密歇根新闻广播 如果野战医院达到容量

 

On Thursday, Governor Gretchen Whitmer announced that the TCF Center would begin accepting its first 25 COVID-19 patients.

The announcement also stated that Henry Ford¹ Health System, Beaumont Health, McLaren Health and Detroit Medical Center would be stepping in to provide administrative² support, and that a FEMA strike team would provide initial staffing.

Still unclear, however, is where other workers will come from if the facility swells³ toward its 1,000-patient capacity. The state has not explained in detail a comprehensive plan to staff the field hospital, nor has FEMA, which is leading the operation.

Meanwhile, the Army Corps⁴ of Engineers has begun construction at Michigan's second alternate care site, the Suburban⁵ Collection Showplace in Novi. The team in charge there—like at the TCF Center, a collection of state, federal and private organizations—will also have to figure out how to staff the 1,000-bed facility.

Based on a FEMA procedure document that estimates staffing needs for field hospitals housing infectious patients, the TCF Center alone could require over 600 medical staff members, such as doctors, nurses, respiratory specialists and pharmacists.

So, where will they all come from?

Based on what we've heard from Michigan's health department, FEMA and other federal agencies, staffing will flow from three main sources: local volunteers, workers recruited by private staffing agencies, and federal medical units.

Local workers: volunteers, students and staffing agencies

According to a health department spokesperson, as of April 8th, 16,400 volunteer medical workers—retired or otherwise free to commit time—had responded to the call for assistance Gov. Whitmer put out on Saturday, March 28th.

In an executive order, the governor eased licensing⁷ and certification requirements in a bid to attract as many skilled volunteers as possible. Its terms allow out-of-state medical practitioners⁸ to practice without a Michigan license⁹, and medical students to volunteer in the facilities.

About a third of those volunteers are medical workers, such as doctors, nurses and respiratory therapists; another third are public health professionals; and the final third have volunteered to support community service efforts.

16,400 sounds like a lot, but the health department spokesperson didn't indicate the extent of volunteers' commitment (the volunteer form asks for workers who can commit anywhere from four to 12 hours a day).

The health department also said it has hired private staffing agencies to help with recruitment. Some advertisements for positions at the field hospital are offering almost double what a nurse might normally make. For example, a registered nurse with one year of experience could make $65 an hour.

One nurse at a Beaumont hospital, whose name we're not using to protect her job, said many of her colleagues are considering picking up extra shifts at TCF; of course, extra shifts at Beaumont are available too, but as of now, they don't pay as well. (A similar dynamic is playing out across state lines, with some Michigan health care workers traveling all the way to New York.)

"Nurses will follow the money," the Beaumont nurse said.

The Department of Defense¹⁰

A FEMA spokesperson explained to us that a state, having determined¹¹ that its local resources are insufficient¹² in managing a crisis, may request support from FEMA. As lead agency in the national COVID-19 response, FEMA then works through the National Response Coordination¹³ Center to assess federal options for meeting the state's needs—in this case, to staff Michigan's field hospitals.

In a pinch, staffing support can come directly from FEMA. According to Gov. Whitmer's Thursday announcement, the TCF Center will be initially¹⁴ staffed by a public health strike team from FEMA, which will care for TCF's first 25-50 patients.

But according to a MDHHS spokesperson, FEMA is also investigating other federal options. One is the Department of Defense.

On April 8th, MDHHS director Robert Gordon said in a tele-townhall that "we will be getting some help from DoD around staffing the TCF site," And on Saturday, an Army spokesperson notified us that 85 Army reservists, all medical officers, had arrived in Detroit to help care for the TCF Center's first patients. In such a case, the DoD selects the military branch that, based on location and the status of ongoing¹⁵ operations, is best fit to serve the request. On March 28th, for example, Lt. Gen. Laura Richardson, the director of U.S. Army North, activated¹⁶ two National Guard task forces, sweeping¹⁸ the typically state-controlled units under the federal wing. One of those task forces was the 46th, based out of Lansing. Now stationed in Battle Creek¹⁹, the 16th is providing transportation and other logistical support to the 85-person medical team.

One of those task forces was the 46th, based out of Lansing. A spokesperson from the 46th explained to us that under the direction of the Army, National Guard medical units might be sent to the TCF Center, but couldn't confirm.

The Army has already deployed²⁰ to New York City, where hundreds of medical officers are staffing the Javits Convention Center, which has been converted into a field hospital; and to Seattle, where a mobile field hospital was set up at CenturyLink Field (and then left after nine days, without seeing a single patient).

