Military doctors battle against COVID-19

UC Davis Health’s military members have served around the world in a huge range of situations, including in combat zones. But this year, many of their battles for their country have had the same focus as much of their work at home: COVID-19.

Just a few examples:

Rory Stuart, a UC Davis Health emergency physician and associate professor, is also an Air Force Lt. Colonel who returned in June from a deployment in Afghanistan. He helped plan the response to COVID-19 for U.S. and NATO forces throughout that country and was awarded the Bronze Star for his work.

Josh Elder is another UC Davis Health emergency physician and an assistant professor. He’s a Major in the Army Reserve and just finished a six-month deployment supporting special operations on the Arabian Peninsula. He was there to support military missions but the bulk of his work became COVID-19 control and care.

And UC Davis Health emergency and critical care physician and associate professor Roderick Fontenette, who is also an Air Force Lt. Colonel, led a team of 22 medical personnel from Travis Air Force Base in Fairfield from July to September in a deployment at Fresno Community Regional Medical Center (CRMC).

“This was a little different,” Fontenette said, “In my usual deployment, I’m thousands of miles from the U.S. and pretty far forward because of the need for emergency medical care and patient stabilization and transport. On my last deployment (in 2018 in the Horn of Africa), we were in tents. This time, I was sleeping in a hotel and working in a civilian community hospital just a couple hours from home.”

Same goals wherever they’re deployed

“Being in the military allows you to work for something bigger than yourself … In Fresno, just as we’re doing at UC Davis Health in Sacramento, we were fighting against a virus on U.S. soil, protecting our country and our community.” – Lt. Col. Roderick Fontenette, M.D.

Fontenette said the mission was the same as ever: Defend the country and the American people. CRMC is the third largest hospital in California and health care providers there were under siege from a huge surge of COVID-19 cases.

Besides adding more medical personnel to the efforts to care for patients, Fontenette’s team also helped create a COVID-19 medical/surgical unit, worked with CRMC doctors to convert a pediatric intensive care unit into an adult ICU for COVID-19 patients, and helped screen and clear CRMC health care workers who had been exposed to COVID-19 so they could return to work.

“Being in the military allows you to work for something bigger than yourself … In Fresno, just as we’re doing at UC Davis Health in Sacramento, we were fighting against a virus on U.S. soil, protecting our country and our community.” – Lt. Col. Roderick Fontenette, M.D.

“It was important to help get them back in the fight,” Fontenette said. “The more health care people who can’t work because of isolation, the more it hurts your ability to care for patients.”

As unusual as it was, Fontenette said deployments like his work in Fresno were one of the reasons he entered military service in 1997.

“Being in the military allows you to work for something bigger than yourself,” he said. “At a moment’s notice, you’re deployed around the world to defend those at home. In Fresno, just as we’re doing at UC Davis Health in Sacramento, we were fighting against a virus on U.S. soil, protecting our country and our community.”

Battling COVID-19 overseas

Air Force Lt. Col. Rory Stuart, a UC Davis Health emergency doctor, won a bronze star for helping fight COVID-19 in Afghanistan.

The deployments of Stuart and Elder were a bit more conventional, but only at the start. They were both sent to support military missions, but quickly shifted to fighting COVID-19 and protecting U.S. soldiers and others.

Starting in fall 2019, Stuart was the lead emergency physician at Bagram Airfield in northern Afghanistan, a NATO airbase controlled by American forces. He was scheduled to return in April. COVID-19 kept him there until the end of June.

By March, COVID-19 was spreading wildly through the region. Stuart’s team faced two linked problems – a possible medical crisis leading to a serious security issue.

“The point wasn’t lost on our adversaries that if COVID-19 became rampant among our population, particularly our base defenders, our defensive integrity would be vulnerable,” Stuart said. “We could not afford to lose those people out on the wall.”

Military and medical leaders, including Stuart, reacted by forming a working group that developed a rapid response to COVID-19 for all of Afghanistan. He was awarded a Bronze Star for his work.

“That was totally unexpected,” Stuart said. “It also speaks to how high the stakes were. If we had swung and missed, there was the potential that the entire operation could have collapsed.”

Military mission evolves to COVID-19 prevention

Josh Elder, UC Davis Health emergency physician and an Army Reserve major, on his first overseas deployment last spring.

Elder’s deployment, his first overseas, began in March and was scheduled to last three months. He stayed until September. He can’t give too many specifics about it, except to say everyone had to adapt for COVID-19.

“There is the mission and there’s the mission that comes to be,” Elder said. “We were there for trauma care supporting special operations but pretty quickly COVID-19 was overwhelmingly our daily work.”

Along with treating COVID-19 cases – largely among their allies and others in the operation – Elder’s team oversaw quarantine and isolation efforts, testing, and effort to help soldiers avoid coronavirus infections on missions.

“Because of the nature of our work, these missions weren’t optional,” he said. “They had to occur. Our job was to help keep our soldiers as safe as possible during the mission and after they returned. I’m really proud that we didn’t have a single U.S. soldier who contracted COVID-19 while I was there.”

Elder said he was impressed by the way all the military people around him reacted and adapted and continued moving forward on their missions.

“It is the best camaraderie that you could imagine … It’s a very good-hearted feeling knowing we’re all on the same team fighting for the same cause. That’s one of the things that makes service in the U.S. military so special.” – Maj. Josh Elder, M.D.

“There have been a lot of experiences related to COVID-19, but I do think the tale of the soldier has not been talked about,” he said. “At these moments of great tribulation and in dangerous circumstances, I saw all these soldiers putting up with very challenging conditions and a lot of unknowns. They just forged through it to do their jobs. It gave me great faith in the American spirit.”

As a physician, Elder said one part of his job was made easier by every soldier’s unquestioning adoption of measures to prevent the spread of COVID-19, like wearing masks and social distancing.

“The military posture is to try do the best for our home defense and  what is best for the country,” he said.

An extraordinary partnership

All three are back in Sacramento working at the UC Davis Medical Center. Fontenette and Stuart remain full-time Air Force. They are co-directors of a military training program that is part of a partnership between UC Davis Health and the David Grant Medical Center at Travis Air Force Base.

The partnership began in 1995 with an Air Force residency rotation in trauma surgery at the medical center, and the programs have been steadily expanding. In 2005, the entire residency program of David Grant merged with the UC Davis Medical Center.

The partnership now encompasses everything from an active duty emergency medicine residency program to training for nursing, physician assistants, respiratory therapists and medical technicians. The Air Force has staff, fulltime faculty and residents embedded in the medical center in specialties ranging from internal medicine to vascular surgery to a cardio-thoracic intensive care rotation for nurses.

Elder is Army Reserve and a full-time UC Davis Health physician. He said there is a special bond among all the current military people and the veterans in the health system – and maybe a touch of cheerful inter-service rivalry along the lines of an Army-Navy football game.

“It is the best camaraderie that you could imagine,” Elder said. “It elevates the friendships. We all have this kind of family ‘competition-slash-love’ for each other. It’s a very good-hearted feeling knowing we’re all on the same team fighting for the same cause. That’s one of the things that makes service in the U.S. military so special.”

Related Stories:

• Air Force, UC Davis Health partnership reaches new heights
• UC Davis Health partnership with Air Force: valuable training and better care
• UC Davis Health physician awarded Bronze Star for efforts battling COVID-19 in Afghanistan.
• Military partnership helps advance health for all.
• Video of Rory Stuart from Afghanistan about Air Force Partnership with UC Davis Medical Center.