STAFF: All right, good morning, everybody.
Today we have with us three military medical providers currently serving in New York City as a part of the Defense Department's continued support to state and local authorities to help combat COVID-19. In a moment I'm going to turn it over to their public affairs officer, Air Force Captain Thomas Barger, to introduce the medical providers and talk very briefly about their efforts.
Today's briefing is on the record. After his remarks, we will have about 20 minutes for questions. If you are on a phone line, please ensure your phones are muted until you are called upon.
With that, Captain Barger, the floor is yours.
CAPTAIN THOMAS BARGER: Good morning, everyone. This is Captain Tom Barger with Joint Task Force New York/New Jersey.
Just to give you an update here, in New York City we're using what we call a -- a flexible three-pronged approach focused upon our capability, capacity, and providing relief to the city's hospitals. The USNS Comfort is here, and affords a high-end medical capability. The Javits Center provides greater capacity for patients. And then we have military doctors, nurses, and medical personnel with their high-demand skills. They're out providing relief to the hospitals across the city.
Today, seated with me, I have Air Force Colonel Jennifer Ratcliff. She's a doctor that has been serving out at Lincoln, Jacobi, and Queens Hospitals here in New York City. I have Navy Captain Joe Kochan. He's primarily been serving at Elmhurst Hospital. And I have Army Lieutenant Colonel Leslie Curtis. She's a registered nurse and the chief nurse here at the 9th Field Hospital in Javits, primarily responsible for -- for setting up the -- the patient care here and -- at the Javits Center. And she's also worked as a -- as a liaison officer with some of the hospitals on getting patients here to the Javits Center.
So those are our three subject matter experts we have on the line today. That's my quick introduction, and with that, we'll toss it out to questions.
STAFF: Okay, let's go ahead and start with right here in the room, Terace from Newsy, please.
QUESTION: Hi, good morning. Thank you for taking my question.
There's talks about various states opening back up, and so I wanted to know what your role would be once New York decides to open. What will be your role, and when do you expect to start implementing those procedures?
CAPTAIN JOSEPH J. KOCHAN: Good morning. This is Captain Joe Kochan from the Navy.
We really are here to support the citizens and the state of New York and support FEMA as long as we're needed.
QUESTION: And so what all will that entail? Have you gotten any word of when they plan on possibly opening the state back up? And are there any concerns in regards to once they do open up, that there may be a second wave that comes back through?
COLONEL JENNIFER R. RATCLIFF: Hi, ma'am. This is Colonel Ratcliff from the Air Force Reserves.
The answer to that is a difficult answer. It's really up to the city of New York and the government of both the city of New York and the state of New York to decide when that's going to happen. We're here, again, as long as we're needed and that's the decision of the government here.
STAFF: Okay, thank you.
We're going to go to the phone lines.
Jeff Schogol from Task and Purpose, go ahead, please.
QUESTION: Hi, thank you.
Just a quick question about the beds at the Javits Center. Are 10 percent of them going to be ICU beds? And can you give us an update on how many patients aboard the -- the Comfort are COVID -- are being treated for COVID-19?
Thank you.
COL. RATCLIFF: I can't speak to the Comfort.
CAPT. KOCHAN: Good morning, again. This is Joe Kochan.
Just to speak to the Comfort, really, we -- the three of us at this table -- are not directly involved with the USNS Comfort. We do have colleagues that are there. They are working very diligently to take care of patients for the city of New York. And we would just have to refer you to their PAO, public affairs officer, to get information about what's happening on that ship -- that hospital ship.
Thank you.
STAFF: Jeff, do you have a follow-up to that?
QUESTION: Thank you. The hospital beds at the Javits Center, will 10 percent be for -- be ICU beds?
LIEUTENANT COLONEL LESLIE CURTIS: Okay. Hi, this is Lieutenant Colonel Curtis. I'm the 9th Hospitals' chief nurse.
And so Javits Center, we do have available beds that are in a second phase -- there's phase one and phase two. We do have more appropriate beds assigned for any ICU needs depending on the need.
