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Commanding Officers of Medical Treatment Facility USNS Comfort and USNS Mercy Hold a Press Briefing via Teleconference

STAFF:  Ladies and gentlemen, good morning.  For the folks on the phone, good morning.  Thanks for joining us today.

Just a few ground rules before we get started.  Today's briefing is going to be on the record and it'll be with the Medical Treatment Facility Mercy and Medical Treatment Facility Comfort commanding officers.  Please, when asking questions, identify yourself and your outlet for the record, as they are on the phone, as well, and cannot see you.

So we're going to start with opening remarks from the Medical Treatment -- Medical Treatment Facility Mercy C.O. Captain John Rotruck followed by the MTF Comfort C.O. Captain Patrick Amersbach.

So, Captain Rotruck, the floor is yours, sir.

CAPTAIN JOHN R. ROTRUCK:  Good morning, everyone.

The professionals aboard USNS Mercy left Naval Base San Diego March 23rd after receiving a five-day notice of this deployment.  While we have never responded to a pandemic, this is the type of mission that we train for, as our ship is uniquely outfitted for humanitarian assistance and disaster relief.

We steamed to Los Angeles to be the relief valve for local hospitals so they would have the capability to combat COVID-19.

I could not be more proud of the sailors aboard Mercy and how they came together as a team so quickly.  We are accomplishing our mission and showing the power of Navy Medicine in support of the American people, and we will stay here until it is decided that our support is deemed no longer necessary.  We are honored to answer the call in this time of need and are committed to protecting the health of our force and the health of our nation.

Thank you.

STAFF:  Captain Amersbach

CAPTAIN PATRICK AMERSBACH:  Good morning.

I'm Captain Patrick Amersbach, commanding officer of the military treatment facility aboard the USNS Comfort.  I am humbled and honored to lead a team of true professionals committed to helping our fellow Americans during this great time of need.

We received our first patients last night and are ready to receive more in order to provide safe, high-quality health care to non-COVID patients of New York City.  We cannot thank FEMA, state, and local representatives enough for their professionalism and continued effort to make this process as smooth as possible.

The hope is that our presence will ensure that local hospitals can focus on treatment of COVID-19 patients.  We arrived early to need to New York City and are grateful to serve the needs of our nation.  We will continue to coordinate requests for patient care directly with community representatives.

Thank you again for this opportunity to speak with you.

STAFF:  Okay, we'll be -- we'll begin questions and answers.  Idrees from Reuters.

Q:  Sure.  If you could both provide an update on how many patients both of the ships have treated.

And -- and -- and the second part to that is why were both ships rushed to both cities, given that it appears that you guys are only treating a handful of patients right now?  ‘Cause from here, it just seems like more of a political symbol by the governors, given that the capacity is not being used, even a fraction of it, on board the ships?

CAPT. ROTRUCK:  Hi.  Captain Rotruck from the Mercy.  I -- I'll go first on that.

So, we've got a total of 15 patients transferred so far.  We have 10 patients currently on the ship.  So that's just in the past four days, which means that we've discharged five patients, as well.

And I think the take-home message there is that we are able to actually bring patients aboard and also discharge them effectively to generate that patient throughput so that they can continue to effectively act as a relief valve to local hospitals.

If we were not able to discharge patients effectively, we would essentially fill up and then -- and then no longer be of any use to the local hospitals.  But I think that's a good news story for us.

In reference to the second part of your question, I think -- I -- hopefully understanding the intent of DOD's senior leadership that they really wanted to get the capability and capacity in place early before the hospitals in the local areas were already overwhelmed, so that we could establish the relationships and ensure the processes were sound to get patients to the ship, so that when they -- the capacity demand really increases, we'll be ready.

Thank you.

CAPT. AMERSBACH:  This is Captain Amersbach from the Comfort.

We've treated about three patients so far and have worked diligently, again, with local authorities and FEMA to ensure that the correct information of our capabilities is communicated and in order to facilitate a greater number of (inaudible).

We were also brought into New York City as quickly as possible so we were available and -- and -- and in place to accept COVID-19-free patients to take some of the pressure off local health systems before the wave hit or as quickly as we possibly can.

