The US military is woefully unprepared for the catastrophic casualties of a major Pacific war
The National Disaster Medical System needs revitalization to boost military-civilian medical ties.
US military experiences in combat casualty care over the past two decades won't translate.
There are a lot of unknowns when it comes to great-power war, but one thing is fairly certain: the casualties would be horrific.
The US military's healthcare system, however, is woefully unprepared to handle the numbers of wounded that could come with large-scale, high-intensity combat against a major military power like China in the Pacific, military health experts told Congress on Tuesday.
"The Military Health System does not have the capacity to care for every casualty," Paul Friedrichs, a retired Air Force general and former Joint Staff Surgeon, said of the high numbers of wounded troops who would stream back to the US from war.
The Pentagon did not respond to Business Insider's request for comment in time for publication.
Getting the US military healthcare system better prepared and developing the much-needed relationships with civilian medical institutions before it's too late is going to be a very heavy lift, Friedrichs and others told the Senate Armed Services Committee. He added that the current challenges are more than it can handle.
"We don't have the capacity to care for the people in peacetime right now," he said, arguing that "to think that somehow we can do this on our own is another mistaken belief."
Friedrichs touted the usefulness of the National Disaster Medical System, originally created to boost national casualty preparedness in the event of large-scale warfare by increasing interoperability between military and civilian medical facilities.
But the program has been overlooked for years and now needs drastic attention as part of a broader national medical effort.
"We're short 300,000 nurses nationally. The projections are we will be short 130,000 doctors by 2035. There is no way that we can do this individually," Freidrichs said.
When the NDMS was originally created in the Cold War era, lawmakers realized that a war effort could not rely solely on the military's healthcare system, Friedrichs said. Rather, it would need to be augmented with the veteran's health administration and civilian partners, including hospitals and academic institutions.
Such partnerships have fallen to the wayside, the panel said.
"We need to put our foot on the gas," echoed retired Air Force Colonel Jeremy W. Cannon, a professor of surgery at the University of Pennsylvania, noting "we don't have five years, 10 years, 20 years. We need the solution really now."
"No one in the DoD truly owns combat casualty care," he added, making it harder for the military to even begin to better prepare.
That military healthcare experts have expressed such concerns about combat casualty care may come as a surprise to some after two decades of war in the Middle East.
During the height of combat in Iraq and Afghanistan, American air supremacy and regional support infrastructure meant troops could often be evacuated for higher-level medical care within the "golden hour" window.
But the logistics of warfare, including triage for the injured, is poised to be dizzyingly complex in the Pacific, especially as the US faces a severe shortage of ships. The US has just two hospital ships that are in need of replacement.
And that's not even factoring in threats posed by enemy activity.
Adding to the complexity is that the military's health system remains siloed in their healthcare operations and training, without a truly meaningful "joint" approach to healthcare, said Friedrichs.
Jointness helps various parts of the military more easily work together, and creates standardization that can make fighting wars and taking care of the wounded easier and more effective.
And the challenges don't stop there. Just 10% of military general surgeons are receiving the patient volume and variety needed to keep their medical skills sharp and prepared for combat injuries. In the absence of active warfare and without sufficient training opportunities to work in facilities like civilian emergency rooms or other surgical facilities, medical skills are becoming rusty.
"We're actively falling into the trap of the peacetime effect," Cannon said, noting that in a Pacific war, the US military could see up to 1,000 troops killed and wounded each day for months, overwhelming the systems in place. Neither the military health system nor the civilian sector could absorb such extreme numbers in their current capacities.
"Many of these patients will have survivable injuries," Cannon said. "Yet one in four will die at the hands of an unprepared system."
