Transcript

National Guard Leaders and Polish Medical Officer Brief Reporters on Illinois COVID Efforts

April 29, 2020
Air Force Brigadier General Thomas B. Hatley, vice director of strategic plans, policy, and international affairs for the National Guard Bureau; Army Brigadier General Richard R. Neely, Illinois National Guard adjutant general; and Polish Military Medical Corps Captain (Dr.) Jacek Siewiera

STAFF: Good afternoon, everyone, and good morning, for those in Illinois joining us on the press conference today. Today, well, we'll get started here in just a moment. For everybody on the phone lines, I'd like to remind you to keep -- please keep your phones on mute until called upon. That way, it helps us to limit feedback on the phone. And without further ado, we'll get started.

Nine members of the Polish military's medical corps will be in Chicago, or are in Chicago to support the state's response to COVID-19. They're there from April 23rd until May 2nd. Polish doctors, nurses, and emergency medical technicians recently treated COVID-19 patients in Italy and in Poland, and they're visiting Illinois as part of the Illinois National Guard's State Partnership Program with the Polish military. The Medical Corps officers will share lessons learned and best practices from their fight against COVID-19 in Europe,and will exchange information with medical professionals in Illinois.

Joining us on the phone lines today are vice director of strategy, plans, and policy and international affairs, J-5, at the National Guard Bureau, Brigadier General Thomas Hatley; the adjutant general of the Illinois National Guard, Brigadier General Richard Neely; and from the Polish Military Medical Corps, we have Captain Dr. Jacek Siewiera.

Gentlemen, without further ado, we'll go ahead and go for opening comments, and General Hatley, it's yours.

BRIGADIER GENERAL THOMAS B. HATLEY: Outstanding. Happy to join you today, and many thanks to General Neely and Captain Dr. Siewiera for joining us today, as well. I'll just give you a brief overview of the SPP program.

So, created in 1993, after the fall of the Soviet Union, the State Partnership Program is a unique Department of Defense security cooperation program pairing the National Guard of a U.S. state or territory with a partner country's military, security forces, and/or government agencies responsible for emergency and disaster response. Originally focused on assisting former Soviet and Warsaw Pact countries in Eastern Europe as they sought to join Euro-Atlantic political security structures, the State Partnership Program today is a global, low-cost, and high-impact security corporation tool that supports the National Defense Strategy by developing enduring relationships with partner countries built on mutual trust and shared values.

The State Partnership Program helps to build partner capacity, improves interoperability while increasing the readiness of U.S. and partner forces to meet emerging challenges. Currently, the State Partnership Program encompasses 82 partnerships involving 89 countries in all six geographic combatant command areas of responsibility. All 54 state National Guards have at least one partnership.

The partnership between Poland and the Illinois National Guard was established in 1993, making it among the first one since the program's inception.

During Poland's transformation from a former Warsaw Pact member to an indispensable U.S. ally and NATO member, the Illinois National Guard has been engaged with their Polish counterparts in every step. Thank you, this concludes my opening remarks.

STAFF: Okay. At this time, we'll go ahead and open up to -- oh, wait, no, actually, do we have -- I'm sorry, General Neely, do you have -- do you have opening comments?

BRIGADIER GENERAL RICHARD R. NEELY: Yes, I do. And I will be followed by Dr. Siewiera, who will also -- captain, the head of the team, who will also have opening comments, so good morning from Chicago, and good afternoon to all those joining us from the East Coast. And thank you for joining us today to discuss the Polish medical team's visit to Chicago, Illinois. I'm Brigadier General Richard Neely, last name spelled N-E-E-L-Y.

Appreciate General Hatley's outline of the National Guard's State Partnership Program and how the National Guard started with a partnership between 13 countries, and how it's grown into 89 partnerships across 89 different countries. It's truly an amazing program that's (inaudible) in cooperation throughout the DOD and the State Department.

