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March 19, 2020

How the VA, the Defense Department, and other agencies are gearing up for coronavirus response

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    The Trump administration on Tuesday directed multiple federal agencies to prepare to mount a wide-ranging government response to the new coronavirus pandemic.

    Today at 1 p.m. ET: Where the coronavirus outbreak stands now

    COVID-19 in the US

    As of Thursday morning, state and federal officials had reported 10,201 cases of COVID-19—up from 5,881 reported cases on Wednesday. Officials as of Thursday morning also had reported 149 deaths linked to the new coronavirus in the United States, up from 107 on Wednesday. However, state and local officials say it's likely the actual number of Americans with COVID-19 is drastically higher than what's been reported so far because testing kits for the new coronavirus have been scarce in the United States.

    A report released Tuesday by Imperial College London estimated that, without action by the government and individuals to curb the new coronavirus' spread, as many as 2.2 million Americans could die from the virus. The researchers said the United States would need to implement stringent restrictions on social gatherings, school, and work across the entire country until a vaccine for the virus is available—which could take up to 18 months—to control the outbreak.

    HHS in an internal report obtained by the New York Times also has projected the United States' COVID-19 outbreak could "last 18 months or longer" and called for a coordinated response by the federal government.

    DOD offers equipment, guidance to help support US response

    According to the Wall Street Journal, Department of Defense (DOD) Secretary Mark Esper on Tuesday said the U.S. military is preparing to help with the country's coronavirus response where possible.

    For example, Esper said DOD is ready to open as many as 16 labs for civilian COVID-19 testing. In addition, DOD will make five million N95 facemasks available to HHS, including one million that should be available immediately.

    DOD also is working to provide 2,000 ventilators to hospitals across the country, Esper said. However, Esper noted that the ventilators are not designed for civilian use, meaning the military will need to provide training on how to use the devices, and some of the ventilators are designed for "single-use." As such, he cautioned that the ventilators might not adequately address the dearth of ventilators hospitals may face. "When you look at how many people who may need it, 2,000 doesn't put much of a dent into it," Esper said.

    Further, Vice President Pence on Tuesday announced that the Trump administration will "consider every request from governors" to deploy "field hospitals, or the Army Corps of Engineers" to help increase the country's capacity to treat patients amid the COVID-19 outbreak.

    Trump said the Army Corps of Engineers likely would be deployed in areas with the highest amounts of COVID-19 cases, such as California and New York, The Hill reports.

    DOD is also in talks with state and local leaders to determine a need for field hospitals, according to The Hill. Esper said the field hospitals, which would be located near local hospitals in areas most affected by the new coronavirus, could be designated to treat trauma and other patients who aren't infected with the virus, therefore freeing up hospital capacity for infectious COVID-19 patients.

    In addition, Trump on Wednesday announced that the Navy is preparing to deploy its two hospital ships, Mercy and Comfort, to serve in a similar capacity. Trump said Comfort will be berthed at New York Harbor, while Mercy will be used to treat patients on the West Coast. The Navy in a statement said, "Both ships are currently working to complete scheduled maintenance cycles and identify necessary medical staffing to deploy as soon as possible."

    However, Esper on Tuesday noted that while DOD could supply the ships and field hospitals, medical personnel to staff the facilities might need to come from the private sector—which could cause a shortage of clinicians where they're needed. He said, "What I don't want to do is take reservists from a hospital where they are needed just to put them on a ship somewhere else where they are needed. So we have got to be very conscious of that."

    Esper added that he is prepared to deploy National Guard and Reserve units to assist with medical support and planning, but said he hopes local and state authorities would be the first line of defense against COVID-19. "In some ways we want to be the last resort," Esper said.

    Other agencies awaiting orders for coronavirus response

    Meanwhile, the Department of Veterans Affairs—which is legally designated to serve as a backup to the U.S. health system in a time of crisis—also is preparing its 1,000 outpatient sites and about 170 medical centers to help with the country's coronavirus response efforts if needed. According to the Times, VA's medical centers typically have a surplus of beds, as well as special rooms equipped to treat patients with breathing disorders.

    In addition, the National Disaster Medical System, a system of emergency doctors and nurses that operate through HHS, currently is staffed at multiple locations in the country and has been working to redirect passengers offloaded from cruise ships for quarantine. The group currently is waiting for additional orders on how they can help with the country's response, the Times reports.

    Further, according to the TimesFederal Emergency Management Agency (FEMA) officials as of Tuesday had said they were waiting for orders from HHS on how the agency could ramp up its support for the government's COVID-19 response. "FEMA will continue supporting all states and territories during this dynamic situation," said Lizzie Litzow, a FEMA spokesperson.

    Trump on Wednesday said FEMA "now is fully engaged at the highest levels."

    A FEMA spokesperson said the agency is preparing more than 50 teams to help states and U.S. territories "as they activate their emergency operations centers and address the COVID-19 threat" (Weixel, The Hill, 3/17; Burns, ABC News, 3/17; Ali/Stewart, Reuters, 3/17; Youssef/Lubold, Wall Street Journal, 3/17; Lipton et al., New York Times, 3/17; Kube/Siemaszko, NBC News, 3/18; Naylor, NPR, 3/19).

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