STAFF:  All right, thank you.

Ryan.

Q:  Hi, thank you for doing this.  Ryan Browne with CNN.

Can you say what is, kind of, the -- the process?  I know that they're referred -- the patients are referred to the ships from the hospitals, so can you talk a little bit about why is it only, you know, 15 patients for the Mercy and I think you said three for the Comfort?  Is that because you're just not receiving the referrals from the hospitals?  Is that FEMA that's not passing those folks along?  What is, kind of -- what is the limiting factor on the patients that you're receiving?

CAPT. ROTRUCK:  So, Captain Rotruck here.

Just speaking specifically to the Los Angeles area, our process is that the local hospitals call in to the county's medical alert center, which has already been a pre-existing system by which local hospitals transfer patients between each other.  So we were able to nest into an existing system instead of trying to create something new.

It's really driven by demand from the local hospitals based on their current capacity.  And, you know, we're here in support of FEMA and the state of California, so we're -- we're ready to answer whatever that demand signal is.  And as -- if that demand signal ramps up, we'll certainly be ready to accommodate that.

Thank you.

STAFF:  Jennifer.

Q:  Jennifer Griffin with Fox News.

Can -- Captain, can you talk about -- can you both talk about the nature of the injuries that you've been treating, how serious are they, what are the range of injuries?

And how are you testing for COVID-19 in the patients that are coming to you so you're sure that they don't have COVID-19 when you're treating them, especially since the latest guidance is that most people can be carriers without knowing they have it or without having a fever.

What is the process to be ensure?  Do you have instant testing and are these patients going through that before they are on board the ships?

CAPT. ROTRUCK:  So Captain Rotruck here, speaking for the Mercy before Captain Amersbach answers on his coast.  So in brief, we've -- we've had a pretty broad range of medical and surgical patients come to us.  We have not actually performed any surgeries thus far.

The surgical patients that have come to us have been people who have already had surgery or been evaluated by a surgeon but it's definitely been quite a wide variety of patients.  In terms of the process to ensure that patients who come to us are not infected with COVID, we are not performing that test here, the -- the local referring hospital is actually screening and testing the patients before they are transferred.

Thank you.

Q:  And just back to the types of injuries, are you talking gunshot wounds or broken legs?  What -- what is the range of injuries?

CAPT. ROTRUCK:  Captain Rotruck here.

Yes and yes on all of that.  So again, it's -- it's people who have been in traumatic accidents who are now recovering, it's people with gastrointestinal and heart and lung problems.  So pretty much the gamut of patients that you'd expect to see in a community hospital.

Thank you.

STAFF:  Courtney Kube from NBC.

Q:  Hi, thank you.

Okay, I just want to ask two quick follow ups and then one question that -- Captain Rotruck, when you say that the local hospitals are -- are testing the people before they're transferred, you don't mean that they're physically getting a -- a COVID test that's being sent out and -- and -- and have to be tested negative before they're transferred, right?

CAPT. ROTRUCK:  No, I -- I do mean they're getting a COVID test and a result prior to being transferred.

Q:  I'm so sorry, you said you did mean that or you did not?

CAPT. ROTRUCK:  I -- I do mean they are all getting COVID tested at the local hospitals and where they're coming and that test result is coming -- coming back negative, of course, before we approve a request for transfer.

Q:  Okay, great.  Thank you.

And then my question is -- is for Captain Amersbach.  Can you tell us exactly when the -- the Comfort started accepting patients?

And then for both of you, I just want to clear up something that Secretary Esper said at the White House briefing yesterday.  He was asked specifically whether the hospital ships could accept -- could begin accepting COVID patients and he -- I think he caused a lot of confusion because he didn't -- he said that they would do what they're asked to do and -- and we've been hearing not -- nothing but the fact that they would only be non-COVID patients on the hospitals.  So is there any discussion about either ship, if you don't start getting more cases, then, you know -- or more local patients, somehow retrofitting or accepting the -- the -- your spaces so that you can start accepting COVID patients?