In the National Guard, we talk about three primary tenets or focuses for the National Guard: We fight in America's wars; protecting the homeland, much like we're doing today with the COVID-19 response; and, thirdly, we talk about partnering.

And partnering is where we see the highlight today as this partnership. We not only in the National Guard partner within our communities, but we partner with first responders and -- and we partner with those in our communities in a lot of different ways.

But the State Partnership Program is another great example of partnering across the National Guard. This makes a difference when we have to respond. And one of the strengths of the National Guard is that we have -- we build these enduring relationships, which we have done because we stay in our states for -- usually for a number of years, and have this.

As General Hatley outlined today with a State Partnership Program, I believe that Illinois has the best partnership going with the partnership that we have with the Polish military. It is the very best for a number of reasons, and this is why, today, we have this nine-person medical team from Poland joining us, who have traveled to Illinois to respond to this COVID-19 fight.

Our state partnership began in Poland in 1993, and was one of the first 13 partnerships with the newly emerged countries coming out of Eastern and Central Europe. Poland, this new country, which had just emerged behind the Iron Curtain in 1989, started a partnership with Illinois in 1993.

Why Illinois, you might ask? Well, few probably realize that Chicago's the largest Polish city outside of Poland, with nearly 7 percent of the population tracing their descent from Poland.

Over the last 26 years, nearly 27 in July, the Illinois National Guard has had over 400 training events with the Polish military, to include exercises, leadership engagements, training events, and the -- and the integration of major weapons systems such as the F-16 that we -- and the C-130 aircraft that we've flown in the Illinois Air National Guard, that is also flown by the Polish military.

However, the best example of this relationship is the co-deployments that we had since 2003. First starting in Iraq and then into Afghanistan, the Illinois National Guard have embedded personnel within the deployed Polish brigade for each of these rotations. These rotations are occurring every six months for the last 17 years and it's still ongoing today.

Today, our middle grade and senior officers who have moved through the ranks together with their Polish counterparts are still in the military and the Polish -- and those within the Polish brigade, as well. And so today what we have is some of the most senior Polish Army officers within the Polish military have served with Guardsmen in this deployed brigade environment.

We have fought side-by-side for many years and now we fight this pandemic together. Today we are deeply moved by the incredible act of kindness and support from our friends from Poland who are joining us here in Chicago to share their experiences and expertise in fighting this disease and offering to lend a hand in some of the local hospitals.

This team is made up of military and civilian doctors, nurses, and EMTs. Not only has this team been involved in a COVID-19 fight in Poland but it also deployed to Italy in response to the pandemic and then brought their lessons learned to share with us.

This type of support is a testament to the 26 year relationship between the Illinois National Guard and the Polish military through the state partnership program. We're the only state to have this type of cooperation during COVID-19. I'm very proud of the Illinois relationship with the country of Poland.

Thank you for joining us today and at this time I'll be followed by the medical team lead, Captain Dr. Siewiera.

POLISH MILITARY MEDICAL CORPS CAPTAIN JACEK SIEWIERA: Thank you very much. 

BRIG. GEN. NEELY: One second. Mask change.

CAPT. SIEWIERA: Mask change.

We are very pleased with the hospitality and the welcome with which we experienced from the National Guard in the last few days. As General Neely said, our relations last for -- last 30 years, and in this period, we fight against our enemies arm by arm and we adjust to the type of threat which we are fighting with.

Today, the threat is the COVID-19, so the Polish Ministry of Defense and the Military Institute of Medicine, with General Gregor Gararok, dedicates this mission consisting of medics, doctors, nurses and EMT technicians to support National Guard in the efforts of fighting this COVID-19.

We are here from 22 of -- 23 of April, and since that time we have visited, especially the Stroger Medical Center in Cook County, also the Cook County Emergency Management and Communication of Chicago Center.

We have made a great webinars during that mission -- during that visit with an ICU team, the head of the cardiology department, the head of the infectious disease department and all of these meetings were supported with the webinars for the personnel.

