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Federal health care providers are on the ground in Texas, Alabama, Louisiana, and Mississippi

Last summer, a team of US Department of Veterans Affairs (VA) health care professionals deployed to Alabama’s Bill Nichols State Veterans Home to help during the COVID-19 crisis. They were there as part of the “Fourth Mission”—supporting national, state, and local emergency management, public health, safety and homeland security efforts. “It was a really humbling experience,” said Mary Holloway, an RN with the Birmingham VA Health Care System. “Seeing the dedication of the staff there, some coming back to work after recovering from COVID themselves, was inspiring.”

But that turned out to be only one battle in a sadly long and drawn-out war. Since March 2020, more than 5,000 military medical personnel have deployed to 14 states and the Navajo Nation, 51 cities, 71 hospitals, all struggling to keep their heads above a cresting tsunami of new COVID patients.

Last year, the crisis spots for deployments included major metropolitan areas in coastal states: New York, California, and New Jersey. The urgency now is in the Southern states. Those tend to be reporting the highest numbers of new cases and deaths. Alabama, Arkansas, Florida, Louisiana, and Mississippi, for example, have all ranked among the highest rates of cases and hospitalizations per 100,000 people across the country in the last seven days.

This year, military teams have also deployed to support vaccination centers in 25 states and 42 cities. Nearly all—97%—of the new COVID patients in recent months are unvaccinated. And, again, they predominate in Southern states. In Alabama, for instance, only 37% of the population are fully vaccinated. In Louisiana, that number is 40%.

The at-risk states also tend to be the ones that are rapidly running out of space to put the patients in, ICU or otherwise. Where patients who might have been in the intensive care unit (ICU) are housed in the emergency department and in hallways, and where patients without COVID-19 who might have been hospitalized are being turned away. Some Louisiana hospitals, for instance, have been sending patients in ambulances to Texas for care.

These states are at a breaking point. Take Alabama. On August 18, it was “negative 11.” It had 1,568 patients with COVID-19 who needed ICU beds. Only 1,557 beds were available. Patients “may even stay on the regular floor where you’re already stretched for capacity to take care of these people because so many of our staff are out with COVID,” Jeanne Marrazzo, director, Division of Infectious Diseases at the University of Alabama at Birmingham, told a CNN reporter. “It’s really just a domino effect that then clogs up our ERs, clogs up everything else. … It’s a very very tenuous situation.”

The state reported more than 4,000 new cases of COVID-19—“a new high for us,” Marrazzo said. “If you project these numbers out, you can expect that we will at some point, probably around Sept. 1, have at least 5,000 people in our hospitals. If the ratio of people who have to go to the ICU remains stable. That means that probably a third of those people are going to require ICU beds,” she continued. “That is frankly untenable, given the infrastructure, the resources, and really importantly, the staff that we have. I think it is basically apocalyptic. I do not use that word lightly.”

 

 

Thus, the US Defense Department (DoD) must once again rise to a sad and desperate occasion. At the request of Federal Emergency Management Agency and the state of Louisiana, the first of five teams of Navy doctors, nurses, and respiratory therapists were sent last week to Ochsner Lafayette General Medical Center in Lafayette, Louisiana.

The teams, consisting of approximately 20 members each, are coming from throughout the DoD’s universe, including the National Guard. US Army North, under US Northern Command’s oversight, is providing operational command of the active-duty military COVID-19 response. Lt. Gen. Laura J. Richardson, ARNORTH commander, noting that “[t]his is the second time Department of Defense medical assets have deployed to support Louisiana during the pandemic,” calls it a “whole-of-government fight against COVID-19.”

Why Louisiana and Mississippi, with so many states in dire need? “Our joint forces go where FEMA needs us,” Richardson says. “[R]ight now FEMA has determined the military’s unique surge capabilities are most needed in these two states.”

