November 2020 Newsletter

News from MHCE
NOVEMBER 2020 EDITION
Monthly Newsletter
WWW.MHCE.US
Biden wins White
House, vowing
new direction for
divided US
By Jonathan Lemire and Zeke Miller
WASHINGTON (AP) — Democrat Joe
Biden defeated President Donald Trump
to become the 46th president of the
United States on Saturday, positioning
himself to lead a nation gripped by the
historic pandemic and a confluence of
economic and social turmoil.
His victory came after more than three
days of uncertainty as election officials
sorted through a surge of mail-in votes
that delayed the processing of some ballots.
Biden crossed 270 Electoral College
votes with a win in Pennsylvania.
Biden, 77, staked his candidacy less on
any distinctive political ideology than
on galvanizing a broad coalition of voters
around the notion that Trump posed
an existential threat to American democracy.
The strategy proved effective, resulting
in pivotal victories in Michigan
and Wisconsin as well as Pennsylvania,
onetime Democratic bastions that had
flipped to Trump in 2016.
Biden was on track to win the national
popular vote by more than 4 million, a
margin that could grow as ballots continue
to be counted.
Trump seized on delays in processing
the vote in some states to falsely allege
voter fraud and argue that his rival was
trying to seize power — an extraordinary
charge by a sitting president trying to
sow doubt about a bedrock democratic
process.
As the vote count played out, Biden tried
to ease tensions and project an image of
presidential leadership, hitting notes of
unity that were seemingly aimed at cooling
the temperature of a heated, divided
nation.
“We have to remember the purpose of
our politics isn’t total unrelenting, unending
warfare,” Biden said Friday night
in Delaware. “No, the purpose of our
politics, the work of our nation, isn’t to
fan the flames of conflict, but to solve
problems, to guarantee justice, to give
everybody a fair shot.”
Kamala Harris also made history as the
first Black woman to become vice president,
an achievement that comes as the
U.S. faces a reckoning on racial justice.
The California senator, who is also the
first person of South Asian descent elected
to the vice presidency, will become
the highest-ranking woman ever to serve
in government, four years after Trump
defeated Hillary Clinton.
Trump is the first incumbent president to
lose reelection since Republican George
H.W. Bush in 1992. It was unclear
whether Trump would publicly concede.
Earlier Saturday Trump left the White
House for his Virginia golf club dressed
in golf shoes, a windbreaker and a white
hat as the results gradually expanded
Biden’s lead in Pennsylvania. Trump
repeated his unsupported allegations of
election fraud and illegal voting on Twitter,
but they were quickly flagged as potentially
misleading by the social media
platform.
One of his erroneous tweets: “I WON
THIS ELECTION, BY A LOT!”
The White House did not immediately
respond to a request for comment.
Biden was spending Saturday morning
with family and advisers at home in Wilmington,
Delaware, his campaign said.
Americans showed deep interest in the
presidential race. A record 103 million
voted early this year, opting to avoid
waiting in long lines at polling locations
during a pandemic. With counting continuing
in some states, Biden had already
received more than 74 million votes,
more than any presidential candidate before
him.
More than 236,000 Americans have died
during the coronavirus pandemic, nearly
10 million have been infected and millions
of jobs have been lost. The final
days of the campaign played out against
the backdrop of a surge in confirmed
cases in nearly every state, including
battlegrounds such as Wisconsin that
swung to Biden.
The pandemic will soon be Biden’s to
tame, and he campaigned pledging a
big government response, akin to what
Franklin D. Roosevelt oversaw with the
New Deal during the Depression of the
1930s. But Senate Republicans fought
back several Democratic challengers
and looked to retain a fragile majority
that could serve as a check on such Biden
ambition.
The 2020 campaign was a referendum
on Trump’s handling of the pandemic,
which has shuttered schools across the
nation, disrupted businesses and raised
questions about the feasibility of family
gatherings heading into the holidays.
The fast spread of the coronavirus transformed
political rallies from standard
campaign fare to gatherings that were potential
public health emergencies. It also
contributed to an unprecedented shift to
voting early and by mail and prompted
Biden to dramatically scale back his travel
and events to comply with restrictions.
Trump defied calls for caution and
ultimately contracted the disease himself.
He was saddled throughout the year
by negative assessments from the public
of his handling of the pandemic.
Biden also drew a sharp contrast to Trump
through a summer of unrest over
the police killings of Black Americans
including Breonna Taylor in Kentucky
and George Floyd in Minneapolis.