It was very exciting to have the opportunity for sharing our lessons learned from Lombardy in the time of the biggest threat in that region of northern Italy.

In the following days, we have been invited to share our knowledge via the webinars with medical personnel from Polish American community and we have visited Harwood Heights Testing Center.

Also, now we are visiting the DuPage County with two hospitals, St. Alexis Hospital and (inaudible) Hospital, and the team is involved in consultations and experienced exchange with all the issues regarding the COVID, so the organizational aspects of the medical approach, the organizational aspects of organization of hospitals, emergency departments, the triage sections, and also the medical aspects of clinical procedures, of diagnosing and treatment.

In the plan, we have also -- visits in the Edward Hospital, the Glenbrook Hospital in DuPage County with a webinar prepared by Dr. Namadid Kirkadal for their medical physicians and nurses, and also in the Hines V.A. Hospital on Friday also supported with a webinar prepared for the Illinois physicians.

Our team consists of four doctors. Within the group, there is a (inaudible), Colonel (inaudible) organization of (inaudible) in preventive care and has been (inaudible) prepare (inaudible) care department in Poland and two anesthesiologists who were the chief of (inaudible).

(Inaudible) nurses without (inaudible). They are prepared for sharing their knowledge, which has happened in (inaudible) hospital. So the experience exchange appears in every level of the professional services.

And we are learning a lot from military personnel, from National Guard. And we are trying to provide the best practices which we have seen. When the pandemic in Italy was increasing with nearly vertical curve and slowing down to decreasing as well now. We -- we have been the partners in the problem, so we have some experience in how it was accomplished.

Across Europe, we've got some important points, and we see some differences between U.S. approach and the European Continental approach. So we have seen the collapse of medical health systems in northern Italy, in Lombardy, when the crowds of the patients and their families were admitted to the hospital and the selection of the patients were done when only one ICU bed was available among 15 patients with respiratory failure caused by the COVID-19.

We have been there also when the decision-making process, the fact that there was a shift from the hospital services to ambulatory treatment process and the engagement of family physicians to the EMT services.

The important fact was that the EMT services were prepared to admit physicians to the ambulance, and even some services were delivered in the homes of the patients, and even preparing ambulances with the X-ray testing machines were considered on the crisis teams.

We now know that the COVID-19 caused by the SARS-CoV-2 is a disease which has two phases. We see the differences in the mechanical ventilation of the phase one and phase two, but also sometimes appearing that these are different types of ARDS with a different compliance underlying.

We know that these differences, we suspect that these differences are caused by the different time of admission of the patient, and they are not related to different types of the disease, or manifestations of side effects, as we call this.

We suspect that protocols for ARDS treatment should be adjusted to the ventilation of COVID patients, and we have some procedures for that prepared in Poland.

We also use the scales for X-ray testing, which are substitutes -- in some ways, substitutes for the PCR test. When a lot of patients are admitted to the hospital with symptoms related to COVID-19, we are trying to make the X-ray with a scale from zero to 18, like in Lombardy, our partners, our doctors done with six sectors in the lungs.

And the number, the score of this scale depends on the status of the symptoms in the X-ray picture. That supports the decision to dismiss patients home or admit to the hospital, above 10 to 12 points in the scale.

We also have some insight and experience -- experiences which we exchanged with the personnel in the United States, in Illinois, about the personnel testing and the transmission, horizontal transmission, of the COVID-19 among the medical personnel.

We have some insights in the regulations, when the decontamination showers should be taken out after the shift, as well as the isolation maybe, in homes, for the medical personnel, self-isolation, if they want, if they can, due to the possibility (inaudible).

But we also have seen that one of the most important vectors of these disease might be the clothes, which were taken from the hospital to the homes, to the families, and the procedures there. We also have some insight in these.

