It all started when my phone rang that fateful January day; the voice on the other end of the line said, “Ted, are you ready for this?” It was Kevin, the local representative of the U.S. Health and Human Services Department’s Assistant Secretary for Preparedness and Response.; all I could do was clear my throat and say, “I’m ready…” It was then that I learned that due to the novel coronavirus pandemic, employees of the U.S. Department of State and their families working abroad in the Wuhan China area would be repatriated to Travis Air Force Base in Solano County where I have the honor of serving as the county’s Emergency Medical Services Director.
The issue I was faced with was how medical transport and treatment would be handled since the repatriates would be quarantined on base, and the base hospital was not authorized to provide any services or support for the mission. It’s important to note the only hospital in Fairfield, other than the Base hospital, is NorthBay Medical Center, a local hospital affiliated with the Mayo Clinic. I must commend them for the extraordinary job they did in taking care of repatriates from Asia and later from international waters right off the coast of California; more about that later.
It’s also important to point out that Kaiser Permanente is the healthcare home for about two-thirds of our insured population, making it the predominant provider of medical treatment and care in Solano county. As such, Kaiser Foundation Hospital, Vacaville, is the county’s designated Level II Trauma Center and Multi-Casualty Incident (MCI) Base Station. I began coordinating planning calls, a few days before the mission was to commence, with representatives from Kaiser and the other local hospitals, public health, ambulance providers, and the federal government. Together we agreed to use a modified version of our jurisdiction’s MCI Plan, which is heavily dependent upon ReddiNet (a secure health information exchange program), to determine which hospital quarantined repatriates would be transported to, when necessary.
"It all started when my phone rang that fateful January day; the voice on the other end of the line said, “Ted, are you ready for this?”
Because a Federal Disaster Medical Assistance Team was on-site providing basic healthcare services to the quarantined residents calling the base hotel their home, the system we created seemed to work like a charm! The MCI Base Hospital (Kaiser Vacaville) facilitated calls between the on-site physicians at the quarantine station on base and a receiving physician at the hospital where the patient would be going. They ensured there was a negative pressure isolation room available to protect staff and visitors from the potential of novel coronavirus exposure, and they confirmed the hospital’s emergency department wasn’t otherwise overwhelmed.
This mission was calendared to endure for 14-days, or thereabouts, dependent upon progression of the virus. A few days after the first group of repatriates arrived, a decision was made by the Federal Government to repatriate additional families from China. This decision extended the projected end-date by a few days…
Things were moving along satisfactorily, the modified MCI Plan, using ReddiNet’s software, seemed to be working quite nicely to manage patient movement. The clock was ticking, only a matter of days before we could clear out the quarantine station and get back to business as usual; or so we thought. It was now mid-February and my phone rang again, you guessed it, it was Kevin, the same caller that I spoke with in late January. He asked how I’d like to continue the mission as there are now some U.S. citizens in Japan who need to come home. These, of course, were the folks aboard the Diamond Princess cruise ship when the COVID-19 outbreak occurred. To make a long story short, we prepared for and received a couple hundred cruise passengers who would make the quarantine station on base their home for at least the next two weeks.
The difference between this group and the previous repatriates is the fact that the majority of cruisers were a bit older with underlying health conditions, both of which contribute to a higher likelihood of contracting the virus and potentially severe complications. These cruisers came a few days later, and we managed their healthcare much the same way we managed the repatriates from China.
We did such a great job with the Diamond Princess passengers that the Grand Princess decided to dock at the Port of Oakland and send its passengers to join the ranks of repatriates and Diamond Princess passengers at the quarantine station at Travis Air Force Base; their home for the next two weeks or so. This was the last cohort of individuals, and the repatriation quarantine station was finally decommissioned in the latter part of March.
To sum it up, everyone pulled together to make these missions a success. Leaders from federal, state, and local levels of government and the healthcare community, particularly Kaiser Permanente, NorthBay Healthcare, and Medic Ambulance (our local exclusive emergency ambulance provider) came together, worked together, and achieved successful outcomes together because we remembered we’re all in this together and that at the end of the day what matters most is saving lives and tending to the needs of the people who trust us with their care.