Civilian Medical Responder Perspectives to a Federal Military Medical Deployment in New York City during the COVID-19 Pandemic

Abstract

Objectives

This study aims to describe the civilian experience and perceptions of the patient coordination and management at the interface of the New York City (NYC) civilian and the military health systems during a large-scale public health emergency.

Methods

A qualitative study design was implemented with interviews conducted using a basic descriptive approach. Purposive sampling was used to recruit participants with experience working during the first wave of COVID-19 in NYC. Inclusion criteria were civilians who worked at the Javits Center, the USNS Comfort, or NYC hospitals, who interfaced with patient transfer and military personnel during the city-wide medical response to COVID-19. Semi-structured video interviews were conducted between July 20, 2021 and March 11, 2022.

Results

Civilian responders working in the clinical and transfer operations of patients to military facilities in NYC during March and April of 2020 described initial confusion, as well as logistical (patient selection, transfer logistics, patient tracking), communication, and leadership challenges. While the military deployment was felt to be necessary to address the surge capacity in hospitals, the lack of clarity about military medical resources and frameworks for response resulted in confusion about what was being offered by the military deployment. This was balanced by the positive impression of working with military members and the resources that they brought to the response more generally. The need for future trainings and exercises were highlighted.

Conclusions

Initial challenges with civilian-military roles and responsibilities, regional needs assessment, patient selection, and logistics were ultimately resolved through adaptation of civilian and military leadership. Improvements in patient tracking, medical records, and standard hospital admission and discharge functions for patients in military alternative care facilities were identified as areas for improvement. Civilian government, health care, and military leaders should consider these ideas when planning for future military deployments in support of a domestic medical response.

Acknowledgments

None.

Author Contributions

M. Redlener was responsible for the conceptualization, resources, investigation, and supervision for this research. M. Redlener and C. Kim were responsible for data curation and project administration. C. Kim, M. Auten, and D. Wang were responsible for formal analysis. M. Redlener and A. Zebrowski were responsible for funding acquisition. C. Kim and A. Zebrowski were responsible for methodology. All authors were responsible for validation. M. Redlener, C. Kim, M. Auten, and D. Wang were responsible for writing the original draft. M. Redlener, C. Kim, and A. Zebrowski were responsible for the review and editing of the manuscript.

Disclosure Statement

The authors report no other declarations of interest.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by the Henry M. Jackson Foundation for the Advancement of Military Medicine.