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Military forces drafted in as Europe risks being overwhelmed by Covid cases

Posted November 7, 2020 12:01 a.m. EST

— The soldiers of 1st Battalion, The Yorkshire Regiment are used to driving armored vehicles in combat for the British Army. Now they've been called up to a new front line -- in the fight against Covid-19.

Over the top of their military fatigues they now wear plastic aprons and face shields. They've been trained to administer new rapid tests for the virus on members of the public, shuttling swabs from booths to test tubes to get results in as little as half an hour.

The soldiers are among 2,000 military personnel who have been drafted in to help roll out a new mass testing program in England's northwestern city of Liverpool.

The UK government hopes to test the entire population of nearly 500,000 in 10 days. It's a voluntary scheme open to anyone who lives and works in the city, regardless of whether they have symptoms. And it's the largest call-up of the military to help with a civilian crisis in recent years.

While some residents may prove reluctant, hundreds of people were lined up waiting when the doors first opened Friday at a Liverpool sports center now serving as a test site.

The initiative could be the face of things to come. "Dependent on their success in Liverpool, we will aim to distribute millions of these new rapid tests between now and Christmas and empower local communities to use them to drive down transmission in their areas," Prime Minister Boris Johnson said as he announced the program.

The pilot started a day after England entered new national lockdown measures, with Johnson warning of a danger that the UK National Health Service (NHS) could "collapse" if infection rates are not brought down.

As Europe battles a second wave of coronavirus cases, with increasing numbers of countries imposing partial or nationwide lockdowns to try to limit infection rates, the United Kingdom is not alone in drafting in the military to help ease the huge strain on its healthcare systems.

Across the continent, members of the armed forces have for months been taking on roles ranging from supporting overstretched hospital staff to disinfecting testing sites to transporting patients.

"If you look across Europe, all of their armed forces have contributed to the national response to the coronavirus," said Martin Bricknell, Professor in Conflict, Health and Military Medicine at King's College London and a visiting fellow at the Center for Global Development.

"In the first instance, they've been a source of essentially reserve, organized manpower, so have supported logistics including both the procurement of medical supplies, the movement of medical supplies and in some countries the movement of other essential goods," said Bricknell, who was Surgeon General of the UK Armed Forces before retiring from the military last year.

The military have also provided planning support to different parts of government, and all nations have used their military medical services to augment their medical capacity, Bricknell told CNN.

"Some nations have deployed field hospitals in the early phases -- notably France and Italy -- and other nations have opened up access to civilians to their military hospitals or used military hospitals to specifically treat Covid cases at the beginning of the pandemic when they were trying to keep it under control," said Bricknell.

British soldiers worked alongside contractors in the spring to build seven so-called Nightingale hospitals to provide hundreds of additional ICU beds. The temporary hospitals, put up in a matter of days, have been little used so far but remain on standby.

In countries including France, Belgium, Italy and Spain, the armed forces have trained and assisted care workers in nursing and elderly care homes, Bricknell said.

And in the early days of the pandemic, military forces across Europe aided the repatriation of citizens stranded overseas as national borders closed.

"The armed forces have been a very valuable source of government-controlled manpower to point at large-scale problems and say 'go and solve it,'" said Bricknell. "You've got a disciplined, organized force that can work out how to do it."

Growing hospitalizations

Europe's military may be needed more than ever as autumn advances into winter with infections on the rise.

Slovakia called on its armed forces as it tested more than 3.6 million people -- or two-thirds of its population -- in the course of one weekend, using rapid antigen tests which provide results in minutes.

The Slovak military was in charge of deploying some 40,463 staff, including 14,500 health workers and 6,319 soldiers, to nearly 5,000 testing locations across the country.

Switzerland's government announced Wednesday that 2,500 soldiers would be available to help manage the growing number of hospitalizations and Covid-19 patients admitted to ICU, in places where local resources have been "exhausted."

And Belgium, with one of the highest case rates in Europe, said last month that 1,500 military personnel would be made available to support the coronavirus response if needed, although fewer than 100 have been deployed so far, according to the Belgian military, La Défense.

Eighteen military medics are being used in the Belgian city of Liege, where a new emergency unit has been set up in a hospital's disused surgical wing to help relieve pressure on hospitals across the region. The unit will take up to 26 patients at first, according to La Défense. A military helicopter and crew is also on standby to airlift intensive care patients around the country.

