July 24, 2020
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BY ANDRÉ SOBOCINSKI
Since the beginning of the pandemic, Navy Medicine
has continually adapted to meet the evolving nature of COVID-19. One
example is the historic deployment of Naval Hospital Jacksonville's
Expeditionary Medical Facility-M.
On March 30, EMF-M answered the nation’s call by doing what no other
expeditionary hospital has ever done: it deployed to five stateside
locations simultaneously in support of a pandemic response.
EMFs — known as Fleet Hospitals prior to 2005 — are forward deployed
platforms with Role Three medical and surgical capabilities designed to
increase the survivability of those injured in a combat theater. They
are the Navy's equivalent to Mobile Army Surgical Hospital, or MASH,
units made popular by the film and TV series of the same name. For the
Navy, they have been deployed in one form or another since World War II,
but historically, nothing quite compares to the pandemic mission.
Navy Capt. Kevin Brown, who served as EMF-M's commanding officer for
this deployment, acknowledged the uniqueness of the mission.
''The traditional deployment of an EMF would be into a theater where
there's some sort of activity, usually it's a combat related activity,
on the ground that would be generating [or would be anticipated to
generate] a large number of combat related casualties,'' Brown said.
Brown said he began hearing rumors in mid-March that the EMF-M would
mobilize as part of the U.S. Northern Command pandemic response as part
of the Federal Emergency Management Agency's request for Defense Support
to Civil Authorities. The destination was uncertain, and there was
discussion about possible deployments to Montana, Wyoming or the Jacob
K. Javits Convention Center in New York. But within 48 hours of a
planned deployment to New York, the destination changed, with the EMF
now being sent to Dallas and New Orleans to serve as ''release
valves'' for the local hospital systems.
Brown sent planning cells to these cities to determine their
requirements and to work with local community leaders on how the Navy
could best support the mission. Unlike typical EMF wartime missions, the
Navy did not use pre-positioned equipment for setting up a 150-bed
hospital. Instead this mission called for the EMF to supply the
personnel based on the requirements of local communities as validated by
FEMA. For this mission, EMF-M tapped into its pool of 450 medical
providers attached to the platform and distributed them to each location
by requirement. As additional needs materialized at other locations,
personnel were taken from the original two detachments, as well as those
serving on standby awaiting orders.
The folks on the deployments were willing to participate in that
chaos and do it with a smile and do it with a high level of
professionalism and integrity.''
Navy Capt. Kevin Brown
Two weeks into the original mission, EMF-M transferred 104 medical
providers from the Dallas and New Orleans detachments to Baton Rouge,
Louisiana, where they staffed two 30-bed COVID-19 wards and helped care
for some 600 patients.
As the Baton Rouge mission was getting underway, EMF-M was deploying
another detachment to the hospital ship USNS Comfort in New York.
''It was decided they needed more critical care capability, and where
was the Navy going to find it?'' Brown said. ''Well, the Navy's going
to find it in its 'Tier One' assets.''
Navy Cmdr. Meredith Miller served as the officer in charge for the
EMF's USNS Comfort detachment. She and her team of 50 critical care
specialists received orders for deployment April 13, and were aboard the
ship the next day. The presence of the detachment gave the beleaguered
medical staff much-needed support.
''When you realized some of them had worked 14 days straight,
12-on-12-off, ... they were just ecstatic to have more support,'' Miller
said. ''So, we were pretty excited to be there and be able to jump in
and help the team.''
On April 24, the fifth and final detachment deployed to the Bennett
Medical Center in Stamford, Connecticut. Forty-nine members of the EMF-M
worked in conjunction with 85 Army Reserve soldiers with the 811-1
Urban Augmentation Medical Task Force to provide support in treating
COVID-19 patients.
For Navy Capt. Chad Roe, the executive officer of the EMF and the
Dallas detachment's officer in charge, this was another example of how
Navy Medicine comes together to accomplish a specialized mission.
''If it's Afghanistan, or if it's shipboard in the middle of the
Baltic Sea, you've got a group of people who know how to take care of
patients and to get a mission done,'' Roe said. ''And it's been a real
pleasure to be able to come in and support that in your own country.''
Brown said he believes that the unprecedented nature of the
deployment enabled a great deal of latitude for how to meet the mission
requirements.
''The bad news was that there was no templated plan for how to break
an EMF into five detachments and organize it in a way where you can
maintain positive command and control'' Brown said. ''The good news is
there was no template that locked us in.''
As for the hallmarks of the mission, both Brown and Roe note the resilience and adaptability of EMF-M personnel.
''We were going into a situation that was completely uncertain; and
once we had an understanding of what the local community needed, we
would have to somehow figure it out and get it done,'' Brown said. ''And
the folks on the deployments were willing to participate in that chaos
and do it with a smile and do it with a high level of professionalism
and integrity.''
EMF-M's last operating detachment wrapped up its mission in Baton
Rouge on May 31. Over two months, some 340 members of EMF-M deployed in
support of the pandemic response.
(André Sobocinski is assigned to the U.S. Navy Bureau of Medicine and Surgery.)
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