Read the original article on Business Insider
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
3 hours ago
- Yahoo
8 Surprising Ways to Strengthen Your Immune System Naturally, According to Doctors
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links." We live in a time in which we have a vaccine, medication or other treatment strategy for almost any illness. Still, keeping your immune system (your body's natural defenses against illnesses and invaders) in tip-top shape will help you avoid catching a virus here or an infection there. And the good news is that there are plenty of super simple ways to boost your immune system naturally. Meet the experts: Julia Blank, M.D., family medicine physician in Pacific Palisades, CA; Jessica Cording, M.S., R.D., a dietitian and health coach; Beth Warren, R.D., founder of Nourished by Beth. How the immune system works Your immune system is actually made up of 'multiple layers of defense,' said Julia Blank, M.D., family medicine physician in Pacific Palisades, CA. This includes physical barriers like your skin, cilia (tiny, hair-like structures) that line your airways, and specialized cells that recognize and attack foreign substances like viruses and bacteria, she explained. 'Some of these immune cells are nonspecific and destroy anything that appears foreign. Other cells produce antibodies that recognize and target protein markers (called antigens) on the surface of germs,' Dr. Blank added. Your immune system also has the ability to recognize pathogens you've come into contact with before and mount a quick response. 'This is why we don't usually get sick after being exposed to a germ we've already encountered and fought off in the past,' Dr. Blank said. How to boost your immune system naturally 'Maintaining a healthy immune system requires that you take good care of your body,' Dr. Blank said. Indeed, these simple strategies will help strengthen your immune system, plus boost your overall wellness. 1. Sip alcohol in moderation. 'High alcohol intake has been shown to suppress immune function,' said Jessica Cording, M.S., R.D., a dietitian and health coach. Plus, booze 'can be dehydrating, and hydration is really important for protecting yourself from illness.' When you're dehydrated, your cells aren't able to function at their optimal level—and that can open up the door for you to get sick, Cording explained. If you don't want to cut out booze completely, sip in moderation. That means having up to one drink a day for women and two drinks a day for men, according to the Centers for Disease Control and Prevention (CDC). 2. Curb your stress levels. Stress seems harmless enough once you get over whatever it is you're anxious about, but chronic stress can 'compromise or suppress the immune system and make us more vulnerable to infection,' Dr. Blank said. Consistently high levels of stress causes a release of the hormone cortisol, which can lead to inflammation and a weakened immune system, per the Cleveland Clinic. Chronic stress may also interfere with the infection-fighting ability of your white blood cells, per a review in the Annals of Medicine & Surgery, making you more susceptible to contracting illnesses. Daily practices like mindfulness meditation, journaling, or just going for a walk outside can help reduce stress. 3. Enjoy plenty of fruits and vegetables. Putting a rainbow of fruits and vegetables on your plate can do your immune system a solid, said Beth Warren, R.D., founder of Nourished by Beth. 'Fruits and veggies help arm your body with antioxidants it needs to fight oxidative stress, which includes contracting a sickness, in your body,' she explained. Not sure how much you need? The U.S. Dietary Guidelines for Americans recommends that people who eat 2,000 calories a day have two cups of fruit and 2.5 cups of vegetables a day. Some solid options: Leafy greens, bell peppers, citrus fruits, sweet potatoes, and berries. 4. Increase your intake of vitamin D. Vitamin D plays an important role in supporting the immune system by helping your body produce antibodies, which can then fight illness, Cording said. 'Active vitamin D gets sent to different areas of your body, including your bones, intestines, colon, brain, and immune cells, where it binds with the receptors on these cells and ultimately turns them on,' added Warren. The kicker: Most people don't get enough of it, according to the Cleveland Clinic. Your body primarily produces vitamin D from the sun's UV rays (it's called the sunshine vitamin for a reason!), but you can also load up on vitamin D-rich foods to boost your intake, including fatty fish and seafood, mushrooms, eggs (don't skip the yolk), and fortified foods, Cording said. If you suspect your vitamin D intake is low and would like to take a supplement, be sure to talk to your doctor. He or she can do a blood test to determine the appropriate dosage for you. 5. Prioritize sleep time. Spending more time snoozing is key, Dr. Blank confirmed. 