CAPT. ROTRUCK:  So Captain Rotruck here, speaking on the Mercy side with respect to your question.  So right now, our mission, as assigned by the Department of Defense in support of FEMA, is to accept non-COVID-19 patients. FEMA, in -- in cooperation with the state of California, decides that our mission should change or we should start taking COVID patients, we will take action on that and execute.

STAFF:  Captain Amersbach, are you still on the line, sir?

CAPT. AMERSBACH:  Yes, I apologize, our call got dropped on our end.

So as the Mercy had mentioned, we are following the orders from the Department of Defense as they work with other federal agencies.  And right now, the -- those rules still apply that we are accepting only COVID-19 patients.  If anything changes --

Q:  Non-COVID --

CAPT. AMERSBACH:  Non-COVID, excuse me, non-COVID-19 patients.  If that changes in the future then we will adjust accordingly but right now, that is how we are operating.

Q:  Can I just follow up -- it's Jennifer Griffin -- on Courtney's question.  How would you accommodate COVID-19 patients?  We've seen the situation on the Roosevelt and how difficult it is on ships and in that kind of environment.  How would you adjust to bring COVID-19 patients onto either Mercy or Comfort?

CAPT. ROTRUCK:  Captain Rotruck speaking for Mercy here.  That is an interesting question, and I think it's something we would have to give some thought to.  But if I were to conjecture how we would accomplish that mission, essentially, we would transition from a non-COVID-19 patient treatment facility to a COVID-19-only patient treatment facility.

So in other words, we would probably have to transfer the non-COVID-infected patients off the ship and become 100 percent COVID operation.

Thank you.

STAFF:  We'll go with Patty from Al Jazeera.

Q:  Sorry about that.

So just to follow up on that, how would you actually -- could you actually take COVID patients?  I mean, it's a ship.  I don't -- could you physically do that and keep everyone safe?

And the other question is just about billing.  How does that work?  Is the health care free, or do you bill insurance, it's just kind of unheard-of.

CAPT. ROTRUCK:  So Captain Rotruck here.

There is no billing of patients for care delivered on the hospital ships.

Thank you.

Q:  And how could you -- could you actually take COVID patients, given that it's a ship?

CAPT. AMERSBACH:  This is Captain Amersbach --

(CROSSTALK)

CAPT. AMERSBACH:  -- on the Comfort -- sorry, John, didn't mean to step on you there.  Do you want to continue?

(CROSSTALK)

CAPT. AMERSBACH:  Captain Amersbach on the Comfort.  We would, again, if we were directed to, potentially be able to take COVID-19 patients if we reconfigured the availability of beds on the ship, based on the separation of COVID and non-COVID patients.

But again, I really can't speculate on that at this point.  I would rather, as we go through a -- as we go through trying to take on non-COVID patients, if directed, we will go ahead and move into a planning period for that potential move.

STAFF:  Tara Copp.

Q:  Thank you both for doing this.

I have a follow-up.  Captain Amersbach, I just -- I couldn't hear, I'm on the line.  Just to confirm, the Comfort has taken three patients so far?

CAPT. AMERSBACH:  Yes, ma'am, that is correct.  So we -- again, we're working with local officials and FEMA, we have everything laying flat as far as communication and our ability to move patients from local hospitals to the ship.  To this point, late yesterday afternoon, we started taking on our first patients.

Q:  Okay, so your first patients, you started taking on yesterday afternoon.  Is there -- are any of the delays in getting patients on the ship in part because you are testing everyone before they get on board?

CAPT. AMERSBACH:  Ma'am, I can't speak to that.  I don't think that is potentially a delay at this point.  The criteria for acceptance has been shared, both through FEMA and local authorities.  It was a requirement before we pulled in.  So whether or not it is an issue, I'm not sure.  The process continues, but again, it is settling out and we are honestly looking forward to seeing a significant increase in patients being transferred to the Comfort today.

Q:  Okay.  And secondly, with the -- for the Mercy captain, we've seen recently that both California and Washington State seem to be -- being successful in flattening the curve.  Now, who knows if that will continue, but how difficult would it be to relocate the ship -- actually either ship -- for another hotspot such as New Orleans that may not have been that prepared and may see their cases surge?