In a press briefing at the time, Pentagon Press Secretary Rear Adm. John Kirby said, “We expect that there could be additional requests from other states for other teams, so that’s why we’re being prepared to stand up five teams.” He was right: An Air Force team has now headed to Our Lady of the Lake Regional Medical Center in Baton Rouge. Mississippi also asked for assistance; an Air Force team will be supporting at University of Mississippi Medical Center in Jackson, and an Army team at North Mississippi Medical Center-Tupelo. 

The support will likely include bolstering and extending the infrastructure. From July to December 2020, the Veterans Health Administration (VHA) Emergency Management Coordination Cell delivered Fold-Out Rigid Temporary Shelters (FORTS), C-FORTS (clinics), mobile ICUs and isolation units to locations across the US, such as North Chicago, El Paso, and Oklahoma City. In 2021, they’ll be needed in more hospitals unprepared to house the spiking numbers of patients. Some Louisiana hospitals, for instance, have been sending patients in ambulances to Texas for care.

The first go-round with COVID taught hard lessons that can help hone the Fourth Mission responses. One lesson, according to the VHA COVID-19 Response Report- Annex A, published this May, was the need to conduct due diligence, to be both efficient and effective. VHA, it says, now works to determine actual need before deploying resources. “For example, VHA might receive a request from a [State Veterans Home] for 50 RNs. But once VHA delved into the request and worked with the associated VISNs, it would find that 20 RNs or 10 LPNs could meet the needs of the request.”

Meeting the requests is, for the beleaguered hospitals, like answering letters to Santa. When the team of doctors, nurses, and respiratory therapists arrived at Ochsner Lafayette General Medical Center (OLGMC) last week the hospital staff greeted them with cheers and applause.

 

 

OLGMC CEO Al Patin said, "We're already in a nursing shortage, coupled with high numbers of this pandemic [which] creates a situation where we need additional support. We have patients boarding in our emergency rooms, patients in our ICU setting that can't transition out. That creates a bottleneck and does not allow us to continue to take in patients from our community."

That day, OLG posted on Twitter:

“Today, we received some much-needed assistance in the fight against COVID-19. Our team at Ochsner Lafayette General Medical Center is being expanded by four doctors, 14 nurses and two respiratory therapists – all highly trained personnel on loan from the U.S. Navy.

“These healthcare professionals are being onboarded in our facility today and are specially trained for the emergency department, ICU and Med Surg. Because of them, we’ll be able to staff an additional 16-18 beds – beds sorely needed as cases continue to rise in our area.

“We requested support from the Federal Emergency Management Agency and we were one of five U.S. cities to receive it.. We are most grateful and humbled.”

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Federal health care providers are on the ground in Texas, Alabama, Louisiana, and Mississippi
Federal health care providers are on the ground in Texas, Alabama, Louisiana, and Mississippi

Last summer, a team of US Department of Veterans Affairs (VA) health care professionals deployed to Alabama’s Bill Nichols State Veterans Home to help during the COVID-19 crisis. They were there as part of the “Fourth Mission”—supporting national, state, and local emergency management, public health, safety and homeland security efforts. “It was a really humbling experience,” said Mary Holloway, an RN with the Birmingham VA Health Care System. “Seeing the dedication of the staff there, some coming back to work after recovering from COVID themselves, was inspiring.”

But that turned out to be only one battle in a sadly long and drawn-out war. Since March 2020, more than 5,000 military medical personnel have deployed to 14 states and the Navajo Nation, 51 cities, 71 hospitals, all struggling to keep their heads above a cresting tsunami of new COVID patients.

Last year, the crisis spots for deployments included major metropolitan areas in coastal states: New York, California, and New Jersey. The urgency now is in the Southern states. Those tend to be reporting the highest numbers of new cases and deaths. Alabama, Arkansas, Florida, Louisiana, and Mississippi, for example, have all ranked among the highest rates of cases and hospitalizations per 100,000 people across the country in the last seven days.

