Every year on November 11, we pause to show our admiration and appreciation to our veterans — both living and deceased — for their bravery, loyalty, and sacrifice. Many veterans walk among us, as colleagues and friends, as partners in bringing world-class health care to our nation’s veterans, service members, and their families. Thank you once again for taking the time to celebrate them and to thank them for their service. November is also Warrior Care Month, a time to contemplate the perseverance and strength of our wounded and injured service members. I met some of these amazing men and women, and the people that care for them, when I visited the Center for the Intrepid in San Antonio. As you know, caring for these service members is a top priority for the DoD. The resources available for our wounded warriors goes far beyond their immediate health needs. From adaptive sports to education and employment resources, there are many ways that we support these wounded, injured, and ill service members.
Our mission requires an array of dedicated men and women at the top of their profession. This month, Dr. David Smith, Deputy Assistant Secretary of Defense for Health Readiness Policy and Oversight, was named Healthcare Government Executive of the Year at the Pinnacle Awards, an annual program that highlights successful executives and businesses saving money and fostering innovation across the DC region. Dr. Smith spearheaded DOD’s change management effort to reform the Military Health System (MHS) developing 11 comprehensive initiatives resulting in sustained improvements in readiness, patient outcomes, and taxpayer savings of over $1 billion in 2019 alone. I would like to give a shout out to the MHS Communications Team for winning two awards at last month’s Public Relations Society of America virtual awards ceremony.
The 2019 Infectious Disease and Summer Safety Campaign called “Bug Week” received the Silver Anvil in the category Events and Observances, and the team also received a runner up Award of Excellence for their content marketing program. The Silver Anvil is recognized as the Oscar in the Public Relations career field. This is the second straight year the MHS has received a Silver Anvil. Congratulations to the entire communications team for this great achievement. As you know, each year on the 4th Thursday in November, Americans take a collective breath to celebrate the blessings of the last year. While 2020 has been a challenging year for all of us, much occurred that reminded us how grateful we should be, especially the dedication of our nation’s health care workers and our MHS colleagues who have passionately supported the nationwide response to COVID-19. As we pause to celebrate on November 26th, I sincerely hope that your table will be filled with loved ones, whether in person or virtually, and filled with gratitude for our many blessings in this trying year.
Finally, please see attached, my November Monthly Newsletter:
Here is the message from the ASD(HA):
As you know, we have been on a temporary pause in our implementation plan to transition the administration and management of military medical treatment facilities from the Military Departments to the Defense Health Agency. Yesterday, the Secretary lifted this pause and directed that we continue implementation of the transition in accordance with Section 702 of the FY2017 National Defense Authorization Act. Attached you will find yesterday’s guidance from the Secretary (note that I did not attach this as I was uncomfortable putting a SECDEF memo on a blog, but you can see it here if you have a CAC reader and can log onto MilSuite).
I am confident we will achieve this important Military Health System milestone through collaboration between the DHA and the Military Departments with a continued focus on sustaining a ready medical force and a medically ready force while supporting our 9.6 million beneficiaries across the globe.
Here is the message from DHA:
This week we received guidance from both the Secretary of Defense and the Assistant Secretary of Defense for Health Affairs to resume the transition of MTF administration and management from the Military Departments (MILDEPs) to the DHA in support of our implementation plan. Paraphrasing the Secretary, he charged DHA with three priorities: ensuring the delivery of high-quality health care, utilize the MTFs as much as possible for readiness workload, and ensuring the medical readiness of the force. We must work collaboratively with our colleagues in the Services to implement a smooth and successful transition while ensuring safe, high-quality care for our 9.6 million beneficiaries. You can read the complete memorandum from the Secretary of Defense here:
Over the past month, our Military and the Nation has continued to respond and meet the unique challenges presented during the COVID-19 pandemic. The Military Health System (MHS) has been central to this effort in numerous ways, both as an organization and through individual accomplishments. And while supporting the pandemic response we also have continued to advance an array of other MHS initiatives. Updates on a few of these efforts include:
MHS GENESIS Go-Live. The rollout of MHS GENESIS continues to make enormous strides leveraging lessons learned from the previous execution of the Initial Operational Capability sites on the West Coast and Wave Travis. On September 26, 2020, the Nellis Wave went live at the following bases: Beale AFB, Edwards AFB, Los Angeles AFB, Nellis AFB, Vandenberg AFB, Fort Irwin Army Base, and the United States Marine Corps Air Ground Combat Center. The volume of WAVE Nellis requirements was two times the size of any previous roll out. Leadership at each facility reported no show stoppers and provided positive feedback. Lessons learned from previous sites were instrumental to a seamless release and resulted in a significantly reduced number of initial trouble tickets requiring action. The next deployment will be WAVE Pendleton and the “Go-Live” is 31 October.
