Military’s Medical Response to COVID-19 in NJ May Lead to New Blueprint for Public Health Emergencies

Army Reserve has assembled hundreds of soldiers trained as health care professionals to support New Jersey’s field stations and hard-hit community hospitals   
Credit: 22nd Mobile Public Affairs Detachment
U.S. Army Lt. General Laura Richardson visited University Hospital, Newark where 85 Army medical providers are supporting the response to COVID-19.

The U.S. military has long played a key role helping American communities respond to natural disasters and other public health emergencies. But the work it is doing during the coronavirus crisis is unique and may lead to a new blueprint for the way soldiers provide civilian assistance during a pandemic.

The U.S. Army has deployed hundreds of Reserve soldiers trained as health care professionals to New Jersey over the past month to support the state’s medical response to COVID-19, with doctors, nurses and other clinicians now serving in both field stations and at hard-hit community hospitals. Nearly 96,000 residents have now been diagnosed with the disease, including more than 5,000 who have died.

The response includes three 85-member Urban Augmentation Medical Task Force units, new groups assembled in recent weeks by the Army specifically to backstop and support local health care systems swamped by the coronavirus. These units can work as a team to provide the services needed to run a 250-bed field hospital, as they are doing at the convention center in Edison, or can be deployed as an entity or in parts to assist other acute care facilities.

Another task force arrived at Newark’s University Hospital, the region’s only Level 1 trauma center, on April 15 — at a time when the staff was struggling to keep pace with patient needs, according to president and CEO Dr. Shereef Elnahal. The nurse-to-patient ratio had risen to alarming levels when the Reserve soldiers showed up to plug “very key gaps” in their frontline workforce, he said.

“They’ve been tremendous across the board,” Elnahal said Monday; he served in the U.S. Department of Veterans Administration under President Barack Obama before becoming Gov. Phil Murphy’s first state health commissioner. “Their role has been absolutely critical. They really came when we needed them most.”

Army Col. Dr. Mark L. Passamonti, a primary care physician at Walter Reed Army Medical Center in Bethesda, Md., said the military team has been well-received in Newark. “We are helping the hospital with allowing them to get some of their patients off the (critical care) wards earlier than they would if we were not helping them,” he said.

Two to three times normal patient load

Passamonti said team members were able to relieve pressure on the hospital’s nursing staff facing two to three times the normal patient load — a result of the COVID-19 patient surge and a workforce diminished by “illness and exhaustion. The staff at University Hospital is happy to have our assistance and let us know when they see us. The patients benefit because of the additional help the hospital is receiving,” he added.

Reserve medical personnel are typically deployed to run field hospitals or similar sites that serve to support the existing civilian hospital system, as in the case of past disasters or deployments, officials said. So it is unusual for these soldiers to be embedded in a hospital like University, where they are working alongside the hospital’s own team. The arrangement has attracted the attention of a number of generals, according to Elnahal, and is now being considered as a new model for responding to public health emergencies.

Among those taking notice is Army Lt. General Laura Richardson, who visited the Newark hospital on Monday to meet with the medical team. Based in Houston, Richardson oversees the Army forces deployed within the United States in response to COVID-19.

First Sgt. Jeremy D. Crisp, a public affairs officer, called this partnership “a natural fit” for both the hospitals and the Army Reserve providers since these soldiers typically work at similar facilities in their civilian careers. “So it’s familiar territory for them,” he said.

All branches of the military — other than the newly created Space Force — have reserve components that allow personnel to serve part-time, training near home and working at a civilian job until they are deployed alongside the Army in times of war, or in a national emergency. (The Army National Guard is a separate part-time unit that tends to respond within its home state.)

Teams have been deployed nationwide

The Army’s medical task force teams  — which are also serving at the field hospital in Atlantic City and will staff the Salem Medical Center when that is reopened to provide more bed capacity in South Jersey — are among at least 15 such groups deployed nationwide, according to the Army; others are working in Boston and Detroit. The Army vetted these clinical volunteers carefully and only selected individuals who were not engaged in treating COVID-19 cases at home, officials note.

Passamonti, with the Newark team, said it all happened very quickly. “Most of us had less than 72 hours to finish packing, wrap up work items, and say goodbye to family for up to six months deployment,” he said. “Secondly, I believe the U.S. Army Reserve has never mobilized in this manner to support a domestic mission to support hospitals in this manner — so it was completely new for all of us.”

Their work also depends on efforts by other military units. This includes the U.S. Army Corps of Engineers, which is responsible for setting up the field hospitals and reopening shuttered facilities, and the National Guard, which is manning the Meadowlands field hospital in Secaucus and veterans’ homes in Paramus and Menlo Park.

For military medics, the coronavirus deployment is also a unique opportunity to serve.

“This is our war. Never in the history of the United States military has medical been the warfighter, but we are the warfighter,” Maj. Gen. Joe Robinson, the commanding general of the 3rd Medical Command, told soldiers awaiting deployment. “We are the tip of the spear.”

Task force components

Each task force is comprised of 14 physicians — including an infectious disease specialist and four respiratory care experts — 16 medics, or emergency responders, 13 nurses, between two and five physician assistants, dentists, pharmacists, clinical psychologists, occupational therapists and dieticians, plus at least one psychiatrist, according to the Army. The groups also contain 18 support staff to help with administration, logistics and other tasks.

The task forces are designed to focus on treating those with more limited medical needs — which means they don’t provide critical care services, but they are trained to test for COVID-19 and can handle a wide range of clinical duties. Passamonti said the team in Newark has nurses and medics working directly with University clinicians in the critical care wards, while other soldiers are caring for the lower-acuity patients who no longer need the same levels of monitoring or treatment.

While the coronavirus mission is unlike other deployments in so many ways, Passamonti said one challenge is the same: leaving your family during uncertain times. He has already missed his wedding anniversary, which was Monday, and may not be home to celebrate with his kids when their birthdays come in May.

While the epidemic had forced major changes on daily life, Passamonti said he had come to enjoy spending time at home playing cards and board games as a family. “None of us will be able to get that time back again. All of us deployed here are missing that wonderful opportunity,” he said.