Their deaths sparked the largest racial
protest movement since the civil rights
era. Biden responded by acknowledging
the racism that pervades American life,
while Trump emphasized his support of
police and pivoted to a “law and order”
message that resonated with his largely
white base.
The president’s most ardent backers never
wavered and may remain loyal to
him and his supporters in Congress after
Trump has departed the White House.
The third president to be impeached,
though acquitted in the Senate, Trump
will leave office having left an indelible
imprint in a tenure defined by the shattering
of White House norms and a dayto-day
whirlwind of turnover, partisan
divide and the ever-present threat via his
Twitter account.
Biden, born in Scranton, Pennsylvania,
and raised in Delaware, was one of the
youngest candidates ever elected to the
Senate. Before he took office, his wife
and daughter were killed, and his two
sons badly injured in a 1972 car crash.
Commuting every night on a train from
Washington back to Wilmington, Biden
fashioned an everyman political persona
to go along with powerful Senate positions,
including chairman of the Senate
Judiciary and Foreign Relations Committees.
Some aspects of his record drew
critical scrutiny from fellow Democrats,
including his support for the 1994 crime
bill, his vote for the 2003 Iraq War and
his management of the Clarence Thomas’
Supreme Court hearings.
Biden’s 1988 presidential campaign
was done in by plagiarism allegations,
and his next bid in 2008 ended quietly.
But later that year, he was tapped to be
Barack Obama’s running mate and he
became an influential vice president,
steering the administration’s outreach to
both Capitol Hill and Iraq.
While his reputation was burnished by
his time in office and his deep friendship
with Obama, Biden stood aside for Clinton
and opted not to run in 2016 after his
adult son Beau died of brain cancer the
year before.
Trump’s tenure pushed Biden to make
one more run as he declared that “the
very soul of the nation is at stake.”

2 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
experienced people and pick their brains," said Tozier, an Active Duty
Soldier assigned to the 3rd Medical Command. "The Soldiers who
have been here for the past year have gained an incredible amount of
knowledge and they are more than willing to pass that along to their
counterparts."
The PAs in attendance agreed.
"We just got on the ground here a few days ago, so it's important we
talk to the people who've been here and who have done what we'll be
expected to do in the next year," said Maj. Todd Kreykes, a PA with
the 1171st Area Support Medical Company (ASMC).
Physician Assistants
By Maj. Bobby Hart
CAMP VICTORY, Iraq -At any one time, more than 120 physician
assistants (PAs) are in Iraq performing the full gamut of medical
services ranging from trauma, acute and primary care, training for
medics and clinics for Iraqi civilians.
A group of these physician assistants met in the Oasis Dining Facility
here as part of Physician Assistant Week which runs from October
6-12.
"This was a good opportunity for our PAs to get together and share
ideas," said Col. Jim Tozier, the Army's senior PA. "We have people
spread all across Iraq. Even with this group tonight, we are all on the
same FOB (Forward Operating Base), but this is the first time some
of us have met."
Tozier and Maj. Jose G. Mangrobang, the senior Corps PA, organized
the event to recognize the job PAs do in theater and to give the Soldiers
an opportunity to mingle and unwind.
One responsibility of the 1171st is to man the Troop Medical Clinic
(TMC) on Camp Victory, which Kreykes says provides the unit an
opportunity to treat a wide range of injuries.
"Being on post, we see a lot of orthopedic injuries resulting from
sports-related accidents," Kreykes said. "But we are a Level two
facility, so we do see trauma victims who we have to stabilize and
then transport to other facilities."
Another 1171st PA, Capt. Brian McKeon, said the most common
ailment coming through the TMC is what Soldiers call the "Baghdad
Bug" or "Grunge" which keeps the medical facilities full almost every
day during sick call.
"This is a very dusty environment so we get a lot of upper respiratory
ailments," McKeon said. "I think almost everybody here will suffer
through at least a few days feeling the effects of the environment."
Tozier said the work being done at the TMC is typical of the high
tempo action PAs see in Iraq.
"Our PAs here have an excellent opportunity to see the full realm of
ailments," Tozier said. "It's a very stressful situation, but the wide
range of activities gives the PA's a chance to hone their skills they
couldn't get anywhere else in the world."
"One of the important things that came out of this was the chance
for some of the people who just got into country to meet some of the

WWW.MHCE.US Monthly Newsletter | 3
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Corona Positives Are
Automatically Requires To
Go Into Quarantine
Press release of the city of Wiesbaden, 06 NOV 2020
Courtesy Translation: Lena Stange, Public Affairs Specialist
WIESBADEN, Germany -- The administrative staff met again on
Friday, Nov. 6, and discussed the current situation of the corona
pandemic.
