When a COVID-19 outbreak hit USS Kidd (DDG-100) last month, the Navy sent a medical team with specialized lab equipment to the guided-missile destroyer to test for novel coronavirus among the crew. An outbreak at sea could easily and quickly overwhelm a warship’s small medical department, in this case an independent-duty corpsman and two hospital corpsmen in a crew of about 330.
Fortunately for Kidd, amphibious assault ship USS Makin Island (LHD-8) was training in the Southern California Operating Area when the Navy on April 23 ordered it to rendezvous with Kidd and escort it to San Diego.
Extra medical help was on its way. Aboard Makin Island were four members of Fleet Surgical Team 1, who were training with the ship’s medical staff during the at-sea operations.
Within days, as both ships headed toward California, 15 Kidd crew members suspected of being infected by the virus were flown to Makin Island to be monitored for the virus.
The big-deck amphibious ship’s medical department is among the largest, most-advanced treatment facilities in the fleet, aside from the Navy’s two hospital ships operated by Military Sealift Command. It has large treatment spaces, including a 15-bed intensive-care unit and a 45-bed ward designed to treat combat-wounded Marines.
Along with the four members already embarked on Makin Island, the San Diego-based FST-1 sent an additional four – a certified registered nurse anesthetist, critical-care registered nurse, respiratory therapy technician and laboratory technician – to the ship to help treat the Kidd sailors. When deployed, a Navy fleet surgical team generally has about 15 medical personnel and provides “Role 2,” or resuscitative damage control surgery and mental health, care to naval amphibious forces.
“Once we were notified that there was a possibility that we would be helping the USS Kidd, we decided to bring onboard four additional team members, just based on the possibility of getting patients,” Lt. Jose PonceVega, the FST-1 division officer and medical regulating control officer, told USNI News.
“As soon as we heard that call, we decided we were going to bring those people,” said PonceVega. “So within an hour, we called our staff and said, ‘Hey, pack your bags, you’re coming with us,’ and they were onboard within four hours.”
They arrived the same day Makin Island got directed to assist. The team had two-and-a-half days to prepare before the 15 sailors arrived. They worked with Makin Island’s medical department to treat the patients and handle necessary laboratory work and X-rays en route to San Diego. “Our goal was to provide basically observation on the patients, based on their medical condition and based on the symptoms they were displaying,” he said. The patients remained aboard the Bremerton, Wash.-based ship until San Diego.
FST-1 sent one of its independent-duty corpsmen, who have specialized training including in preventative medicine, to the Kidd to assist the destroyer’s crew, PonceVega said. “He is very experienced and very knowledgeable, so him going to that ship really helped out the crew and their medical staff.”
On the trek to San Diego, Kidd got extra support including fuel, protective masks and other medical supplies from Makin Island in air deliveries flown by Navy Helicopter Sea Combat Squadron 23, according to an Expeditionary Strike Group 3 news story. A MH-60R from Helicopter Maritime Strike Squadron 75, embarked aboard Kidd, transferred the patients from Kidd to Makin Island, which instituted quarantine and decontamination measures to prevent the spread of any coronavirus.
“We were standing by and able to bring those sailors to Makin Island while still maintaining isolation and quarantine of them and the medical professionals that we have onboard who treated them,” said Capt. Chris Westphal, the ship’s commander, said in the news story. “We took every precaution to ensure the safety of both Makin Island and Kidd sailors, and to ensure Kidd returned to San Diego safely, and we were proud to be able to help our fellow shipmates.”
The emergent mission put FST-1 members to the test. “This was definitely new for us. I think with the spirit of protecting our people, we had made some plans to care for COVID-positive patients at some point,” PonceVega said. “As soon as we got out of the pier and started doing normal operations in the SoCal area, we started making plans for that. But we didn’t expect to employ those plans right away. So we planned for it, but we didn’t think it would happen so soon. So we learned a lot through that process.”
FST-1 leaned on the Naval Health Research Center and the Navy Environmental Preventative Medicine Unit for information and lessons learned from similar missions.
“One thing that we’ve learned the most is about how to use our protective personnel equipment, our PPE,” said PonceVega. “When you’re taking care of a patient, you don’t typically wear a mask and face shield, so just getting used to using that and putting it on and taking it off appropriately is a learning experience itself.” So they practiced in drills using the protective gear enroute to the Kidd.
They took measures to limit interactions of medical staff with each patient, at least until they knew whether the sailor was infected with the coronavirus. “You don’t need everybody to have close contact with a positive patient right away,” PonceVega explained. “So you assess the patient and figure out what you need, then if you need additional staff to support the care that you’re going to provide, then you bring them in.”
“That ability to scale your staff, based on the needs of the patient, was definitely something we learned,” he said. “Also from the perspective from the administrative requirements of moving the patient from one ship to the other and tracking them through the levels of care, that was something we paid close attention to to make sure we got it right.”
“We had developed plans what to do with patients if we ha positive patients onboard. Our initial plans were to get the patient to a medical facility to get the care they need. But in this situation obviously we had to keep the patient longer than” expected, he said, “so coordinating that care to make sure that once you get to a location that they get to the right facility for care.”
“The Navy’s primary mission is to protect our people,” he added, “so we pride ourselves on being able to provide care to our sailors and be ready to respond to whatever the needs are of the fleet.”