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'Mobilization on Steroids':How the Reserve got 125 medics to COVID's front lines in 48 hours

Reserve medics from the 433rd Airlift Wing, Joint Base San Antonio-Lackland, Texas, report for duty 48 hours after being notified they were mobilizing. (Staff Sgt. Sean Evans)

Reserve medics from the 433rd Airlift Wing, Joint Base San Antonio-Lackland, Texas, report for duty 48 hours after being notified they were mobilizing. (Staff Sgt. Sean Evans)

As Air Force Reserve Command’s execution arm for mobilizations and deployments, the Force Generation Center is used to answering the call to provide Reserve support around the world when it is needed. It’s what the FGC’s dedicated experts have been doing on a daily basis since the center was established in 2011.

Perhaps the FGC’s biggest test to date came on the first Friday in April this year when the request dropped for 125 specific Reserve medical specialists to report to Joint Base McGuire-Dix-Lakehurst, New Jersey, to help overburdened health care providers deal with the COVID-19 pandemic in the New York City area. The catch: they needed to be in place in 48 hours.

This is the story of how the FGC and the Reserve’s Surgeon General’s office teamed up to pass this test with flying colors.

When President Trump signed an executive order authorizing mobilization of the Reserve Component on March 27, the specialists in the FGC anticipated the call requesting Reserve Citizen Airmen to support the nation’s pandemic would be coming soon.

“We had a feeling for what was coming,” said Maj. Millie Grey Theriot, chief of the FGC’s Agile Combat Support Branch. “We just didn’t anticipate the extremely short suspense. This was a mobilization on steroids.”

Theriot explained that for a normal planned mobilization, the FGC usually has about two years lead time to start the planning process and Reservists know well in advance when they will be deploying. “For a normal deployment, 180 days before they are leaving, Reservists will know where they’re going, all of the pre-deployment requirements they have to have and how long they’ll be gone,” she said. “They then have several unit training assemblies to meet all of their pre-deployment requirements.”

Even in the event of a natural disaster or other sudden crisis, the FGC usually has more time to execute a mobilization.

“It rarely happens that the Secretary of Defense mobilizes someone with less than 30 days’ notice,” Grey Theriot said. “And when it does happen, it requires notification of Congress. Congress has to agree that it’s OK to mobilize someone with less than 30 days’ notice. Well, in this case that requirement was waived immediately, so what we thought was a 30-day notification was now down to two days.”

When the FGC received the Secretary of Defense Orders Book on April 3 requesting the 125 medics in 48 hours, it was the first it heard of the request.

“Normally, before we see an SDOB we already know the requirement. We have the unit type codes, the unit line numbers and line remarks,” the major said. “We didn’t have any of that this time.”

When the FGC received the request on April 3, the call was made immediately to the surgeon general’s office functional area managers, Lorenzae King and William Smoot, to begin identifying the Reservists who would be mobilized.

Typically, King and Smoot would forward the mobilization request out to the various Reserve units and let the units decide what qualified Reservists they had available and willing to fill the requirements. In this instance, there wasn’t time so SG had to do all of the sourcing directly from the headquarters level with some input from the wings.

“Thankfully we already had a list of Reservists who volunteered to deploy,” King, SG’s chief of medical readiness operations, said. “Unfortunately, the list didn’t match up perfectly with the requirement that was coming down.”

“Normally for us in deliberate planning, it’s usually more nurses and med techs than doctors,” Smoot, SG’s medical readiness manpower manager, said. “We’ll be asked to provide 60 people and four or five may be doctors. The rest hold other types of medical Air Force Specialty Codes. This request was for a lot of doctors, and by the way, we want to limit the impact on the local communities so we don’t want people who are already involved in treating a lot of COVID patients.”

King and Smoot worked closely with their counterparts throughout SG to find the right Reservists for the mobilization.

As the chief of manpower and the individual mobilization augmentee manager in SG, Capt. Joshua Black played a critical role.

“My involvement came into play because I have access to a lot of reports and sources of information and have a great understanding of what capabilities we have and how to find that capability,” he said. “There are 66 different medical AFSCs, and there are different shred-outs on each of those depending on what their specialties are. When we got this request to provide support in New York, it was important we were able to clearly identify those capabilities.”

