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How to Partner With the Military in Responding to Pandemics—A Blueprint for Success

Educational Objective
To understand how military-civilian partnerships can be used to offload civilian hospitals during crises caused by infectious diseases.
1 Credit CME

The rapid emergence and spread of coronavirus disease 2019 (COVID-19) is presenting challenges to medical clinicians not previously encountered in our lifetime. As the US Navy hospital ships are preparing to launch (USNS Comfort and Mercy) and governors are calling for military field hospitals to be used, there are several unanswered questions to be considered, such as who will staff these military installations, who will direct them, and what services will they provide. Many military medical clinicians are currently deployed to Iraq, Afghanistan, and Syria, as well as other areas of the world, and are unlikely to be called back anytime soon. Others will be needed to keep the 54 military treatment facilities (MTFs) open to care for the 9.4 million military beneficiaries and their families. Additionally, as key members of the health care community, military medical personnel will be needed to treat patients with COVID-19 who are seen at MTFs. In 2007, we described the unique partnership developed between the US Department of Defense and several civilian professional surgical societies to assist in the care of combat casualties alongside military medical personnel at the US Army Hospital in Landstuhl, Germany.1 It is now time to consider a similar such program in the US for this and future national emergencies.

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Article Information

Corresponding Author: M. Margaret Knudson, MD, Department of Surgery, Zuckerberg San Francisco General Hospital, University of California, San Francisco, 1001 Potrero Ave, Ward 3A, San Francisco, CA 94110 (peggy.knudson@ucsf.edu).

Published Online: April 6, 2020. doi:10.1001/jamasurg.2020.1227

Conflict of Interest Disclosures: None reported.

References
1.
Moore  EE , Knudson  MM , Schwab  CW , Trunkey  DD , Johannigman  JA , Holcomb  JB .  Military-civilian collaboration in trauma care and the senior visiting surgeon program.   N Engl J Med. 2007;357(26):2723-2727. doi:10.1056/NEJMsr073207PubMedGoogle ScholarCrossref
2.
US Congress. National Defense Authorization Act for fiscal year 2017. Accessed March 20, 2020. https://www.congress.gov/bill/114th-congress/senate-bill/2943/text
3.
US Department of Health & Human Services. Pandemic and All Hazards Preparedness and Innovation Act. Accessed March 20, 2020. https://www.phe.gov/Preparedness/legal/pahpa/Pages/pahpaia.aspx
4.
Knudson  MM .  A perfect storm: 2019 Scudder oration on trauma.   J Am Coll Surg. 2020;230(3):269-282. doi:10.1016/j.jamcollsurg.2019.11.009PubMedGoogle ScholarCrossref
5.
American College of Surgeons. Military-civilian partnerships for trauma training, sustainment and readiness. Accessed March 20, 2020. http://www.facs.org/military
6.
Walk  RM , Donahue  TF , Stockinger  Z ,  et al.  Haitian earthquake relief: disaster response aboard the USNS comfort.   Disaster Med Public Health Prep. 2012;6(4):370-377. doi:10.1001/dmp.2012.67PubMedGoogle ScholarCrossref
7.
Howard  JT , Kotwal  RS , Stern  CA ,  et al.  Use of combat casualty care data to assess the US military trauma system during the Afghanistan and Iraq conflicts, 2001-2017.   JAMA Surg. 2019;154(7):600-608. doi:10.1001/jamasurg.2019.0151PubMedGoogle ScholarCrossref
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