In a press conference on April 1st, commander of U.S. Northern Command General Terrence J. O’Shaughnessy said that the Defense Department would be judicious²¹ in calling for backup. "What we don’t want to do is activate¹⁷ a reservist that, say, is working right now in a hospital, in an infected area with a high demand for that skill set, and have her or him be deployed to another area at the expense of that [other] area," he said.

U.S. Health and Human Services

FEMA confirmed that medical teams from the U.S. Department of Health and Human Services would be assisting the FEMA strike team in caring for the TCF Center's first patients. HHS is currently working on a response to our request for details; we'll update this post when we hear back from them.

One option within HHS is the Public Health Services Commissioned Corps. The USPHS is a uniformed unit that includes physicians, public health experts, epidemiologists, nurses, engineers and other specialists. Its officers have responded to most major national disasters, including 9/11 and Hurricane Katrina.

During the COVID-19 pandemic, USPHS teams have been dispatched to the Life Care Center in Kirkland, Wash., where the virus initially hit hard in the U.S., and to Japan, where officers helped provide critically ill patients with remdesivir, an investigational²² antiviral treatment.

Right now, at the TCF Center alone, we're seeing collaboration²³ among MDHHS, FEMA, HHS, the Army Corps of Engineers, the DoD, and, per Whitmer's Thursday announcement, four private health care systems. And that's not a complete tally²⁴.

Matthew Seeger, a professor at Wayne State University who studies crisis and emergency risk communication, says this swirl²⁵ of stakeholders always presents challenges during disasters.

"The coordination problem in disasters is like the quintessential, defining problem of many disaster responses," he said.

According to Whitmer's announcement, those in charge of the TCF Center include Dr. Jenny Atas, who will lead medical services at the facility.

In her role as medical director of the Region 2 South health care coalition²⁶, Atas has been coordinating²⁷ Michigan's medical resources for weeks in response to the pandemic. We spoke⁶ with Atas the last week of March, when she helped select the TCF Center as a field hospital.

Now she'll be responsible for ensuring it has sufficient staff and equipment to run at full capacity.

Editor's note: This article has been updated to reflect that an 85-person medical unit from the Army has been deployed to the TCF Center.

1 Ford   

n.浅滩，水浅可涉处；v.涉水，涉过

参考例句：

• They were guarding the bridge,so we forded the river.他们驻守在那座桥上，所以我们只能涉水过河。
• If you decide to ford a stream,be extremely careful.如果已决定要涉过小溪，必须极度小心。

2 administrative   

adj.行政的，管理的

参考例句：

• The administrative burden must be lifted from local government.必须解除地方政府的行政负担。
• He regarded all these administrative details as beneath his notice.他认为行政管理上的这些琐事都不值一顾。

3 swells   

增强( swell的第三人称单数 )； 肿胀； （使）凸出； 充满（激情）

参考例句：

• The waters were heaving up in great swells. 河水正在急剧上升。
• A barrel swells in the middle. 水桶中部隆起。

4 corps   

n.(通信等兵种的)部队；(同类作的)一组

参考例句：

• The medical corps were cited for bravery in combat.医疗队由于在战场上的英勇表现而受嘉奖。
• When the war broke out,he volunteered for the Marine Corps.战争爆发时，他自愿参加了海军陆战队。

5 suburban   

adj.城郊的，在郊区的

参考例句：

• Suburban shopping centers were springing up all over America. 效区的商业中心在美国如雨后春笋般地兴起。
• There's a lot of good things about suburban living.郊区生活是有许多优点。

6 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

7 licensing   

v.批准，许可，颁发执照( license的现在分词 )

参考例句：

• A large part of state regulation consists of occupational licensing. 大部分州的管理涉及行业的特许批准。 来自英汉非文学 - 行政法
• That licensing procedures for projects would move faster. 这样的工程批准程序一定会加快。 来自辞典例句

8 practitioners   

n.习艺者，实习者( practitioner的名词复数 )；从业者（尤指医师）

参考例句：

• one of the greatest practitioners of science fiction 最了不起的科幻小说家之一
• The technique is experimental, but the list of its practitioners is growing. 这种技术是试验性的，但是采用它的人正在增加。 来自辞典例句

9 license   

n.执照，许可证，特许；v.许可，特许

参考例句：

• The foreign guest has a license on the person.这个外国客人随身携带执照。
• The driver was arrested for having false license plates on his car.司机由于使用假车牌而被捕。

10 defense   

n.防御，保卫；[pl.]防务工事；辩护，答辩

参考例句：

• The accused has the right to defense.被告人有权获得辩护。
• The war has impacted the area with military and defense workers.战争使那个地区挤满了军队和防御工程人员。

