Nearly a week after taking on its first patient, hospital ship USNS Comfort (T-AH-20) is prepared to treat up to 500 patients infected with the COVID-19 virus, officials said Tuesday.
Comfort, berthed at Pier 90 along New York City’s Hudson River, “has 500 beds that are fully staffed and fully equipped now,” Vice Adm. Andrew Lewis said during a Pentagon press briefing. “We also have 100 (intensive care unit) beds with the same number of ventilators and we are looking to provide more, although we can’t convert anymore to ICU beds. But we are still looking to push ventilators as required if required.”
“The higher-acuity patients – trauma patients, emergency and urgent-care patients – regardless of their COVID status can be treated on the Comfort,” Lewis said.
As of midday Tuesday, Comfort had five patients aboard who tested positive for the virus.
“They came onboard – in all cases – COVID negative. They were hospitalized for something different than COVID, but they were retested because they had some other condition that was causing a clinical evaluation of COVID,” he said. “They are remaining aboard because they can be treated properly and isolated currently, isolated within one of the wards.”
Lewis said one staff member aboard the ship has tested positive for the virus, which can be deadly.
“That crew member has been isolated,” he said. “There is absolutely no mission impact and there has been no exposure to patients prior to the testing of positive. The testing was actually done out of an abundance of caution. Nobody had been in close contact with the isolated individual, but those that have in the recent past are in an isolated status themselves being monitored for symptoms, and none of them are symptomatic at this time.”
“We’ve had to adjust what we do and how we do it, and reconfigure the ship accordingly,” he added. “But I’m very confident that we’ve taken all the requisite steps to do so and mitigated what risks we have incurred to the maximum degree possible.”
The five COVID-positive patients were among 44 civilian patients, as of midday Tuesday, who were being treated aboard the Norfolk, Va.-based hospital ship as part of the military’s COVID-19 support mission in New York City. That federally led operation includes a large field hospital set up in the city’s Jacob Javits Convention Center to treat COVID- and non-COVID patients. As of midday Tuesday, 66 patients were being treated at the Javits Center, Jonathan Hoffman, the chief Pentagon spokesman said, “and we expect to increase the number of patients rapidly in the next few days.
“We are looking to reach a capacity of 500 patients at the Comfort,” Hoffman said, “and 2,500 non-urgent, COVID patients” at the Jacob Javits Convention Center, where 917 military personnel are assigned to the Federal Medical Station. The sprawling Javits center will provide more space for the convalescence of COVID-positive patients who are recovering but no longer require ventilators, as well as an expanding intensive-care unit, to total 96 beds, for patients who might require ventilators, officials said.
Military and federal officials on Friday had changed Comfort’s initial mission to take and treat non-infected trauma and emergency cases from New York City hospitals inundated with infected patients, many which require ventilators if symptoms become more severe. (As of Tuesday afternoon, officials have not changed the status of hospital ship USNS Mercy (T-AH-19), which is berthed at the port of Los Angeles to help local hospitals by taking on non-infected patients.) Officials on Saturday changed the treatment level of the Javits center to enable treatment of COVID-19 patients.
But with local hospitals reporting fewer patients admitted who aren’t suffering from the virus, “we are not really able to achieve our mission that we were sent here… to really get at where the relief is needed,” Lewis said. Most hospitals have patients who are COVID-positive, although many originally were hospitalized for something else, he added.
Military medical liaison teams continue to work with local hospitals and coordinate the transfer and acceptance of patients, including those with COVID-positive tests, officials said. “We are looking at Javits and Comfort as a single ecosystem, a single care provider for COVID – regardless of COVID status – but to cover emergency, trauma and urgent-care patients,” Lewis said, while Javits center will focus on COVID convalescence.
The new focus required reconfiguring areas aboard the 1,000-bed hospital ship to provide more spaces for quarantine and expanded intensive care units. “We are already transitioned. We are fully transitioned. We have done some minor configurations on ship, and there is no threat to any of the patients who are non-COVID (infected) at this time,” Lewis said. “We are able to isolate, within the ship, the non-COVID patients from the COVID-positive patients.”
It also required additional safeguards the 1,200 or so people aboard Comfort and protect the doctors, nurses, anesthesiologists, surgeons, respiratory therapists and others who comprise the Medical Training Facility assigned to the ship. So Comfort is segregated into two zones: The “red zone” covers any area with patient interaction while the “green zone” includes ship operations such as auxiliary spaces, security and the power plant. “They don’t go back and forth,” he said.
Berthing for MTF personnel has been moved off Comfort to a local hotel and they are transported back and forth for their 12-hour shifts. “Right now we have about 500 people there,” but about 800 will be housed there in single rooms and fed once the ship fully transitions, he said. The ship’s crew of merchant mariners have their own staterooms and separate spaces aboard the ship.
“The doctors and nurses, they are absolutely comfortable with all of the protocols they are meeting as far as remaining safe and treating… patients that are COVID positive,” added Lewis.
Defense officials have sought to balance the risks to the hospital ships and support the mission while mitigating risks “as much as we can” to those aboard in the decision to open Comfort to COVID patients. “We’ve also reduced the number of beds available and have taken steps to get the risks of exposure, particularly exposure that could effect a longer term of deployment,” Hoffman said.
The military’s latest moves to expand its medical and support mission to support hospitals in the New York region include several new overflow sites in nearby counties and additional medical teams
The Pentagon’s medical support includes: two Army field hospitals; a Navy expeditionary medical facility with 400 personnel; 340 personnel with four Army area medical task force units inbound to New York; and three Army medical task forces bound for New Jersey and Connecticut. Starting Wednesday, 325 Department of Defense medical professionals will support 11 NYC public hospitals – each receiving 20 to 30 medical personnel to augment hospital staff – and an additional 775 Navy, Army, Air Force and Air Force Reserve medical professionals will arrive in New York City “in the coming days to further support our efforts,” Hoffman said.