areas in unused spaces.

“It’s morphed over time,” VanHerck, who heads US Northern Command and is responsible for homeland defense, said of the response.

Overall, about 24,000 U.S. troops have been deployed to the pandemic, including nearly 6,000 medical personnel in hospitals and 5,000 to help administer vaccines. Many have done multiple tours. This mission is over, at least for now.

Cobleigh and his team members were deployed to two hospitals in Grand Rapids from December to February as part of the U.S. Army’s effort to relieve civilian medical personnel. And just last week, the last military medical team that had been deployed for the pandemic finished their stay at the University of Utah Hospital and returned home.

VanHerck told The Associated Press that his command was rewriting pandemic and infectious disease plans, and planning war games and other exercises to determine if the United States had the right balance of medical personnel. military on active duty and in the reserves.

During the pandemic, he said, the composition and equipment needs of teams have evolved. Now he has put around 10 teams of doctors, nurses and other staff – or around 200 soldiers – on deployment readiness orders until the end of May in case infections rise again. Team sizes vary from small to medium.

Dr. Kencee Graves, inpatient chief physician at the University of Utah Hospital, said the facility finally decided to seek help this year as it postponed surgeries to treat all COVID patients. -19 and closing beds due to lack of staff.

Some patients have had surgery postponed more than once, Graves said, due to critically ill patients or other people’s critical needs. “So before the military came in, we were looking at a surgical backlog of hundreds of cases and we were understaffed. We had tired staff.

His mantra became, “All I can do is show up and hope it helps you.” She added, “And I did it day in and day out for two years.”

Then came a medical team of 25 Navy personnel.

“A number of employees were overwhelmed,” said Cdr. Arriel Atienza, Navy team medical officer. “They were burned. They couldn’t call in sick. We are able to fill some gaps and need shifts that would otherwise have gone unstaffed, and the patient load would have been very demanding on existing staff.

Atienza, a family doctor who has been in the military for 21 years, spent Christmas vacation at a hospital in New Mexico and then traveled to Salt Lake City in March. Over time, he said, the military “evolved from things like pop-up hospitals” and now knows how to integrate seamlessly into local health facilities in just days.

This integration has helped hospital staff recover and catch up.

“We’ve gone through about a quarter of our surgical backlog,” Graves said. “We haven’t called a relay doctor this month for the hospital team… it’s the first time this has happened for several months. And then we haven’t called a patient to ask them to reschedule their surgery for the majority of the last few weeks.

VanHerck said the pandemic has also underscored the need to review the country’s supply chain to ensure the right equipment and drugs are stocked, or to see if they are sourced from overseas distributors.

“If we’re relying on getting them from a foreign manufacturer and supplier, that may be something that’s a national security vulnerability that we need to fix,” he said.

VanHerck said the United States is also working to better analyze trends to forecast personnel, equipment and protective gear needs. Military and other government experts watched the progress of COVID-19 infections move across the country and used that data to predict where the next outbreak might be so personnel could be prepared to get there.

The need for mental health care for military personnel has also become evident. Team members coming out of tough shifts often needed someone to talk to.

Cobleigh said military medical personnel were not used to caring for so many people with multiple health conditions, which is more likely to be found in a civilian population than in military ranks. “The level of illness and death in the civilian sector was far beyond what anyone had experienced in the military,” said Cobleigh, who is currently stationed at Fort Riley, Kansas, but will soon be moving to Aberdeen Proving. Ground in Maryland.

She said she found that her staff needed her and wanted to “talk about their stresses and strains before resuming their shift”.

For civilian hospitals, the lesson was knowing when to call for help.

“It was the bridge to help us get out of omicron and into a position where we can take good care of our patients,” Graves said. “I don’t know how we would have done this without them.”