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Asking the military to build a parallel health system to fight coronavirus (opinion)

In fact, Covid-19 is likely to put a strain on an already overwhelmed healthcare system in the United States, with many hospitals operating nearby or at full capacity. This is even more worrying if we consider that Italy, where Covid-19 is currently causing chaos on the health system, has significantly more hospital and medical beds per capita than the United States. While hospitals in the United States are working to expand their capabilities, we may still not be up to par, especially if coronavirus continues to spread at current transmission rates.

How do we take care of everyone who will need it in the coming weeks and months? We need to create a Covid-19 parallel assistance system.

Establishing a parallel health care system for coronavirus that uses a secondary workforce would allow us to rapidly increase our capacity, mitigate the burden on the workforce of the existing supplier and reduce patient-to-patient or patient-to-supplier transmission that it could endanger vulnerable people who have already been hospitalized for other reasons.

Led by the U.S. Public Health Service with army support, this Covid-19 parallel care system would consist of designated treatment centers established for the explicit purpose of evaluating and providing supportive care to patients with suspected or confirmed Covid-19 infection. Ideally, these centers would exist in less densely populated areas easily accessible from major metropolitan areas.

Our military – logistics experts in high-stress emergency scenarios – have a long history of rapidly growing structures like these. The U.S. Army, for example, distributes Combat Support Hospital, mobile hospitals housed in expandable tents and containers, to provide assistance in combat settings. Covid-19 treatment centers could borrow functionality from these existing models.

Our logistics-led military branches adapt perfectly to the staff of this parallel system, as they can be trained and implemented quickly. This secondary workforce could be supervised by medical professionals (military or civilian) and widely capable of tracking contacts, containment, mitigation and supportive medical care. Strengthening their efforts may require the recruitment of retired doctors and nurses, empowering resident doctors and training non-providers with something similar to what emergency medical technicians receive so that they are able to administer basic care under the supervision of an authorized health care provider.

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This would fill the gaps that exist in our public health and healthcare infrastructure and release some of the burden on local authorities and health care providers. Of course, providing adequate personal protective equipment and rigorous training and education is a prerequisite for any deployment.

A patient with Covid-19 symptoms may report to a local emergency room (or, preferably, call a national hotline number or virtually interact with a healthcare professional). After medical professionals confirm that a patient has Covid-19 or rule out alternative diagnoses, the patient is immediately transported to a specific COVID site through a free, safe and accessible transit designed to prevent transmission. There, skilled workers would evaluate the patient and provide supportive medical care.

Importantly, the Covid care system must be prepared to manage the sickest patients – such as those with significant breathing difficulties – because they require most of the resources and present the greatest challenge to the existing healthcare system. This will require both negative pressure rooms that prevent cross-contamination and fan support, which is currently limited in the face of a pandemic wave.

In this regard, Covid-19 will require us to draw on the strategic national escort of the Center for Disease Control and Prevention, but also to innovate new technologies to provide ventilation support quickly, efficiently and on a large scale.

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In addition to relieving stress on our healthcare system, this parallel system would also better support public health functions, such as monitoring, data communication and quarantine. The protocols would be centralized and performed uniformly, rather than disparate from private systems with their own standard operating procedures.

Setting up a parallel health system for Covid-19 and hiring staff with a secondary workforce are no small task. It requires thoughtful planning, expert input to elaborate the details, near-perfect coordination between many groups at all levels of government and careful execution to be implemented on a large scale. Above all, it requires leadership.

Now is the time to act decisively. With the direction of the White House and Congress appropriations, we can mobilize the resources needed to create the Covid care system we need to reduce stress on our health care system and provide quality care to those who will suffer from this epidemic.

Without aggressive measures like the ones we propose here, we fear the consequences of Covid-19 on the function of our healthcare system for all patients.

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