This year, military teams have also deployed to support vaccination centers in 25 states and 42 cities. Nearly all—97%—of the new COVID patients in recent months are unvaccinated. And, again, they predominate in Southern states. In Alabama, for instance, only 37% of the population are fully vaccinated. In Louisiana, that number is 40%.

The at-risk states also tend to be the ones that are rapidly running out of space to put the patients in, ICU or otherwise. Where patients who might have been in the intensive care unit (ICU) are housed in the emergency department and in hallways, and where patients without COVID-19 who might have been hospitalized are being turned away. Some Louisiana hospitals, for instance, have been sending patients in ambulances to Texas for care.

These states are at a breaking point. Take Alabama. On August 18, it was “negative 11.” It had 1,568 patients with COVID-19 who needed ICU beds. Only 1,557 beds were available. Patients “may even stay on the regular floor where you’re already stretched for capacity to take care of these people because so many of our staff are out with COVID,” Jeanne Marrazzo, director, Division of Infectious Diseases at the University of Alabama at Birmingham, told a CNN reporter. “It’s really just a domino effect that then clogs up our ERs, clogs up everything else. … It’s a very very tenuous situation.”

The state reported more than 4,000 new cases of COVID-19—“a new high for us,” Marrazzo said. “If you project these numbers out, you can expect that we will at some point, probably around Sept. 1, have at least 5,000 people in our hospitals. If the ratio of people who have to go to the ICU remains stable. That means that probably a third of those people are going to require ICU beds,” she continued. “That is frankly untenable, given the infrastructure, the resources, and really importantly, the staff that we have. I think it is basically apocalyptic. I do not use that word lightly.”

 

 

Thus, the US Defense Department (DoD) must once again rise to a sad and desperate occasion. At the request of Federal Emergency Management Agency and the state of Louisiana, the first of five teams of Navy doctors, nurses, and respiratory therapists were sent last week to Ochsner Lafayette General Medical Center in Lafayette, Louisiana.

The teams, consisting of approximately 20 members each, are coming from throughout the DoD’s universe, including the National Guard. US Army North, under US Northern Command’s oversight, is providing operational command of the active-duty military COVID-19 response. Lt. Gen. Laura J. Richardson, ARNORTH commander, noting that “[t]his is the second time Department of Defense medical assets have deployed to support Louisiana during the pandemic,” calls it a “whole-of-government fight against COVID-19.”

Why Louisiana and Mississippi, with so many states in dire need? “Our joint forces go where FEMA needs us,” Richardson says. “[R]ight now FEMA has determined the military’s unique surge capabilities are most needed in these two states.”

In a press briefing at the time, Pentagon Press Secretary Rear Adm. John Kirby said, “We expect that there could be additional requests from other states for other teams, so that’s why we’re being prepared to stand up five teams.” He was right: An Air Force team has now headed to Our Lady of the Lake Regional Medical Center in Baton Rouge. Mississippi also asked for assistance; an Air Force team will be supporting at University of Mississippi Medical Center in Jackson, and an Army team at North Mississippi Medical Center-Tupelo. 

The support will likely include bolstering and extending the infrastructure. From July to December 2020, the Veterans Health Administration (VHA) Emergency Management Coordination Cell delivered Fold-Out Rigid Temporary Shelters (FORTS), C-FORTS (clinics), mobile ICUs and isolation units to locations across the US, such as North Chicago, El Paso, and Oklahoma City. In 2021, they’ll be needed in more hospitals unprepared to house the spiking numbers of patients. Some Louisiana hospitals, for instance, have been sending patients in ambulances to Texas for care.

The first go-round with COVID taught hard lessons that can help hone the Fourth Mission responses. One lesson, according to the VHA COVID-19 Response Report- Annex A, published this May, was the need to conduct due diligence, to be both efficient and effective. VHA, it says, now works to determine actual need before deploying resources. “For example, VHA might receive a request from a [State Veterans Home] for 50 RNs. But once VHA delved into the request and worked with the associated VISNs, it would find that 20 RNs or 10 LPNs could meet the needs of the request.”