Spain's military is involved in contact tracing and is being used to disinfect locations including coronavirus testing centers and elderly care homes.

During the first wave of infections, its soldiers helped build a number of coronavirus field hospitals, including one in a convention center in the capital, Madrid, that was hailed as the largest hospital in Spain.

More unusually, Russia has used members of its military during clinical trials for a coronavirus vaccine candidate being developed by the Moscow-based Gamaleya Institute. State news agency Tass reported in June that the Russian Defense Ministry had selected 50 military volunteers from across Russia to take part in vaccine testing.

Russian Deputy Prime Minister Tatyana Golikova said late last month that military service members have also been sent to aid the coronavirus response in the Amur, Irkutsk and Kurgan regions, as well as Abkhazia and Crimea.

In France, the military has in recent days resumed transfers of Covid patients to hospitals in less affected regions, Health Minister Olivier Véran said Thursday.

Italy's military has been involved in running field hospitals, Covid hospitals and coronavirus testing projects. In late October, its Ministry of Defense launched a drive-through testing initiative, with 200 teams aiming to process 30,000 swabs a day.

"All nations in Europe had reduced this emergency expansion over the course of the summer," Bricknell said. "And now as the outbreak gets worse again, then different countries are using their armed forces again to assist with planning response and augmenting capacity, particularly in terms of testing."

Agility, flexibility, resilience

So what does the military bring to a civilian pandemic response?

In Britain, it offers a large, agile workforce which is used to acting quickly, said Lt. Col. Chris Gibson (retired), who now offers leadership training to the medical community through charity The Staff College and his own company, SOS Medical.

"Agility is really important, the willingness to adapt to a new environment quickly is a real positive asset because agility in the NHS is not normal jogging for them -- that's not a criticism, it's just how the NHS is," Gibson told CN

While chief instructor for the UK Ministry of Defence, Gibson played a leading role in training UK military personnel and NHS volunteers to combat Ebola in West Africa from 2014 to 2016. He has used lessons learned there to advise NHS leaders on protocols to manage infectious diseases and set up effective temporary hospitals.

The military are also very good with people, Gibson said, a skill which can be vital at a time of great pressure.

"They understand how to get the moral component right -- because if you don't get that right, how do you get your people to cross the start line and engage with the enemy? So that ability to build camaraderie in adversity is really important. And if there was ever a situation where that was the case, it was Covid for the NHS," he said.

Bricknell highlights the military's strength in planning, the "positive, will-do attitude" encouraged in its personnel and its capacity to provide large-scale logistical capability at short notice without having to go to commercial contractors.

The military could also help in future by sharing its expertise on boosting resilience for NHS staff affected by the toll Covid-19 has taken on co-workers, Gibson suggested.

"When people join the NHS, they join it rationally to not expect that their colleagues would suffer from injury or harm as a result of doing the job. That's not the case for the military. That doesn't mean we go to work thinking we are going to lose our colleagues every day but we have rigor built into our training mechanisms and support systems should that happen."

Gibson warns that the longevity of the crisis will prove an additional challenge for healthcare workers who are on the front line and, unlike the military, do not alternate tours of duty with periods of training and leave.

'Testing is the best way forward'

Signs of coronavirus fatigue among wider European populations are already clear. Protests against lockdowns and other coronavirus-related restrictions have gathered force in recent weeks in countries including Spain and Italy, where some have turned violent.

While France and Italy used military forces in the early stages of the pandemic to assist police in enforcing restrictions on movement, such as carrying out document checks at train stations, they have not been deployed to maintain order.

Announcing a previous round of coronavirus restrictions in September, Johnson said the police would have the option to request military support, should they become overwhelmed.

However, that wouldn't mean troops patrolling the streets. Downing Street said the military could be used to fill office roles and to guard protected sites, freeing up the police to enforce the virus response.

Back in Liverpool, which has seen one of the highest death rates in England from Covid-19, the city's residents hope the mass testing pilot can offer a route back to a more normal life.

"Our hospitals are at around about 90-95% capacity in the ICUs, the intensive care units, so we know we've got to release the pressure on our hospitals and this will hopefully help us do that," Mayor of Liverpool Joe Anderson told CNN.

"We've been told this is the best way to drive cases down so it makes sense. Testing is the best way forward," said Dillon Thomson, a member of public standing in line for a test. "The more people who know whether they've got it or not the better."

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