How do we fight COVID-19? Military medical actions in the war against the COVID-19 pandemic in France

Pasquier, Pierre; Luft, Antoine; Gillard, Jonathan; Boutonnet, Mathieu; Vallet, C.; Pontier, J-M; Duron-Martinaud, Sandrine; Dia, Aïssata; Puyeo, L; Debrus, F; Prunet, Bertrand; Beaume, Sébastien; Maurice, Guillaume de Saint; Meaudre, Éric; Ficko, C.; Mérens, Audrey; Raharisson, G; Conte, Brianna; Dorandeu, Frédéric; Canini, Frédéric; Michel, R.; Ausset, Sylvain; Escarment, J.

doi:10.1136/bmjmilitary-2020-001569

Cited by 43 publications

(23 citation statements)

References 27 publications

(12 reference statements)

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“…In this study, we identified that 82.7% of medical student respondents would be willing to volunteer; however, only 34.5% were volunteering at the time of the survey. While other studies have shown a similar association, they have not explored the reasons why this may be the case in depth [17][18][19] . Studies in other fields have demonstrated an intention to behavior gap Although McCrea and Murdoch-Eaton suggest medical students possess little awareness of the applicability of prosocial behavior to their role 11 , our study shows this does not appear to be the case during COVID-19.…”

Section: Discussionmentioning

confidence: 96%

Examining Medical Student Volunteering During The COVID-19 Pandemic As A Prosocial Behavior During An Emergency

Byrne

Ashcroft

Wan

et al. 2021

Preprint

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Introduction: COVID-19 has caused major disruptions to healthcare, with voluntary opportunities offered to medical students to provide clinical support. We used the conceptual framework of prosocial behavior during an emergency - behaviors whose primary focus is benefiting others - to examine volunteering during COVID-19. Methods: We conducted an in-depth, mixed-methods cross-sectional survey, from 2nd May to 15th June 2020, of medical students studying at UK medical schools. Data analysis was informed by Latane and Darley's theory of prosocial behavior during an emergency and aimed to understand students' decision-making processes. Results: A total of 1145 medical students from 36 medical schools completed the survey. While 947 (82.7%) of students were willing to volunteer, only 391 (34.3%) had volunteered. The majority (92.7%) of students understood that they may be asked to volunteer; however, we found that deciding one's responsibility to volunteer was mitigated by a complex interaction between the interests of others and self-interest. Further, concerns revolving around professional role boundaries influenced students' decisions over whether they had the required skills and knowledge to volunteer. Deciding to volunteer depended not only on possession of necessary skills, but also seniority and identification with the nature of volunteering roles offered. Conclusions: We propose two additional domains to Latane and Darley's theory of prosocial behavior during an emergency that students consider before making their final decision to volunteer. These are 'logistics' - whether it is logistically feasible to volunteer - and 'safety' - whether it is safe to volunteer. This study highlights a number of modifiable barriers to prosocial behavior that medical students encounter and provides suggestions regarding how Latane and Darley's theory of prosocial behavior can be operationalized within educational strategies to address these barriers. Optimizing the process of volunteering can aid healthcare provision and may facilitate a safer volunteering process for all.

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Section: Discussionmentioning

confidence: 96%

Examining Medical Student Volunteering During The COVID-19 Pandemic As A Prosocial Behavior During An Emergency

Byrne

Ashcroft

Wan

et al. 2021

Preprint

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“…They successfully mitigated risk and prevented the spread of infection within the field hospital by implementing three zones that each required personnel to don a different level of PPE. 13 …”

Section: Literature Reviewmentioning

confidence: 99%

Rapid Deployment of National Guard Alternative Healthcare Facility With Isolation Unit Capabilities in Response to COVID-19

2021

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At the direction of Governor Phil Scott, the Vermont National Guard rapidly erected a 400-bed alternative healthcare facility field hospital to increase the state’s medical capacity early in the COVID-19 pandemic when information was limited and cases were rapidly rising across the country. This case study reviews the preparation and management of the alternative healthcare facility’s first COVID-19-positive patient assigned to the 50-bed COVID-19 isolation ward. Despite austere conditions with rudimentary improvements to a nonstandard facility, the ad hoc team composed entirely of members of the Vermont National Guard successfully oversaw patient care from admission to discharge while maintaining a zero-percent transmission rate to staff. While the local civilian medical infrastructure was never overwhelmed and patient census at the facility remained low, this case study highlights the capability of the National Guard enterprise as a community response to pandemic crises.

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“…In an unprecedented initiative, the French Military Health Service designed a Military Health Service Field Intensive Care Unit ( Élément Militaire de Réanimation du Service de Santé des Armées : EMRSSA), providing a full and integrated intensive care system. 4 The EMRSSA field hospital joined up with and supported the Emile Muller Hospital, an 850-bed general hospital in Mulhouse, Eastern France, which was the initial epicenter of the COVID-19 epidemic in France. 3 The Emile Muller Hospital has a usual capacity of 36 ICU beds, located in a medical ICU (20 beds) and a surgical ICU (16 beds).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of COVID-19-Related ARDS Patients Hospitalized in a Military Field Intensive Care Unit

et al. 2021

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Introduction Little evidence of outcome is available on critically ill Coronavirus Disease 2019 (COVID-19) patients hospitalized in a field hospital. Our purpose was to report outcomes of critically ill COVID-19 patients after hospitalization in a field intensive care unit (ICU), established under military tents in a civil–military collaboration. Methods All patients with COVID-19-related acute respiratory distress syndrome (ARDS) admitted to the Military Health Service Field Intensive Care Unit in Mulhouse (France) between March 24, 2020, and May 7, 2020, were included in the study. Medical history and clinical and laboratory data were collected prospectively. The institutional review board of the French Society Anesthesia and Intensive Care approved the study. Results Forty-seven patients were hospitalized (37 men, median age 62 [54-67] years, Sequential Organ Failure Assessment score 7 [6-10] points, and Simplified Acute Physiology Score II score 39 [28-50] points) during the 45-day deployment of the field ICU. Median length of stay was 11 [6-15] days and median length of ventilation was 13 [7.5-21] days. At the end of the deployment, 25 (53%) patients went back home, 17 (37%) were still hospitalized, and 4 (9%) died. At hospital discharge, 40 (85%) patients were alive. Conclusion In this study, a military field ICU joined a regional civil hospital to manage a large cluster of COVID-19-related ARDS patients in Mulhouse, France. This report illustrates how military teams can support civil authorities in the provision of advanced critical care. Outcomes of patient suggest that this field hospital deployment was an effective adaptation during pandemic conditions.

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How do we fight COVID-19? Military medical actions in the war against the COVID-19 pandemic in France

Cited by 43 publications

References 27 publications

Examining Medical Student Volunteering During The COVID-19 Pandemic As A Prosocial Behavior During An Emergency

Examining Medical Student Volunteering During The COVID-19 Pandemic As A Prosocial Behavior During An Emergency

Rapid Deployment of National Guard Alternative Healthcare Facility With Isolation Unit Capabilities in Response to COVID-19

Outcomes of COVID-19-Related ARDS Patients Hospitalized in a Military Field Intensive Care Unit

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