CAPT. ROTRUCK:  So I think I can answer that for the Mercy.  You know, essentially, we're in a constant state of readiness to do whatever mission that our -- our higher officials ask of us.

So, the issue for us in relocating would just be providing a safe disposition for all the patients that are currently on board the ship.  And once we accomplish that, we could leave in fairly short order in order to do so.  And, again, that would be at the direction of FEMA, directed to the Department of Defense, for us to do that.

Thank you.

STAFF:  And just as a reminder, when I call on you, please identify your name and outlet as well.

We'll go with Jeff Schogol.

Q:  Thank you for doing this.

There was a news report about a man who derailed a locomotive near the USNS Mercy.  Question for the Mercy skipper, are you taking any extra security as a result of this action?  And can you say how disinformation and rumor is affecting your safety?  Thank you.

CAPT. ROTRUCK:  Sure.

So with respect to the train incident, there was really no impact to the Mercy whatsoever, if you'll forgive the use of that word.  It happened well outside of our fence line.

In terms of security, the Department of Defense and the Navy always has a Force Health Protection posture and they'll continue to maintain that and adjust if needed if there's a concern.

(CROSSTALK)

STAFF:  Hot mike.

(CROSSTALK)

STAFF:  Tara, you have a hot mike.

Q:  I don't, though; I'm on -- I'm on mute.

(UNKNOWN):  Somebody's recorded it --

(CROSSTALK)

STAFF:  Yeah, okay.  For all channels, please just ensure that you mute your lines.

Sam LaGrone.

Q:  Hi.  Thanks for doing this.

I -- given some of the shortages in medical supplies, particularly in New York City, I mean, I think there's images of PPE, assigned PPE being like a Yankees poncho for at least one -- one case.  How much -- how integrated are you with the medical systems in terms of sharing equipment, sharing supplies and responding to needs of some of the local hospitals systems, not necessarily with patients but with materiel?

And then I've got a follow-up after that.

STAFF:  I'm sorry, so was that a question for the Mercy or for the Comfort?

Q:  That was a question for the Comfort specifically.

STAFF:  I'm sorry, I apologize.

CAPT. AMERSBACH:  Okay.  We're tracking.  This is -- this is Captain Amersbach.  We haven't had any requests at this point as far as us sharing resources or equipment.  If that was to occur, that would obviously be coordinated back through FEMA local authorities for the ask.

We currently have enough PPE equipment and source on board to take care of patients here in New York City for the -- well, for probably at least for the next couple of weeks, depending on how many patients we get aboard the ship.

And then we have a very robust logistics system in which to get resupply while we are pierside.

Q:  Yeah, just as a follow up, are you going through the Defense Logistics Agency for resupply and husbanding, for -- for both of you, the Mercy and the Comfort, in terms of -- I'm just curious how you all are getting new equipment coming on board both ships.

Thank you.

CAPT. AMERSBACH:  Yeah, this is Captain Amersbach on the Comfort.

Exactly, DLA is working diligently with us to ensure that we -- we have what we need.

CAPT. ROTRUCK:  And Captain Rotruck here, just to echo that our supply lines are always intact in the Department of Defense and with the Navy, in particular, so we're -- we're getting supplies as we expect.

Thank you.

STAFF:  Okay.  Ellen from Synopsis.

Q:  Hi, this is Ellen Milhiser from Synopsis.

When you all deployed, you stated specifically that you would not be doing obstetric or pediatric cases but with the number of patients being relatively low and the problem of women giving birth not being allowed to have somebody with them in a hospital, will you be changing that from -- priority at all, do you think?

CAPT. ROTRUCK:  So Captain Rotruck here.  We -- we have not been directed to change our plan of the scope of care that we're going to provide.  And just to expand on that a little bit, to provide obstetric care requires a fairly large footprint in terms of both staff and capabilities within a hospital.

Since that was not part of our initial plan, we don't have those specialists aboard.  We have the staff that we need to focus on the mission that we said we would deliver.  In the event that we are directed to do otherwise -- to deliver obstetric care, we'll certainly adjust our staffing mix as directed by the DOD in conjunction with FEMA and move out appropriately.

