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DoD ready to help with Coronavirus, but capability limited

Misook Choe, a laboratory manager with the Emerging Infectious Disease branch at the Walter Reed Army Institute of Research in Silver Spring, Md., runs a test during research into a solution for the new coronavirus, COVID-19, March 3, 2020. The Emerging Infectious Diseases branch, established in 2018, has the explicit mission to survey, anticipate and counter the mounting threat of emerging infectious diseases of key importance to U.S. forces in the homeland and abroad. (U.S. Army Sgt. Michael Walters) Misook Choe, a laboratory manager with the Emerging Infectious Disease branch at the Walter Reed Army Institute of Research in Silver Spring, Md., runs a test during research into a solution for the new coronavirus, COVID-19, March 3, 2020. The Emerging Infectious Diseases branch, established in 2018, has the explicit mission to survey, anticipate and counter the mounting threat of emerging infectious diseases of key importance to U.S. forces in the homeland and abroad. (U.S. Army Sgt. Michael Walters)

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"The Department of Defense is ready, willing and able to support civilian authorities to the greatest extent possible with the direction of the president," Jonathan Rath Hoffman said during a Pentagon news conference. "We just want to make sure that the conversation that is being had is informed by the facts of what is possible, what is not, and what those trade-offs are."

While the U.S. military is often depicted in movies and on television as having the capacity to stand up vast medical capabilities at a moment's notice, both Hoffman and Air Force Brig. Gen. (Dr.) Paul Friedrichs, the Joint Staff surgeon, cautioned against overestimating the department's capacity to provide medical capabilities to support a contagion like coronavirus.

Hoffman told reporters that DoD has only about 2% to 3% of the number of hospital beds that the private sector has. The department runs only 36 hospitals in the United States, Friedrichs said, many of which are ill-suited for caring for large numbers of contagious patients.

"Many of them are configured to support, as you might imagine, our immediate military needs," Friedrichs said. "They take care of the active duty population and their families and some retirees. Some large facilities such as the Walter Reed National Military Medical Center in Bethesda, Maryland, have much more diverse services," he added. "We have a number of smaller facilities in more remote locations, like Fort Wainwright, Alaska, [which] has a small hospital that offers obstetrical services and basic community hospital type services," the Joint Staff surgeon said.

Hoffman pointed out that military doctors are better trained for wartime injuries than for treating communicable illnesses such as COVID-19.

"Our doctors are, unsurprisingly, trained highly in traumatic injuries and [for] dealing with traumatic injuries," he said. "We have a much younger population that we're dealing with treating in our hospitals. And so all of these kind of factor into what is that capability we have for a potential outbreak that generally has been more devastating to older persons who require a different type of attention than we normally do."

Even military tent hospitals that can be set up ad-hoc to respond to an emergency are designed for trauma care, not contagious diseases, Friedrichs said.

"We do have tent hospitals. They are deployable hospitals. ... The challenge is they're designed to take care of trauma patients and combat casualties," he said. "We have supported humanitarian operations. ... We've supported relief efforts during natural disasters. But what we're trying to be very careful of is not over-promising, you know. We want to be factual about what we have.

"Our fixed facilities are designed to the force that we have," he continued. "There are not thousand-bed medical centers all over the United States. They are, for the most part, small community hospitals. Our deployable hospitals range in size and range in capabilities that are very much focused and designed to take care of those in combat."

While both the National Guard and the Reserve components have medical doctors that can be called out to provide support, if needed, both Hoffman and Friedrichs noted that medical personnel in the Guard and Reserve are often also medical personnel in their private-sector jobs.

"If you mobilize the Guard and Reserve medical personnel from their civilian jobs, they're no longer in their civilian jobs, and that directly impacts the community where they worked, and that's the trade-off that — whether it's a natural disaster, or the coronavirus or anything else — that's part of the trade-off that we look at as we offer options going forward," Friedrichs said.

So far, Hoffman said, the Defense Department has received requests for assistance from the Department of Health and Human Services for quarantining and housing of people who were evacuated from China, those who had been on the Grand Princess and Diamond Princess cruise ships, and those who flew back to the United States through 11 feeder airports and needed to be quarantined.

"We have not received any other [requests] at this time that we have responded to," he said.

Hoffmann told reporters that DOD has seen 37 reported cases of COVID-19: 18 military personnel, 13 military family members, three civilian employees and three contractors.

To stem further spread of the coronavirus, he said, the department has issued updated guidance on domestic travel. Effective today through May 11, all domestic travel for military personnel is halted unless it's for mission-essential travel or humanitarian reasons.

Additionally, he said, DoD has given directors of installation commissaries additional authorities to manage their inventory to provide the best service to military members and their families.

"Today the department has given authority to local commissary store directors to impose restrictions on purchasing high-demand products," Hoffman said. "This will be in coordination with base leadership. The department is working to make sure that service members and their families on base understand these changes and have access to the goods that they need."

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