National Influenza Vaccine Modernization Strategy (NIVMS). To help ensure we are prepared to address the impacts of seasonal and pandemic influenza viruses, DoD and HHS co-hosted a series of stakeholder listening sessions. I had the chance to provide a welcome video for those attending these virtual sessions. This effort is a collaboration among industry, academia and government to support the strategy released 8 June to implement the Executive Order to modernize the flu vaccine and promote national security and public health. Exciting advances will most certainly result from this enlightened collaboration. We discussed the role of federal and non-federal partners in NIVMS, and solicited feedback and viewpoints from external stakeholders. I’d like to thank COL Jennifer Kishimori, Director, CBRN Medical Countermeasures Policy of Health Readiness Policy and Oversight in Health Affairs, for representing the Department during this effort. Anything we can do to increase the effectiveness of flu vaccine development and distribution will improve military readiness and capability.
Speaking of the flu vaccine, we are in the beginning of the 2020-21 flu season. Flu vaccination will help reduce the overall impact of respiratory illnesses on the population and decrease the burden on the health care system during the COVID-19 pandemic. We encourage all of you to get the flu vaccine. Beneficiaries can also get a flu vaccine at no cost by visiting a TRICARE participating network pharmacy. Visit www.tricare.mil/flu to learn about TRICARE coverage and the flu vaccine.
COVID Convalescent Plasma: At the onset of the pandemic, the DoD developed a convalescent plasma (CCP) collection strategy to ensure we were able to independently support advanced COVID-19 illness within the force. We were charged by the Secretary of Defense to collect 10,000 units by September 30, 2020. Thanks to our dedicated Service members, their families, and our beneficiaries, we exceeded our 10,000 unit goal by collecting 10,745 units by the close of the fiscal year. Critical research continues to study the science on the impact of CCP on moderately and critically ill patients and how the DoD can protect our operational forces with the availability of CCP for use in remote locations. Thank you to everyone that made this possible, especially those working with COL Audra Taylor in the Armed Services Blood Program.
AMSUS Update: We are working with AMSUS representatives to support this year’s virtual conference by planning to highlight the MHS pandemic response through participation in the plenary session and breakout presentations. The conference will occur virtually 6 – 10 December, and the MHS Plenary will be held on 8 December. We are excited to announce that Deputy Secretary of Defense HON David Norquist and Dr. Matt Hepburn, JPEO CBRN and SME on vaccines for Operation Warp Speed will both be speaking during the plenary. Please save the date!
Women’s Reproductive Health Survey: The DoD Women’s Reproductive Health Survey is available for female active-duty Service members. The survey assesses reproductive health and well-being and examines behaviors and experiences that may impact readiness. The survey is voluntary, confidential and .anonymous and takes about 15 minutes. Participation is by invitation only, so if you were invited to participation please take a few minutes to complete this important assessment. The results will be used to improve policies, programs and services. This is the first time in nearly 30 years that a DoD-wide study of only female service members’ experiences has been completed. Some service members may have seen some of these questions on other surveys in the past. But because those studies were of limited groups of women, and because of confidentiality protections, that information cannot be used to provide a complete picture of service women’s experiences, reproductive health and well-being. Please visit the site before 3 November and use your military email to determine your eligibility to participate: https://dodwomenshealth.com.