'Getting enough sleep helps our bodies recover from everyday stress—both physical and mental—and promotes better functioning of our immune system,' she said. When you don't get enough shut-eye, your body may decrease the production of protective proteins called cytokines, which your immune response needs more of when it's dealing with an infection or inflammation while under stress. So just how much sleep are we talking about? The National Sleep Foundation says adults up to age 64 should snooze between seven and nine hours per night, while adults 65 and up should aim between seven and eight hours. 6. Wash your hands frequently. Washing your hands regularly will help keep viruses and bacteria away from your eyes, nose, and mouth, which can do your immune system a solid, Dr. Blank said. 'This reduces the variety and number of germs we are exposed to and keeps our immune system from getting overwhelmed,' she explained. The CDC specifically recommends washing your hands with soap and water for at least 20 seconds, or the amount of time it takes to hum the 'Happy Birthday' song from beginning to end twice. Hand sanitizer that contains at least 60% alcohol also works in a pinch. 7. Move your body every day. Being physically active can help keep pathogens out of your lungs and airways, according to the National Library of Medicine, which can minimize your odds of getting a cold, the flu, or other illnesses. Exercise can also give antibodies and white blood cells a boost, causing them to circulate more widely throughout your body, where they might detect illnesses better than they would if you didn't get moving. 8. Quit smoking. You already know smoking is bad for your health in so many ways, but it can also wreak havoc and 'cause direct damage' to parts of your immune system, Dr. Blank said. For example, smoking immobilizes cilia, the hair-like structures in your airways that help 'sweep' out bacteria. 'These cilia form the first line of defense against respiratory infections,' Dr. Blank said. When they're immobilized, germs have 'much easier access' to your lungs, she explained. Cue the coughing and sneezing. The good news: According to research in the journal Nature, the detrimental effects of smoking on the immune system vanish immediately once you stop. You Might Also Like Can Apple Cider Vinegar Lead to Weight Loss? Bobbi Brown Shares Her Top Face-Transforming Makeup Tips for Women Over 50
Medscape
4 hours ago
- Medscape
Is Red Meat Bad for You? The Proof Is in the Processing
This transcript has been edited for clarity. Is red meat bad for you? On the one hand, meat makes you strong, and it's every American's God-given right to grill a steak on his barbecue during the summer. I believe this came up in a church synod at some point… But on the other hand, the WHO (World Health Organization) has declared red meat a carcinogen, with a hot dog being as bad as cigarette. Yes, that was headline when the report came out. So, how do we reconcile these opposing ideas? Part of the solution is realizing the WHO organization in question is based in France. Maybe they're still angry about the "freedom fries" thing, but actually examining the nuances of the French language will help us understand what's going on. If you don't speak French, don't worry I got you covered. Ce n'est pas si difficile de tout n'inquiétez vous pas. Vous allez voir . Sit back, grab a baguette, and let's find out how dangerous red meat really is. I'm Christopher Labos, and this is Medscape's On Second Thought . Bonjour, tout le monde! Now, meat doesn't seem like it should be a complex topic to study, but it is. Many people around the world eat animals, but we don't all eat the same animals. For example, this is a cow, often used to make hamburger and steak. And this is Tobi, God's perfect angel who gets a more elaborate birthday party than I do each year. He is my son, and I would throw myself in front of a moving car for him. By necessity, when we do medical research on meat, we are lumping together a whole lot of a different human behavior, with people eating different types of animals based on where they live. There's no real alternative, and frankly, you can't let the perfect become the enemy of the good. Most credible research will at least separate out red meat from white meat. But most people don't really know what the difference is. If you thought pork was white meat, you're wrong. You think that because of a marketing slogan. In 1987, the National Pork Board paid for the marketing campaign "Pork. The Other White Meat." They were basically trying to position pork as an alternative to chicken. People also usually think veal or deer is white meat. They think the difference between white and red meat has something to do the age of the animal, whether its free range, or the color of the meat. But it doesn't. Chefs and restaurants say all kinds of things, but the real definition is simple: Mammals are red meat, and birds are white meat. Now, there's another thing we need to explain. We have red meat, but we also have processed red meat. Processed red meat