It is uncharacteristically quiet in the checkered-floor hallways of Baptist Medical Center, a hospital serving downtown residents for more than 70 years.
The usual bustle of patient care is happening mostly behind wide, card-access-only doors in about half of the towering facility where up to 127 patients at one point were admitted with treated for the highly contagious coronavirus. No visitors are allowed.
“All the chaos occurs when you actually get on a physical unit,” said John Vega, administrative director at the Baptist.
Consequently, the private hospital is one of many in San Antonio where military physicians, nurses, and others have stepped in to respond to the public health crisis, providing relief for overtaxed medical staff.
Considered a key measure of the pandemic’s local severity, hospital capacity is carefully monitored by the Southwest Texas Regional Advisory Council (STRAC), a network of hospitals and first responders managing the area’s coronavirus response. On Aug. 3, STRAC considered the local hospital system to be under “severe stress,” with 886 residents hospitalized with COVID-19. A total of 370 Bexar County residents have died.
When federal officials in early July denied a state request to allow Brooke Army Medical Center (BAMC), one of the city’s largest hospitals, to expand its care of civilian COVID-19-positive patients, BAMC appeared to drop from the equation.
But not entirely.
In addition to taking on more of the region’s trauma patients to ease the burden on private hospitals, BAMC and other military hospitals have deployed active duty and reserve physicians, nurses, and other medical specialists to hospitals that are feeling the weight of the crisis.
Through the Federal Emergency Management Agency (FEMA), which oversees government response to the pandemic, the Department of Defense (DoD) provides military support to help state and local governments respond to emergencies.
In the current situation, U.S. Army North is leading the operation in Texas and California, deploying 740 DoD medical and support professionals from the Army, Navy, and Air Force. The first of the 580 deployed to Texas, an 85-member team from Fort Carson in Colorado, arrived July 6 and began treating patients at five San Antonio hospitals three days later.
Critical care nurses, emergency room nurses, medical-surgical nurses, and respiratory specialists are serving at Baptist Medical Center, Christus Westover Hills Medical Center, Christus Santa Rosa Medical Center, Methodist Hospital Metropolitan, and University Hospital.
The arrival of military support in San Antonio has relieved some of the stress and provided respite for the medical teams who have been working on the frontlines since the outbreak began.
“Our community is dealing with the surge of COVID-19-positive patients, particularly those that require hospitalization, and in several instances, need to be in the intensive care unit and occasionally ventilated,” said Dr. Lynnette Watkins, chief medical officer at Baptist. “So that really did put stress across all of our systems, and on our bed capacity, particularly intensive care,” where each patient often requires a nurse’s full attention during a shift.
Four military physicians are assigned to Baptist Medical Center, including an internist and specialists in pulmonology critical care and infectious disease.
The Texas Medical Board issued emergency practitioner licenses to the visitors, and the Baptist Health System’s “code gray” emergency response plan authorized disaster credentialing for the physicians. Within days of arriving, each was issued a hospital badge and lessons in using the Baptist’s electronic medical record system.
“The physicians that we’ve had coming on board have been extremely talented and they became acclimated very quickly,” Watkins said. “While the numbers are small, the impact has been significant.”
Twenty nurses, respiratory therapists, and others also have been deployed to Baptist. Among them was registered nurse Jacob Brown, an Army lieutenant who didn’t have far to go to report for duty.
A member of the Army unit deployed to hospitals around the country, Brown usually works on a surgical floor at BAMC. He already knew orders to deploy were coming and was notified during the July Fourth weekend of his assignment at Baptist.
“So we knew we could [be sent] anywhere, we just didn’t know when or where,” Brown said. “It just so happened for me, it was five minutes from my apartment.”
Brown is now working 12-hour shifts on a COVID-19 intensive care unit at least four or five days a week.
The work is providing new training in infectious disease care for Brown, who is adjusting to wearing more personal protective equipment than ever before and witnessing more death “in a shorter amount of time,” he said.
But helping in his community has been a meaningful experience for Brown. “I’ve been in San Antonio for two years, so I’m very happy to help serve my neighbors,” he said.
Dr. Mary Saleeby crossed an ocean to arrive in San Antonio on July 10. An Army captain and internal medicine physician stationed at Tripler Army Medical Center in Hawaii, Saleeby is now working with a group of other staff physicians at Baptist admitting patients to the hospital.
“By far, COVID is the most common admission right now,” she said. “It’s an unfortunate situation, but we wanted to come and help.”
Saleeby completed her medical residency only a year ago and as an active-duty Army physician, she’s already experiencing the kinds of service opportunities she sought in joining the military.
At Baptist, she’s overcome the challenges of working in a new hospital and learning new systems. And while she has deepened her knowledge of the coronavirus and how to treat it, seeing so many people die of complications from COVID-19 hasn’t been easy.
“It’s really sad, but there are a lot of successes as well,” she said.
The presence of the military also has brought positive goodwill during a trying time, Watkins said.
“Seeing them here has really lifted the spirits of the medical staff,” she said. “We’re Military City USA, and we’ve got a lot of colleagues that are on staff here who have trained in facilities across the country, including BAMC and, back in the day, Wilford Hall [Medical Center].
“There are always silver linings in these tough situations and they are definitely one of them.”