Photo By Tech. Sgt. Sean Madden | New York Army National Guard Soldiers of the 133rd Composite Supply Company, part of...... read more read more
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NEW YORK – Anticipating a tidal wave of COVID-19 patients flooding New York City hospitals, the New York National Guard teamed up with the Army Corps of Engineers, the Federal Emergency Management Agency (FEMA) and dozens of state and city agencies and turned a convention center into an alternative treatment center.
New York established the facility in the expansive Jacob Javits Convention Center on the west side of Manhattan in the course of a week in March, establishing its first 1,000 beds March 27.
New York Governor Andrew M. Cuomo announced the deployment of four federal field hospitals, each with 250 beds, to Javits, utilizing its 1.8 million square feet of space.
"We are doing things we have never done before to find more hospital beds to ensure our healthcare system is not overwhelmed when the apex hits,” Cuomo said March 27 at the Javits Center to inspect the initial work.
“We have a plan in place to get all of these new facilities and beds online in the next three to four weeks, which is the same timeline the apex is expected to hit our state, so when it does eventually hit our hospital capacity will be as high as it can possibly be,” he said.
“We are on a rescue mission to save lives, and I am proud to be on this mission with all the brave men and women of the National Guard, healthcare workers and first responders who are truly doing God's work,” Cuomo said.
The New York National Guard was tasked with establishing the unified command post for the facility reception, staging and integration of what would be 2,700 staff.
A combined task force of New York National Guard members, active duty and reserve medical forces and hundreds of officials from city, state and federal agencies equipped Javits with thousands of beds. Then, over two more weeks equipment and staffing were added to create a complete hospital center to care for coronavirus patients.
“That’s been the biggest challenge, just getting everyone together,” said New York Army National Guard Col. Dennis Deeley, the unified command post incident commander. “Once they’re together, you give them a problem and they’re working, they do a fantastic job.”
On March 19, Cuomo announced that the site would be for non-COVID-19 patients. The plan was to open bed space across city hospitals.
At the same time, the governor directed all hospitals to increase their capacity for patients by 50 percent, to handle expected new admissions as the pandemic spread.
“It’s been a very unique experience to come into this building when there was only ten of us, to meet with the Army Corps of Engineers and to see it transform to the facility it is today,” said Air National Guard Maj. Edward Roden, assigned to the 105th Airlift Wing and serving as the unified command post safety officer.
The sheer number of military and civilian agencies, each with a stake in the medical station operation, was overwhelming, Roden said.
Military forces on site include Army and Air National Guard members, active Army forces, Navy representatives from the USNS Comfort, Marines, Coast Guard sailors and hundreds of reservists from the Army, Air Force and Navy.
“To see all the units come together, different Army, Air Force, HHS (Health and Human Services), FEMA, for them to all work together. It’s pretty impressive,” Roden said.
City hospitals discharged as many non-COVID-19 patients as possible to clear bed space rapidly. So the decision was made to take on convalescing COVID-19 patients.
"The goal post kept moving," Deeley said. "We just had to keep moving the ball forward."
The change meant dramatic upgrades to equipment and staffing needs, Deeley explained.
The 44th Medical Brigade moved equipment into Javits and the state purchased other necessary patient care equipment.
Meanwhile, the unified command went to work to redo the infrastructure needs, said Zachary Iscol, the Deputy Director of Javits Medical Center.
“The team here immediately went to work identifying every possible way to increase our capabilities by sourcing medical equipment like x-rays, sonograms, EKGs, lab equipment, dialysis, and methadone treatment in the hopes that by increasing the acuity of care that could be treated here, the hospitals would have more people to send us,” Iscol said.
But in less than a week, the mission changed again.
Realizing that the coronavirus could rapidly overtake capacity at city hospitals, state officials determined Javits would become the relief valve for COVID-19 care.
The National Guard staff, Army medical leaders and government agencies went back to work.
“We’ve been up and running, we’ve had three significant changes at the level of hospital care we are supposed to give. We got through those, worked through them nights, weekends, everybody pulled together and got it done,” Deeley said.
Javits staff had to establish intensive care beds, isolation wards and all of the logistics, pharmaceutical supplies, staffing stations and medical needs for the needs of a comprehensive coronavirus care facility.
“We had no oxygen on station, no pulse oximeters to measure oxygen,” Iscol said. “We were a low acuity shelter.”
“In less than a week, the team here turned a medical shelter into one of the largest COVID hospitals in the city,” he said.