We have the ability to scale up to whatever the demands are, based on the needs of the city or any particular mission that is required. So we have the ability to fluctuate to the need of the people here and the hospitals here.
STAFF: Okay, thank you, Jeff.
Let's move on to Abraham Mahshie from Washington Examiner.
QUESTION: Yeah, thank you for -- for taking my question.
So as we've seen an under-capacity at the hospitals and on the hospital ship, keeping those assets in place right now, you're keeping them just in case there's a need.
But is there -- is there a thinking behind, for example, "We're going to keep, you know, 75 percent or 60 percent of that capacity in place just in case, but we really don't need to keep everything that we originally had? So we can reposition some personnel, some assets, maybe close a portion of something, move those to a different hotspot."
Is there any thinking about, like, just so much, having so much excess capacity right now?
Thank you.
COL. RATCLIFF: Hi there. This is Jennifer Ratcliff again with the Air Force.
I think the benefit of the military is we are scalable. We have different teams out in the city and in different environments within the Javits and probably the ship as well, which, again, I'm not really tracking. But we are scalable and that can be utilized in whatever ways, city or state or this region requires it to be. So that capacity can go up or down as -- as needed.
But as far as percentage-wise in numbers, that -- that changes on a -- on a daily basis. That changes certainly weekly. But the benefit of us being down here as sister services is that we can -- we can scale as needed.
STAFF: All right, thank you, ma'am.
Abraham, did you have any follow-up to that -- or excuse me -- yes, Abraham, did you have a follow-up to that, or?
QUESTION: Yes, right.
STAFF: Go ahead.
QUESTION: So has there been such scaling as you've noticed that you have an enormous unused capacity? And I appreciate you taking my questions.
COL. RATCLIFF: This is Jennifer Ratcliff again.
I can tell you, out in the -- the city hospitals, that is not an issue right now. I think both the Navy and Air Force are needed where they're at, at the numbers that we're at. Again, that can change at some point. The Javits might have a different statement on that, but capacity is not an issue.
We're still working. They're very busy here in New York City and -- the benefit of the military is we are scalable. We have different teams out in the city and in different environments -- sorry. That was -- that was repeating back somehow.
The city, I believe, still needs our assets, especially the Navy and now Army in the city. We're helping as needed and I don't think there's -- there's talk of scaling that back. But again, we'll do whatever the government of New York needs.
LT. COL. CURTIS: Hi. This is Colonel Curtis, again, the head nurse here at the Javits Center -- the chief nurse.
So I can help with a better understanding of that. So right now, our interests and our needs change daily. We take on -- we have a multitude of services here, as we have mentioned earlier, the Navy, the Air Force Reserve units. We are onboarding them at very high numbers every day as well our civilian agencies. We've been bringing in 20, 30 nurses a day, onboarding them through the agencies, and then what they do is shadow for a day or two and they're put on the schedule.
So our schedule is a standing, we’ve gone from 12 teams or so up to 27 teams that are actively filling a 24-hour operation and growing. So as quickly as we continue to combine assets -- available assets and train on or, onboard is how many patients we're able take. And that has been -- as the groups and the other supporting agencies are coming into New York City and come here to support this mission -- that determines how many patients that we're able to take quickly.
So that would kind of help you understand the flexibility of our scaling.
STAFF: Okay, thank you. We're going to move on to Ellen from Synopsis, please.
QUESTION: Hi.
According to the numbers I have, Javits Center is running around 323 patients a day and you all have a lot of staff. Is there any thought of moving any of the staff from the Javits Center or the Comfort into the New York hospitals?
LT. COL. CURTIS: Hi. This is Colonel Curtis again.
I cannot speak to staff moving to the actual hospitals.
But what I can say is we equally have a large amount of discharges. So we take on an average of -- it fluctuates into the 120s to 150s a day, as well as discharging more than probably 10 -- greater than almost 40 to 50 patients as well, as well as some discharges. So we've been fortunate to be able to discharge patients home.