Meeting the requests is, for the beleaguered hospitals, like answering letters to Santa. When the team of doctors, nurses, and respiratory therapists arrived at Ochsner Lafayette General Medical Center (OLGMC) last week the hospital staff greeted them with cheers and applause.

 

 

OLGMC CEO Al Patin said, "We're already in a nursing shortage, coupled with high numbers of this pandemic [which] creates a situation where we need additional support. We have patients boarding in our emergency rooms, patients in our ICU setting that can't transition out. That creates a bottleneck and does not allow us to continue to take in patients from our community."

That day, OLG posted on Twitter:

“Today, we received some much-needed assistance in the fight against COVID-19. Our team at Ochsner Lafayette General Medical Center is being expanded by four doctors, 14 nurses and two respiratory therapists – all highly trained personnel on loan from the U.S. Navy.

“These healthcare professionals are being onboarded in our facility today and are specially trained for the emergency department, ICU and Med Surg. Because of them, we’ll be able to staff an additional 16-18 beds – beds sorely needed as cases continue to rise in our area.

“We requested support from the Federal Emergency Management Agency and we were one of five U.S. cities to receive it.. We are most grateful and humbled.”

Last summer, a team of US Department of Veterans Affairs (VA) health care professionals deployed to Alabama’s Bill Nichols State Veterans Home to help during the COVID-19 crisis. They were there as part of the “Fourth Mission”—supporting national, state, and local emergency management, public health, safety and homeland security efforts. “It was a really humbling experience,” said Mary Holloway, an RN with the Birmingham VA Health Care System. “Seeing the dedication of the staff there, some coming back to work after recovering from COVID themselves, was inspiring.”

But that turned out to be only one battle in a sadly long and drawn-out war. Since March 2020, more than 5,000 military medical personnel have deployed to 14 states and the Navajo Nation, 51 cities, 71 hospitals, all struggling to keep their heads above a cresting tsunami of new COVID patients.

Last year, the crisis spots for deployments included major metropolitan areas in coastal states: New York, California, and New Jersey. The urgency now is in the Southern states. Those tend to be reporting the highest numbers of new cases and deaths. Alabama, Arkansas, Florida, Louisiana, and Mississippi, for example, have all ranked among the highest rates of cases and hospitalizations per 100,000 people across the country in the last seven days.

This year, military teams have also deployed to support vaccination centers in 25 states and 42 cities. Nearly all—97%—of the new COVID patients in recent months are unvaccinated. And, again, they predominate in Southern states. In Alabama, for instance, only 37% of the population are fully vaccinated. In Louisiana, that number is 40%.

The at-risk states also tend to be the ones that are rapidly running out of space to put the patients in, ICU or otherwise. Where patients who might have been in the intensive care unit (ICU) are housed in the emergency department and in hallways, and where patients without COVID-19 who might have been hospitalized are being turned away. Some Louisiana hospitals, for instance, have been sending patients in ambulances to Texas for care.

These states are at a breaking point. Take Alabama. On August 18, it was “negative 11.” It had 1,568 patients with COVID-19 who needed ICU beds. Only 1,557 beds were available. Patients “may even stay on the regular floor where you’re already stretched for capacity to take care of these people because so many of our staff are out with COVID,” Jeanne Marrazzo, director, Division of Infectious Diseases at the University of Alabama at Birmingham, told a CNN reporter. “It’s really just a domino effect that then clogs up our ERs, clogs up everything else. … It’s a very very tenuous situation.”