is when red meat is transformed in some way — and that doesn't mean cooking. If you just take a piece of steak and cook it on your barbecue or in the oven, that's not processed meat. Processing is doing things like salting the meat, smoking it, or curing it. Processed meat includes items like bacon, sausages, hot dogs, salami, corn beef, and smoked meat. So, when we talk about red meat and health risks, we are primarily talking about processed red meat. And the people talking about this are the International Agency for Research in Cancer (IARC). IARC is a WHO organization, and their mandate is to promote international research on cancer — particularly its cause. One of their programs is a monograph program that evaluates the evidence of the carcinogenicity of specific exposures. Here's where a knowledge of French is going to come in handy. IARC likes to look at something called the hazard, rather than the risk. In fact, every time they have a press conference, they spend about 5 minutes explaining the difference to people, which begs the question: Why not just study risk and be done with it? In English, those words seem pretty much like synonyms. And with the way most people use them, they essentially are. But in French, they are slightly different. Le risque et le hasard don't quite mean the same thing in French. To be fair, their definitions are technically different in English, as well — as those of you who read the dictionary for fun already know. A risk is the probability that something harmful will happen. A hazard is a potential source of harm. For example, a grenade is a hazardous thing to have on your desk, but the risk of it exploding is quite low… unless you pull the pin. IARC is researching hazard. They are evaluating whether something is associated with cancer, not how risky that something is. IARC categorizes everything into groups: carcinogenic to humans, probably carcinogenic, possibly carcinogenic, or not classifiable. There is technically a "not carcinogenic" group, but there's nothing in there. Well, there was one substance in there for a bit, but they removed it. Comment below if you know what that substance is. Here's a hint: You find it in yoga pants. So, IARC has never found anything that doesn't cause cancer. When they go hunting for heffalumps and woozles, they find heffalumps and woozles. To be fair, which I am under no contractual obligation to be, they are a WHO agency, and they are tasked to review substances that are of interest to world governments. As such, they are not going to review stuff that is clearly unrelated to cancer… but still. They put a lot of stuff in Group 1, the (definitely) carcinogenic group. Tamoxifen is in Group 1, and as most of you know, tamoxifen treats breast cancer. It has saved countless lives. Calling it a carcinogen sounds a bit daft, but it is associated with abnormal uterine bleeding and an increased risk of uterine cancer. And the data is pretty uncontroversial, right? Thus, IARC says, 'We are certain this association is true, therefore it goes in Group 1.' But what's the risk of tamoxifen causing uterine cancer? It's 0.3% on the absolute risk scale. It's basically zero and a heck of a lot lower than the breast cancer risk. Clearly, you should take the drug if you have ER-positive breast cancer. So, this is the problem. IARC is saying how certain they are that something is dangerous, but not how dangerous something is. Conclusive data will land a substance into Group 1: carcinogenic. Strong but not conclusive data goes into Group 2a: probably carcinogenic. If there's only some evidence, contradictory evidence, or maybe just animal data, you get sorted into Group 2b: possibly carcinogenic. And Group 3 is used when there's not much data to work off of. Generally, their system works okay. They put tobacco, asbestos, and gamma radiation in Group 1, which makes sense. But then also put stuff like birth control pills, estrogen, and tamoxifen in Group 1. Sure, there is a small increased risk of breast cancer with birth control pills if you have a family history, but it's a pretty small risk and frankly negligible for the general population — plus, it's largely outweighed by the decrease in ovarian cancer risk that comes with using birth control pills. But IARC isn't doing that type of nuanced calculation. They say, 'Estrogen causes breast cancer. The pill has estrogen. The link is proven. The pill goes into Group 1.' So, it was IARC that reviewed all the data about processed red meat and declared it a Group 1 carcinogen. Fun fact: Unprocessed red meat was only put in Group 2A because the data was less solid. For anybody grilling a steak right now, this doesn't apply to you. But not everybody agreed with IARC. The Nutritional Recommendations (NutriRECS) Consortium was a group of researchers who also reviewed the data on red meat and came to a completely different conclusion. Their analysis was motivated by two things: 1) the funding they received from the beef industry (this is why we can't have nice things), and 