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NEWS | Feb. 3, 2021

NEPLOs work closely with tribal authorities in response to COVID-19 spike

By Cmdr. Kip Wright, NEPLO Program Public Affairs

A nurse wearing personal protective equipment checks a patient.
SLIDESHOW | 1 images | Patient Care Navy Lt. Kathryn Hrezo, a critical care nurse assigned to the Rural Rapid Response Team, checks a patient’s blood sugar level while working in the COVID-19 ward at the Northern Navajo Medical Center, Shiprock, N.M., Dec. 31, 2020. Northern Command, through Army North, remains committed to providing flexible Defense Department support to the whole-of-America COVID-19 response.

The Navy Emergency Preparedness Liaison Officer (NEPLO) program was heavily engaged throughout 2020 in the Department of Defense whole-of-America response to the COVID-19 pandemic. During the holiday season, NEPLOs directly assisted Tribal authorities to fight a spike in COVID-19 cases.   

The NEPLO program consists entirely of Navy Reservists professionally trained in emergency management. NEPLOs provide Defense Support of Civil Authorities during hurricanes, earthquakes, wildfires and other national emergencies — including pandemics.   

Navy Reserve Captains Tony Nelipovich and Matthew Koerber deployed from Dec. 14 to Jan. 14 to Navajo Nation hospitals in Chinle, Arizona, and Shiprock, New Mexico serving as liaisons between Navy healthcare professionals, the Indian Health Service, the U.S. Department of Health and Human Services, and Navajo Nation hospital staff. 

Nelipovich operated out of the Task Force-51 command post in Chinle, while Koerber worked at the hospital in Shiprock. Both NEPLOs were under the direction of U.S. Army North, U.S. Northern Command’s Joint Force Land Component Commander. Task Force-51 is Army North’s deployable headquarters and directs the efforts of DoD Emergency Preparedness Liaison Officers working jointly in support of civil authorities and healthcare professionals. 

“After years of experience providing U.S. support to countries overseas, it was an uplifting and humbling experience to be an enabler for the Navy nurses and corpsmen to deliver critical healthcare services to the Navajo Nation,” said Nelipovich. 

While deployed, the NEPLOs served mostly in a command and control capacity, coordinating the efforts of four Navy Rapid Rural Response Teams (RRRT), each of which consisted of five registered nurses and an enlisted respiratory specialist. 

“The Navy medical personnel directly contributed to the care and treatment of COVID-19 patients at the two hospitals,” said Nelipovich. “They initially provided relief for over-worked staff and then tightly integrated into staffing schedules, which increased treatment capacity for the local community. As NEPLOs, we interacted closely with hospital leadership, enabling the Navy healthcare professionals to integrate effectively with local staff and focus on saving lives and mitigating suffering.”   

Nelipovich said in a typical two week period, the RRRT assigned to the Chinle Comprehensive Health Care Facility provided a little over 1,000 hours of direct care and treatment of COVID-19 patients. 

Meanwhile, at the Northern Navajo Medical Center in Shiprock, Koerber, the RRRTs provided vital intensive care in a Post-Acute Care Unit space. Converted to a COVID-19-only intensive care unit (ICU) in which RRRT members worked alongside the NNMC staff, Kerber said the PACU essentially doubled the center’s ICU-level COVID-care capabilities. 

“Beginning the first day the RRRT offered care, the PACU was utilized at nearly 100% capacity,” Koerber said. “Witnessing the Navy team members administer care to the Shiprock Chapter of the Navajo Nation’s most critical COVID-19 patients was something I will never forget. I walked away thinking, ‘those are the professionals I would want treating my loved ones, if the need ever arose.’” 

The RRRTs, which consist of staff from Fort Belvoir, Naval Hospital Jacksonville, Naval Medical Center Portsmouth and Walter Reed National Military Medical Center served as force multipliers in treating COVID-19 patients.   

According to Koerber, the Navy doubled the ICU capacity at each hospital and enabled civilian medical staff to attend to patients with other healthcare needs. 

In addition to coordinating RRRT efforts, Koerber assisted in the preparation of COVID-19 vaccinations at Shiprock.  

“The NNMC received a large allotment of Pfizer vaccines just after the New Year,” said Korber. “The leadership plan was to administer roughly 800 doses of the vaccine to the most vulnerable elders via a drive-up distribution at the Chapter House, which is the local government building. Hospital staff made the vaccination announcement via social medial, print, and word of mouth.  Hours prior to the start of the mass vaccination the line of cars, beginning at the Chapter House, stretched for over a mile.”   

Transportation and storage of the COVID-19 vaccine has proven to be a logistical challenge in some areas according to Koerber. 
Vaccines are shipped from the manufacturer in a frozen, highly concentrated form requiring dilution of each dose with a saline solution prior to immunization. Koerber explained that in order to efficiently react to the large response, hospital leadership called for an ‘all hands on deck’ approach to help prepare the vaccine doses. 

“I noticed the staff was all engaged in vaccine prep work, so I volunteered to help,” said Kerber. “I half expected them to wave-off this old naval aviator to allow the organic hospital staff to do the heavy lifting. To my surprise, they pulled me up a seat, handed me some PPE, a packet of vials and syringes, and trained me in the preparation procedures for this critically important vaccine.”  

Over a two-day period Koerber prepared around 400 doses handed over to healthcare workers to vaccinate patients. 

“Having had COVID-19, I felt extremely proud that my hands-on work would directly help protect the Navajo Nation’s elders from falling victim to the virus,” he said.