CAPT. AMERSBACH:  This is Captain Amersbach on the Comfort.  And to echo Captain Rotruck, absolutely, we take our -- our orders and directions from higher authority and if our mission shifts we will -- we'll do what we can to meet that mission.

Q:  Thank you.

STAFF:  Jack from Foreign Policy.

Q:  Hey, I'm just curious -- I know you're not in a situation right now where you -- you see your beds potentially being filled but if -- if that is the case, if your case load surges, do either of the commanders have contingency plans to refer patients to other installations or hospitals?

Thank you.

CAPT. ROTRUCK:  Captain Rotruck from the Mercy here.

That would entirely be an issue of coordination with our local authorities here in L.A.  As I mentioned before, we have people from the Mercy embedded within the Medical Alert Center, which is the coordination agency for all inter-hospital transfers.  So they -- they would manage that at that level.   We would not be managing it here on the Mercy.

Thank you.

CAPT. AMERSBACH:  This is Captain Amersbach.

Same here.  We go through the -- the Javits Center and all coordination for care beyond what would be provided from the ship would be coordinated through them.  Over.

STAFF:  Last question, Ryan.

Q:  Yeah, I just had a quick follow-up.

We heard from the Mercy captain about how patients are referred and kind of what that process is like.  Captain Amersbach, who is responsible for referring patients to the Comfort?  What entity is -- takes -- is -- is -- is kind of responsible for making sure that patients get to the Comfort?

CAPT. AMERSBACH:  Thanks for the question.

So the central communications and referral is being ran through the Javits Center in -- in New York City.  They have local health officials.  They're working in conjunction with FEMA to ensure that the hospital-to-hospital transfers are occurring as smoothly as possible, and again, to make sure that those patients that are coming aboard the ship are suitable for our environment, as well as right now, COVID-19-free.

Q:  Thanks.

STAFF:  Last question, Jennifer.

Q:  It's Jennifer Griffin from Fox News.  Just a quick follow-up for my colleague, Jeff Schogol.  Captain Rotruck, he asked about disinformation.  Are you suffering from any disinformation campaign about what you are doing?  Are you seeing any -- any -- any harm from that?  Also, are people just showing up at the docks trying to be treated?  Are you having an issue with that?  And finally, how do you know all the staff on board both ships, since you had to deploy so quickly, how do you know that they are all COVID-free?  Were they all tested or put into isolation for 14 days in advance?

Thank you.

CAPT. ROTRUCK:  Hi.  Hi, Captain Rotruck from the Mercy here.  Thank you for that series of questions.

With respect to misinformation, I'm not personally aware of any misinformation campaign with respect to the mission that we're doing here.  With respect to people just showing up for care, we've had a few phone calls here on the ship of people that believe they could access here directly, as opposed to being patients in a hospital and being transferred.  We just answer those calls as appropriate.  A lot of people know that the mechanism for receiving here on the Mercy comes from being a patient in a local hospital first.

And then finally, we have a lot of measures in place to make sure that we remain a COVID-free ship.  We did screen for everybody before they came aboard.  After they came aboard, we've been doing all the individual measures that you're familiar with – hand washings, frequent use of hand sanitizers placed widely throughout the ship, the other CDC recommendations that you don't touch your face, that you exercise social distancing to the maximum extent possible and that you do frequent cleaning of high-touch surfaces.

In addition, for our new staff coming aboard the ship since we left San Diego, they are in a period of what we call restriction of movement for 14 days, so they're coming up here to Los Angeles, to the local areas, actually, essentially being in self-quarantine or self-isolation, if you will, to ensure that it's -- had -- had they been exposed to somebody with COVID and they didn't know it, that would be time for the disease to declare itself.  Obviously, we would not have those people come aboard the ship, but that -- that's part of our means of ensuring that any new staff are COVID-free, as well.  And then of course, all of our -- all of our patients are screened and tested for COVID prior to coming on the ship.

So we think we have a pretty robust group of measures in place to remain COVID-free, although obviously, we recognize that there is always risk inherent in (inaudible).

STAFF:  All right, gentlemen, thank you very much for your time.

And for the press, thank you as well.  That concludes today's briefing.

Q:  Thank you very much.