Trump and New York Gov. Cuomo’s fight over the Army Corps of Engineers highlights divide over the virus and how government should respond.
A growing number of prominent Democrats are calling for President Donald Trump to deploy the U.S. military to help respond to the coronavirus pandemic, amid fears that hospitals will be overwhelmed by the burgeoning number of cases.
“I would call out the military now,” former Vice President Joe Biden said at the Democratic primary debate on Sunday night. “They have the ability to provide this surge that hospitals need. They have the capacity to build 500 hospital beds and tents that are completely safe and secure.”
In an op-ed in the New York Times on Sunday, New York Governor Andrew Cuomo called for the Army Corps of Engineers “to retrofit and equip existing facilities — like military bases or college dormitories — to serve as temporary medical centers.”
“Then we can designate existing hospital beds for the acutely ill,” Cuomo wrote.
The governor again pressed Trump for Army help in a Monday morning press conference. But after a conference call with Cuomo and the other U.S. governors, Trump tweeted, “Cuomo of New York has to 'do more.'” In response, Cuomo tweeted, “Happy to do your job, too. Just give me control of the Army Corps of Engineers and I’ll take it from there.”
But Pentagon officials speaking to reporters Monday afternoon cautioned that the military’s ability to create hospital facilities to help handle the growing cases may be limited.
“We do have tent hospitals, deployable hospitals. The challenge is, they’re designed to take care of trauma patients and combat casualties,” U.S. Air Force Brig. Gen. Paul Friedrichs, the Joint Staff surgeon, told reporters at the Pentagon and on a conference call, “We don’t have any 500-bed hospitals designed for infectious disease outbreaks.”
The military's largest moveable medical facility is USNS Comfort, the Navy's hospital ship. But Friedrichs cautioned that the Comfort is also not designed to care for highly infectious disease patients — its close quarters and enclosed spaces are the opposite of public health recommendations for preventing the spread of the virus.
And any personnel that active duty forces or the National Guard might be able to lend to the crisis would be pulled away from helping in their own communities, said top Pentagon spokesman Jonathan Hoffman.
“Even if we are able to build tents for hospitals, we need the nurses, we need the doctors, we need the orderlies,” Hoffman said. “Those individuals in our system would come from existing hospitals or the Reserve.”
The Pentagon is looking at what kind of help it can provide to civilian agencies battling the disease, said Hoffman, but so far, the military has only been called upon to provide quarantine facilities for travelers coming from Wuhan, China, the epicenter of the outbreak, and disembarking cruise ship and airport passengers.
Some Democrats who argue that Trump has not done enough to contain the spread of the virus — which has killed at least 68 Americans as of Monday afternoon — have begun elevating calls for a more muscular military response to the crisis in rhetoric historically used for politically potent national crises: Both Biden and Cuomo have referred to coronavirus response efforts as a “war.”
“We’re at war with the virus,” Biden said Sunday night.
Those calls stand in stark contrast to some conservative lawmakers, who have questioned the severity of the crisis and encouraged constituents to ignore state, local and federal guidance calling for Americans to avoid public gatherings, especially in closed spaces as in bars and restaurants.
“It’s a great time to go out and go to a local restaurant, likely you can get in easy,” Rep. Devin Nunes, R-Calif., told Fox News on Sunday. “Let’s not hurt the working people in this country … Go to your local pub.” By Monday, several state governors were ordering bars, restaurants, casinos, gyms, theaters and similar establishments to close.
So far, Democrats have not called for National Guard or other military elements to be used to enforce a growing number of rules put in place by state and local governments, such as restricting travel and mass gatherings and closing restaurants and bars. Local and national politicians have sought to avoid inflaming fears of “martial law” that are circulating on some darker corners of the internet. (The National Security Council has publicly refuted the rumors.)
"It is not a police activity, they are not in tanks, they are in regular vehicles. They are not armed," said New Rochelle City Manager Charles Strome.
“Please stop spreading stupid rumors about marshall [sic] law. COMPLETELY FALSE,” Sen. Marco Rubio, R-Fla., tweeted Monday morning. “We will continue to see closings & restrictions on hours of non-essential businesses in certain cities & states. But that is NOT marshall [sic] law.”
Some National Guard units across the country already are helping with voluntary screening and temperature checks at the Maryland State House, assisting with cleaning and sanitizing efforts in the locked-down New York town of New Rochelle, and other efforts. In West Virginia, troops trained staff at Charleston’s Cabell Huntington Hospital on Wednesday in the proper use of the protective suits they might wear if they need to treat coronavirus patients.
Trump on Friday declared coronavirus a national emergency under the Stafford Act, which gives him the authority to call up the Corps of Engineers if a state government sends a request to the Federal Emergency Management Agency, which would assign the mission.
“We believe the use of active duty Army Corps personnel would not violate federal law because this is a national disaster,” Cuomo wrote. “Doing so still won’t provide enough intensive care beds, but it is our best hope.”
The Pentagon is “aware” of Cuomo’s suggestion, Hoffman said, but has not received a request for the Corps to do any construction. “That would be something we would look at,” Hoffman said, but “At this point I think there are some other options out there,” including leaning on the private sector.
Trump said during a Monday afternoon press conference that the White House is considering using the Army Corps to build hospitals.
The big benefit of the Defense Department is logistics and planning support,” Hoffman said. “Those are two things that we are able to provide a lot of assistance to.”
Public health experts caution that it is impossible to know how many Americans will be sickened by coronavirus — making it difficult to determine how much hospital surge capacity will be needed. But some epidemiologists project that between 40 and 60 percent of 327 million Americans could become infected, and policy experts have issued dire warnings that U.S. hospitals may be overwhelmed.
There are 5,198 hospitals in the United States, according to American Hospital Association data provided to the health-care trade publication Healthcare Dive, and 792,000 beds. Of those, 65,000 are ICU beds. Hoffman said most of the military’s hospitals are small, and only a tiny fraction of the hospital beds in the United States belong to the Department of Defense.
There are also concerns about equipment supplies. A 2005 report from the Center for Disease Control and Prevention estimated that the United States would need mechanical ventilators for 740,000 patients in the event of a pandemic like the 1918 influenza pandemic. But there are only 160,000 ventilators currently available for patient use, according to an estimate from Johns Hopkins researchers, with another 8,900 held in what’s known as the Strategic National Stockpile.
"If a Wuhan-like outbreak were to take place in a U.S. city, even with strong social distancing and contact tracing protocols as strict as the Wuhan lockdown, hospitalization and ICU needs from COVID-19 patients alone may exceed current capacity," researchers from Harvard and Johns Hopkins warned in a March paper.