So it's -- the numbers are not consistent, they fluctuate throughout the day based on discharges, disposition, as well as admission. So that's every day, ongoing.
CAPT. KOCHAN: And this is Joe Kochan again.
Speaking to the hospitals in the city, we're onboarding hospitals pretty much since we've arrived, so we -- we started earlier last week. Every day, we seem to onboard another hospital with a different sister service.
So as it stands right now, we're really pushing out into the hospitals to really support their needs, and they are reaching to us directly through the Army command here, to help us develop teams that are truly needed in those centers.
LT.COL. CURTIS: In addition, I would like to say that our staff has been used on many missions, our respiratory teams and CRNAs, which are nurse anesthetists and-or they're teams that have been dispatched out into the hospitals to help transport patients that maybe needed to transfer to another facility.
So we've been multitasking them a variety of ways to help assist the hospitals. They call us, we dispatch teams to support the needs that they have. And so that was used on several missions like that, which has been quite exciting for us, to be able to provide that service for them.
STAFF: Okay, thank you.
We're going to move on to Rose from Stars and Stripes. Your question, please?
QUESTION: Hey, good morning. Thank you for taking the time today.
I have sort of a two-part question, to get more of a feel what it’s like to be in the Javits Center, and then also what it's like to be in the hospitals.
So can you describe, like, the -- I know when we hear low numbers of patients, we think of the medical personnel are then just, like, standing around, waiting for someone to come in. But can you describe what it really feels like in the center? Like -- and what you're doing even though, you know, we hear 1,500 beds, 300 patients. I'm sure you're busy.
And then in the hospitals, the military personnel show up, are they taking on their own cases or are they just assisting? How are they sort of fitting into the rhythm that those hospitals already have?
LT. COL. CURTIS: Okay, hi. This is Lieutenant Colonel Curtis again.
We are extremely busy. And our days start quite early.
Just an example, today, we got here about -- we left at 4:30, we were here around 5:00 -- before 5:00 to welcome almost 200 nursing onboarding, and going through the donning and doffing process, which they must do. We have a very strict protocol to protect force protection, to protect every single person -- civilian, military, housekeeping -- they have to go through that process to get into the Javits Center, which is where we have all of our patients.
So we have to be here to not only expedite that process and do it safely, but also go through the staffing and the scheduling, as I mentioned. We have 20, 30, 40 different groups at a time that need to shadow and align with all the teams that are running. We have a very, very active, busy floor, taking care of patients. We also have teams. So we have teams of combined military, Air Force, Navy, civilian, working together, hand-in-hand.
This has never been done before. This has been extraordinary time in history, where we've come together, all the services, providing care, in an arduous and tough situation that requires us to really take heed of the environment, that there's a safety consideration, because of the huge -- patients are all positive, so we have to make sure that our processes are formulated, that we have good training and -- to be able to allow people to work safely through the course of their day. They’re averaging 12-hour shifts, and we work every single day, really, more than that at times, but that's what we're doing, every day.
CAPT. KOCHAN: Yeah, good morning. Again, Joe Kochan.
So just to answer the question about the hospitals and how we're integrating into the hospital systems, we went out to those hospitals, asked what their needs were. Some of them were for needs, hey, can you set up or man your own group, your own area, your own ICU, which we’ve done.
In addition, they asked us to augment their teams in place, that have been working tirelessly for the past 30 to 45 days. So what we're doing is, whatever the hospitals need, we're filling that need as best we can.
COL. RATCLIFF: And this is Jennifer Ratcliff.
I'd like to reiterate that as well. When we arrived at the Javits Center, we were instructed to start formulating these teams and let the city know what assets we had. And then the city decided where we should go which best aligns with our skills and capabilities, with theirs.
So the Navy's gotten hospitals they're covering, the Air Force has some hospitals that they're covering, and the Army is starting to integrate within those hospitals as well.
What I find interesting is that once we were credentialed within these hospitals, how quickly we've been able to actually integrate and how welcoming the city has been with our care. We’re a fresh face, and we've got the energy and the enthusiasm to really help these people that are tired, have been working very, very long days and weeks.
