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Military medicine confronts an invisible enemy

Image of Medical personnel set up in an outside military tent. Click to open a larger version of the image. Military and civilian healthcare personnel run the drive-thru testing center at Blanchfield Army Community Hospital, Fort Campbell, Kentucky, as patients come to the site for scheduled evaluations and nasal swabbing. (U.S. Army courtesy photo.)

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In recent decades, combat on the front lines for the American military has meant overseas deployments, missions with sophisticated weaponry, and deaths — mostly in lands a world away.

In 2020, a new enemy emerged, one hiding in the air we breathe. Just as deadly, it knows no borders, is silent, invisible.

This new battlefield includes intensive care units, labs, makeshift testing centers, and warehouses for masks, syringes, and thermometers. In this match, there is no specific theater of operations for the Military Health System.

“COVID-19 has been just this ever-evolving enemy that we’re fighting, and that’s a fight where we’ve shown great resilience,” said Raven Connell, a nurse with Blanchfield Army Community Hospital at Ft. Campbell, Kentucky. “We continue to adapt and overcome all these obstacles that we’ve faced. We’ve had to completely revamp the way that we see and care for patients, and that’s no small feat in medicine.”

Navy Lt. Cmdr. Clifton Wilcox, public health emergency officer for Navy Region Southeast and Naval Hospital Jacksonville in Florida agrees. In April, as COVID increasingly affected his part of the world, Wilcox was working seven days a week and juggling three phones.

Then he was asked to join a small team of specialists to fly aboard the USS Kidd, a destroyer working off the coast of El Salvador with a third of its crew infected with the deadly virus. This was in the immediate wake of the highly publicized outbreak aboard the aircraft carrier USS Theodore Roosevelt.

“The virus caused the Kidd to return to port,” said Wilcox, who flew aboard the floating hot spot within a day of being notified. “So, it had effects not just on hospitals back in [the continental United States], but it affected our ability to remain operationally deployed. We had to race back to San Diego before things got out of control.”

The collective response to the pandemic underscored the MHS reputation for innovation, with practical applications beyond military medicine.

Image of Ms. Connell in hospital dress, wearing a mask
Army civilian Raven Connell is a registered nurse who was a member of the initial team that established Blanchfield Army Community Hospital’s COVID-19 Clinic earlier this year. (U.S. Army photo by Maria Yager)

Being nimble in the face of calamity “continues a long history of military medicine,” said Army Sgt. Major Esteban Alvarado, a senior enlisted leader at the Defense Health Agency. “The next year will continue to present challenges, and things will be a little different than we are used to. I have no doubt that the MHS team will continue to innovate, adapt and overcome in order to meet the mission.”

Wilcox barely had enough time to quarantine from the Kidd before being selected for special deployment to the USS Ronald Reagan, an aircraft carrier in the Pacific that was looking to avoid the kind of trouble the Roosevelt experienced. His team included an internist, a critical care nurse, a respiratory therapist, an environmental health officer, and a microbiologist.

“Once the virus was onboard, we had to innovate in a way to re-establish the bubble on a ship without just going into port like the Teddy Roosevelt did,” he said. “We found a way to test the entire crew, twice.”

Wilcox and his teammates worked for 20 days at sea to bring the USS Ronald Reagan around.

“It was very challenging,” he said.

Re-invention of daily care at Ft. Campbell meant creating an outdoor and drive-through COVID clinic, with testing and triage, one that will be operating for the foreseeable future. But the usual MHS priority of military readiness did not take a back seat.

“When COVID hit, we’ve got two primary missions,” recalled Connell, who previously served as an active duty Army nurse. “Once we started getting that solid foundation for testing, evaluating, and treating patients with COVID, we had to formulate a plan to be able to still get active duty [troops] back in training. It was a large collaborative effort for Ft. Campbell to find out how we were going to get those missions to function simultaneously.”

This battle in 2020 was also unique in the way in which America’s men and women in uniform — active duty, Reserve and National Guard — worked in tandem with civilian colleagues in fighting a common enemy. The uniform was often simply a gown and tended to be powder blue or white. In lieu of helmets, COVID-19 fighters donned goggles, medical gloves, surgical masks, and N95 respirators.

For MHS professionals at all levels, working from home has rarely been an option. And while the recent news of vaccines that have proven effective in trials has been welcome, it won’t affect the short-term daily mission. “Business as usual” is a moving target.

“I have never been prouder to be a MHS professional in a collectively dynamic and inspiring team,” said Air Force Tech. Sgt. Christina Pyeatt, an independent duty medic with the 90th Ground Combat Training Squadron at Camp Guernsey, Wyoming.

“Our Reserve and National Guard brethren have deployed to assist us with our operations as well as to other hard-hit states across the country.”

A collective effort sounds right to Raven Connell.

“In both civilian and military medicine, I think we’re all trying to figure out what that’s going to look like, because it’s becoming very apparent that [COVID-19 is] not really going anywhere anytime soon,” she said. “So, we’re trying to figure out what the new norm is going to be, and that’s a huge undertaking.”

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