National Physician Assistant’s (PA) Week. The US Military played a critical role in the development of the PA profession. The vision of Dr. Eugene Stead Jr, a doctor who served in WWII, to solve a growing shortage of primary care providers in the 1960’s led to the launch of the profession. The first graduating PA class, created at Duke University in 1967, consisted of three former US Navy corpsmen. I had the opportunity to visit the Fort Belvoir Community Hospital to celebrate National PA Week and personally thank the 14 PA’s assigned to the hospital and recognize all active duty, reserve, civil service and contractor PAs serving our military, their dependents, and all beneficiaries. Thank you to CAPT Cynthia Judy, Director of FBCH and CAPT Saira Aslam, Chief of Staff of FBCH, and their incredible staff for their hospitality in giving me a chance to highlight the remarkable work of our amazing MHS corps of PAs.
MHS STAFF IN THE SPOTLIGHT
On 15 October, during a Health Affairs Town Hall, I had the honor to present the Secretary of Defense Medal for Meritorious Civilian Service to Dr. Mark A. Hamilton, recognizing his exceptional leadership, invaluable contributions, and extraordinary performance across the MHS as Health System Transformation Office, Chief of Staff, for the Office of the Assistant Secretary of Defense for Health Affairs from October 2017 until October 2019. Well done, Dr. Hamilton!
COL(Ret)/Dr. Paul Pasquina, Professor and Chair of the Department of Physical Medicine & Rehabilitation (PM&R) at the Uniformed Services University of the Health Sciences, is the 2020 recipient of the AMSUS Lifetime Achievement Award. Congratulations Dr. Pasquina!
As we head into the final weeks of 2020, I want to say how proud I am of this remarkable team and all we have accomplished together, especially amidst the challenges faced operating in a Covid-19 environment. Thanks for all you do for the Military Health System and those we serve.
September Message from the Assistant Secretary of Defense for Health Affairs to the Military Health System Team
Last week I had the opportunity to see our MHS team in action and observe a training rotation at Joint Readiness Training Center at Ft. Polk, Louisiana. I was humbled by the warm hospitality and support for our visit, even in the midst of their recovery from Hurricane Laura. Through it all the Ft. Polk medical team has continued operations while also helping their community. The incredible team at Bayne-Jones Army Community Hospital showed me examples of their successes and challenges in providing safe, high-quality care to patients. I also got to observe the awe-inspiring training of 1st Brigade, 101st Airborne Division during their rotation at the world-class JRTC. Thank you to COL Jody Dugai, BJACH commander and BG Patrick Frank, Commanding General of Ft. Polk and JRTC – and their teams – for an extremely productive visit.
September is Suicide Prevention month. Suicide remains far too common in our ranks. It is unfortunate that so much stigma is still attached to mental health issues. I want to emphasize how important it is for us to establish and maintain an environment where people feel comfortable asking for the help they need. I encourage each of us to use the resources available if we are struggling, and I want all of us also to be one of those resources for those seeking help. We each may have the chance to intervene at any time with our friends, family, or coworkers if we reacquaint ourselves with the signs of trouble. Let’s renew our vigilance and work to reduce and ultimately eliminate suicides amongst our peers.
September is also Pain Management month. The MHS has implemented a comprehensive pain management and opioid safety strategy using the evidence-based Stepped Care Model for Pain developed in the Department of Veterans Affairs. We’re educating beneficiaries to better participate in their own pain management with an approach that considers opioid safety. We’re leading a culture change in pain management, towards a biopsychosocial approach that emphasizes use of non-pharmacologic treatments and, when necessary, safe opioid prescribing. Our data indicate MHS providers are actively modifying their prescribing behaviors in line with emerging evidence-based guidelines, clinical standards, and DHA policies. One positive data point is a decrease in cases of active-duty service member Opioid Use Disorder – from about 3,000 (in 2013) to about 550 (in 2019) – significantly lower than the U.S. adult population as a whole.
