I have been in command of the U.S. Army Corps of Engineers for over four years. While we have stepped up to a significant number of challenges, including volcanoes, hurricanes, wildfires and rebuilding power grids, none has been as monumental a challenge as the coronavirus response. In each emerging hot spot, we knew upfront that we had a short window of five to 14 days to build hospital bed capacity to align with state-projected virus infection peaks.
The Corps’ credibility depends on our ability to deliver results on time, on budget and of exceptional quality. We work with the Federal Emergency Management Agency (FEMA) to provide Emergency Support Function #3, which focuses on public works and engineering response.
It began when the governor of New York appeared on national television on March 14. For three days he repeated, “I need help,” adding wording like, “I’m not going to have enough hospitals. I need the Corps of Engineers because they’re the only ones that can do this.” He also published an open letter to President Donald Trump in The New York Times outlining the things that would be needed, including the Corps.
I told the team to get ready, and on March 16, the White House called, asking to send someone over. That’s when the initial White House Coronavirus Task Force stood up. I went over that afternoon and quickly realized that there was going to be a real problem with bed shortages if we didn’t move quickly. I briefed Secretary of the Army Ryan McCarthy, and he gave me an airplane to take my team of supersmart hospital folks to New York.
Critical Function
FEMA called on the Corps through mission assignments to increase emergency hospital bed capacity. Within hours, our planning and response teams, subject-matter experts and specialized support teams who become integrated into local Corps districts across the nation began their critical function of helping communities prepare and recover.
Unlike hurricanes and other natural disasters that affect a specific geographic location, during the pandemic response we spread across the country and in five territories, conducting infrastructure assessments and contracting support.
This situation was a challenge: Mission Command and leveraging the great working relationships we developed during pre-coordinated mission discussions with FEMA and other response agency partners provided our way ahead. Mission Command includes the application of mutual trust and shared understanding among leaders of all ranks. It allows for rapid decision-making and execution, including rapid response to changing situations.
Testing and improving on state-of-the-art tools like the Deployable Tactical Operations System and our geospatial resources helped us maintain situational and operational awareness through interactive dashboards and maps.
Our goal was to take site limitations out of the equation. We never want to have an ambulance pull up with patients and somebody say, “I’m sorry, there’s no room at this hospital.”
Simple Solution Needed
COVID-19 is a complex situation that needed a simple solution: three legs of a stool that required sites (hospital beds), supplies and staff. We provided the sites while our disaster-relief partners—local, state or federal players—were responsible for supplies and staff.
So we designed a standard solution—COVID and non-COVID facilities—and planned for converting hotels and dormitories; small rooms. And then, really large facilities like convention centers and field houses.
Once we got approval for the site designs through the Department of Health and Human Services and FEMA, we built a lot of them. But we also took our designs and site assessments and passed those to our partners to use. If they wanted to build it, they had a clear picture of what it should look like.
We also empowered our district commanders to meet with their governors and mayors to assess sites that could become alternate care facilities. What we ended up building was absolutely up to the governors and mayors. Most were hands-on to ensure they knew what we were doing. We talked them through the design, and they let us know what they needed.
Hospitals have some specific requirements, and there are a few critical areas I want to touch on to illustrate the problem-solving that went into our efforts.
Oxygen, for example, is important to a hospital, but not so much for a dormitory or convention center, so we had to build that feature into the converted facilities. If you think about your house, the water comes in with a big line, goes throughout with pipes, and feeds the faucets and water-using appliances in your house. We did the same thing with oxygen. In the case of the Colorado Convention Center in Denver, we brought in about 6 miles of 5-inch copper pipe and ran it throughout the structure to provide that capability.
Heating, ventilation and air conditioning (HVAC) is another critical capability, and you’re probably thinking every building has that. You’re right, but an intensive care unit-type environment requires modifications to that HVAC unit to moderate airflow in and out. Controlling airflow is critical when you’re fighting an airborne virus. But it wasn’t enough to just control the ventilation. We also set up negative pressure baffles between work areas to further limit the potential spread of any infection.
Then we had to build showers. Most of our big convention centers don’t have those. There were adequate bathroom facilities, but hospitals require wheelchair-accessible showers, which was another major design consideration we had to implement.
By the Numbers
Altogether we’ve had more than 15,500 people engaged in this response, in all 50 states and five territories. We’ve completed 64 FEMA mission assignments totaling $1.8 billion. All this is in addition to our ongoing $66 billion portfolio of programs and projects around the world. We have a tremendous surge capability thanks to lessons learned from years of disaster-relief missions.
As of mid-June, we’ve accomplished 1,155 facility assessments, constructed 38 facilities and expanded national capacity by 15,074 beds. Our state and local partners are also using our designs to build an additional 51 sites, adding more than 17,000 beds. These state and local efforts take the load off the Corps and create work opportunities for local businesses.
While many of these sites haven’t been used to capacity, having extra beds is a small price to pay to keep people alive ... and the virus gets a vote. We know there will be a next phase, and this is insurance for when it hits.
This monumental surge to build alternate-care facilities has only been possible because the Corps has a world-class workforce. Building and taking care of that workforce has been driven by the unpredictability of disaster-response missions and the unique challenges of our engineering missions. We have a robust workforce development program to build and diversify skill sets: an absolute necessity for surge capability.
We are always looking for talented high performers. To recruit the best candidates, we’ve built being a great place to work into the U.S. Army Corps of Engineers brand. We’re ranked 85th in the top places to work in the federal government out of 420 agency subcomponents, according to the 2019 Best Places to Work in the Federal Government Survey, and we take those results to heart. Every commander in the Corps reviews their survey results and uses that data to build a stronger command climate. The survey is a tool for employees to share their thoughts about the workplace in critical areas like the quality of their work experiences, agency and leadership. The survey has provided us with great metrics for improvement.
Building a Culture
It goes back to the intangibles of leadership and how you build a culture. For the past four years, I’ve been on a kick to revolutionize the Corps. I grew up in a small town in Vermont, and 5 miles down the road there was a reform school all the “bad kids” were sent to; that’s not what we’re doing. We are revolutionizing culture, not reforming processes.
It’s not concrete and steel, but rather empowering leaders to anticipate requirements, be willing to take risk and ruthlessly execute. That doesn’t mean treating people without dignity and respect, or breaking the law; it means understanding commander’s intent and aggressively working to bring that to fruition.
We’ve also had great support from the administration, Congress and all our partners to succeed in our mission. It’s amazing how fast we can overcome challenges when there’s a common vision and people come together.
I am proud of the work the Corps accomplishes, but I am equally aware the organization can continue to improve. I have been—and remain committed to—instituting lasting changes to the Corps’ delivery process to become a more efficient and effective organization.
For nearly 245 years, the Corps has adapted to meet the challenges of the day. Today is no exception.