The health authority expressly points out to citizens that a 14-day
quarantine is mandatory for people who receive a positive result
(starting with the day of the test). This obligation to quarantine also
applies automatically to all household members. This was regulated
in the 1st Ordinance to Combat the Pandemic of the State of Hessen.
This also applies without a written quarantine order from the health
authority.
The administrative staff did not decide on any further measures in its
meeting, but reserves the right to do so if the number of infections in
Wiesbaden continues to rise unabatedly. "The measures currently in
force are necessary to slow down the spread of the corona pandemic, to
protect people from risk groups and to ensure that sufficient treatment
capacities are still available in clinics," say Lord Mayor Gert-Uwe
Mende and Mayor and Head of the Health Department Dr. Oliver
Franz. "We ask all Wiesbaden residents for their understanding and
urge them to adhere to the measures and to wear a mouth and nose
covering and to avoid contacts that are not absolutely necessary."
Details of all regulations so far can be found in the substantiated versions
of the general regulations. These can be downloaded from wiesbaden.
de/coronavirus under “Pressemeldungen und Verordnungen”.
VISIT OUR WEBSITE AT MHCE.US

4 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
The VA Is Now Offering
Transition Services Specially
Tailored for Female Veterans
By Jim Absher
The Department of Veterans Affairs is teaming up with the Department
of Defense to offer Women's Health Transition Training (WHTT) for
female service members who are transitioning to civilian life.
The voluntary training program is in addition to the normal Transition
Assistance Program (TAP) that all separating military members are
required to attend, and is not a substitute for TAP training. This training
is only available to female service members and will be led by a
woman veteran who actually uses VA health care.
The training began as a pilot program in 2018 in response to reports
that female veterans were not using their VA benefits as much as male
veterans did, mainly because they didn't know what programs were
available to them. Due to the great success of the pilot program, a
joint VA/DoD Executive Committee voted to make this program a
permanent offering by the VA.
Due to the COVID-19 outbreak, this year's remaining training sessions
will be offered online only. Sessions will be held twice daily
through Dec. 21, 2020. All women are encouraged to attend to learn
more about the special benefits for which they may be eligible.
Some of the subjects that will be discussed in WHTT include:
• Female specific health care including reproductive services, maternity
care, mental health services, newborn care, and gynecological
care and musculoskeletal care.
• Resources available for servicewomen during the military to civilian
transition process.
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WWW.MHCE.US Monthly Newsletter | 5
• Special programs available through the
VA for women veterans.
• Services available through the Center for
Women Veterans
According to the VA, a great number of women
veterans do not apply for healthcare and
other benefits they may be eligible for due to a
lack of knowledge of these programs. In fact,
since the WHTT program began as a pilot in
2018, women who attended the training sessions
applied for VA benefits at a rate 114%
higher than in previous years, and they did so
quicker,
TO ADVERTISE
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The VA says that women veterans have a higher
prevalence of chronic pain, obesity, musculoskeletal
issues and depression than their
male counterparts. Further, since 2001, rates
of suicide among women veterans has increased
by 85.2%, versus 30.5% among men
among the youngest age groups.
Women veterans with a mental health diagnosis
who do seek VA care often do it later than
their male counterparts. VA hopes this new
training will let women veterans know what
benefits they have available to them and to
enroll for care and other benefits as soon as
possible.
The program is intended to complement TAP
and to provide all servicewomen with specific
women's health information that will aid their
transition to civilian life. The goal of the program
is that participants leave the course feeling
empowered to proactively manage their
health care and to be comforted by their new
support system at VA who can guide them
through the military transition process and
help them.
There will be two four-hour long sessions
daily Monday through Friday through Dec.
21. Sessions will be held at various times to
allow those stationed across the globe to attend
at a convenient hour.
VISIT OUR WEBSITE
AT MHCE.US

6 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
One reason is because elections officials
were not allowed to process mail-in ballots
until Election Day under state law. It’s a form
of voting that has skewed heavily in Biden’s
favor after Trump spent months claiming
without proof that voting by mail would lead
to widespread voter fraud.
Biden ‘Time to Heal’ in First
Speech as President-Elect
Biden spent Thursday trying to ease tensions
and project a more traditional image of
presidential leadership. After participating in
a coronavirus briefing, he declared that “each
ballot must be counted.”