Operation Warp Speed. One of the ways the Department is participating in the whole-of-government COVID-19 vaccine effort is through the participation of five DoD MTFs in the AstraZeneca candidate vaccine’s Phase 3 trials at MTFs in San Diego, San Antonio, and the National Capital Region. We’re actively preparing those sites to meet the rigorous standards needed for these important trials. It is a tribute to the high-quality health care in the MHS that DoD locations are being included in the clinical trials.
Some updates on current MHS issues –
COVID-19 Convalescent Plasma: As directed by Secretary Esper, DoD made a strong months-long push to collect COVID-19 Convalescent Plasma. Thanks to COVID-recovered MHS beneficiaries who have answered the call, we’ll reach the Secretary’s goal of 10,000 units collected to increase the medical readiness of our uniformed forces. We will continue to collect convalescent plasma to ensure we maintain adequate amounts where we need it, to ensure readiness, and to provide high-quality care for families. https://go.usa.gov/xGEuj.
DoD COVID Testing: DoD has now administered more than 1 million COVID-19 tests and has been consistently conducting more tests per capita than the United States as a whole. This milestone is not a celebration but rather, an indication of the tireless work of the Diagnostics and Testing Task Force, working in lockstep with the DHA, the military Services, combatant commands, and other agencies. Our testing is showing a steady decline in overall DoD and active-duty service member positivity rates since mid-July, which is consistent with national trends. Now, we’re entering the next phase of this fight, with advanced therapeutics as well as vaccine development and dissemination. We’re dedicated to continuing to integrate new and proven technologies into the testing strategy with a variety of testing modalities, including point-of-care tests and oral-saliva tests – all focused on military medical readiness. Kudos to Maj Gen (Dr.) Lee Payne for leading this outstanding and sustained team effort!
One last thought about health care. As flu season approaches, I encourage everyone to get this year’s flu vaccine. There is a ready supply of vaccine this year and the DHA has planned for enough doses to support our beneficiaries. Either at an MTF or in the TRICARE network, flu shots will be available. Please help protect our medical resources by getting your flu shot. I remain humbled by all of your continued efforts to ensure our Nation has a medically ready force and ready medical force.
To close out, we note a couple of important new additions to the Health Affairs team. I would like to welcome Dr. Robert Mabry, our new Principal Deputy Assistant Secretary of Defense. His multi-disciplinary clinical expertise and experience as an operator will be a superb asset to Health Affairs and the entire MHS. I’d also like to take this opportunity to thank Dr. Dave Smith for stepping up these past many months to serve as acting PDASD. His time as acting PDASD has included not only some of the most significant changes to the MHS in decades, but also the Department’s response to the COVID-19 pandemic. Thank you, Dave, for an outstanding job.
And, finally, I would like to introduce Dr. David Strong, a White House Fellow coming to us from Detroit. He is an emergency medicine physician and holds a Ph.D. in Immunology. Dr. Strong will be spending the next year working with the Health Affairs front office and also with DHA. Welcome to the team, Dr. Strong.
The message can be viewed here in PDF form and cut/pasted below.
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:
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:
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.
As the Department and the Nation begin to transition to reopening in
alignment with White House guidelines, the Military Health System continues
to focus on our mission to prepare, protect, and care for our service
members and beneficiaries. I am increasingly impressed with your endeavors
serving on the front lines, despite the unprecedented challenges our Nation
is currently facing. While many of you have had to manage changes to your
daily lives due to COVID-19, you continued to rise above those hurdles to
ensure our military, their families, and our retirees continue to get the
best quality healthcare we can provide.
