Fort Detrick Installation Utilizes Whole of Government Approach to Tackle COVID-19
Fort Detrick, located in Frederick, Maryland, may be small in size, but its scientific expertise is mighty – and when faced with a global pandemic, the installation is at the forefront of the COVID-19 response.
"We are using both our immediate research capabilities and our larger interagency partnerships to help tackle COVID-19," said Brig. Gen. Michael Talley, commanding general of the U.S. Army Medical Research and Development Command (USAMRDC) and Fort Detrick. "The trust and hope placed in our team by the Department of Defense, the Department of the Army and the American public have already enabled us to make great strides in this fight, and we are eager to pursue this effort to the end."
The installation is home to the National Interagency Confederation for Biological Research (NICBR), of which USAMRDC is a member. This consortium of eight agencies shares a common vision of federal research partners working in synergy to achieve a healthier and more secure nation. It serves as a framework for facilitating and encouraging interaction among member organizations on topics of mutual interest, like COVID-19. NICBR includes elements of the DOD, Health and Human Services, the U.S. Department of Agriculture and Homeland Security, and its members collaborate and share technical expertise and scientific support.
There is no better place to witness the whole-of-government approach in action than at Fort Detrick, which is playing a significant role in COVID-19 response efforts by relying on unique communities of research and acquisition personnel during this challenging and unprecedented time.
"When it comes to infectious disease threats, we have extensive capabilities and an international research infrastructure already in place that allows our scientists to anticipate and develop countermeasures against emerging infectious diseases," said Talley. "We've been able to move quickly in advancing a vaccine candidate at one of our labs, while growing the live virus and developing animal models to test effectiveness at another."
In early January, as the COVID-19 infection spread throughout the world, scientists at USAMRDC's Walter Reed Army Institute of Research (WRAIR), located in nearby Silver Spring, Maryland on Fort Detrick's Forest Glen Annex, began developing several vaccine candidates utilizing a previously tested platform. These vaccine candidates are currently being tested in various models to identify those that induce the strongest immune response. "Based upon WRAIR's long experience developing vaccines for other viruses and recent work on coronaviruses, we've been able to move quickly in advancing a vaccine candidate," said Dr. Kayvon Modjarrad, director of WRAIR's Emerging Infectious Diseases Branch.
While USAMRDC scientists hope to have a vaccine available within 12-18 months, they are also utilizing their extensive laboratory capabilities to rapidly advance COVID-19 antiviral treatments. The U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), located on Fort Detrick, has consistently been at the forefront of the discovery and development of biodefense therapeutics, including remdesivir, mAB114 and ZMapp, which were used during the 2018-2020 Ebola virus disease outbreak in the Democratic Republic of Congo. WRAIR has participated in the development of every malaria prevention drug approved by the U.S. Food and Drug Administration (FDA), most recently tafenoquine in 2018.
USAMRIID and WRAIR investigators are collectively implementing a screening-based approach to find repurposed drugs for SARS-CoV-2, the virus that causes COVID-19, in the near-term, as well as broad-spectrum drugs that target coronaviruses in general in the long-term. The work leverages USAMRIID's biology expertise, WRAIR's chemistry expertise and the extensive network of industrial, academic, non-profit and U.S. government collaborators at both laboratories.
USAMRIID is also pursuing additional medical countermeasures, including monoclonal antibodies and convalescent plasma from COVID-19 survivors. The institute recently received samples from New York to evaluate the ability of the antibodies in such plasma to block the SARS-CoV-2 virus, according to Dr. John Dye, chief of Viral Immunology at USAMRIID. "This testing has revealed that not all convalescent patient plasma contains neutralizing antibodies to the virus, and demonstrates the need to evaluate donor plasma for its potential therapeutic effects," said Dye.
USAMRIID has both the trained personnel and specialized Biosafety Level 3 containment laboratories to safely work with SARS-CoV-2. The institute has generated large quantities of authentic, well-characterized virus for use in developing multiple diagnostic assays and models. These tools are essential to evaluate and prioritize the most promising vaccines and treatments developed by USAMRDC scientists and their collaborators.
USAMRDC laboratories are also working to improve the ability to detect COVID-19 infections in Service Members and their dependents. Scientists are working closely with industry partners in order to advance a range of diagnostic options. These include high-throughput tests to identify who is currently infected and who may have been previously infected.
