Courtesy Photo | On April 12, members of the Navy Expeditionary Medical Support Command Expeditionary...... read more read more
Months before a United States Navy aircraft carrier pulls into a foreign port, a multitude of systems are activated to ensure the appropriate amount of space is available. Not just for the ship, but also for the thousands of Sailors who immerse themselves in the local communities. To accommodate crews from the carrier and ships accompanying the carrier, the host nation must prepare for the influx of visitors.
Local vendors hire additional staff, ground transportation units are increased, hotel vacancies are managed to ensure rooms are available, cleaning staffs are increased, more food is ordered, and practically everything imaginable is planned, stocked and prepared prior to their guests’ arrival.
That was the case when USS Theodore Roosevelt (CVN 71) and USS Bunker Hill (CG 52) visited the Central Vietnamese city of Da Nang in March 2020. The city extended a hearty welcome to the officers and crew of the ships. Published reports documented that Sailors from both ships participated in cultural exchanges and community service projects. One professional exchange focused on cooperating on infectious disease prevention. (US Indo-Pacific Command).
After Roosevelt departed Vietnam, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the COVID-19 pandemic, was detected on the carrier while she was at sea. Affected members of the crew were evacuated and the ship was ordered to Naval Base Guam. For two months, the ship remained pier side with practically its entire crew cycled through the 14-day quarantine on shore before being allowed to return to the ship.
But the ship and Naval Base Guam faced an immediate challenge - where to provide medical screening for nearly 5,000 Sailors, of which, hundreds had already tested positive for COVID-19.
As it turned out, the United States Navy already had an asset in its inventory with the capability to respond to such a cause and it is specially equipped to handle this exact type of mission.
Navy Expeditionary Medical Support Command (NEMSCOM), Williamsburg, Va., is responsible for building and maintaining rapidly deployable medical systems to support contingency operations, humanitarian assistance, and real-world events and exercises around the globe. In order to address emerging requirements more responsively, Navy Medicine transformed the legacy Fleet Hospitals into more agile, flexible, scalable, modular Expeditionary Medical Facilities (EMF) to support the full range of military operations.
“We were first alerted to the possibility of activating an EMF in March. We anticipated a warning order to deploy the USNS Mercy (T-AH-19), the USNS Comfort (T-AH-20), and an EMF for the Guam mission to support the USS Theodore Roosevelt,” said NEMSCOM’s Commanding Officer, Capt. Robert C. Morrison, “It was anticipated that EMF capabilities would be set up somewhere in the continental United States to support COVID-19.”
The pandemic became a widespread health emergency throughout the world with USS Roosevelt reporting rampant COVID-19 cases. That was when the EMF activation in Guam became imminent. NEMSCOM personnel were poised to take immediate action.
“By April 12, the EMF Activation Team (EMFAT) was on a Navy Air Logistics Office flight to Guam, and the local military forces in Guam were pulling the containers off of the USNS Dahl (T-AKR-312) prepositioning program ship. That is how rapid the response was for on-island medical infrastructure support in response to the pandemic,” Morrison said.
Further explaining aspects of the logistics effort, one subject matter expert discussed the size, cost and manpower requirements to support the evolution that was underway to provide assistance to COVID-19 patients.
“NEMSCOM worked as a team to ensure that the push blocks of medical materials were provided expeditiously to Guam so that the EMF received the critical supplies to get the hospital up and running,” said NEMSCOM’s Executive Officer, Cmdr. Janine Espinal. “There were time sensitive deadlines to get the materials ordered and shipped quickly.”
The team worked tirelessly placing urgent orders, packing over 15,500 pieces of push block material worth more than $2 million, and coordinating numerous priority shipments and flights to ensure all required material arrived onsite to get the job done.
“Push block materials consist of medical surgical consumables, pharmaceuticals, hazmat and information technology equipment for internal communications. These items are not pre-positioned like the other EMF assets due to their shelf life and the rapid changes in IT technology,” explained NEMSCOM’s EMFAT Officer in Charge, Lt. Brian Howard. “Only 60 percent of what is required for a 150 bed EMF is pre-positioned. That is a common misunderstanding. The remaining 40 percent of material comprise the push block which is sent out upon activation.”
The amount of coordination required to complete this massive undertaking was tremendous. Moving that amount of stored material across the globe, sometimes with little to no infrastructure in place, would typically be a daunting task. But NEMSCOM is well positioned as the one-stop, Navy asset that houses and manages the logistics expertise necessary to accomplish this mission.
“There were a host of logistical challenges associated with the activation of such a large platform. Luckily, the activation occurred in Guam with some on-island resources, onsite military installations and air terminals, less complications due to customs clearance, and close proximity of the activation site to the receiving air terminal,” Howard said.