Some updates on current MHS issues:
Vaccine and Therapeutics Acceleration Plan. Health Affairs is partnering
with the Joint Program Executive Office for Chemical, Biological,
Radiological and Nuclear Defense (JPEO-CBRND) in implementing a strategy to
accelerate development of COVID-19 vaccines and antibody therapeutics. This
joint effort, funded by the CARES Act, capitalizes on our enormous capacity
to develop, manufacture, and distribute medical countermeasures to the
force. Antibody therapeutics could play a vital role in supporting our
operational missions with prophylaxis measures and post-exposure treatment
COVID-19 Convalescent Plasma. The Department has launched an effort to
obtain 10,000 units of COVID-19 Convalescent Plasma (CCP) in support of
force readiness. It is critical to collect as much plasma as possible, both
for potential treatment purposes now as well as for use in research efforts
and potential use as a future therapeutic. To qualify to be a donor, DoD
personnel and their families, as well as non-DoD civilians with access to
collection facilities on installations, must have fully recovered from
COVID-19 to support this effort. To date, we have already obtained 4,367
units through a combination of procurement and individual donations at Armed
Services Blood Program donor centers across the continental United States,
Hawaii, Guam, and Germany. More on this campaign can be found here:
A special call out to Navy Medicine who, in support of the DoD CCP campaign,
sent a team to Guam and rapidly collected CCP from volunteers aboard the USS
Theodore Roosevelt. Over the course of three days, the blood donor center at
U.S. Naval Hospital Guam collected more than 200 life-saving plasma units.
This was the first of many donations as crew from the USS Kidd also
Navy Medicine is also directly involved in COVID-19 research efforts. For
the past two months, the USS Theodore Roosevelt was the focus of a public
health outbreak investigation conducted by the Navy and Marine Corps Public
Health Center in partnership with the CDC. Volunteer crew members completed
a short survey and provided two specimens for laboratory testing (voluntary
blood and nasal swab samples). This was the first CDC-published report on
this specific demographic of young adults. One of the key findings was that
loss of taste or smell was the main symptom most associated with COVID-19
infection. This joint effort furthers our understanding of this disease and
will inform future testing and mitigation strategies to ensure the readiness
of our Nation’s military force.
Force Health Protection Guidance Supplement 11. On June 11, 2020, the
Department issued new Force Health Protection guidance outlining the
military’s surveillance strategy for the COVID-19 pandemic response,
including health surveillance activities, screening, asymptomatic testing,
and sentinel surveillance testing. The Department’s surveillance and
screening strategy is designed to break the chain of disease transmission to
reduce risk to the force and to DoD missions. The full guidance can be found
COVID-19 Registry. The DHA has established a COVID-19 Registry to provide a
centralized data collection platform of COVID-19 patients. This registry,
which already includes data from 6,510 patients, will support COVID-19
clinical performance improvement and track the epidemiology of the disease.
The data will help research and medical teams, both in the DoD and the
civilian sector, provide more accurate insight into future advancements in
vaccines and treatments. The registry also will track the outcomes of
patients who receive COVID-19 Convalescent Plasma compared to those who do
not – all of which will greatly enhance efforts toward therapeutic treatment
development. The expediency of the design, implementation, and execution of
this monumental task would not have been possible without the dedication and
hard work of Col Stacy Shackelford, Chief, DHA Joint Trauma Center (JTS),
and Mr. Phil Sartin, Data Acquisition Branch Chief for JTS.
As communities begin to slowly open back up, please stay vigilant. The COVID
fight is not over. Many of you are working tirelessly in MTFs, labs, or in
supporting roles to help achieve our health system’s goals and meet the
evolving needs of the Department. Your efforts are critical to ensuring we
accomplish our mission. Please practice self-care, take time for your
families, and check in on each other. As a medical enterprise, we must
remain strong and healthy to ensure we keep our military in the fight.
Thank you for your service and selfless commitment to our troops, their
families, and to our Nation during these challenging times.
The Department of Defense continues to deliver on Secretary Esper’s
priorities during the COVID-19 pandemic to protect our people, maintain
readiness, and support the national COVID-19 response. Together, Health
Affairs, the military services, the Joint Staff surgeon, the Defense Health
Agency, and the Uniformed Services University are rising to the challenge of
managing an aggressive response to the virus.
Here are updates on issues Health Affairs is tracking.
