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Army Infectious Disease Doctor Aided Guam's COVID-19 Response

May 12, 2020 | BY Lori Newman , Brooke Army Medical Center

An infectious diseases physician from Brooke Army Medical Center at Joint Base San Antonio-Fort Sam Houston, Texas, recently deployed to Guam in support of the aircraft carrier USS Theodore Roosevelt's response to COVID-19.

Sailors disembarking an aircraft carrier.
Leaving Ship
Navy sailors assigned to the aircraft carrier USS Theodore Roosevelt depart the ship to move to off-ship berthing, April 10, 2020. Upon arriving in Guam on March 27, the Theodore Roosevelt established an emergency command center, initiated a roving and deep-cleaning team and continually educated the crew on social distancing and proper protective procedures and behaviors to assist in mitigating and controlling the spread of COVID-19.
Photo By: Navy Petty Officer 1st Class Christopher Liaghat
VIRIN: 200410-N-CH038-1120C

Army Maj. (Dr.) Gadiel Alvarado served as the infectious disease expert for the COVID-19 Public Health Task Force from April 12-22. The team, consisting of five Army officers, was there to perform a comprehensive and multidisciplinary review of processes, assess the situation and help with mitigation plans surrounding the COVID-19 outbreak aboard the ship.

The ship arrived in Guam on March 27 for a scheduled port visit. Prior to its arrival, three sailors tested positive for COVID-19. The Navy has since undertaken an aggressive mitigation plan of isolating, quarantining, and treating affected sailors to keep the ship prepared to execute its mission.

"This population of personnel in close quartered and close proximity living on the USS Theodore Roosevelt represented an increased risk population with high likelihood for COVID-19 infection transmission," Alvarado explained.

Army officer poses for a photo.
Physician Pose
Army Maj. (Dr.) Gadiel Alvarado, an infectious diseases physician, poses for a photo in Guam with the aircraft carrier USS Theodore Roosevelt in the background, April 18, 2020. Alvarado served as the infectious disease expert for the COVID-19 Public Health Task Force from April 12-22. The team, consisting of five Army officers, was there to perform a comprehensive and multidisciplinary review of processes, assess the current situation and help with mitigation plans surrounding the aircraft carrier’s COVID-19 outbreak.
Photo By: Courtesy photo
VIRIN: 200418-A-A4714-1001

The 10-day mission consisted of face-to-face interviews, data gathering, on-site evaluations, discussions and recommendations to the Joint Regions Marinas leadership, working closely with Navy Rear Adm. John Menoni, the Joint Regions Marinas commander, and personnel from the Roosevelt, Navy Base Guam and U.S. Naval Hospital Guam to prevent further transmission of the virus.

"The proper public health decision making and management of personnel was critical to preventing death and disease burden from COVID-19 affecting the sailor population and Guam civilian population," Alvarado said.

Alvarado, a native of Puerto Rico, who completed his infectious diseases fellowship at the Brooke Army Medical Center, relied on his previous training and lessons learned during the medical center's initial preparation and response to COVID-19.

A sailor takes a COVID-19 sample for testing.
Taking Samples
Navy Seaman Hayden Runyon, a medical corpsman assigned to 3rd Medical Battalion, 3rd Marine Logistics Group, takes a sample from aUSS Theodore Roosevelt sailor to be tested for COVID-19, April 20, 2020. Upon arriving in Guam on March 27, the Theodore Roosevelt established an emergency command center, initiated a roving and deep-cleaning team and continually educated the crew on social distancing and proper protective procedures and behaviors to assist in mitigating and controlling the spread of COVID-19.
Photo By: Navy Seaman Apprentice Kaylianna Genier
VIRIN: 200420-N-LH674-1033A

"I was heavily involved with the risk identification and testing procedure planning," he said. "One of my main roles was helping with the tent screening process, and I was also on the inpatient call team for COVID patients. I had already gone through the motions at BAMC."

Alvarado credits his training, Brooke Army Medical Center leaders and being part of the COVID-19 planning efforts early on for his success in this mission.

"It was a very efficient and elaborate operation," he said. "We were a very cohesive team. We all had our own specific skills, and we were able to get the job done. It was amazing."

A sailor cleaning a handrail.
Handrail Sanitizer
Navy Airman Preston Rosiere sanitizes a handrail aboard the aircraft carrier USS Theodore Roosevelt, April 19, 2020. Upon arriving in Guam on March 27, the Theodore Roosevelt established an emergency command center, initiated a roving and deep-cleaning team and continually educated the crew on social distancing and proper protective procedures and behaviors to assist in mitigating and controlling the spread of COVID-19.
Photo By: Navy Petty Officer 3rd Class Wade Costin
VIRIN: 200419-N-FZ335-1025

Army Col. Samuel Jang, the Guam Public Health team lead, praised Alvarado for his efforts.

"Major Alvarado shared many nuances and in-depth insights into COVID-19 disease epidemiology and disease transmission," Jang said. "His clinical insights were translated into strategic public health planning and operational decision making. He is a highly competent physician and leader."

Army Lt. Col. Ronal Cole, a public health nurse and task force member, agrees.

A sailor takes a nasal sample.
Nasal Sample
Navy Seaman Christian Akins, a hospital corpsman assigned to Naval Hospital Guam, takes a nasal sample from a sailor assigned to the aircraft carrier USS Theodore Roosevelt as part of a public health outbreak investigation, April 22, 2020. This specific outbreak investigation is expected to provide a better-informed understanding of this outbreak and guide decision making for the crew, officials said. Upon arriving in Guam on March 27, the Theodore Roosevelt established an emergency command center, initiated a roving and deep-cleaning team and continually educated the crew on social distancing and proper protective procedures and behaviors to assist in mitigating and controlling the spread of COVID-19.
Photo By: Navy Petty Officer 1st Class Christopher Liaghat
VIRIN: 200422-N-CH038-1064

"His professionalism is to be commended and emulated," he said. "His ability to function in a diverse team made our long days of interviews, data gathering, evaluations and discussions stress-free. He is to be commended for his contributions in saving the lives of approximately 160,000 civilians and 20,000 military personnel during this time of worldwide distress."

Although the praise of his fellow Public Health Task Force teammates means a great deal to Alvarado, the support from his wife, Maureen and 8-year-old son Aidan was invaluable.

"My wife was very supportive of this mission, but my son was very sad that I was going," Alvarado said. "But he looked at me and said 'daddy I'm very glad they picked you.' When I asked him why, he said 'because I know you can help them.'"

(Lori Newman is assigned to Brooke Army Medical Center.)