Descriptive record of the activity of military critical care transfer teams deployed to London in April 2020 to undertake transfer of patients with COVID-19

What can the Defence Medical Services learn from the COVID-19 pandemic in order to be ready for the future?

The COVID-19 pandemic placed significant global pressure on public health, with the demand for specialist clinical input, equipment and therapeutics often outweighing supply in many well-established healthcare systems. The UK was no exception to this burden, resulting in unprecedented demands being placed on its NHS. Throughout the pandemic, the UK Defence Medical Services (DMS) aided the civilian healthcare sector, while concurrently adapting as an organisation to meet its enduring commitment in promoting the operational output of the wider UK Armed Forces. This paper serves to provide an overview of some of these key activities while offering proposed lessons which can be learnt, in order to promote the DMS' output in times of future crises. Of note, the DMS aided to mitigate surge demands placed on the NHS' supply chain, assisting in promoting its resilience to provide key materials to civilian clinical personnel. Adaptation of military policy generation mechanisms, together with adoption of novel technological approaches to promote remote working, empowered efficient DMS operational output throughout the pandemic. Direct provision of personnel to assist in the NHS' clinical output served to foster mutually beneficial interorganisational relationships, while providing objective benefit for the UK public.This paper was selected as the BMJ Military Health Royal Society of Medicine Colt Foundation National Essay Prize Winner 2021.

Global key concepts of civil-military cooperation for disaster management in the COVID-19 pandemic-A qualitative phenomenological scoping review

Background

In the context of a holistic and comprehensive disaster response effort to the COVID-19 pandemic, many countries across the globe mobilized their military forces in order to cope with sudden and exponential surges of critically ill patients with COVID-19 in stretched healthcare systems.

Objective

The purpose of this work is to identify, map, and render world-wide key concepts of civil-military cooperation (CIMIC) in disaster management during the COVID-19 crisis visible.

Material and methods

Literature was systematically searched in three databases (PubMed, Web of Science, Cochrane Library) on 26 January 2022, and analyzed with qualitative, mixed narrative-phenomenological methods in compliance with PRISM-ScR and SRQR.

Results

Forty-five publications were included in the analysis; pertinent authors were from 22 countries covering five continents. We identified three key thematic clusters in the published literature: Cluster (1) Medico-scientific contributions with the participation of military medical personnel or institutions: members of the military acted as subject matter experts, clinical and experimental (co-) investigators as well as co-founders for enabling COVID-19 relevant research. Areas covered were relevant to the COVID-19 patient's clinical journey from prevention, exposure, diagnostics, and treatment and included pertinent fields such as digital health and telemedicine, global and public health, critical care, emergency and disaster medicine, radiology, neurology, as well as other medical specialties, i.e., respiratory care, pulmonology, burn medicine, and transfusion medicine, in addition to environmental and occupational sciences as well as materials science. Cluster (2) CIMIC field experiences or analyses included areas such as political framework, strategy, structure, nature of civil-military interaction, and concrete mission reports in selected countries. Themes covered a broad spectrum of pandemic disaster management subjects such as capacity and surge capacity building, medical and pharmaceutical logistics, patient care under austere circumstances, SARS-CoV-2 testing support, intelligent and innovative information management, vaccination support, and disaster communication. Cluster (3) The military as a role model for crisis management.

Conclusion

Civil-military cooperation made a significant contribution to the level of resilience in crisis management on a global scale, positively impacting a broad spectrum of core abilities during the COVID-19 pandemic.