Watching the White House briefings on the pandemic is prompting questions about the officials gathered near the podium, including: Who's that in the blue uniform with four stars on his collar?
Admiral Brett Giroir, M.D., is assistant secretary for health – not in the Navy but in the U.S. Public Health Service (USPHS), one of the country's two unarmed services. (For extra credit: The other one is NOAA.)
The Public Health Service has a commissioned officer corps of about 6,300 doctors, nurses and other professionals. Thousands of them deployed after Hurricane Katrina in 2005. They went to Liberia during the Ebola outbreak in 2014.
Now, about 1,800 corps members are focused on the coronavirus in the United States. More are needed, but these doctors and nurses all have day jobs.
"About 3,000 of the corps is actually delivering care on a daily basis to the Indian Health Service, to all the tribes throughout the country, including Alaska, to the Bureau of Prisons, and to those in detention under Immigration and Customs Enforcement," Giroir told NPR.
So every officer heading to New York or New Orleans would leave behind an empty exam room on a Native American reservation or in a federal prison.
"It is really impossible to deploy those [people] because they're dealing with COVID-19 right now among some of the populations hit the hardest," he said.
The obvious solution would be a ready reserve, either to deploy to disasters, or to backfill jobs so active officers can go. In fact, that solution has been in the works – for 10 years.
"This whole idea of having a ready reserve has already been on the books since the Affordable Care Act. That in fact was a provision within that act," says retired Rear Admiral Boris Lushniak, who oversaw operations for the U.S. Public Health Service's Commissioned Corps from 2010 to 2015. He says part of the Affordable Care Act was supposed to create a ready reserve, but it got lost in red tape and never happened.
"My hope is that the Department of Health and Human Services and the U.S. Public Health Service Commission Corps can really begin working on this ready reserve quickly," said Lushniak.
He's hopeful because Giroir began pushing for a congressional fix for the ready reserve when he took office two years ago. A group of military veterans in Congress got behind it: the bipartisan For Country Caucus.
"As veterans from across the military branches, we know reserve units are an essential part of any sustained operation," said Rep. Jared Golden, D-Me. "As Members of Congress from across the political spectrum, we agree on the importance of encouraging Americans to serve their community and their country."
On the Senate side, Mike Rounds, R-S.D., sponsored a bill to fund the ready reserve back in January, before the coronavirus outbreak in the U.S. had taken off.
And when the coronavirus hit, supporters inserted that funding into Congress's massive stimulus bill. The CARES Act now authorizes the ready reserve.
It's better late than never, Giroir said. "Right now we could use every single one of those people," he added. "Obviously, [if] we'd had this years ago, we would have that reserve corps now and be ready. But, I'm glad we have it now, moving into the future."
Congress and the Department of Health and Human Services are still working out the details for funding the reserve. And Giroir is busy: The president put him in charge of COVID-19 testing nationwide. Still, the admiral said he's excited about standing up the ready reserve — though it may take until winter to do it.