“I ask everyone to stay calm. The process
is working,” Biden said. “It is the will of
the voters. No one, not anyone else who
chooses the president of the United States of
America.”
Biden’s victories in the upper Midwest put
him in a strong position, but Trump showed
no sign of giving up. He was back on Twitter
around 2:30 a.m. Friday, insisting the “U.S.
Supreme Court should decide!”
Trump’s campaign engaged in a flurry
of legal activity to try to improve the
Republican president’s chances, requesting a
recount in Wisconsin and filing lawsuits in
Pennsylvania, Michigan and Georgia.
Judges in Georgia and Michigan quickly
dismissed Trump campaign lawsuits there on
Thursday.
Trump held a small edge in Georgia,
though Biden was gaining on him as votes
continued to be counted. The same was true
in Pennsylvania, where Trump’s lead had
slipped to about 22,000 votes — and the race
is destined to get tighter.
Mail ballots from across the state were
overwhelmingly breaking in Biden’s
direction. A final vote total may not be clear
for days because the use of mail-in ballots,
which take more time to process, has surged
as a result of the coronavirus pandemic.
The Trump campaign said it was confident
the president would ultimately pull out a
victory in Arizona, where votes were also
still being counted, including in Maricopa
County, the state’s most populous area. The
AP has declared Biden the winner in Arizona
and said Thursday that it was monitoring the
vote count as it proceeded.
“The Associated Press continues to watch
and analyze vote count results from Arizona
as they come in,” said Sally Buzbee, AP’s
executive editor. “We will follow the facts in
all cases.”
Trump's campaign was lodging legal
challenges in several states, though he faced
long odds. He would have to win multiple
suits in multiple states in order to stop
vote counts, since more than one state was
undeclared.
It could take several more days for the vote
count to conclude and a clear winner to
emerge. With millions of ballots yet to be
tabulated, Biden already had received more
than 73 million votes, the most in history.
Trump’s erroneous claims about the integrity
of the election challenged Republicans now
faced with the choice of whether to break
with a president who, though his grip on his
office grew tenuous, commanded sky-high
approval ratings from rank-and-file members
of the GOP.
Maryland GOP Gov. Larry Hogan, a potential
2024 presidential hopeful who has often
criticized Trump, said unequivocally: “There
is no defense for the President’s comments
tonight undermining our Democratic process.
America is counting the votes, and we must
respect the results as we always have before.”
But others who are rumored to be considering
a White House run of their own in four years
aligned themselves with the incumbent,
including Sen. Josh Hawley, R-Mo., who
tweeted support for Trump’s claims, writing
that “If last 24 hours have made anything
clear, it’s that we need new election integrity
laws NOW.”

WWW.MHCE.US Monthly Newsletter | 7
Some of the Trump team's lawsuits only demand better
access for campaign observers to locations where
ballots are being processed and counted. A judge in
Georgia dismissed the campaign’s suit there less than
12 hours after it was filed. And a Michigan judge
dismissed a Trump lawsuit over whether enough GOP
challengers had access to handling of absentee ballots
Biden attorney Bob Bauer said the suits were legally
“meritless.” Their only purpose, he said “is to create an
opportunity for them to message falsely about what’s
taking place in the electoral process.”
Weissert reported from Wilmington, Delaware.
Associated Press writers Jill Colvin, Colleen Long
and Alexandra Jaffe in Washington contributed to this
report.
This article was from The Canadian Press tight contests
in some key battleground states.
With his pathway to re-election appearing to shrink,
Trump on Thursday advanced unsupported accusations
of voter fraud to falsely argue that his rival was trying
to seize power. It amounted to an extraordinary effort
by a sitting American president to sow doubt about the
democratic process.
“This is a case when they are trying to steal an election,
they are trying to rig an election,” Trump said from the
podium of the White House briefing room.
The president's remarks deepened a sense of anxiety in
the U.S. as Americans enter their third full day after the
election without knowing who would serve as president
for the next four years. His statements also prompted
a rebuke from some Republicans, particularly those
looking to steer the party in a different direction in a
post-Trump era.
Neither candidate has reached the 270 Electoral
College votes needed to win the White House. But
Biden eclipsed Trump in Wisconsin and Michigan, two
crucial Midwestern battleground states, overtook the
president in Georgia and was inching closer to doing
the same in Pennsylvania, where votes were still be
counted.
It was unclear when a national winner would be
determined after a long, bitter campaign dominated by
the coronavirus and its effects on Americans and the
national economy. The U.S. on Wednesday set another
record for daily confirmed cases as several states
posted all-time highs. The pandemic has killed more
than 233,000 people in the United States.
