ASDHA July Message to the Military Health System Team

Posted on August 2, 2020 Updated on August 1, 2020

The message can be viewed here in PDF form and cut/pasted below.

MHS Team:

July is Health Innovation Month in the Military Health System. Innovation drives how we meet many of the challenges that arise, and that’s especially the case in a crisis – when routine thinking doesn’t match the complexity, speed and urgency of the issues that confront us. Your ability to innovate is something that impresses me every day. Examples of innovative breakthroughs are occurring with vaccine development, testing and diagnostics, and preventative and rehabilitative care.

Two of the Department’s vaccine candidates have successfully advanced and are in the mix for vaccine development. Artificial Intelligence and Machine Learning-assisted efforts are helping to accelerate the process of discovering a new drug. This will help not only DoD, but potentially the Nation. The Department is also leveraging innovative research in anti-virals, anti- inflammatories, plasma products, and antibodies.

The Department’s sights are set on integrating emerging new technologies, like serology and point-of-care antigen tests, into the Department’s next testing strategy. We’re exploring alternative approaches like pooled testing, for which the Food and Drug Administration just issued an Emergency Use Authorization, allowing us potentially to accelerate our rate of screening and testing, while maintaining appropriate surveillance of COVID-19. In the meantime, MHS data are providing a common operating picture for commanders up and down the line, and are in alignment with the White House Coronavirus Task Force, through partnerships with the Department of Health and Human Services and the Food and Drug Administration. For instance, the Defense Health Agency, the military services, and the Uniformed Services University’s work on the Department’s first-ever COVID-19 patient registry is informing our medical research, clinical practice guidelines, and contributions to peer- reviewed journals, and are also being adopted as part of other policy and guidance products throughout the interagency. You can read more about our COVID-19 innovations at https://go.usa.gov/xfYGx.

Innovation is more than what takes place in a lab. I just returned from a visit to several sites in the Pacific Northwest and witnessed impressive examples of MHS innovation in action. At the 1SFG (Airborne) command at Joint Base Lewis-McChord, for example, the team is working hard on the Tactical Human Optimization Rapid Rehabilitation and Reconditioning THOR3 program, based on the training model used by professional athletics strength and condition coaches. They’re using this unconventional set of tools to build stronger, more resilient special operators who are less prone to injury and able to get back in the fight faster if injured. They’re laser-focus on reducing injuries associated with training. And they’re tackling the challenges with creative problem solving and new, cutting-edge resources.

Read more about the MHS’s COVID-19 innovations at https://go.usa.gov/xfYGx.

Some updates on current MHS issues:

MHSRS Canceled. Out of an abundance of caution about COVID spread, we canceled the Military Health System Research Symposium, our annual venue for showcasing cutting-edge, innovative research and development in military medicine. But the innovation continues, so we’re going to make sure the abstracts and success stories will not be lost. We’re creating a way to best share all of the important work that furthers the science and practice of military medicine, and tells the story of our innovative and caring enterprise.

DoD Testing Updates: DoD’s COVID-19 Diagnostic and Testing Team, led by the Defense Health Agency’s Maj Gen Lee E. Payne, continues to make measurable progress to screen, detect, and monitor risk through an integrated DoD-wide COVID-19 testing strategy. The Diagnostic and Testing Team works in several key areas. First, it ensures that the testing requirements are identified by the Services and Combatant Commands and that these requirements are supported by the Department’s laboratory and testing capabilities. Second, it ensures laboratories and testing sites have adequate supplies to execute testing. And third, it coordinates with the Joint Acquisition Task Force and HHS/FEMA to enhance the supply chain and acquire additional testing platforms and associated supplies.

The Secretary of Defense has prioritized the diagnostic and screening testing of the force in the following categories of units and commands: critical national capabilities, engaged field forces, forward deployed and redeployed forces and all other forces.

Since January, the Department has conducted more than 480,000 clinical and screening tests. Maj Gen Payne and his team have successfully set the framework for executing the Department’s tier-based testing program, increasing active-duty weekly testing fivefold in three months. DoD has expanded testing capacity from 15 to 125 laboratories conducting 60,000 tests per week, with the capability for up to 200,000 per week. In fact, in the last five weeks alone, we have doubled our testing rate, having now completed more than 466,000 tests. And the team continues to contribute to the military medical enterprise’s unparalleled expertise to inform Force Health Protection Guidance – with Supplement 11, for instance, centered on surveillance, screening and testing:

https://media.defense.gov/2020/Jun/12/2002315485/-1/-1/1/DOD-Guidance-for-COVID- 19-Surveillance-and-Screening-with-Testing.pdf.

Excellent job by Maj Gen Payne and his entire D&T CVTF team.

COVID-19 Convalescent Plasma Update: At the direction of Secretary Esper, we are about half way toward our goal of obtaining 10,000 units of convalescent plasma to help service members who are hit with COVID to recover more quickly, ultimately preserving our forces’ military readiness. We’re also able to use convalescent plasma to advance research against the virus.

The collected convalescent plasma is already making a difference. We’ve treated more than 50 patients, who have received more than 70 transfused units of plasma. And that’s just the beginning, in part because a lot of people recovered from COVID are rolling up their sleeves and donating their blood and their blood plasma to help others who may need it. Armed Service Blood Program Blood Donation Centers are contacting all beneficiaries who have tested positive for COVID-19 to let them know about how they can help the cause.

While plasma donations are completely voluntary, I was pleased to learn about Marines assigned to the Marine Corps Recruit Depot San Diego, who have tested positive for COVID-19, lining up to donate their plasma to help a fellow service member or military beneficiary. “It makes me feel good to be a part of the solution to this pandemic,” said Marine Corps Pfc. Xavier Flores, a recent donor. That’s the spirit that will get us through. Read more about this inspiring story here:

https://www.defense.gov/Explore/Features/Story/Article/2282184/marines-donate-plasma-in- fight-against-covid-19/

And at another stop while I was visiting Joint Base Lewis-McChord, it was inspiring to see the incredible blood center team in action for myself. I witnessed first-hand the kind of dedication we’re looking for on the plasma collection front. It was clear the team there understands that we need everyone eligible to donate. It could very possibly save a life. If you’ve been diagnosed with COVID-19, have fully recovered, and meet other eligibility requirements, or if you know someone who meets those requirements, please consider the importance of donating at an Armed Services Blood Program donor center. Learn more here: https://go.usa.gov/xfY7d.

Return to the Workplace: Throughout the MHS, we’re using a phased approach to return to more normal operations. Supervisors have the responsibility to carefully navigate through these stages with each employee, according to local conditions, health risk factors, and mission requirements. The Defense Health Agency recently released a Concept of Operations to guide resumption of full health care delivery operations, readiness support, enterprise threat reduction, and ongoing support for COVID-19 response efforts. Critical to our resumption of full health care operations will be risk mitigation practices and a deliberate focus on lessons learned. At every level of the MHS, thank you for finding the ways to best protect and care for our providers, patients, and the active force.

Resuming some travel, I was able to get out of Washington and to see some of the great work you all do every day to ensure our nation’s military medical readiness, support the warfighter, and care for the patient – and in the middle of an historic pandemic. My only thought was how proud I am to be a part of something so big and important to so many real people. Together, we are building an enterprise of dedication and innovation that is protecting our people, advancing readiness, and supporting the national COVID-19 response. Let’s continue to build on this success. Stay healthy and thank you for being a part of the fight.

Tom