Black explained that a typical mobilization might call for a flight surgeon, a doctor with a 48R AFSC. But flight surgeons can be internal medicine doctors, pulmonologists, emergency care doctors, critical care doctors, general surgeons, anesthesiologists, etc…

“A typical deployment will just ask for a flight surgeon, but this situation was different in that they were very specific in what they needed,” he said. “It takes a lot of data mining and analyzing several different reports to pull all of that information together – hours and hours of analysis to provide those reports to senior leaders so they know where our capability exists and how much we have available.

“What made this requirement even more challenging is that if you are medical in the military, chances are you are medical on the civilian side as well. We didn’t want to take away their ability to support their local communities so we had to disqualify anyone who was heavily involved in treating COVID patients in their civilian job.”

Smoot said another factor that made this mobilization so difficult was the joint nature of the deployment. “We have AFSCs, the Army has MOSs (Military Occupational Specialties) and the Navy has something different altogether. They aren’t all interchangeable. The Navy may equate an Air Force Reserve med tech with a Navy corpsman, but they aren’t the same thing at all. There is a lot of education that needs to happen.”

As SG’s chief of medical operations, Col. (Dr.) Henry Schwartz had a critical role in helping the Reserve meet the quick request for medical specialists. “One of the things we did was help Mr. King in determining the medical qualifications of the medics going out the door,” he said. “Looking at the request and seeing they are asking for an emergency physician but we have an internist who is available, would that suffice for the request for forces? In some cases it might and we assisted in making that determination.”

Schwartz was also involved with accelerating the credentialing and privileging process for some Reserve medics who are not involved in day-to-day operations at a military treatment facility. “They may not have DOD credentials and privileges in place for the deployment so we had to accelerate that,” he said. “That’s usually a process that can take two to three weeks. In one case, we did it within 24 hours. It required immense coordination with the members who had to get us all of their civilian credentialing information.”

The colonel was instrumental in helping the Reserve match the right people to the requirement. “In one case we needed an infectious disease expert, so I made a call to an infectious disease doc I had on my team when I was assigned to the 349th Medical Group at Travis (Air Force Base, California),” Schwartz said. “It turns out that the doc (Maj. (Dr.) Sanjiv Baxi) was already deployed in place with his civilian company in the New York governor’s office to help fight the coronavirus. He said his company was extremely supportive and he wanted to be boots-on-the-ground in the trenches so he agreed to mobilize.”

“I had been working on COVID-19 for a few months before it hit,” Baxi said. “Because of my background and being a medical provider for the 349th MDS, I felt I had something to bring to the fight.”

Col. Sherry Hemby, AFRC’s command nurse, and Lt. Col. Ann Selimos, chief of education and training, helped ensure the Reserve mobilized the best nurses possible for the deployment.

“They needed nurses with ventilator experience and typically those are emergency room and critical care nurses,” Hemby said. “We had to help identify the Reservists who did these kinds of things in their outside jobs without taking the people who were already involved in COVID activities in their local areas. Nurses want to take care of people. That’s where their hearts are so we didn’t have a shortage of volunteers, but we had to make sure we were sending people with the right skills.”

One of the final pieces of the mobilization deployment puzzle for the SG team was making sure deploying members had the proper personal protective equipment.

“Our big role was attempting to get PPE for our Reserve medics going to support this mission,” said Lt. Col. (Dr.) Jessica Dees, AFRC’s chief of public health. Dees, along with Master Sgt. Kunta Dubose and Tech. Sgt. Lorimar Rivera Morgado, worked around the clock to try and secure hard-to-find PPE items for the mobilized Reservists.

“N95 masks were the hard commodity,” Dees said. “But we also had to try and get our hands on shoe covers, hair nets and scrubs. We were able to secure a significant amount of PPE for our host units, but had some problems with our co-located units. Thankfully, we were able to send a large shipment of PPE to the Javits Center for our deployers and two of our other Reserve units also sent shipments. Our Reservists may not have left with their PPE, but by the time they got to Javits they had enough PPE to start their orientation right away.”

Since the unprecedented mobilization of 125 Reserve medics the first weekend in April, the FGC has mobilized 98 Reserve aeromedical technicians and a second group of 149 Reserve ground medics to help with the battle against COVID-19.

Lt. Gen. Richard Scobee, AFRC commander and chief of the Air Force Reserve, said he couldn’t be more proud of the Reservists who have mobilized and the people who have worked behind the scenes to get them in place.

“Our Reserve medics have done an incredible job of easing the burden on health care workers in and around New York City and the professionals at the headquarters and units across the country have worked tirelessly to provide them with everything they need to succeed. I am extremely proud of how the entire Air Force Reserve team worked together to make these mobilizations a success,” he said. #ReserveReady    ■