VISIT OUR WEBSITE AT MHCE.US

8 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
The Harbert College of Business ranked among the
top 30 public business schools in the nation
By EETV Web Team
AUBURN, Ala. (EETV) -The U.S. News & World Report has ranked
Auburn Univesity's Harbert College of Business as one of the top 30
public schools in the nation.
“The Harbert College of Business is keenly focused on delivering
quality graduate programs that prepare our students to step into
leadership roles at corporations of their choosing and influence sound
decision-making,” said Associate Dean of Graduate and International
Programs Stan Harris.
starting salaries, to recruiters' assessments. This is the third year in a
row The Harbert School of Business has been ranked.
“Our Full-Time MBA draws talented students from across the country
due to its robust curriculum, talented and engaged faculty, and
outstanding return on investment,” said Executive Director of Full-
Time and Online MBA Programs Jim Parrish. “When you consider
that we provide students a firm foundation in advanced business theory
and practical training in leadership and career development, the value
of our program becomes obvious.”
The ranking was based on a survey of Full-Time MBA programs.
The survey took into account a wide range of criteria from graduates
AUBURN, Ala. (WRBL) – Auburn University’s Harbert College of
Business has partnered with Radiance Technologies to provide the
companie’s employees with the ability to pursue higher edcuation
with an online MBA.
Radiance has employees across 12 states who will be eligible to earn
an Auburn Online MBA beginning in the fall 2020 semester. The
release from the university says Radiance is paying 100 percent of
the tuition and fees in order “to build the next generation of leaders.”
“We hope employee-owners take advantage of this opportunity as
Radiance is committed to promoting professional development and
higher education,” said Radiance CEO Bill Bailey.
VISIT OUR WEBSITE AT MHCE.US

WWW.MHCE.US Monthly Newsletter | 9
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10 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
Experienced Nurses Needed as Nurse Educators
By EETV Web Team
At a certain point in their clinical practice careers,
many longtime nurses -- even those who have
sacrificed much to care for patients -- come to ask
themselves, "Is this all there is?"
Leaders in nursing say the answer is an emphatic
no. Nurses who have suffered the slings and arrows
of the managed-care environment while helping to
bring thousands of patients back to health over the
years do have a noble alternative: Teaching.
"The most wonderful reason to become a faculty
member is that you get to shape the profession,"
says Geraldine Bednash, executive director of
the American Association of Colleges of Nursing
(AACN). "Anyone with lots of clinical experience
has got some very important perspectives that new
graduates need to have."
RNs with master's or doctorate degrees are in great
demand as faculty at nursing schools. Indeed,
the current nursing-faculty shortage, which the
AACN reports at 7.6 percent nationally for the
2008-09 academic year, is a major contributor to
the mushrooming shortage of all types of nurses.
Nursing schools turned away nealy 28,000 qualified
applicants in 2008 due to a shortage of faculty and
resources, according to the AACN.
And the shortage of nursing-school professors is
expected to worsen in coming years as many faculty
retire. According to AACN survey data released
in March 2005, 65 percent of the nearly 11,000
faculty members teaching in the nation's bachelor's
and graduate nursing programs were older than 50.
Education for Nurses Who Teach
The current emphasis on clinical experience as a
key element of nursing education means nurses
who teach don't have to give up patient contact.
"People can have the joys of being an educator
while continuing to do their practice," says Janet
Allan, dean of the University of Maryland's School
of Nursing in Baltimore.
Teaching in a nursing baccalaureate program does
mean earning an advanced degree. About one-third
of faculty positions require a master's degree, and
two-thirds require a doctorate. Many nurses find
ways to earn an advanced degree without entirely
giving up their clinical practice income.
Online programs enable nurses to fit graduate study
into their busy lives. For example, the University of
Maryland's nursing education certificate program is
offered both in the classroom and in cyberspace.
"The whole program -- all 12 credits -- can be done
online," Allan says.
Financial Aid: Needed and Available
Tuition for a graduate nursing degree is likely to run
into tens of thousands of dollars, but nurses can get
help paying tuition and related costs.
Financial aid for nurses attending graduate school
is available from many sources, including the
federal and state governments, hospitals and other
healthcare employers, nursing associations and
nursing schools, as detailed in AACN's financial aid
directory.
Some nurses bridge the financial gap by working
while they study. That was the path taken by Lisa
Lowery, who is simultaneously studying for the
University of Maryland's nurse-educator certificate
and a doctorate of pharmacology, which she hopes
will enable her to become a nursing school's director
of pharmacology. "I work 12-hour shifts on Saturday
and Sunday as an agency nurse in emergency
rooms," she says.