Javits is an overflow relief valve as a backstop for the efforts at New York City hospitals, Deeley explained.
The mission of keeping supplies and equipment flowing into the facility went to the Soldiers of the Army National Guard’s 133rd Quartermaster Company. These Soldiers had also helped set up the facility.
The unified command post, located upstairs from the treatment floor and run by the Soldiers of the 104th Military Police Battalion, is supporting personnel tracking, operations, logistics, contracts, and building management.
Many of the National Guard Soldiers are city residents, and the mission took on a special meaning for them, explained 1st Lt. James Rucinski, the command post Assistant Personnel Officer.
“I’m a Manhattanite, born and raised,” he said. “I’m proud to be mobilized in my hometown, the epicenter of the whole thing.”
Staffing of the medical station comes primarily from two U.S. Army hospital centers, part of the 44th Medical Brigade based at Fort Bragg, North Carolina.
The 531st Hospital Center from Fort Campbell, Kentucky and the 9th Hospital Center from Fort Hood, Texas have some 600 personnel on site, providing for the care and administration of the treatment floor.
“One of the biggest challenges with setting up the hospital is creating a work environment where multiple agencies, thirty to be exact, could all work together, each with their own chains of command, that all come from their disparate worlds, and they had to work together,” said New York Army National Guard Col. Jamie Green, the unified command post medical liaison officer.
“So we have active duty, we have the National Guard, we have city agencies, state agencies, federal agencies all with their own bosses having to work together to create this place in short order.”
Additional National Guard Soldiers are conducting access control, helping to monitor the thousands of arriving staff each day. They also assist in monitoring the donning and removal of PPE for personnel working with COVID-19 patients in a more controlled environment.
“Javits is a very real success story and what the people here have accomplished in a short amount of time is nothing short of remarkable,” Iscol said.
The entire team rose to meet all sorts of challenges, ranging from backup power generation, N95 fit testing, fire evacuation plans, patient meal contracts, formulary management or fatality management plans and resources, Deeley said.
“We’re all learning as we’re going,” said 1st Lt. Anuraj George, Signal Officer for the 104th Military Police Battalion, who oversees communications and network management for the multi-agency team.
The center was able to take in its first 45 patients April 6. In ten days the number of patients seen at the medical station grew to more than 915 patients.
“The team that came together, that’s FEMA, HHS, the National Guard, active Army, reserve Army, Navy, Air Force, Marines, you name it, everybody is here, all the state agencies, all the local city agencies,” Deeley said.
“It’s been military and civilian, there’s over 500 civilians here right now working with us.” he added.
“Our job was to help alleviate the strain on New York City's hospital system and to give our doctors and nurses a fighting chance,” Iscol said.
A healthcare evacuation coordination team works directly with hospitals to identify patients for transfer to Javits, or alternatively, to the USNS Comfort hospital ship in New York Harbor.
“Working with the Navy and the DoD has been really interesting,” said U.S. Coast Guard Commander Rebecca Albert, part of the patient transfer coordination team. “It’s been real fulfilling,” she said in an April 15 phone call with Coast Guard Commandant Adm. Karl Schultz.
Even as hospitalizations in New York City hospitals reached a plateau of new admissions around April 9, meaning the capacity to provide care was stretched, but did not break.
“You see the flattening of the curve,” Cuomo said April 15, referring to a three-day rolling average of COVID-19 patients. “Net change in hospitalizations, down. That's good news. ICU admissions is down, that's good news. Intubations are down, that's very good news. Just on a real life level.”
"Basically, the health care situation has stabilized," Cuomo said.
"The fears of overwhelming the health care system has not happened, thanks to the phenomenal front line workers,” Cuomo said, “thanks to all the additional capacity that the hospital system created; thanks to the work that our federal government did, Army Corps of Engineers, providing the beds at Javits and Comfort."
"Javits, which is 2,500-bed capacity, is the overflow valve, about 800 people have gone through Javits. So thank you very much," Cuomo said of the military and healthcare officials who operate the station.
Now the goal at Javits is to maintain and improve the care for future needs that might arise.
“Everybody’s efforts, and however many people who have been through here to work, and we just continue to keep making it better and better and taking care of people to take the pressure off the New York City hospital system,” Deeley said.
“That was our goal and that’s what we’re here to do.”
| Date Taken: | 04.17.2020 |
| Date Posted: | 04.17.2020 15:41 |
| Story ID: | 367730 |
| Location: | MANHATTAN, NEW YORK, US |
| Web Views: | 1,425 |
| Downloads: | 0 |
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