Updated March 30, 2020
The penetration and rapid spread of COVID-19 throughout the U.S. has presented significant challenges to the day-to-day management of patients infected with this virus, as well as the organization and structure of the health care system needed to manage this pandemic. It's clear that the existing hospital infrastructure is insufficient to deal with the potential number of patients, particularly individuals who require intensive care and ventilator support. The civilian hospital infrastructure will need to develop creative methods to manage these patients as well as the patients who are already in hospitals.
A 1,000-bed hospital has been established in New York, NY, and other portable hospitals are being established in other states and cities. A number of these portable hospitals have been constructed by the Department of Defense (DoD), the Federal Emergency Management Agency, or the National Guard. The operation of the hospital falls under the purview of the state where it is located and the hospital or hospital system that will provide care in the facility. It is possible that there will be military and civilian collaboration in providing care in these hospitals. A portable military facility staffed with a combination of military and civilian medical personnel could offload large civilian trauma centers, making available staff, beds and equipment in those civilian hospital for the care of victims of COVID-19. For such a program to succeed, criteria outlined in the American College of Surgeons (ACS) “Blue Book,” need to be considered. The Blue Book: Military-Civilian Partnerships for Trauma Training, Sustainment, and Readiness, provides guidance on important topics such as institutional commitment, governance and administration, human resources, physical resources, education, and evaluation.
The Blue Book was created under the aegis of the Military Health System Surgery Partnership ACS (MHSSPACS), established in 2014 as collaborative effort between the College and the DoD. The 2017 National Defense Authorization Act established military-civilian partnerships to develop training and sustain essential trauma knowledge and skills to ensure a ready medical and surgical workforce. The MHSSPACS has developed the criteria for the selection and evaluation of military civilian partnerships to effectively provide this training. These criteria are outlined in the Blue Book, which is designed for military readiness and can be easily adapted for the collaboration of civilian and military teams in response to any disaster, including the COVID-19 pandemic.