Slowing the Sickness Spread of COVID-19 at NMRTC Bremerton

March 28, 2020

It spread like the common cold, caught many unaware, and sparked multi-nation and multi-community afflictions.

The influenza pandemic over 60 years ago in 1957 resulted in over a million deaths world-wide, including 70,000 who died, and countless others were sickened.

Fast forward to today where the ongoing coronavirus disease (COVID-19) outbreak has sparked similar global concerns, as multiple city, county and federal agencies work to protect, prevent and preclude citizens from getting the disease.

COVID-19 has been closely monitored from the onset by federal government lead agencies such as U.S. Centers for Disease Control and Prevention (CDC), with Department of Defense closely following their lead.

In preparing for the unpredictable, limiting the unforeseen and controlling the unexpected, military treatment facilities like Navy Medicine Readiness Training Command (NMRTC) Bremerton are coordinating and communicating with interagency and municipal partners in providing care to those in need.

There is a definitive need. The state of Washington has over 3,000 confirmed cases of the disease. The CDC report as of March 27, 2020, lists 85,356 total COVID-19 cases in the U.S., with 1,246 deaths. There are ten reported positive cases of active duty service members being tracked by NMRTC Bremerton experts.

“We are really in a rapidly changing, dynamic phase of dealing with this disease. What was current information even just a week ago has now been succeeded by more accurate, relevant updates. We remain agile and dedicated to providing the highest quality healthcare available to our Sailors, Marines, and their families during this ongoing COVID-19 pandemic,” stated Capt. Shannon Johnson, Navy Medicine Readiness and Training Command Bremerton commanding officer, noting that along with protecting beneficiaries, the hospital still prioritizes mission readiness, as well as supporting the whole-of-government effort.

To that end, NMRTC Bremerton’s role in this national effort involves continuous collaboration between healthcare providers, emergency managers, public health officers and hospital leaders, with an unrelenting focus on preventing the spread of the outbreak, reducing the threat for high-risk populations and keeping the military community supplied with timely, accurate information to ensure the healthcare system is not overwhelmed.

“Since COVID-19 is primarily spread from person to person, our nation’s Public Health experts are imploring everyone to remain at home and follow the social distancing guidance from the Centers for Disease Control. Therefore, we are ask that our patients only come to the hospital or one of our clinics when they need medical care,” Johnson said.

In response to the significant public health challenges posed by COVID-19, NMRTC Bremerton has been methodically reducing services in accordance with guidance provided by the CDC and the Defense Health Agency. This reduction in services is designed to shift medical assets and resources to meet the demands of the COVID-19 pandemic by allowing medical professionals to evaluate and treat affected patients, while protecting healthy patients by reducing potential exposure to those seeking evaluation for Influenza, upper respiratory illness, and possible COVID-19.

Several strategies are being used to ensure patients’ healthcare needs can be addressed despite the importance of complying with social distancing guidance to the extent possible. Primary and specialty care clinics are employing virtual health resources on a much broader scale, maintaining direct communication between providers and patients.

“Based on the work we have already done together to build relationships and enhance our patient’s health, we are continuing to protect everyone’s health by offering our patients virtual visits with their health care provider. There are two ways patients can set up a virtual appointment. A patient can call the clinic to set up a date and time for the virtual appointment or they can use the MHS GENESIS Patient Portal,” explained Johnson, adding that in accordance with CDC, the best way to minimize the spread of this disease is through social distancing.

“Therefore, we have curtailed large gatherings to reduce the chance of person-to person disease transmission,” continued Johnson. “The goal is to keep healthy and sick people separated. Beneficiaries have also been encouraged to only come to the hospital or branch clinic when they are actually in need medical care. Beneficiaries who are feeling well or who have mild cold symptoms are encouraged to stay home and to reach out via one of the phone numbers offered for questions or need guidance.”

Beneficiaries who assess their symptoms to be greater than mild cold symptoms and who desire further evaluation have been informed to come to the hospital between the hours of 9:00 a.m. and 8:00 p.m. where they will be guided through a screening and triage process. They will either be seen in the Urgent Care Clinic, or in the established respiratory illness screening tents.

The initial big change immediately noticed by staff, patients and visitors was implemented on March 13, 2020 when separate points of entry were established. Patients and visitors were directed to two points of entry into the hospital where a staff member would assess them for suspected seasonal influenza, COVID-19, or other respiratory symptoms.

Acute services at the hospital are being maintained. Clinics are daily evaluating the capability, need and safety of delivering healthcare services, while also ensuring the readiness of our Force. Clinical decisions to postpone routine care will be based on a risk assessment by subject matter experts in conjunction with maintaining mission readiness for the Fleet and Fleet Marine forces. Any changes made are to protect patients and staff, and to conserve limited resources.

“We have temporarily suspended elective surgeries and procedures. We are rescheduling these procedures for a later date and I deeply regret any inconvenience,” said Johnson.

NMRTC Bremerton is also limiting visitors to one per patient and has recommended alternate ways for patients and visitors to interact, such as phone calls, video-call applications on cell phones, tablets or laptops, and other web-based means. Visitors are being notified they will be asked to take precautions such as wearing masks and gowns, and washing their hands frequently prior to entering and exiting a patient’s room.

Johnson attests that for NMRTC Bremerton Labor and Delivery, although it’s still business as usual, to prevent the spread of COVID it’s also just one visitor per patient.

“Most importantly, I want to reassure our beneficiaries that anyone who needs medical care will get the care they need. Our doctors, nurses, corpsmen and support staff stand ready to provide for you during this challenging time. We are unwavering in this commitment and we are proud to be part of the military family here in the Pacific Northwest,” stressed Johnson.