By Dawn Grimes
Navy Medicine and Readiness Training Command Guantanamo Bay
When Cindy Wilkerson (Capt., USN Ret.), Assistant Dept. Head and Quality Manager for the Laboratory Dept., US Navy Medical Readiness and Training Command Guantanamo Bay (US NMRTC GB), first learned that COVID-19 testing may be required for passengers leaving the installation, she was concerned. “There was no way we had the staff to collect that many or a location to collect as many samples needed to meet the mandate for everyone flying ‘Space-A’ or on non-funded orders, in such a short time-frame.”
That was almost five months and more than 600 COVID-19 tests ago. With the help of National Guard and U.S. Army Reserve Medics, passengers leaving Guantanamo Bay who are required to show proof of testing negative for COVID-19, have been able to get the test the day before departing.
“We’re the only place in town, we can’t tell people to go to CVS or Walgreens.” Wilkerson explained. “That’s what’s happening in Norfolk, Charleston, Jacksonville. Those hospitals are not providing pre-travel testing, travelers are being told to go out in town and get their testing.”
According to Wilkerson, the additional requirement has had little to no impact on military hospital staffing or training for most other military installations because tests are being performed primarily outside the gate. With no such option at Guantanamo Bay, it was up to the US NMRTC GB Laboratory to figure out how to test up to 75 people within 72 hours with one portable testing unit that takes 15 minutes to produce a result, per test. Due to staff limitations, Wilkerson and her team collaborated with reservists at the Kittery Beach Aid Station (KBAS).
“Spc. Vanessa Wagner, who is an Army Reservist, brainstormed how they could set up the testing.” Wilkerson explained. “The Sophia devices are a little bit different than the devices we have, so we talked about how we could stagger testing and how we could maximize throughput, but it was really Spc. Wagner figuring out the logistics of it and then Capt. Susan DeLozier-Hooks who said ‘we can do this.’”
Since then, Reserve Medics have managed nearly every aspect of the pre-flight testing requirement for Space ‘A” and unofficial travelers including active duty, their military family members on unofficial orders, and foreign nationals flying to Jamaica.
“Sometimes there is a language barrier and we want to keep our professionalism so that’s difficult and it’s also rewarding because once you do cross that barrier then you’re starting to develop a relationship and your patient starts trusting you,” explained Spc. Nydia Salazar, who joined the National Guard three and half years ago. “When that happens then the test goes easily and that really is rewarding.
DeLozier-Hooks added, “Watching them work with kids, which they never do here, we never see children at KBAS. They had to learn to communicate with a kid on their level, you don’t always get that opportunity. They’ve learned how to do it and it’s been both challenging and rewarding.”
Spc. Yanellie Urizar joined the National Guard in 2016 and plans to put her experience to use as she trains to become a firefighter. “We’re doing so many new things and we wouldn’t be able to do back in the states especially with how they’re struggling right now so we have the opportunity to learn and do new things over here that will benefit us and our communities when we get back home.”
DeLozier-Hooks explained the experience is helping these reservists learn critical patient care skills. “Providing customer service to a military member and providing customer service to their spouse and or other civilians is a little bit different. With military people you can be a little more direct, not rude, but the expectations are different and it’s been a great learning experience.”
The team has also learned more about new technologies as testing capabilities have been researched, tested, developed and rolled due to the COVID-19 pandemic. Wilkerson led training for the crew to teach them how to perform the nasal swab test and carry out the sampling. The reservists however, applied their own ingenuity, when it came to figuring out how to most efficiently perform the tests which must incubate for at least 15 minutes.
“We realized that if you time them correctly and you interval the tests and they will still incubate for 15 minutes but we don’t have to wait the full 15 minutes before beginning another test because we closely monitor and they are timed perfectly and we capture the read outs every 2 -3 minutes as each sample ages to 15 full minutes." Salazar explained. The team employs an army of stop-watches to round-robin the samples from beginning to end to maximize throughput on the solitary testing unit and deliver results within the shortest possible time.
Urizar added, “We first started we left a lot of room for error so we do a test and let it incubate for maybe like 4 minutes apart but as we soon we started to get the hang of it we said well it’s too easy and then we started cutting the time and we started to be able to get the results much faster.” The team has maximized efficiency and throughput with only two people performing between 40 and 55 tests during a two hour testing window for passengers required to test prior to departing Guantanamo Bay for the United States or Jamaica.
“This whole evolution really was made possible by Capt. DeLozier-Hooks and her team,” Wilkerson concluded. “We’re really here to support them in this effort.”