* Testing: Major General Lee Payne, Defense Health Agency Assistant
Director, Combat Support, has been designated by the Department’s COVID-19
Task Force as the DoD’s lead to implement the Department’s tiered approach
to increase diagnostic and surveillance testing for personnel tied to
critical mission requirements. Thanks to the hard work from your teams, we
are on track to meet the operational Tier 1 requirements. We’ve completed
more than 85,000 tests and tested nearly 1,000 DoD personnel supporting the
New York City response. As we work through Tier 2 and Tier 3 requirements,
we are also looking to support sentinel surveillance testing for Tier 4
requirements. Maj Gen Payne and his team are carrying out impressive work to
spearhead testing protocols, identifying and validating Service and
combatant command requirements, managing logistics, and finalizing reporting
requirements for this massive effort.
* Advancing Force Health Protection: Health Affairs subject matter experts
are deeply involved in developing Force Health Protection guidance for the
Department, including the most recent update, Supplement 8, for protecting
personnel in the workplace. We expect new and revised guidance to be issued
shortly on Clinical Laboratory Diagnostic Testing Services; Surveillance and
Screening with Testing; Risk-Based Lowering of Health Protection Condition
Levels; and Resuming Elective Surgical, Invasive, and Dental Procedures in
Military Medical and Dental Treatment Facilities.
* Vaccine & Antibody Therapeutics Acceleration Strategy: Military Medicine
has a long history of rapid innovation and medical advances. From a
battlefield evacuation system that became the foundation for a modern
Emergency Medical Services system to advances in damage control surgery and
trauma management that have informed nationwide trauma practice, our
commitment to continuous learning and evolution of medicine has always
placed the Military Health System at the forefront. Now, once again, DoD is
out in front leveraging our world-class research capabilities and
partnerships with the Department of Health and Human Services and others to
not only develop an effective COVID-19 vaccine, but to also ensure its rapid
mass production to support a rapid national vaccination effort. This effort,
known as Operation Warp Speed, and supported through funding from the CARES
Act, is streamlining multiple research efforts both in vaccines and
therapeutics and is producing developmental strategies for the manufacturing
and distribution of a COVID-19 vaccine and treatment therapies.
The pandemic response I’ve seen from our collective MHS team has reinforced
the significant roles you play and the historic difference you are making.
Thank you for joining the fight against COVID-19 and ensuring that the MHS
is not only supporting the DoD’s response to the pandemic, but also
supporting the whole-of-government effort to defeat the pandemic.
Every year at this time, cities and towns across the Nation gather to
remember the contributions and bravery of generations of men and women who
have made the ultimate sacrifice for our country. But this year will be
different. Observances for the holiday will not look like years past because
of the pandemic, and many of the traditional Memorial Day parades and events
we are accustomed to will not proceed. While we may not be able to gather in
person this year, that doesn’t mean we cannot pay our respects to our fallen
heroes. This Memorial Day, I encourage you to pursue other ways to honor the
brave men and women who sacrificed their lives to ensure our safety and
Please stay safe and healthy!
The latest admiral is RDML(s) Cynthia Kuehner:
In addition, here is a message about Nurse’s Week from the ASD(HA):
Tomorrow marks the start of National Nurses Week. As we celebrate the long history of military and civilian nurses who have served our nation, we recognize the unique contributions nurses have made – and continue to make – to military medicine in both peacetime and wartime. This year, Nurses Week coincides with the 200th anniversary of nurse pioneer Florence Nightingale’s birth, further reminding us of the critical role nurses play in our national life.
To the dedicated nurses across the Military Health System: thank you.
Thank you for your service to the nation, working to keep our forces ready to answer the call, anywhere and anytime. Thank you for serving our 9.5 million beneficiaries – whether across our military hospitals and clinics, in our research laboratories, in our military medical classrooms, or in the office performing data analytics. Thank you for serving on the front lines in the fight against COVID-19, directly delivering on Secretary Esper’s priorities to protect our people, maintain readiness, and support the national response. Thank you for your enduring commitment to protect, promote, and improve military health care and readiness every day, building a stronger, more effective Military Health System for those depending on us.