The United States, this pandemic has totally different phase. Here, we don't have collapse of the administration, of the medical services. We experience extending of the capacity of hospitals, and we are amazed how it was done, how it was done by the National Guard in the McCormick, how it was done by the Cook County Emergency Medical Center, and we are amazed how data are supporting the decision-making process. It should look like this all the time.

So at the end of my statement, I would like to thank for the National Guard, for General Neely and for the team J-5, with Major Adamczyk, for how they received us, and for their generosity here in Chicago. We will remember this as a sign of our alliance for the rest of our lives. Thank you.

STAFF: Thank you, sir.

And with that, we'll go to the phones lines. We'll take a few questions from the phone lines, then come back here to the floor.

First up, we have Tara Copp from McClatchy.

Q: Hi. Thanks, everyone, for doing this.

I was wondering if I could get one or two examples for what sort of advice Polish military leaders are taking on what changes, what permanent changes you think will happen in the Polish military due to coronavirus, and how you train, how you operate. Will everyone always have to wear a mask? Any sort of details. Thank you.

CAPT. SIEWIERA: Okay. So the situation in Poland is quite different because decisions were made in very early phase of this pandemic. We've got something like 300 new cases per day in all the country, and the country is something about 40 million of citizens -- people. So the pandemic now, under control.

But we are trying to get to the business as usual as much as this is possible. And we some -- we see some differences in the approach, because in Poland, we do not trying to -- at -- in this moment -- to provide screening tests for PCR method to all the communities.

We are selecting tests and guarantee the testing -- the free testing for the medical personnel. They can do it whenever they want, they can do it when they feel sick, when they have a contact with a COVID, even when they suspect that they have conduct with a COVID.

That is something what is a little bit different in -- with the United States, where I see that there is an approach in which, we are trying -- you are trying to provide with PCR tests to as much citizens as you can.

Time will show which approach will be more effective, but we feel that it would have to be adjusted to the situation in the appropriate country. So we know that we have to deal with it on the medical personnel level.

And the second big difference which I see is the focus on resources in the ICU segment. In Poland, this is the weakest point of our medical health system, so there is a possibility that if this pandemic expands there will be a lack of ICU beds.

So the military institute medicine has prepared for architectures and products for temporary emergency ICU hospitals which can be set up in different places in the country, in different moments they can go -- they can be shifted to other locations where it can be needed. Here we see that the ICU beds are available and you have capacity to take and admit patients for their treatment.

And National Guard is focusing on providing a huge logistical challenge with a campaign -- patients with COVID-19 in medical – medical facilities like McCormick place, which is impressive. 

This is the main differences which we see in approach.

Q: Just a quick follow-up: Do you think that in Poland the military will go back -- completely back to normal, or will there be permanent changes?

CAPT. SIEWIERA: Unfortunately, I'm skeptic about that.

When I observed the progress in the vaccination trials and the pharmacological trials we also to this point in discussion with clinicians from the university hospitals here in Chicago, and we see that didn't have any antiviral treatment until now. And there is a little chance that we will find a golden treatment of the viral pneumonia in the nearest month.

We will see how the vaccination can game change -- change the game, but I'm skeptic about that and have to be prepared for expanding this pandemic for months and maybe years, each time when the restriction on social distancing will be lowering down. So we are preparing for that to provide the appropriate medical services to our citizens.

I think that this is very close to the approach which we see in -- in General Neely, his perspective and the National Guard perspective. Also by the opinions of physicians around with the critical care insight.

STAFF: Okay. Next up we've got Rose Thayer from Stars and Stripes.

Q: Hi. Thank you for putting this together.

I was just wondering -- I know you just provided some examples, there such as the ICU hospital beds, but have there been any instances, maybe, where things have gone the other way and you've been able to help out the folks in Chicago a bit with some lessons learned that have already been put into practice today?

(UNKNOWN): One second.

CAPT. SIEWIERA: Okay, thank you for this question.

