WASHINGTON—The DoD is throwing the weight and experience of the U.S. military into the fight against the novel coronavirus. Navy ships, Army troops, Air Force cargo planes, National Guardsmen and Reserve forces are all being tapped to battle the invisible enemy: SARS-CoV-2, the pathogen that causes coronavirus disease 2019, or COVID-19.

New York Army National Guard Soldiers with the 133rd Composite Supply Company assemble a cot at the Jacob K. Javits Convention Center in New York City. The convention center will be an alternate care site to ease the bed shortage of New York hospitals related to the COVID-19 outbreak. Photo by Senior Airman Sean Madden

While the DoD positions forces to assist civilian hospitals, state governments and others to prepare for and respond to the pandemic, the Defense Health Agency faced an increasing internal challenge.

Daily call volume to the Military Health System nurse advice line quintupled in March from normal levels, providing an early alert of trouble on the way. The line took a minimum of 8,000 calls per day in March, with many days exceeding 10,000 calls, according to Ronald Place, MD, director of the DHA.

At least 38 sailors on the USS Theodore Roosevelt had been diagnosed with the coronavirus by March 30, up from just three a week earlier. At the time of publication, the ship was indefinitely docked in Guam as cases continued to rise. Acting Navy Secretary Thomas Modly said the ship could test 200 sailors per day. With 5,000 on board, determining which sailors have COVID-19 could take weeks.

Reports of two sailors testing positive on the USS Ronald Reagan on March 27 could not be confirmed at press time, as the DoD adopted a policy of not disclosing specific installations and ships affected by the coronavirus to avoid revealing operational or readiness details of units.

At the time of the ban on revealing location data, 80 servicemembers in Stuttgart, Germany, had COVID-19. Coronavirus cases among military forces in Japan prompted a shelter-in-place order. Cases among contractors and servicemembers in South Korea led Gen. Robert Abrams, the top U.S. commander on the peninsula to declare a public health emergency and adopt measures calling for minimum staffing and shelter in place.

U.S. Forces Korea issued #KILLtheVirus Principles that called for treating the coronavirus like a “combat operation,” including “check the formation for insurgents,” “execute with speed and violence of action” and “protect the force to protect the mission.” The principles were backed with serious consequences, with the Eighth Army posting on Twitter and elsewhere General Officer Article 15 actions taken against soldiers for violating the public health guidance. Punishment included reduction in rank, forfeiture of pay for two months, 45-day restriction, 45-day extra duty and written reprimands.

At the end of March, the DoD reported 652 confirmed COVID-19 cases within the department, including 343 active duty servicemembers and two deaths, a contractor and military dependent.

With the nation also looking for support from the DoD, the agency’s crisis action team has been planning ways to manage patient care, equipment demand, blood supply and other demands on DoD capabilities. The team has evaluated “bed space, military health capabilities and capacity, the trade-offs of shifting resources from one need to another, assisting people with self-screening, triage and testing of patients,” Place said.

To prepare for increased demand as cases rise, “I’ve directed doctors and nurses and staff physicians to shift responsibilities for clinical patient care as much as possible. We’re looking at how our clinics and hospitals might be able to surge bed space that isn’t currently being used for patient care,” he added. The DoD also deferred all elective medical and dental procedures.

 Navy Ships on Site

The hospital ship USNS Mercy began treating patients in Los Angeles on March 30. The ship will provide a full range of care for non-COVID-19 patients, including general surgeries, critical care and ward care for adults, to relieve pressure on local hospitals and allow them to expand intensive care units for coronavirus patients. Staff from 22 Navy commands and 70 civil service mariners will keep the Mercy Military Treatment Facility running, the DoD said.

The hospital ship USNS Comfort began treating patients in New York on March 31 with a crew of more than 1,200. Like the Mercy, the Comfort will handle trauma cases and other emergencies, surgeries and non-coronavirus care. The ship is “acting as a relief valve for other urgent needs, freeing New York’s hospitals and medical professionals to focus on the pandemic,” said Rear Adm. John Mustin, vice commander, U.S. Fleet Forces Command.

“The last time that this great hospital ship was here was in the wake of 9/11, where she served as respite and comfort for our first responders working around the clock,” said Mustin. “Our message to New Yorkers–now your Navy has returned, and we are with you, committed in this fight.”

“For several weeks, the Department of Defense has been surging personnel, capabilities and equipment to help slow the spread of the virus,” said Secretary of Defense Mark Esper. “Thousands of National Guard troops are mobilized across the country conducting a variety of essential tasks ranging from planning to logistics to medical support.”

Guard members in all 50 states, three territories and the District of Columbia have been activated. New York called on the Guard to prepare the Jacob Javits Convention Center for use as a 1,000-bed hospital. California has deployed some members of the Guard to establish a mobile pharmacy, while doctors, nurses and therapists within the Guard ranks are staffing temporary medical facilities.

In Louisiana, guardsmen staffed drive-through testing sites and provided medical and engineering support to the state. In Ohio, the National Guard distributed food and essentials to vulnerable community members. Members in Michigan provided intelligence and logistical support to the state’s emergency operations center.

“We are using every tool available to get through this national crisis as fast as possible and get our great American economic juggernaut back to work,” said Air Force Gen. Joseph Lengyel, chief of the National Guard Bureau. “COVID-19 is the most immediate threat facing our nation, and the virus knows no state boundaries. What the National Guard is doing in the states is part of a nationwide war on the coronavirus.”

 Field Hospitals in NYC

The Army deployed two field hospitals to New York City that began seeing non-COVID-19 patients on March 30. Six Hundred soldiers from the 531^st Army Hospital at Fort Campbell, KY, and the 9^th Army Hospital at Fort Hood, TX, will support staffing needs for the facilities. Another 300 soldiers from the 627^th Army Hospital at Fort Carson, CO, deployed to Seattle to serve patients in a field hospital there.

The Army Corps of Engineers had operations in all states and territories, as well, as it assisted the Federal Emergency Management Agency and states with site assessments and construction of emergency medical facilities.

The Army Medical Research and Development Command and the Army Medical Research Institute of Infectious Diseases have been working on five different potential COVID-19 vaccines and monitoring several dozen other vaccine candidates in development by other groups, according to Army Chief of Staff Gen. James McConville.

On March 27, President Donald Trump issued an executive order enabling the call up of up to one million members of the National Guard, Reserves and Individual Ready Reservists for up to 24 consecutive months.

The following day, U.S. Army North (Fifth Army), based at Fort Sam Houston, TX, requested additional units, totaling 800 people, to provide medical, planning, communication, transportation and logistics support to civil authorities during the pandemic. U.S. Army North is the component of the U.S. Northern Command focused on DoD operations within the U.S.

“I have requested this additional deployment to further expand the use of our military capabilities, in support of FEMA, to the communities which need us most,” said Lt. Gen. Laura Richardson, commander, U.S. Army North. In addition to several National Guard units, the request called up Reserve units in San Antonio, Texas; New Orleans; and Salt Lake City as well as units from Virginia, North Carolina, Colorado and Georgia.