The state reported more than 4,000 new cases of COVID-19—“a new high for us,” Marrazzo said. “If you project these numbers out, you can expect that we will at some point, probably around Sept. 1, have at least 5,000 people in our hospitals. If the ratio of people who have to go to the ICU remains stable. That means that probably a third of those people are going to require ICU beds,” she continued. “That is frankly untenable, given the infrastructure, the resources, and really importantly, the staff that we have. I think it is basically apocalyptic. I do not use that word lightly.”

 

 

Thus, the US Defense Department (DoD) must once again rise to a sad and desperate occasion. At the request of Federal Emergency Management Agency and the state of Louisiana, the first of five teams of Navy doctors, nurses, and respiratory therapists were sent last week to Ochsner Lafayette General Medical Center in Lafayette, Louisiana.

The teams, consisting of approximately 20 members each, are coming from throughout the DoD’s universe, including the National Guard. US Army North, under US Northern Command’s oversight, is providing operational command of the active-duty military COVID-19 response. Lt. Gen. Laura J. Richardson, ARNORTH commander, noting that “[t]his is the second time Department of Defense medical assets have deployed to support Louisiana during the pandemic,” calls it a “whole-of-government fight against COVID-19.”

Why Louisiana and Mississippi, with so many states in dire need? “Our joint forces go where FEMA needs us,” Richardson says. “[R]ight now FEMA has determined the military’s unique surge capabilities are most needed in these two states.”

In a press briefing at the time, Pentagon Press Secretary Rear Adm. John Kirby said, “We expect that there could be additional requests from other states for other teams, so that’s why we’re being prepared to stand up five teams.” He was right: An Air Force team has now headed to Our Lady of the Lake Regional Medical Center in Baton Rouge. Mississippi also asked for assistance; an Air Force team will be supporting at University of Mississippi Medical Center in Jackson, and an Army team at North Mississippi Medical Center-Tupelo. 

The support will likely include bolstering and extending the infrastructure. From July to December 2020, the Veterans Health Administration (VHA) Emergency Management Coordination Cell delivered Fold-Out Rigid Temporary Shelters (FORTS), C-FORTS (clinics), mobile ICUs and isolation units to locations across the US, such as North Chicago, El Paso, and Oklahoma City. In 2021, they’ll be needed in more hospitals unprepared to house the spiking numbers of patients. Some Louisiana hospitals, for instance, have been sending patients in ambulances to Texas for care.

The first go-round with COVID taught hard lessons that can help hone the Fourth Mission responses. One lesson, according to the VHA COVID-19 Response Report- Annex A, published this May, was the need to conduct due diligence, to be both efficient and effective. VHA, it says, now works to determine actual need before deploying resources. “For example, VHA might receive a request from a [State Veterans Home] for 50 RNs. But once VHA delved into the request and worked with the associated VISNs, it would find that 20 RNs or 10 LPNs could meet the needs of the request.”

Meeting the requests is, for the beleaguered hospitals, like answering letters to Santa. When the team of doctors, nurses, and respiratory therapists arrived at Ochsner Lafayette General Medical Center (OLGMC) last week the hospital staff greeted them with cheers and applause.

 

 

OLGMC CEO Al Patin said, "We're already in a nursing shortage, coupled with high numbers of this pandemic [which] creates a situation where we need additional support. We have patients boarding in our emergency rooms, patients in our ICU setting that can't transition out. That creates a bottleneck and does not allow us to continue to take in patients from our community."

That day, OLG posted on Twitter:

“Today, we received some much-needed assistance in the fight against COVID-19. Our team at Ochsner Lafayette General Medical Center is being expanded by four doctors, 14 nurses and two respiratory therapists – all highly trained personnel on loan from the U.S. Navy.

“These healthcare professionals are being onboarded in our facility today and are specially trained for the emergency department, ICU and Med Surg. Because of them, we’ll be able to staff an additional 16-18 beds – beds sorely needed as cases continue to rise in our area.

“We requested support from the Federal Emergency Management Agency and we were one of five U.S. cities to receive it.. We are most grateful and humbled.”

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