To the MHS team: thank a nurse this week and recognize them for their efforts – big and small – that are so integral to caring for our patients and advancing our mission. Share their successes through photos, comments, or stories, on MHS social media platforms using the hashtags #NursesWeek, #YearoftheNurse, and #MHSNurses. And be sure to visit the Nurses Week spotlight page on Health.mil to learn more about how our nurses are going above and beyond the call of duty every day:
Assistant Secretary of Defense for Health Affairs
As the nation faces a historic challenge to combat the COVID-19 pandemic,
military medicine is at the forefront of the battle to protect the health of
U.S. military forces and support the national response. You are playing a
critical role to deliver on the Secretary’s priorities to protect our
Service members, their families, and the workforce, while maintaining
military readiness and supporting the national COVID-19 response. Military
medicine has been at the front lines of the national response – bringing
unique, and agile expertise and rapidly deployable resources to the fight,
including martialing medical staffing and getting them to the place where
they can do the most good: treating patients. We’re mobilizing doctors,
nurses, and medical technicians, both Active and Reserve Component.
Thank you for being a part of our team, and for the long hours you are
putting in to keep our people healthy and safe, and to support our nation in
the fight against COVID-19. I wish to share some key updates as we work
together across the MHS and the Department to tackle this virus.
The pandemic is putting unprecedented pressure on the MHS. As a result, on
April 2 the Department decided to pause the MTF transition activities for 90
days. At the 45-day mark, we’ll reassess to determine the right time to
resume these important efforts. This pause enables the system’s full focus
on the COVID-19 response.
As we direct our attention and resources to meet the increasing military
medical needs from COVID-19, the Military Health System’s agility and
adaptability remain part and parcel to our success. Health Affairs, the
Services, the Office of the Joint Staff Surgeon, the DHA, and the Uniformed
Services University continue to focus on a range of efforts to support the
Department and our beneficiaries. We’ve worked closely with senior
leadership to implement a series of Force Health Protection policies that
provide DoD Guidance on protecting personnel, patient movement and
treatment, the use of personal protective equipment, and laboratory
I issued a policy that began on March 31 directing military Medical
Treatment Facilities and Dental Treatment Facilities to postpone elective,
non-invasive, non-urgent procedures unless those procedures can be safely
performed and are deemed necessary for readiness or for a patient’s safety.
This policy aligns with actions being taken across the nation to conserve
vital healthcare resources to use in support of the national COVID-19
response. The policy has increased medical staff availability to meet MTF
demand, while supporting deployed medical assets and protecting our
patients, medical personnel, and communities from further exposure and
transmission of COVID-19.
The University’s and DHA’s COVID-19 Practice Management Guidelines,
TRICARE’s new Applied Behavioral Analysis therapy guidance, and new MTF
virtual health guidance are great examples of how the MHS is delivering for
our Service members, retirees and their families by adapting in real time to
At the same time, facilities are leveraging advanced telehealth technology
to preserve health care service offerings for patients. In fact, the number
of Direct Care visits has not changed compared to February, thanks in large
part to the virtual care our providers are now offering. On March 30, more
than 35 percent of primary care appointments were conducted virtually, and
we expect the virtual health guidance to facilitate even more virtual care
offerings in the future, in order to continue providing high-quality care to
patients, even as the COVID-19 response continues. I commend MTFs and DTFs
for working hard to execute these changes seamlessly for our patients, and
in support of the whole-of-government efforts to conserve medical capacity
Lastly, I’m pleased to congratulate the hundreds of fourth-year Uniformed
Services University medical students and graduate-level nurses who made
history being the first to graduate early. These new doctors and the nurses
who have completed advanced degrees are joining DoD’s COVID-19 response.
Thank you for your selfless commitment to serve our warfighters, patients,
and nation through military medicine. On behalf of the Military Health
System, welcome to the team!