In a telephone interview, he went on to say, one of the most incredible aspects of this entire evolution is that amount of time it took to set this up. Normally, it would take months considering the pre-planning, the shipping the logistics and everything else involved. We set this up in 10 days.
“Because of the urgent nature of the mission, we worked around the clock to ensure that multiple shipments arrived on-island. As quickly as material could be packed, then transportation was arranged. Material was shipped via multiple methods. Strategic Airlift, Military Channel Flight, Surface (Ship), and FEDEX/DHL were all used to execute the mission,” Howard explained. “Only through the support, collaboration and assistance of United States Fleet Forces Joint Operation Planning and Execution Planners, Load Masters, United States Pacific Fleet Planners, Army Materiel Command personnel, United States Transportation Command and the United States Army Surface Deployment and Distribution Command, was the material able to successfully be delivered in one third of the normal time.”
Because of COVID-19, NEMSCOM was encouraged to send a smaller EMFAT than usual. Guam wanted to minimize the number of personnel traveling to the island. There was even discussion of sending no personnel and having the local Seabee Detachment do the complete set up with remote direction from NEMSCOM.
“Once it was determined that the EMFAT expertise was critical to the activation, the seven personnel team was still hampered by the requirement to restrict movement for 14 days and be tested for COVID-19. The EMFAT was determined to get to Guam to ensure the EMF build was successful and was able to successfully navigate the COVID-19 restrictions.” Espinal said.
“Normally, the personnel required to erect an EMF come from NEMSCOM, the Naval Expeditionary Medical Training Institute, a Construction Battalion Maintenance Unit (CBMU), and the deployed EMF Hospital Staff. In this instance, the build received significant support from Naval Mobile Construction Battalion 5 Detachment already on island,” Howard said. “That support was beneficial since the COVID-19 restriction of movement delayed support normally provided by the CBMU 303 and the hospital staff.”
Furthermore, as noted previously, the set-up of the EMF on site to meet expected timeframes was a challenge. The production and delivery of the push block material that was critical to attaining Full Operational Capability (FOC) to meet required timeframes was another logistical challenge. The EMFAT was enthusiastic to meet the challenges and worked together to achieve the mission and erect the EMF within the required timeline.
“Normally the EMF has 90 days to acquire, produce and transport push block material. Due to the urgent nature of this mission, a period of roughly 30 days was allotted,” Howard said. “It is amazing that in one third of the time, 94 percent of the push block material was provided. The EMF as a whole had 98.8 percent of the material requirement fulfilled.”
Morrison explained how the urgent nature of this mission and many other missions they complete are managed by his team of diverse professionals; and this fuels their passion.
“NEMSCOM is in the business of saving lives. We accomplish that mission by building and maintaining rapidly deployable medical systems to support contingency operations, humanitarian assistance, and real-world events and exercise around the globe. Our staff consists of Active Duty, Government Service Civilians, and a team of dedicated contractors who embodies the idea of strength through diversity,” Morrison said. “This diversity is made up of the individual subject matter experts who possess unique skills sets required to accomplish the mission. This diversity allows NEMSCOM to be the most capable and adept command within the Department of Defense in regards to the design, production, and delivery of deployable medical capabilities.”
Given a chance to speak with Combatant Commanders, he had a specific message that they should know about NEMSCOM’s capabilities and how it can help them further achieve their mission requirements.
“NEMSCOM understands the evolving nature of mission requirements and that various Combatant Commanders have unique requirements for their Areas of Responsibility with respect to the products that NEMSCOM can provide. Requirements for CENTCOM differ from those of EUCOM/AFRICOM and those of PACOM. NEMSCOM is ready to continue to adapt to these differing mission requirements. We are already taking steps to better support more rapid deployment capability,” Morrison said. “However, NEMSCOM would like to open up discussions and opportunities (once available) for representatives from the various Combatant Command’s to meet at NEMSCOM to shape the future requirements, improvements and planning with NEMSCOM/BUMED personnel.”
Considering how NEMSCOM completed the requirements they faced in the midst of a real-world, global pandemic, Espinal expressed her pride and gratitude for the team and its highly successful mission.
“The highlight of this evolution was working collaboratively with key stakeholders in Guam to include the EMFAT team. It was rewarding to know that the EMF set-up would be assisting USS THEODORE ROOSEVELT Sailors in the COVID-19 recovery process,” she said.
For more information about NEMSCOM, visit their homepage by clicking on the following link https://www.med.navy.mil/sites/nemscom/Pages/Gallery.html.
| Date Taken: | 04.29.2020 |
| Date Posted: | 08.03.2020 16:34 |
| Story ID: | 375184 |
| Location: | GU |
| Web Views: | 653 |
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