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DOD Moves to HPCON Charlie, Uses Modeling for Pandemic Response Planning

A member of the 2nd Governor's Horse Guard inspects the outer shell of the mobile field hospital they, along with members of the 1st and 2nd Governor's Foot Guard constructed in the parking lot of Saint Francis Hospital in Hartford, Connecticut, March 24, 2020. Credit: Timothy Koster

Air Force Brig. Gen. (Dr.) Paul Friedrichs today discussed the role of predictive modeling of the COVID-19 pandemic to assist the DoD in planning efforts. “We’ve not tried to predict that we’re going to see a hotspot here, or we’re going to see X number there. We used it for broad planning. Like in the community, if the outbreak occurs and X percent of people are infected over time, what does that mean as far as health care requirements?”

Friedrichs said information sharing among nations that have been afflicted by the coronavirus is increasing the value of data and that this additional data may soon make it possible to build predictive models.

“The good news is our allies in Korea and in Italy and in Europe are sharing data very transparently with us, and we’re building a much more robust database,” he said. “I think in another few weeks we’ll have better fidelity on that data.”

The modeling now available on the coronavirus and the resulting cases of COVID-19 is used to decide where best to place the Defense Department’s medical resources, the Joint Staff surgeon said.

“The approach that we’ve taken, as we do our modeling and as we look at where to place capabilities, is based on how do we balance the immediate needs, either for a DOD population, or as in the case of New York — where we’re sending the [hospital ship USNS] Comfort and two of our field hospitals — the needs of other citizens and supporting that whole-of-government approach,” Friedrichs said. “It is a balancing act, there’s no question about it. Our health care system across the United States is not designed or sized to deal with a pandemic.”

HPCON Level Charlie

Pentagon Press Secretary Alyssa Farah said Defense Secretary Dr. Mark T. Esper released guidance to raise the health protection condition, or HPCON, across the department, to HPCON Charlie. That level limits installation access to essential personnel and reduces the number of installation access points that are open.

Farah said the move to HPCON Charlie also includes measures such as going to maximum telework, cancellation of large-scale meetings, and taking people’s temperature at certain access points within buildings. “This will vary from installation to installation,” she said. “But these are concrete measures we can be taking now to stop the spread, lower the curve.”

The DoD has faced some criticism for not implemented more wide-spread standard distancing and stop travel measures, as highlighted during this exchange between reporter Babara Starr and Joint Staff Surgeon Brigadier General Friedrichs:

Barbara Starr: So General Friedrichs, as you stand here and you say you take it as you find it, currently, do you see any medical indications or evidence that suggests to you any easing up of restrictions is a good medical idea?

And unanswered in all of this is the key question: Why has — you have all repeatedly said, for days — including the secretary, including the chairman — you trust your commanders around the world. But there is not a standard to stop, meet — large meetings, formations, large scale training close together.

Why are you not stopping it? Why not just put a stop to it because you are seeing a rising rate every day in the ranks? You’re on an upward curve, your curve’s not flattening. So do you see any medical indication at this point?”

GEN Friedrichs: “So I think as we look at countries that began their outbreak earlier than the United States, we are seeing that where they’ve implemented measures effectively over a period of weeks to months, their curve flattened and then began to decline.”

You know, our allies in Korea I think have done a very good job of responding to the outbreak. This is incredibly difficult and I don’t mean to minimize it in any way but their measures have been effective and they’re beginning to see now that the impact of what they’ve done has reduced the growth of people who — with the infection or the growth of people who need to be hospitalized or receive ICU care.

Are we going to see that in this country? I believe we will if we’re successful at implementing the measures that we’ve been discussing for the last several weeks —

Barbara Star: Well let me try this again. Do you see any medical evidence that indicates to you that in the coming — but — a month from now, Easter, you would — you would see some beginnings of indications? Are you seeing any medical evidence, medical indications that you could ratchet back?

And since you are not flattening the curve in the U.S. military, why are you not — why is the Secretary, the Chairman, why is there no military medical advice to them to halt these larger gatherings where multiple military people are close together?

Because again, your curve isn’t flattening.

GEN Friedrichs: So you’re correct, our curve is not flattening and that’s why we went to HPCON Charlie today, which includes restrictions on large gatherings, includes additional social distancing. We’re stepping through this like everyone else is and adjusting based on the data as it’s coming in and what we’re seeing with our units.

So I think we have done many of the things that you’ve described there. It’s a balancing act because at the end of the day, we — we have to balance both the health and protection of our service members with our responsibility to this nation to continue to defend it and to deter those —

There’s always commander’s discretion, there’s always a requirement for this nation to be prepared to defend itself and our responsibility is to balance that as — as appropriately as we can.


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