Outside of the laboratory, USAMRDC is using industry agreements to advance existing efforts in the fight against COVID-19. The command's U.S. Army Medical Materiel Development Activity (USAMMDA) signed a cooperative research and development agreement (CRADA) with Gilead Sciences to provide their drug, remdesivir, for the treatment of DOD personnel exposed to COVID-19. Currently, 13 medical treatment facilities (MTFs) are capable of treating patients under this protocol and several patients have received or are currently receiving the treatment.
USAMMDA's Warfighter Deployed Medical Systems (WDMS) team has been tasked with filling shortages for deploying units by surveying current equipment, facilitating delivery of key materials and coordinating with other agencies to ensure deploying units have the equipment required to combat the pandemic. "We have been working on ensuring any shortages in equipment for the mission are top priority to fulfill," said Lindsay Longobardi, Deputy Project Manager for USAMMDA WDMS. "Our team has exercised multiple contracting actions to ensure critical care medical devices [are] shipped to the units [and] on the ground in as little as 24 hours."
USAMRDC isn't the only Fort Detrick entity supporting the COVID-19 response effort. A number of other installation tenants, including the Department of Homeland Security's National Biodefense Analysis and Countermeasures Center (NBACC), are playing critical roles. NBACC is conducting research to help scientists better understand the coronavirus that causes COVID-19 and methods to prevent its spread. The center's unique combination of capabilities in virology and aerobiology are integral to this effort, and will allow researchers to evaluate the impact of a range of conditions – such as temperature and humidity – for the virus to survive.
Medical intelligence is also playing a role in the response at Fort Detrick, the Defense Intelligence Agency's National Center for Medical Intelligence (NCMI) provides analysis on health and medical issues, including pandemics and novel and existing diseases. NCMI supports military operations by assessing the infectious disease risk to U.S. forces as well as foreign health system capabilities, including pandemic preparedness. "We look at medical intelligence not so much to report information like the CDC or the WHO does but we analyze the intelligence as it affects U.S. forces," said COL Shane Day, director of NCMI. "We have many experts who are energized to be able to have an impact on this important mission and this is what we train for."
In addition to research, Fort Detrick also plays a significant role in moving necessary equipment to the frontlines of the fight. The U.S. Army Medical Logistics Command (AMLC), a subordinate command of the U.S. Army Materiel Command (AMC), has ensured the delivery of life-saving medical supplies for three Army hospital centers charged with supporting New York and Washington – two of the states hardest hit by COVID-19. Shipments included syringes, suction tubes, various blood products and oxygen.
With regard to deployments, the 6th Medical Logistics Management Center (6MLMC) has deployed 22 Soldiers across the U.S. to support federal efforts to combat the pandemic. Tasked chiefly with tracking medical materiel, supporting medical maintenance operations and integrating with federal entities such as the Federal Emergency Management Agency (FEMA), six teams have been dispatched to such hotspots as Washington, California, Louisiana and New York.
Similarly, the Medical Communications for Combat Casualty Care (MC4) team – whose Product Management Office is headquartered at Fort Detrick – is responding to the pandemic both domestically and overseas by supplying equipment and direct technical and training support to Army units who use MC4 IT systems. To date, MC4 has deployed more than 175 such systems globally.
Robust acquisition efforts have also played a role in the response to COVID-19. Two organizations reporting to the Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (JPEO-CBRND) – the Joint Project Manager for CBRN Medical (JPM CBRN Medical) and the Joint Project Lead for CBRND Enabling Biotechnologies (JPL CBRND EB) – have been involved in virus response efforts since the first cases were identified. The JPEO-CBRND is leveraging existing partnerships with industry to rapidly deliver diagnostic capabilities to MTFs around the globe.
Elsewhere on the installation, the Barquist Army Health Clinic (BAHC) has initiated efforts to hold the bulk of its current appointments virtually – including behavioral health appointments – to meet social distancing requirements. Patients who must come into the clinic are pre-screened via an outdoor "drive-through" station to determine individual risk levels of COVID-19 exposure and transmission before entering the facility. Patients requesting COVID-19 testing are screened using the same process.
The entire Fort Detrick community – including those outside the biomedical research field – has answered the call for help in the face of the pandemic by relying on unique capabilities and partnerships. As a matter of best practice, the U.S. Army Garrison (USAG) continues to act as the "mayor" of the installation, handling contracts and maintenance efforts so that lifesaving research can continue. USAG has initiated an installation-wide effort to clean and sanitize areas of concern and to conduct trace interviews in order to notify anyone who may have been in contact with individuals testing positive for COVID-19.
These efforts, as many and varied as they may be, provide just a glimpse into the work being done at Fort Detrick – a relatively small installation in Maryland, actively responding to a global pandemic. One might argue that a more capable, committed team does not exist.