Earning Potential Drops, Then Rises
Perhaps the most difficult obstacle for nurses aspiring
to be professors is the salary cut they're likely to
experience at the start of their academic careers.
The average salary of an emergency room nurse
practitioner with a master's degree was more than
$95,000 versus about $68,600 for a nurse professor
with the same academic training, according to a
2007 survey by Advance for Nurse Practitioners
magazine.
But "over the longer term, as they move up the
professorial ranks, faculty members with doctoral
degrees earn well into six figures," Bednash says.
Other nurses who become teachers are satisfied
with the lower salary range and personal benefits
associated with working an academic year in a
secure teaching position.

WWW.MHCE.US Monthly Newsletter | 11
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12 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
Expert: Most Private Physicians Untrained to Handle
Vets' Issues
By Jon O'Connell
Most veterans get some health care from
private doctors.
But most doctors outside the Veterans Affairs
system aren't trained to identify servicerelated
illness, according to a physician
working to educate clinicians on the issues.
"While everybody seems to be mostly
focused on the health care that veterans are
getting at the VA, it sort of went unnoticed
that 80 percent of veterans get most of their
health care from civilian providers," said
Jeffrey L. Brown, M.D., a clinical professor
of pediatrics at New York Medical College
who also teaches at Weill Cornell Medicine.
While about 40 percent of veterans get some
health care from the VA, only about 20
percent of all veterans rely totally on the VA,
according to a 2015 government survey of
health and health care use.
Dr. Brown, a pediatrician and retired U.S.
Armymedic, carried a .45 pistol and treated
wounded and sick soldiers and, at times, local
children in Vietnam. Late in his post-military
private practice career, a New York Times
article alerted him that anyone who served in
Vietnam should consider themselves exposed
to Agent Orange, a carcinogenic defoliant
used to kill thick plant growth and expose
hiding Vietnamese fighters. Those veterans
risked serious illness like cancer, diabetes
and heart disease.
He learned of the risk from a newspaper, not
his doctor, which he thinks is a big problem.
The revelation prompted a new quest to
educate physicians about service-specific
ailments.
"The biggest deficiency: Most health care
providers don't ask patients as they come
through the door if they've ever served in the
military," he said.
Dr. Brown, whose early opinion on the matter
appeared in a 2012 edition of the Journal of
the American Medical Association, will speak
during a symposium at the Commonwealth
Medical College from 8 a.m. to 12:30 p.m.
Saturday.
Service-related issues also could affect
women's health, especially when it comes to
bearing and delivering children, Dr. Brown
said.
Pediatricians also seldom are trained to
identify psychological and learning problems
among veterans' children related to their
parents' service or the effects after returning
from deployment, he said.
About 800,000 veterans live in Pennsylvania,
according to 2015 data from the U.S. Census
Bureau. And on average, they get only
29 percent of their care through the VA,
according to the administration's survey. The
rest comes from outside providers.
More often, veterans get private insurance
either through work or a spouse's job, or
they're on Medicare or Medicaid. Traveling
to a non-military practitioner often is easier
than to a VA facility.
"Unless you speak up and say you are a
veteran or your spouse is a veteran, the issue

WWW.MHCE.US Monthly Newsletter | 13
might not even come to light," said Richard
R. Silbert, M.D. , a psychiatrist and senior
medical director for the Community Care
Behavioral Health Organization.
Dr. Silbert also will be speaking at Saturday's
symposium along with other mental health
and VA clinicians.
"There's just so many other things that they're
(asking) in a doctor's office. 'Do you drink?
Do you smoke? How's your diet?'" he said.
"Everything's kind of competing."
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14 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
Effort at Fort Detrick Leads to
Approval for COVID-19 Treatment
By Greg Swatek
Sometimes, the days and weeks just aren't
long enough for Col. Ryan Eckmeier and his
team at Fort Detrick.
The last 10, almost 11 months, have been
a seemingly endless stream of phone calls,
emails and virtual conferences, trying to get
the right piece of information in front of the
right person at the right time to help corral
the novel coronavirus.
"White space on the calendar is something
that you used to have," Eckmeier said in a
phone interview this week.
However, the payoff, or a form of it, arrived
late last week when the Food and Drug
Administration approved the broad-range
antiviral drug remdesivir as the first drug to
treat COVID-19.