So I've been honored to follow the respiratory therapists around, who really are a key group of people that I think are under-recognized in the health care field, especially during COVID-19, what they're able to do for us. And just having those people in the hospital, really, you can walk around the hospital and just see that the attendings and the residents there really happy to have us, and we're certainly happy to be there and support them and take care of our fellow citizens.
STAFF: Okay, thank you.
We're going to move on to Meghann Myers from Military Times. Your question, please?
QUESTION: All right.
So my question is, you're talking -- Captain Kochan was talking about how many people are surging into the hospitals to support there -- do you have like a rough estimate of how many personnel are working in those hospitals every day, and not just going out on, you know, missions in groups?
CAPT. KOCHAN: Hi. Good morning. It's Joe Kochan again.
So the Navy is this team that we brought to -- to New York City. There are approximately 200 nurses and doctors of various skillsets, various backgrounds from all over, mainly the East Coast, but also the West Coast. We've brought those specialists in.
That's about our rough numbers. And we've pushed them out into teams based on what the hospitals have asked for, to fill in the critical needs they have in their hospitals based on our skillsets.
(CROSSTALK)
QUESTION: All right.
As a follow-up, has any uniformed medical personnel been diagnosed with COVID-19 since arriving in New York?
COL. RATCLIFF: Those -- those numbers are being tracked, but I can't comment on that. We're in the hospitals, so unless it's happened to somebody in my team, I'm not aware of the numbers.
STAFF: Okay, thank you. We're going to move on to Phil Stewart from Reuters.
QUESTION: Hey there.
Listen, I was wondering if you could talk a little bit about how your staff is dealing with this new understanding about asymptomatic patients, so patients who may be -- have COVID and not know it. And -- and also, could you maybe explain a little bit what you're doing for your crew or your personnel who may be feeling a bit of anxiety about this whole thing, especially here now that everyone knows that there is -- there are people that are, you know, asymptomatic, that are carrying the -- carrying the virus and spreading it.
Thanks.
COL. RATCLIFF: At least our team -- and my guess is this is true to everybody here with me -- we're treating everyone as if they're COVID-positive. It -- it's -- it's safer to assume that and take those preventative measures, rather than being, I don't know -- we're -- we're being more cautious, I should say, because it's -- it's everywhere in the city. Odds are more likely that somebody's COVID-positive than they are COVID-negative, so we're using those precautions everywhere we are in the city and -- and everywhere we are in the hospital.
LT. COL. CURTIS: Hi, this is Colonel Curtis. I can speak to some of the things that we're doing to help.
We do have a resiliency center here that does quite a few that, you know, there's a lot of things provided that help make the environment better for the staff at work because it's very difficult to maneuver leaving the facility because the -- we're -- we're in a containment. So a lot of things are brought to us -- food, lunches. We've had a new dining area, literally redesigned the civic center, to accommodate the staff to make things convenient for them so every day something new is happening for them for convenience. We've designed literally male and female changing areas. Everything that they need is provided for them in terms of equipment, the PPE they need -- everything that we can think of to make it easier for them to do the job that they're doing, we have taken into consideration and discussed every day.
And it's quite extraordinary to see it developing. The staff are happy. The civilian staff -- we've got a lot feedback. They absolutely love working here, and one of the things that they said when we talked to them to make sure that they're okay and feeling safe -- they said they feel safe. The processes here are strong. The -- they have the right PPE. They feel very secure working with our military personnel and the team, so they were concerned about being left alone and not knowing what to do. And so we feel very happy that we are listening to what they're saying on the floors and accommodating them.
STAFF: Okay, thank you.
Those were -- those were all the questions from people that indicated they had questions up front. We have time for one last question. If one of the -- our media colleagues did not have an opportunity to ask a question, if they'd like to come on the line now, please go ahead.
QUESTION: This is -- this is Dave Martin. Can I ask a question?
STAFF: Yes, Dave. Dave Martin, please, go.
