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Response to USAF Strategic White Paper

In collaboration with:

Edwin Rivera-Angell, Col. (Ret) PR Air National Guard, Attorney | Jaime A. Inserni-Milam, M.D., Neurosurgeon | Luis V. Clas-Fernández, M.D., MPH, MHSA | Gerhardt Rivera-Gregorio, M.D., Obstetrician & Gynecologist | Oliver Ramírez-Alcantara, M.D., Obstetrician & Gynecologist | Marino Perez, M.D., Maternal Fetal Medicine | Alejandro Paradas, M.D., Obstetrician & Gynecologist | Manuel Díaz-Vargas, General Surgeon | Henry Cátala-Zayas, M.D., Infectious Disease Specialist


The number of COVID-19 infections in the US continues to climb with over three million cases and the number of deaths now reached over 134,000. Still, no specific treatment for Coronavirus exists right now. As the US reopened the economy, in addition to Memorial Day weekend, Father’s Day, 4th of July celebrations and mass protests over police brutality and racism, cases trend climbed in more than half states with an increase in hospitalizations. Dr. Fauci from the National Institute of Allergy and Infectious Diseases declares that a second wave of coronavirus might hit the US in the fall/winter timeframe if the virus is not approached the proper way. Social distancing and state lock downs have had an impact in slowing down the spread of the virus allowing additional time to find a successful treatment and eventually a vaccine. In addition, it has provided time to gather or produce the necessary protective equipment and technologies like ventilators and air purification systems.

As new discoveries are made every day of how the virus spreads and the impact on the body of the old as well as the young, and an effective treatment and vaccine is found, it is imperative that we minimize the spread of the virus. Since the Nation cannot face another economy recession, it is crucial that we approach the response with a disaster mindset as stated in the COVID-19 EMERGENCY PREPAREDNESS & DISASTER RESPOSE, STRATEGIC WHITE PAPER, V2 26 MARCH 2020, by the US Air Force.

The four key areas mentioned in the White Paper has been mostly implemented at the state level.However we must adjust to the daily breakthroughs on virus discoveries particularly in the key areas of Operational Management & Triage and Hospital Operations. Recent studies show that particles of the virus released when talking can remain in the air for 8 to 14 minutes. Therefore, focus should be on air purification.

The following outline describes an air quality and management paradigm applicable to any high-risk industry such as hospitals, clinics, food processing plants, and medical materiel warehousing.

Air Layered Offense and Defense Strategy For A Hospital/Medical Center Environment:

  1. Operational Management and Triage: (This represents only an Air Layered Strategy).

  2. Establish constant repetitive triage during all phases of the response.

  3. Clearly identify and differentiate clinical and managerial personnel.

  4. Clearly identify who performs the assessment and how the assessment is performed.

  5. Identify the areas and personnel that need treatment.

  6. Assess the area and define treatment.

  7. Home.

  8. Hospital Rooms.

  9. Hotel Rooms (overflow).

  10. Tents (overflow).

  11. Community building (overflow).

Stabilize and sanitize the environment: