Defense Secretary Esper Says Military Has 'Limited Capacity' To Provide Hospital Beds

Mar 25, 2020
Originally published on March 26, 2020 11:59 am

Despite urgent pleas from governors and mayors across the country, Defense Secretary Mark Esper cautioned on Wednesday that the U.S. military is not positioned to deploy nearly enough medical resources to address the scale of the coronavirus outbreak. And warning that the pandemic will "inevitably" alter the global strategic balance, he said the virus cannot be allowed to overtake national security as the Pentagon's top priority.

Esper's remarks come amid growing calls for military assistance from state and local officials for everything from extra beds to desperately needed ventilators. With the number of confirmed cases at 65,000 and rising, it's a crisis that President Trump now refers to as a "war" with an "invisible enemy."

But in an interview with NPR's Steve Inskeep, the defense secretary said that while the military may have "a lot of capability, [it is] not as much, I think, as many people think when it comes to medical capacity."

"What we have great capacity for is planning and logistics and things like that, when it comes to supporting civilian authorities," Esper said. "But in terms of hospitals, we have a limited capacity, maybe a few thousand beds ... at most."

That estimate would appear to fall far short of the nearly 90,000 hospital beds that could be needed in New York alone, according to projections from the state's governor, Andrew Cuomo. "The president says it's a war," Cuomo said on Tuesday. "Well, act like it's a war."

In terms of the military's role in the response, Esper has sought to temper expectations. Addressing reporters on Monday, Esper said he has spoken with "seven, eight, nine, 10 governors" and that each has requested military field hospitals. "We clearly can't meet everybody's needs with what we have in our inventory," Esper said.

In his interview with the NPR, Esper said the military wants "to put everything on the table we can to support the American people and help get beyond this." So far, however, there have been few simple solutions.

To help meet the demand for beds, the Army said this week it was preparing to deploy field hospitals to both New York and Washington state. Each hospital can accommodate an additional 248 beds, but as Esper noted, these hospitals are "geared toward treating trauma patients ... not in terms of supporting persons with infectious diseases."

The announcement followed plans by the Navy to send two hospital ships, the USNS Comfort and the USNS Mercy, to New York and Los Angeles respectively. Each ship can accommodate an extra 1,000 beds, according to the Navy. Neither ship will treat COVID-19 patients, according to a U.S. defense official who was not authorized to speak publicly on the matter. Instead, they'll help each city handle seriously ill patients other than those with the disease.

Supporting the military's mission are nearly 10,000 members of the National Guard deployed to all 50 states, four U.S. territories and the District of Columbia, according to Esper. The military has doctors and nurses it can also deploy, he said, but many of them are reservists who may already be responding to the crisis in their local communities.

"We're very conscious as we deploy both the assets and the people that we're not taking somebody from a civilian hospital working with COVID-19 patients in one part of the country to another part of the country to deal with the same problem," said Esper. "We don't want to be robbing Peter to pay Paul."

"The strategic environment"

Responding to the crisis has meant balancing the needs of cities and states with what Esper described as his top two priorities: protecting service members and safeguarding the military's mission capabilities. Esper said if he can do that, he can fulfill what he called priority number three: "provide full support to the whole of government."

"We have to take care of our service members. That's our most important resource, our most valuable asset, are our people," said Esper. "And so I got to take care of them first. But doing that also enables them, freezes them up to conduct that third mission and that is supporting the American people here at home as we deal with the with the coronavirus."

Esper said the military has recorded 227 cases of the coronavirus within its ranks so far. To help control that number, the secretary signed an order on Wednesday freezing the movements of all U.S. troops abroad for 60 days.

Esper said protecting service members and keeping the Pentagon's focus on national security is particularly important at this moment, given that the pandemic is all but certain to alter the global security landscape.

"I think things will change as a result of this pandemic," Esper said. "Countries will behave and act and prepare differently. You could see changes in societies, economies, in the governance of a country, and that's inevitably going to happen. So it's important for all of us to understand what that may look like and and how it may change the strategic environment."

His remarks echoed comments by Gen. Mark Milley, the chairman of the Joint Chiefs of Staff, who on Tuesday similarly warned about what coronavirus could mean for international security.

"This is affecting different countries differently, and it depends on the level of rigor and the robustness of medical facilities, capacity inside each country," said Milley. "It could, in some cases, lead to social breakdowns. It could lead to political chaos in certain countries. We have to be attuned to that."

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For more than 20 years now, I've been interviewing various secretaries of defense. That official oversees millions of uniformed and civilian personnel stationed around the world. So when he agrees to meet, you talk in person and you go to him. Typically, you go to the Pentagon, to the secretary's office, which is long and narrow like the deck of an aircraft carrier and seems only slightly smaller.

When we talked with Defense Secretary Mark Esper yesterday, it was different. Esper has shut down the movement of U.S. troops and ordered social distancing. The rules apply to Esper himself and limit the people in his office. So we spoke by phone. Esper is a veteran, a one-time Army officer well-known in Washington. After his military service, he worked as a staff member in the Senate and for the defense contractor Raytheon. His job now is to help fight the pandemic while also monitoring other threats.

How do you define the military's mission in this crisis?

MARK ESPER: I've identified three priorities for the United States military now in the few months that we've been dealing with COVID-19. Priority No. 1 is take care of our service members, our civilians and their families. Priority No. 2 is safeguard our mission capabilities, those things we need to protect the nation. And then No. 3, provide full support to the whole of government, whole-of-nation effort being directed by President Trump.

INSKEEP: It's interesting that No. 3 there is helping the civilian population. Does that reflect what the priorities have to be? You have to be ready to have a force that is ready to enact its normal mission.

ESPER: Yeah. You know, national security remains No. 1. I think the American people expect at all times we're going to defend them from adversaries beyond our shores and protect our interests abroad. And to do that, we have to take care of our service members. That's our most important resource. Our most valuable asset are our people. And so I've got to take care of them first.

INSKEEP: We know you're sending field hospitals. We know that you're sending hospital ships to some of the worst hit areas. But do you really have significant medical resources available given the scale of this problem?

ESPER: Yeah. It's a great question, and the fact is we really don't. What we have great capacity for is planning and logistics and things like that when it comes to supporting civilian authorities. But in terms of hospitals, we have a limited capacity - maybe a few thousand beds, if you will, at most - to provide, because keep in mind that most of our capacity are deployable field hospitals geared toward treating trauma patients. So they are structured, configured that way, not in terms of supporting persons with infectious diseases.

By the same token, a majority of our military doctors and nurses and other medical professionals are reservists who also have civilian jobs in these same fields. So we're very conscious as we deploy both the assets and the people that we're not taking somebody from a civilian hospital working with COVID-19 patients in one part of the country to another part of the country to deal with the same problems.

INSKEEP: Are you also having to withhold some resources because you don't know how big a coronavirus outbreak you might face?

ESPER: There is that. And I need to make sure I retain some capacity for a deployable force in case we get in some type of conflict somewhere.

INSKEEP: There was a commander at a big U.S. base in South Korea who sealed the base and has been praised since because, if I'm not mistaken, there was only one coronavirus case there even when there was a serious outbreak in South Korea. Since then, of course, there are hundreds of other coronavirus cases within the U.S. military at various other parts of the world. How do you evaluate the military's job at protecting itself against this outbreak in the last couple of months?

ESPER: General Abrams has done a great job over in Korea. And he helped this - update our plans with regard to how you deal with coronavirus and how it spread. So we've been able to put a brake on the spread at this point in time. Of the hundreds of thousands of military persons out there, we have - thank goodness - only 227 cases right now. It's 227 more than I would prefer to have. And I've been able to call up and talk to a few of those service members. But I think the policies and practices we've put in place have held us in good stead right now.

INSKEEP: Do you believe that the Defense Department was on this early enough to ensure that this will not be catastrophic, at least within your area of responsibility?

ESPER: I do. We're doing a lot of good work. I'm very proud of our uniformed personnel and our DOD civilians. But there will always be things to learn and do better in the future.

INSKEEP: I want to ask about something else, Mr. Secretary. General Mark Milley, the chairman of the Joint Chiefs of Staff, has been talking this week of the possibility of social breakdowns in other countries. I don't think that he was forecasting something specific, but he was aware of that possibility as the pandemic spreads. And some countries may handle it worse than others. What are you thinking about how the world could be different after this pandemic passes?

ESPER: Well, you know, Steve, if we do something really well, it's planning and preparation. As I like to say, we plan for the worst and work for the best. And in this case, we have to look beyond our shores to try and understand how this pandemic will affect society today, but also tomorrow. And if you see cases out there where it could cause some type of breakdown, whether in the economy, the political structure or the social structure, how do you prepare for that? How do you posture yourself to be prepared to react to it?

INSKEEP: What are some ways the world might be different in six months because of this?

ESPER: Well, you can see how, you know, the pandemic is going to affect populations - how they act socially, how government may change itself, how it affects governments if certain leaders are affected by the virus. It's hard to predict. But you certainly see it shaping the economy right now as we see economies weather their way through this - and populations, how they react.

Italy, of course, we know has been hit very, very hard by this. And it's such a tragedy to see what's taking place there. It's inevitably going to change countries in one way, shape or form, to include ours.

INSKEEP: To include ours. I guess one possibility is that leaders who don't manage this very well could be discredited. You could have changes of government or even changes in the form of government in some places.

ESPER: I think all of the above is possible.

INSKEEP: One country that's been particularly hard-hit is Iran. Is the pandemic affecting your tactical or even your strategic approach to Iran?

ESPER: Well, we watch Iran very carefully. As you know, they're, you know, a terrorist state in many ways. And so we do see a failure of the government to recognize the threat, to react, to help their people. They seem to be more intent on fueling violence in the region than addressing the coronavirus.

And so, yes, I think it's going to continue to shape that society and that government as well. And we're very conscious of what they're doing and trying to understand how they might react to that. We want to be careful they don't lash out.

INSKEEP: Iranian-backed militias have been lashing out. There have been strikes inside Iraq at U.S. bases in recent weeks. And the United States, to my knowledge, has not retaliated significantly. Are you holding your fire because there's this larger crisis to focus on?

ESPER: Well, we retaliated very significantly a few weeks ago when they killed an American and wounded some others. And with regard to other attacks, I will say what I've said before, and that is, you don't get to kill or wound Americans and get away with it. But what we will do is we will respond at our own time, place and manner of choosing.

INSKEEP: Oh, you're alluding to the fact that the United States killed General Soleimani a couple of months ago. But there have been more incidents more recently. If I'm not mistaken, there have even been some Americans injured. Are you saying retaliation is still possible for those incidents?

ESPER: Yeah. We've responded to some of those attacks, directly to the Shia militia groups by attacking targets of theirs, targets of opportunity within Iraq. And other attacks they've committed or will commit, we will - again, we will respond at the time, place and manner of our choosing. But we will hold them accountable, you can rest assured of that.

INSKEEP: Secretary Esper, thanks so much for your time.

ESPER: Thank you, Steve.

INSKEEP: Practicing social distancing, Mark Esper spoke with us from his office by phone in the Pentagon.

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