QUESTION: So early on the -- there were civilian medical people in New York expressing frustration with trying to work with the military bureaucracy in terms of getting patients admitted to Javits and -- the Javits Center and the Comfort. So from your -- from your point of view, what was the -- the source of the frustration, and what has -- what has been done to alleviate the frustration?
LT. COL. CURTIS: Colonel Curtis.
Yes, that was correct. What had been done is there has been -- first, we had to determine what the needs were and have an understanding, and that initially, as was mentioned earlier that there were groups sent out to the hospitals to speak directly with the leadership to see what they needed.
The military at (inaudible), some of the other groups there -- there is public health, as well as all the supporting services, which are many, quickly and immediately mitigated various requirements to accommodate bringing in the patients faster. We also embedded teams in the hospital, as well as brought providers to the Javits Center as well to help offload the patients into our facility which we are so happy today. This has really made a great impact in terms of the numbers that we're able to move much quickly, and every day they're finding more ways to -- to reduce any requirements.
So I think this is moving in the right direction, and we're always looking for more ways to -- to do it better because we do want to do this. So I think it's been a coordination of care and streamlining. The bureaucracy was -- everyone is willing to do, at every level, so it's been great support in doing that between civilian and military.
QUESTION: Other -- other than the obvious elimination of only accepting non-COVID patients at the beginning, what other requirements have been eliminated?
LT. COL. CURTIS: There have been many. It would be too much to mention them, but some of -- they did look at the tier level, of the level of care of patients that we can do within the -- the confines of this type of environment. And so they did do what they could do safely in this environment, so there has been measures taken for -- to take even a little bit of a sicker patient. And again, we can support that with our services that we have in place. It can scale up to what we need to -- to do.
STAFF: Okay, thank you.
So I wanted to -- that's all the time we have for questions today, so I want to thank our three participants for taking time out of their busy schedules to discuss their efforts in New York. I want to offer the opportunity for any one of the three of them or all three of them to offer any closing comments.
COL. RATCLIFF: This -- this is Jennifer Ratcliff from the Air Force.
I -- I do want to say that the Air Force Reserve Command did an incredible job of getting civilians, and since we're civilians in our real life, within 36 hours we were in New York City. That -- that says a lot for the Air Force personnel that are willing to come here and -- and take care of fellow American citizens. And honestly, this is quite an honor and -- and the -- the first of -- of many more times that we need to be utilized, so we're certainly happy to be here, and we're happy that the city of New York and the state of New York wanted us to be here, and -- and we look forward to providing care for their citizens.
CAPT. KOCHAN: Hello again. This is Joe Kochan.
I just wanted to let you know that the first wave of Navy personnel that came in were able to do this, again, in 36 hours. They were all volunteers. They all left their families, their civilian careers to get out here to help the citizens of New York willingly, and we've had waves after that that have come, as well.
Second, I just want to give a great thanks to all the providers, the nurses, doctors, technicians in the hospitals right now fighting this fight. They started this, we're here to help them and help the burden that they have been carrying for the past, like I said, 30 to 45 days. We thank them, we applaud them, and we can't be more in gratitude to them than -- than we are now.
LT. COL. CURTIS: Hello, this is Lieutenant Colonel Curtis.
And not only do I want to thank our colleagues, but -- and sister Air Force, Navy, public health. But in particular, I am -- want to thank the 9th Hospital, 11th, the, what they did with the 1st Medical Brigade and the 533rd. Two brigades came into the civic center, and created medical services to care for and aid the people of New York.
That's unheard-of, it's never been done before. We did that in 36 hours: We put up two phases, over 500 beds each that we can provide within this facility, and they have other phases that they're doing, 2,500 patients.
And the fact that we're able to do that and then bring together other services in here and offload and man this situation -- complicated situation, with all the issues involved in being in a facility that is not a hospital, and provide for COVID patients? This is history. So I just -- I just want to remind everybody of that, and thank those that are involved in this mission.
STAFF: Okay, thank you very much for your time.
Media colleagues, thank you for your time.
If you have any follow-up questions, you can send them to the OSD duty box. And that's all we have for today. Thank you.