Probably yes, I believe so. There are big differences in our approach to diagnosing the COVID-19. And we began from the easiest points, like our advisers for organization of emergency departments or the patient flow to the hospital tract with the airlocks, with the decontamination of airlocks, which were probably set up -- might be set up in a more appropriate way when we see the ventilation, when we see the passage of the air and the tray around the patient.

We also have seen some point about the possibility of medical personnel infections which we observed in Lombardy. They were using in the first phase of fighting the COVID; they were using the barracks, medical barracks for the -- from the field hospitals, and these barracks were quite low with two meters, 2.5 meters height, and with bad ventilation. So the ICU beds were too big to get inside to treat the patient properly with a good quality of services.

And also, the spray from the ventilator, from the bronchoscopy, from all the procedures to the BAL bronchoscopy, an example, examination. The spray of these procedures were all around these barracks -- within the barracks, and that was suspected as a cause of infections among medical personnel. So now, we see that the ventilation is one of the most important parts of organization -- of organizing the COVID Emergency Department.

We also talk about the approach to diagnostic and imagery-- testing because we know that we cannot provide tomography or more diagnostic procedures, like PCR testing to all the community in one time. And if the situation appears that a lot of people, a lot of patients, are admitted to the hospital with the insufficiency, we are scanning them with an X-ray. It also relates to the condition of the patient, which can very rapidly deteriorate without any signs (inaudible). It is quite normal right now.

But we developed the scales for examining these patients and for cheap and fast scoring of these patients I spoke about it a few minutes ago. We are designing these -- the six sectors, monitoring from zero in each sector and the total score is 18 points.

That was something which was quite interesting for our partners with a -- with the physicians within the Chicago medical service. We also have some insights about the usage of extra-corporeal oxygenation membrane -- oxygenation -- among the patients with the COVID, and the cost-benefit proportion in that procedure. We performed some of these procedures in -- in Poland, and in Lombardy it was also provided to the patients, to the younger ones in the second phase. So these were also quite important insights.

I believe the -- our specialists in the ECMO treatments, we'll be inviting also the -- the personnel from -- from USA to -- to -- to cooperate in the scientific fields, with providing ECMO to -- to COVID patients. So these were one of the points which we were sharing with our partners.

STAFF: Okay, thank you. We've got one more from the phone lines.

Stacy St. Claire, Chicago Tribune?

Q: Captain, what have medical personnel in the United States been asking you -- like, what are their questions and what do they want to know?

CAPT. SIEWIERA: Okay. In the first contact, we had more epidemiological issues about the phases of this pandemic, because in the big picture most of the decision makers are focusing on the curve, and flattening the curves and all of these things which we do among the society to flatten the curve.

But from the clinical point of view, we also see the phases of the type of the patients. We liken it to demographic aspects, and we have seen Lombardy, that after four or five weeks of huge increase in admissions among the nursing homes, among the patients of the hospitals, elderly patients -- after this time, something about one month, maybe month and a half, there -- the -- the -- the doctors were saying quite broadly that they are admitting much younger populations -- 50s, 40s, and the second phase of the pandemic was mostly involved with younger patients with better -- with probably better outcomes, that varied that we -- reacting for -- reacting for the treatment.

All the procedures which were implemented didn't shorten the time of treatment. So it was something like four or five weeks of treatment in the intensive care unit with a drainage of the right pulmonary field, the left pulmonary field with (inaudible), ventilation with procedures like ECMO and the progress was quite poor.

So these were the insights in which we have seen in -- in -- in Lombardy and we are exchanging this with our faculty here to avoid that situation.

STAFF: Okay, we've got time for just a couple more before -- before we open -- or before we head to closing comments. Next up, I've got Jennifer Griffin from Fox.

Q: Thank you very much. I have a few questions and follow ups.

Are you seeing certain drug combinations that you were using in Lombardy or in Poland that are working in terms of treatment and are you sharing those with your colleagues in Chicago?