Clinical trials have shown it to be effective in
reducing recovery time from 15 to 10 days.
The drug can be administered to adult and
pediatric patients who require hospitalization
and are at least 12 years old and weigh a
minimum of 88 pounds.
"It tips the balance of power to the body as
opposed to the virus. It allows the immune
system to catch up," Dr. John Dye, chief
of viral immunology at the U.S. Army of
Medical Research Institute of Infectious
Diseases (USAMRIID) on Fort Detrick, said
of remdesivir.
"When an infection occurs, it really comes
down to the immune system fighting the
virus. Whoever gets the upper hand is going
to win."
As a joint project manager for The Joint
Project Manager for Chemical, Biological,
Radiological and Nuclear Medical (JPM-
CBRN) on Fort Detrick, Eckmeier and his
team helped set up the elaborate, almost
spider-web-like network of connections that
pushed remdesivir across the finish line as a
COVID-19 treatment.
A process that often takes several years was
completed in a matter of months, and much
of the work that was required to earn FDA
approval occurred in the labs and offices on
Fort Detrick.
"It's satisfying," Eckmeier said. "We know
there is more work to be done. For the team
here at Fort Detrick, it's just been an absolute
and unbelievable amount of work behind the
scenes. Most folks will never know about it,
and that's fine."
The phone call that initiated the process
arrived in January, almost two months before
the World Health Organization officially
declared the novel coronavirus a pandemic.
"We got a call from our headquarters basically
telling us, 'Hey, there is this coronavirus like
thing that's showing up in China'," Eckmeier
said. "They had released the genomic
sequence [of the virus], I mean, kind of open
source...We got a call [from headquarters].
They said, 'Hey, what do we have that could
potentially combat this disease if it was to
turn into a global pandemic or if it was to end
up on our shores.'"

WWW.MHCE.US Monthly Newsletter | 15
Remdesivir was originally created in 2009
by Gilead Sciences, a large American
biopharmaceutical company, to combat
hepatitis C and respiratory syncytial virus
(RSV), but it proved to be ineffective against
both.
With the help of the Defense Threat
Reduction Agency's Joint Science and
Technology Office in Fort Belvoir, Virginia,
and USAMRIID on Fort Detrick, remdesivir
was repurposed for use against other viruses,
such as Ebola and Marburg.
In 2015, preclinical trials at USAMRIID
showed that remdesivir blocked Ebola
in Rhesus monkeys, paving the way for
it to eventually be used in human trials.
Remdesivir was used to help curb the Ebola
outbreak in West Africa in 2016.
Doctors, scientists and lab technicians at
Fort Detrick continued to study the possible
effects of remdesivir against a family of
related viruses, known as filoviruses.
When the call arrived in early 2020 about
the novel coronavirus, they sprang into
action, poring over 500-plus pages of highly
technical medical papers in search of ways to
combat it.
"It was daunting," Eckmeier said. "I think
that's the right word for it."
The digging produced a previously published
entry in an academic journal that showed
remdesivir had some in-vitro effectiveness
against other coronaviruses.
Word of the discovery quickly spread through
other government agencies, such as the
National Institutes of Health, and eventually
made its way back to Gilead.
"Gilead was already moving in that direction,"
Eckmeier said. "It was their product. So, they
knew about the academic journal [entry].
They were watching the unfolding events as
the rest of the world was."
With a long-term partnership already
established, the U.S. government and Gilead
began working frenetically to get remdesivir
approved to help fight COVID-19.
"Just absolute huge amounts of work to get
this effort [approved]," Eckmeier said. "It
was a lot of facilitation and linking folks up,
making sure the right people were talking
to the right people to move this forward
quickly. It was a frenzy, and a lot of the effort
is still ongoing. The fact that we have agile
acquisition systems and vehicles through
multiple partnerships allows us to go out and
do these things much quicker."
The speed doesn't have much precedent.
"Normally it takes 10-15 years and a billion
dollars or more to develop vaccines or drugs
all the way to licensing," Eckmeier said. "For
one thing, it's hard."
With the onset of COVID-19, the government
has put a lot of the development and approval
processes on parallel instead of successive
tracks, which has enabled the process to
move faster, according to Dr. Dye.
"It's been impressive, the speed at which
things are happening while keeping in mind
the safety component," he said. "We are
doing this in a compacted time frame with
no less of an emphasis on safety and efficacy.
Those standards are being maintained."
Prior to receiving full approval last week,
remdesivir was approved for emergency use
in severely ill coronavirus patients back in
May. In August, the approval was expanded
to treat mild to severe cases.
