It’s not often that the National Guard is called upon to assist with large-scale medical emergencies. But that’s exactly what happened during the COVID-19 pandemic. In state after state, the guard — the U.S. military’s only force consisting of what it refers to as “citizen soldiers” — has worked with health facilities affected by the crisis, making it the organization’s single largest effort since responding to Hurricane Katrina in 2005.
As a lieutenant colonel in the Pennsylvania Army National Guard and the medical director for the Pennsylvania Task Force West Guard Brigade, WVSOM alumnus Rick Fogle, D.O., helped train and place soldiers in nursing homes throughout western Pennsylvania that were affected by the pandemic. Fogle, a Class of 2008 graduate and former WVSOM faculty member, is a geriatrician who, in the “citizen” portion of his professional life, works in Washington, Greensboro and Clairton, Pa., with Cornerstone Care, a Federally Qualified Community Health Center treating underserved populations.
“The guard has always responded to disaster relief, but this was the first time we’d done anything related to a pandemic,” Fogle said. “We’re used to taking care of people who were injured in tornadoes or hurricanes, cutting trees out of the way and fording rivers to rescue people, and driving out in our Humvees to clear snow, but what we’ve done this year has never been done. This is a very rare thing.”
Fogle, who has been a guard member for 22 years, was asked in March to lend his expertise when the Pennsylvania Emergency Management Association and the state’s Department of Health requested the guard’s help after the virus was identified as a threat. In the subsequent months, as nursing facilities became short-staffed due to employees staying home out of fear or because they were sick themselves, Fogle worked with more than 30 homes throughout western Pennsylvania to keep them operating and mitigate virus spread. In September, as COVID-19 cases in the state continued to fluctuate, he was still being sent to new locations. Some of them, he said, were desperate for assistance.
“We got calls from directors of nursing who were crying on the phone and telling us, ‘We need help,’” he said. “They were completely overwhelmed.”
Fogle’s role included performing site surveys — visiting nursing homes to analyze their equipment supplies, evaluate their COVID-19 protocols and determine how much help was needed — and establishing a system to teach guard members to care for residents and conduct COVID-19 testing.
“I would evaluate things like: Do they really need us? How many shifts do they need covered? How many soldiers need to go in? How many additional supplies should we send them? If we can’t supply enough soldiers to this nursing home, do we need to evacuate it?” he explained. “We send in general-purpose soldiers to do things like maintenance, cleaning, doing laundry, preparing food and feeding residents. And I train medics and nurses in using nasal swabs, as well as refreshing them on things like donning and doffing [putting on and removing personal protective equipment].”
By the time Fogle was called to conduct a site survey near Grove City, Pa., in September, his brigade had developed a system that allowed them to respond to nursing homes almost instantly.
“We’ve developed rapid response teams, with soldiers ready to go within 24 hours,” Fogle said. “Yesterday I drove to Grove City, because there’s a home where 90 percent of the patients and almost half the staff are COVID-positive. We will have our medics in the building tonight, and we’ll have an additional 10 soldiers tomorrow morning. We’ll probably bring in two nurses next week until they can recruit more. Their staff has been working double shifts and has been there every day for the last three weeks. We’re coming in to give them a break.”
Fogle also helped open a testing site in the Pittsburgh suburb of McKeesport, Pa., staffed by members of the guard and other emergency response organizations. The site is able to test up to 250 people each day on a drive-through basis. And he’s taken on these responsibilities while continuing his work as a geriatrician at Cornerstone Care.
Fogle entered the military at age 45 and medical school at age 50. Originally from Pittsburgh, he moved to West Virginia to work as a paramedic and later as a physician assistant. He continued his duties with the National Guard while in medical school, even being deployed to the Guantanamo Bay detention camp, in Cuba, between his first and second years at WVSOM.
Fogle said his time at the school helped equip him to take on the unusual challenges this year has presented for medical professionals.
“My education prepared me to do something the guard has never done before,” he said. “Having great professors to work with students and give us a well-rounded education not only in immunology and the disease process, but also in the mind, body, spirit aspect of osteopathic medicine, was very helpful. It’s been especially invaluable for me in working with an older population whose mortality is in front of them.”
Amidst the tireless work of helping seniors battle the pandemic, Fogle himself succumbed to the virus. In July, he spent two weeks quarantined with his family after contracting COVID-19. Sick with fever, cough, sore throat and fatigue, Fogle found himself sleeping 16 to 18 hours a day. He didn’t require hospitalization, but like many who have the virus, he lost his sense of taste and smell — and, he was surprised to discover, portions of his memory as well.
“I don’t remember the details of those two weeks,” he said. “I would talk to people and then two or three days later I didn’t know them. I couldn’t recall what I’d talked to them about.”
Now fully recovered, Fogle has no plans to slow down.
“I’m on active duty orders until the end of the year,” he said. “The guard will probably be involved in COVID vaccinations in Pennsylvania once they’re available. Then, next June, I’m scheduled to spend a month in Thailand, and I’ll be leaving next November for a three-month deployment in Poland. I like to keep busy.”