And you mentioned the clothes and protective gear, the clothes in particular of the medical workers being taken home as being a vector for the disease spread, if I understood you correctly. Can you expand on that?

And are you seeing that the disease is changing at all or is this the same disease that you are describing in each of the phases, even though it's hitting different populations differently? Is it morphing?

CAPT. SIEWIERA: Okay, thank you for the questions.

In the aspect of pharmacology, maybe. Unfortunately, we see that there is no optimal treatment yet for the COVID. There is no cause treatment and there is no effective treatment in the -- the viral phase because when you look at that in the -- progression of the COVID disease, we see that these -- in each patient, we observed two phases -- the viral phase, with a -- you know, reputation of the RNA, virus RNA, and the second phase of the acute area (inaudible), which requires medical and mechanical evaluation for the treatment and all the life-sustaining treatment procedures.

In this second phase, there is a lack of (inaudible) among the patients very often, and we are talking about the cycle (inaudible) storm in that phase.

So, in the first phase, viral phase, we don't have insights, and other than our partners from United States. The hydroxychloroquine is disappointing. The remdesivir, maybe in some groups, maybe in some cases, could be providing some improvements, but it is not the drug which will totally extinguish these (inaudible). And all of these antibiotics, which were suggested to use were also disappointing in that -- in that phase.

We have spoken with our partners from hospitals about (inaudible) and it -- to -- usage in the second phase with the (inaudible) phase. And this is the draft which provides some improvements, even (inaudible).

So if we have the scientific form in the second phase of the COVID, we see that this drop provides lowering in -- in -- in -- (inaudible) level with a (inaudible) response, but we are not convinced if this will be related to better outcome of the patients, and less mortality. We are skeptics, unfortunately, about that as an anesthesiologist and (inaudible).

So my observation and my recommendation is that we have to be not good, not very good, but perfect in discipline of mechanical ventilation. We have to do best to do what we have done until now. We have to provide appropriate volumes, appropriate energy for the ventilators to avoid the lung injury, because these are the factors which are most important for sparing lungs. Yes, yes, for better life conditions.

If we get to the second question, so PPE, in Poland, I've got -- we've got a broader -- broader possibility to use them. We use gowns, we use masks, and we are using this as a single use, too. But we are excited about experimenting with recycling of these masks because this might be the good idea to provide the community access to high-level protection, breathing system protection--- with droplet (inaudible) protection.

These procedures can be done at home, and are recommended by the FDA right now. So this was one of the ideas which I am reporting to Poland.

About this vectoring, virus particles are in the spray, we know that. And the spray, when the air is not moving, is falling down on the surfaces. On the surfaces, it can last for a long, long time. We know it can last hours and a day. So the spray which is falling down on the medical clothes, on the scrubs or uniforms among the military personnel, medical personnel, these particles can be taken home.

So in some hospitals, especially infectious disease hospitals in Poland, there is a recommendation or obligation for decontaminating personnel with a shower, with detergents after work. And leaving their clothes, their scrubs in -- for -- leaving in washing rooms. I don't know how to say this, but hospitals washing rooms with a detergent that is mostly used with the patients' clothes, not to take them home and to wash with a normal detergent as we use with a baby.

Q: So laundering -- laundering --

BRIG. GEN. NEELY: Laundry.

CAPT. SIEWIERA: Yeah, yeah, laundering. Sorry for that.

BRIG. GEN. NEELY: That’s okay.

Q: -- laundering clothes -- no, no, good, thank you.

CAPT. SIEWIERA: Yeah. So it's a recommendation to use the laundering in the hospital for the professional detergent in a medical setting.

And the third question was about -- could you repeat the third question?

Q: Yes, yes. It was about whether you are seeing the virus morph or change, or is this the same virus at the beginning?

CAPT. SIEWIERA: Thank you, yes.