11 determined   

adj.坚定的；有决心的

参考例句：

• I have determined on going to Tibet after graduation.我已决定毕业后去西藏。
• He determined to view the rooms behind the office.他决定查看一下办公室后面的房间。

12 insufficient   

adj.(for，of)不足的，不够的

参考例句：

• There was insufficient evidence to convict him.没有足够证据给他定罪。
• In their day scientific knowledge was insufficient to settle the matter.在他们的时代，科学知识还不能足以解决这些问题。

13 coordination   

n.协调，协作

参考例句：

• Gymnastics is a sport that requires a considerable level of coordination.体操是一项需要高协调性的运动。
• The perfect coordination of the dancers and singers added a rhythmic charm to the performance.舞蹈演员和歌手们配合得很好，使演出更具魅力。

14 initially   

adv.最初，开始

参考例句：

• The ban was initially opposed by the US.这一禁令首先遭到美国的反对。
• Feathers initially developed from insect scales.羽毛最初由昆虫的翅瓣演化而来。

15 ongoing   

adj.进行中的，前进的

参考例句：

• The problem is ongoing.这个问题尚未解决。
• The issues raised in the report relate directly to Age Concern's ongoing work in this area.报告中提出的问题与“关心老人”组织在这方面正在做的工作有直接的关系。

16 activated   

adj. 激活的 动词activate的过去式和过去分词

参考例句：

• The canister is filled with activated charcoal.蒸气回收罐中充满了活性炭。

17 activate   

vt.使活动起来，使开始起作用

参考例句：

• We must activate the youth to study.我们要激励青年去学习。
• These push buttons can activate the elevator.这些按钮能启动电梯。

18 sweeping   

adj.范围广大的，一扫无遗的

参考例句：

• The citizens voted for sweeping reforms.公民投票支持全面的改革。
• Can you hear the wind sweeping through the branches?你能听到风掠过树枝的声音吗？

19 creek   

n.小溪，小河，小湾

参考例句：

• He sprang through the creek.他跳过小河。
• People sunbathe in the nude on the rocks above the creek.人们在露出小溪的岩石上裸体晒日光浴。

20 deployed   

（尤指军事行动）使展开( deploy的过去式和过去分词 )； 施展； 部署； 有效地利用

参考例句：

• Tanks have been deployed all along the front line. 沿整个前线已部署了坦克。
• The artillery was deployed to bear on the fort. 火炮是对着那个碉堡部署的。

21 judicious   

adj.明智的，明断的，能作出明智决定的

参考例句：

• We should listen to the judicious opinion of that old man.我们应该听取那位老人明智的意见。
• A judicious parent encourages his children to make their own decisions.贤明的父亲鼓励儿女自作抉择。

22 investigational   

[医]调查研究的

参考例句：

• Investigational New Drug Application (IND) for the compound. 为化合物的研究中的新药物申请(IND)。
• He said it representsan investigational H.I. 一位博士说：我们已经向成功迈出了重要的一步。

23 collaboration   

n.合作，协作；勾结

参考例句：

• The two companies are working in close collaboration each other.这两家公司密切合作。
• He was shot for collaboration with the enemy.他因通敌而被枪毙了。

24 tally   

n.计数器，记分，一致，测量；vt.计算，记录，使一致；vi.计算，记分，一致

参考例句：

• Don't forget to keep a careful tally of what you spend.别忘了仔细记下你的开支账目。
• The facts mentioned in the report tally to every detail.报告中所提到的事实都丝毫不差。

25 swirl   

v.(使)打漩，(使)涡卷；n.漩涡，螺旋形

参考例句：

• The car raced roughly along in a swirl of pink dust.汽车在一股粉红色尘土的漩涡中颠簸着快速前进。
• You could lie up there,watching the flakes swirl past.你可以躺在那儿，看着雪花飘飘。

26 coalition   

n.结合体，同盟，结合，联合

参考例句：

• The several parties formed a coalition.这几个政党组成了政治联盟。
• Coalition forces take great care to avoid civilian casualties.联盟军队竭尽全力避免造成平民伤亡。

27 coordinating   

v.使协调，使调和( coordinate的现在分词 )；协调；协同；成为同等

参考例句：

• He abolished the Operations Coordinating Board and the Planning Board. 他废除了行动协调委员会和计划委员会。 来自辞典例句
• He's coordinating the wedding, and then we're not going to invite him? 他是来协调婚礼的，难道我们不去请他？ 来自电影对白