Walter Reed Says It’s Ready for a Holiday COVID-19 Surge

As the COVID-19 pandemic continues to ravage the country, the Walter Reed National Military Medical Center—which recently treated President Donald J. Trump after he contracted the new coronavirus disease—told Air Force Magazine it is poised to handle the surge predicted to grip the nation this holiday season.

The Bethesda, Md.-based hospital’s ability to expand its inpatient and intensive care unit operations lies at the heart of this readiness, the office wrote in a Nov. 30 response to questions from the magazine.

“We developed and tested our expansion plans for inpatient and ICU operations, using patient loads as the catalyst for implementing the changes,” the office wrote.

These efforts including the testing of “Rapid Response Shelter tents,” which the office said boost Walter Reed’s “medical surge capabilities” and can help the hospital respond to any large-scale incident—pandemic or otherwise—that might require it to treat more patients than its indoor beds can accommodate.

Walter Reed National Military Medical Center
This photo shows the interior of one of the Rapid Response Shelters set up as a demonstration of “proof-of-concept” during the Rapid Response Shelter deployment exercise conducted at Walter Reed National Military Medical Center in March 2020. The exercise wasn’t in response to any increase in patients or diagnoses, but, rather, a preemptive measure to assess the ability to rapidly expand the facility in the event of a patient surge. Photo: Harvey A. Duze/DOD

“The shelter is an inflatable tent-based system with HVAC, integrated lighting, privacy curtains, and an oxygen delivery system,” that is powered by portable generators, the office wrote. 

The hospital has also trained and equipped team members to administer “inpatient care for adult medical surgical patients” if Walter Reed does, in fact, run out of internal beds, the office added.

And if the demand for the hospital’s ventilators requires their use to be prioritized, medical providers will be tasked with deciding how their use will be divided up “based on individual circumstances at the time of treatment,” the office wrote. 

At the moment, the hospital has 244 spaces where it can treat patients, it said. 

“During the initial stage of the pandemic, we developed a plan to expand our operational bed capacity by almost 35 percent, then added acute care and ICU beds to increase the capacity up to 50 percent,” the office wrote. “Finally, we identified clinical spaces within the hospital that, if needed, could be quickly repurposed to maximize care for patients. We are glad to have the option to expand, but absolutely grateful that we have not needed to implement the entirety of the plan thus far.”

All of this planning aside, the office said prevention is its first step in tackling the pandemic, with staff members keeping in touch with beneficiaries to inform them about how they can lessen their risk of contracting the new coronavirus and, consequently, helping the hospital keep beds freed up.

“Should the need arise for any of our beneficiaries to require hospitalization, WRB [Walter Reed Bethesda] works closely with the other military hospitals in the National Capital Region to ensure we have adequate staff and resources to continue to provide quality care in the event our capacity ever becomes strained,” the office wrote.

The hospital is also making the most of involvement in the National Capital Region Market—which is made up of the Air Force, Army, and Navy—by taking advantage of shared resources more than it ever has before. 

“The Market approach also provides our patients access to a larger network of specialist and providers and creates greater opportunities to maintain skills and share resources,” the office wrote. “Most importantly it strengthens our medical readiness by allowing us to ready the medical force.”

The whole National Capital Region recently saw a spike in COVID-19 infections.

Walter Reed National Military Medical Center
After administering a COVID-19 test, Hospitalman Austin Clements, assigned to Walter Reed National Military Medical Center, returns the test to be processed at the hospital’s COVID-19 screening station. Photo: Ricardo J. Reyes/DOD

The hospital’s drive-through screening area, where individuals who might’ve been exposed to the virus or who are symptomatic first report, is witnessing a 6-8 percent positivity rate, the office said, which almost mirrors the rate being seen in “the surrounding community,” it noted.

As of the morning of Nov. 30, the Defense Department had recorded a total of 117,736 COVID-19 cases among its uniformed service members, their dependents, and DOD civilians and contractors.

As of the same afternoon, the Department of the Air Force reported 24,510 COVID-19 cases among its Active-duty Airmen and Space Professionals, Air Force Reserve Command personnel, military dependents, and USAF and USSF civilians and contractors. Uniformed personnel account for 14,520 of those cases.

Keeping Staff Prepared, Sane, and Safe

The hospital is also working to ensure its team members are as prepared as possible for any influx in COVID-19 cases, in terms of both technical proficiency and personal resilience, the office explained. These efforts include:

  • The development and execution of training programs that let the hospital widen the critical care skillsets of “more than 1,000 doctors, nurses, and respiratory technicians.”
  • Engineering “tiered medical teams” led by the hospital’s most well-versed physicians and nurses, and comprised of “clinical, nursing, and support” personnel from multiple disciplines with differing levels of experience to help the hospital “maximize [its] ability to care for as many patients as possible”
  • Making psychologist-designed and -developed self-care resources and weekly virtual “resiliency activities” available to its team members
  • Promoting and permitting telework to the fullest extent possible

The hospital is also committed to ensuring its staff has enough personal protective equipment to do their jobs, the office said, adding that its current supply of these items is “strong.”

“To ensure our continued supply strength, we are accounting for our critical items with significant attention placed on detail forecasts of burn rates,” the office wrote. “This process ensures that all orders are placed and fulfilled on time, and also gives us the ability to scale up our supply stock quickly should the need arise.”

The hospital didn’t indicate how long it expects these PPE stores to last.

In addition, Walter Reed is keeping COVID-19-positive patients in designated locations of the hospital to minimize their risk of exposing healthcare workers or other patients to the virus, while continuing to offer “face-to-face care for patients with acute, urgent, emergent, required routine, and readiness healthcare issues,” the office wrote.

The hospital is also screening individuals for the virus at all of its entry points, sending people displaying potential symptoms to the isolation locations, and has beefed up social-distancing and mask rules, it said. 

“The health and safety of our patients, our staff, and their families remains the top priority at Walter Reed Bethesda,” the office wrote.

In cases where hospital personnel are potentially exposed to the virus, Walter Reed’s occupational medicine team works with them individually to figure out appropriate next steps and to keep everyone safe, the office said.

“Out of an abundance of caution, after learning that some patients and staff were unknowingly introduced to asymptomatic people who are now COVID+, WRNMMC staff were appropriately screened and placed on quarantine, as required,” the office noted. “Specified areas of the hospital underwent intense cleaning in alignment with [Centers for Disease Control and Prevention] protocols.”

How Other Hospitals Are Coping with COVID-19

Air Force Magazine also reached out to the Defense Health Agency and the Department of Veterans Affairs to find out how other military and VA hospitals were faring with the current surge in COVID-19 cases and what, if any, steps they were taking to prepare for potential holiday-season influxes.

The Department of Veterans Affairs’ medical centers have enough capacity, personal protective equipment, and supplies to keep up with “current demand,” VA spokesperson Randal Noller wrote in a Dec. 1 statement to Air Force Magazine. However, the statement didn’t indicate how long they expect those stockpiles to last.

“VA has put in place rigorous safety measures at all of its facilities, including employee and veteran COVID-19 screening, physical distancing, and appropriate personal protective equipment such as face coverings,” Noller wrote. “Additionally, VA will continue to maximize the personalized virtual care options of telehealth, phone consults, and wellness checks, as these services have been a valuable link to veterans during this challenging time.”

The Defense Health Agency didn’t respond to an inquiry from Air Force Magazine by press time.