All right, so we have seen and observed this disease for nearly three months right now in different regions. And we suspect that the manifestation and mortality of this disease is different among the locations. We are not sure if this depends on -- this mortality depends on the mutations, or this mortality depends on the demographical factors.

We know that in northern Italy, in Lombardy, the society is quite elderly, so the mortality in Lombardy was higher. We see that the -- an example in Germany, in Poland, we observed less mortality, and there are some complications which state that these are factors connected also with mutations, with the types A, B, C of the virus particle.

But until now, we know that there are 40 mutations, 40 types of this virus already, among which, over three months in Europe and the United States. And I'm skeptic about finding differences in the types related to the particles. Mostly I see the differences in the period and the demographical aspects.

The most important news about the symptoms are coming from the pediatric population. And these manifestations look differently than in the adults, but it's too early to comment on that with high probability.

STAFF: Okay, we've got time for -- we've got time for one last one and then we go to closing comments.

Joe, NGB Magazine?

Q: Hey, thanks for -- for putting this together.

This is a question for General Hatley. Does NGB or any of the states plan on bringing in other state partners for any other states in kind of a similar capacity as Illinois has done with Poland?  
BRIG. GEN. HATLEY: That's a great question.

I would offer this: that up to this point, there's been a continuous dialogue between many of our partner countries in the states and territories that comprise the SPP program, many of which is just an exchange of lessons learned, best practices, challenges that they have encountered.

I will say that this particular instance with Illinois and Poland, Poland reached out specifically to Illinois, which I would go back to kind of bridge upon my opening comments, just truly epitomizes the greatness that is the State Partnership Program, to have that -- that freedom of maneuver, to have that comfort to where they can reach out to states and offer up assistance, moving forward.

That said, we are always open to our partner countries reaching out to us, there's nothing to preclude that. And those are always great opportunities.

I hope that answers your question.

STAFF: Yeah, that's all we've got time for today. At this time, I'd like to hand it over to -- to General Neely for closing comments.

BRIG. GEN. NEELY: Well, thanks for that.

That was a great answer from General Hatley. I echo those comments.

You know, it's the relationship that's built over so many years, where that friendship is there. And a friend will reach out and ask questions about possibilities in that. And that's what we really have seen with this -- with this exchange here, the defense attaché reaching out to -- to myself and based on conversations in Poland to -- to see how we would do this. And -- and we really had to look for ways to -- to bring the team here, and how the team would get transported, and how we would work through customs, and how we'd work through the -- the policy of the -- the presidential policy right now in place for no foreign flights and -- and that. And so we -- we had to work through a lot of those things, but for some of you, thanks to the help from the National Guard Bureau and -- and a lot of different agencies we were able to find our way.

So again, I just want to say thank you for -- everybody, for joining us today. It's a -- it's a real honor to receive this team from Poland and -- and to share their best practices with us here in Illinois. We are all learning how to respond during these challenging times. I believe sharing best practices, understanding how one country may approach it or, you know, even a European approach compared to the U.S., I think we all have things to learn from this.

And this 26-year, almost 27-year relationship will go on into the future based on historic visits like this, this reverse cooperation from, you know, the -- the Republic of Poland. And we're deeply touched by their gratitude and -- and for making this trip, for taking this time away, for being so disciplined in their processes to ensure that -- that they're able to be here and -- and to be healthy through the process as they travel internationally and -- and as we visit a lot of different locations. These teams -- very disciplined in -- in -- in how they hygiene and how do they decontaminate themselves during the day in each one of those to ensure that -- that there is not a spread based on their contacts in different places, and I'm -- I really appreciate all their dedication.

So with that, again, thank you for joining us today.

And -- and thank you to the Pentagon press team for hosting this event. Thank you.

STAFF: Thank you, sir.

And on behalf of everyone involved, I'd like to thank the Illinois National Guard, the Polish military, and the National Guard Bureau for being available to take questions today, and for the members of the media who joined us today, both on the floor and on the phone lines.

Thank you very much. Have a great day.