"It's a great first step," Dye said. "It's not a
cure, not a fix-all. But it gets us one more step
closer to winning this battle. There are more
steps to get there and more battles along the
way. But it's a great first step."
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16 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
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WWW.MHCE.US Monthly Newsletter | 17
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18 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
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WWW.MHCE.US Monthly Newsletter | 19
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20 | MHCE - News www.mhce.us NOVEMBER 2020 EDITION
Effort at Fort Detrick Leads to
Approval for COVID-19 Treatment
By By U.S. Sen. Jerry Moran and
Secretary of the Army Ryan D.
McCarthy
President Dwight D. Eisenhower,
hero of the Second World War and
Kansas' favorite son, established
Veterans Day in 1954 to allow "a
grateful nation (to) pay appropriate
homage to the veterans of all its wars
who have contributed so much to the
preservation of this Nation."
As the chairman of the U.S. Senate
Committee on Veterans' Affairs and
secretary of the Army, we seek to
fulfill Eisenhower's vision as we
support the needs of our military
and veterans. This Veterans Day,
we are particularly mindful of vets
dealing with the challenges of
the COVID-19 pandemic. During
the past eight months, some have
suffered unimaginable loss and
others significant hardship, but one
thing we have all experienced is the
feeling of isolation.
Thanking someone you know, or
even complete strangers, for their
service on Veterans Day is an
American tradition, but this year
will be different. Veterans Day
parades are canceled, gatherings at
local veterans halls are discouraged,
and schools will not host vets for
assemblies. The vet handing out red
poppy pins for donations to the local
veteran service organization might
instead spend this Veterans Day
alone. Unfortunately, this portrait
of a lonely veteran is more common
than we might think.
The statistics on veteran suicide are
chilling. As of 2017, an average of
20 veterans and service members die
by suicide every day. This represents
a 7% increase in the rate of suicide
among veterans in just over a decade.
Some reports indicate that suicides
among service members have
increased as much as 20% this year,
when compared to previous years.
Let's put those numbers into
perspective: Every day, we lose
nearly the same number of veterans
and service members to suicide as
we did soldiers to enemy action
during Operation Gothic Serpent, the
mission made famous by the book
and movie "Black Hawk Down."
Every week, veteran and service
member suicides are equivalent to the
number of soldiers that constituted
the original "Easy Company,"
memorialized in the HBO series
"Band of Brothers." Moreover, every
month, we lose more veterans and
service members to suicide than we
did in our worst year of fighting in
Afghanistan.
The stress of the unknown has been
felt at every level in the U.S. Army;
from the newest recruits on their way
to basic training to the highest levels
of leadership. Just because American
soldiers can carry the weight, doesn't
mean that it isn't heavy. This year has
strengthened the Army's resolve to
take rapid, positive and meaningful
steps to safeguard every American
soldier by listening, learning and
taking action.
Army leaders are developing deep,
interpersonal connections at every
level so they better know their
teammates. When those connections
exist, someone will likely know if a
teammate is struggling. To assist our
leaders and frontline soldiers, we
are fielding better leader visibility
tools and new awareness materials.
These initiatives are integral to equip
leaders at all levels with creative,
effective tools for building resilient
soldiers and cohesive teams.
There is no single explanation for
suicide, but the loss of even one
veteran or soldier to suicide is too
great.
This past year, the Senate Veterans'
Affairs Committee made significant
strides for veterans with an
aggressive agenda, including the
passage of the Commander John
Scott Hannon Veterans Mental
Health Care Improvement Act. This
landmark veteran mental health
care legislation, signed into law last
month, will improve care and services
for our veterans and bolster outreach
by establishing a grant program for
community organizations already
serving vets across the country.
It will also direct the Department
of Veterans Affairs to pioneer new
research on mental health to better
diagnose and treat our vets; improve
rural veterans' access to life-saving
mental health care through a
telehealth expansion; and will hold
the VA accountable for its mental
health care and suicide prevention
efforts.
This Veterans Day, we challenge
you to help us make certain veterans
across our county do not feel alone.
This pandemic continues to impact
the mental and physical health of
communities across the country, and
our veterans depend on us to reach
out and provide support during this
challenging time.
Americans have battled fiercer
enemies before, but the military
community can confirm that it takes
all of us to win.
If you or someone you know is
struggling with suicidal thoughts
or ideations, please contact the
National Suicide Prevention Lifeline
and Veterans Crisis Line at (800)
273-8255, and then press 1, or via
text at 838255.