2) they dismissed much of the research because it comes from observational cohorts, not randomized controlled trials. In food science, randomized controlled trials are hard to conduct, because telling people what to eat is often met with "make me." Regardless, the NutriRECS Consortium conclusion was, 'Keep eating meat, as the data is uncertain because most of it is observational.' This conclusion is a bit reductionist to me, because we have a lot of observational data pointing toward health risks associated with processed red meat, and I have a hard time believing all the stuff added to processed red meat is doing us any favors. But let's take the IARC assessment at face value. They are convinced by the hazard or the hasard. But what's the risk? The cancer risk is most clear cut for colon cancer, which is pretty logical. Your lifetime risk of colon cancer is about 4%, assuming you're of general risk with no family history or genetic risk factors. It's actually 4.2% for males and 4.0% for females, according to the 2022 Cancer Statistics from the American Cancer Society. But let's say 4% for everyone — just for simplicity. The IARC report estimated that eating an extra 50 g of processed meat per day, every day, increased your risk of colorectal cancer by 18%. Take 4%, multiply it by 1.18, and you get 4.72%. So, let's say 5% if we're rounding. All this to say, if you eat hot dogs every day of your life, your risk of getting colon cancer goes up by 1 percentage point on the absolute scale. Now, on first instinct you might say, "Pfff, that's nothing. Pass the bratwurst." But 1% on the absolute scale is not trivial. That's thousands of cases per year. Millions of cases over the course of your lifetime in a country of 300 million people. It has some important public health implications. Is the risk high enough for us to stop killing and eating Bambi's mother? Hard to say. It's not negligible, but it's not astronomical either. And there are economic and environmental factors to keep in mind — issues that are often forgotten when we talk about medicine. I will stress one point, though. The IARC estimates of 1% absolute risk increase are about daily consumption of processed meat. You don't need to eat jerky every day of your life. For Medscape, I'm Dr Christopher Labos… with Tobi.
Yahoo
4 hours ago
- Yahoo
RFK Jr, 71, and Hegseth, 45, in fitness battle at Pentagon where Defense Secretary has decorated walls with pictures of himself
Health and Human Services Secretary Robert F. Kennedy Jr. and Defense Secretary Pete Hegseth competed in a fitness challenge in the Pentagon, where photos of Hegeseth lined the walls. Amid the Trump administration's push to 'Make America Healthy Again,' the Cabinet secretaries participated in the so-called 'Pete and Bobby challenge': completing 100 push ups and 50 pull ups in 10 minutes. The pair posted the challenge in a social media video Monday. Hegseth may have been trying to encourage a remake of America's health scene, but the footage also revealed he seems to have remade parts of the Pentagon, transforming his place of work to feel like home. As the pair walked toward the Pentagon Athletic Center to complete the challenge, the two men passed by photos of Hegseth decorating the building's hallway walls. One picture showed the defense secretary planting a kiss on the cheek of his third wife Jennifer Rauchet as she closes her eyes and smiles at his swearing-in ceremony in January. Another photo seemed to capture Hegseth, President Donald Trump, Vice President JD Vance and Major General Trevor Bredenkamp saluting before laying a wreath at the Tomb of the Unknown Soldier in May. 'It's all about making America healthy again. We're gonna be fit, not fat,' Hegseth said, speaking directly to the camera inside what he called 'the bowels of the Pentagon.' 'We want recruits that are ready to go and challenged,' the defense secretary continued. Kennedy then chimed in: 'Pete and I are going to do our part to encourage American youth to do this challenge.' Hegseth, sporting gym garb, and Kennedy, clad in a t-shirt and jeans, both completed the challenge in under six minutes, according to the video. The video then spliced footage of service members working out in the fitness center, set to high intensity music. Kennedy then challenged Transportation Secretary Sean Duffy while Hegseth challenged Chair of the Joint Chiefs of Staff Dan Caine and his former Fox News colleague Will Cain to participate in the fitness test. 'We hope Americans will take this challenge and you'll pass it along so that we're ready to be fit the way we need to be healthy and to have a healthy fighting force,' Hegseth said. The fitness challenge comes amid the Trump administration's push to 'Make America Healthy Again.' Last month, the president signed an executive order to revive the Presidential Fitness Test schoolchildren. The president 'wants to ensure America's future generations are strong, healthy, and successful,' White House press secretary Karoline Leavitt said in a statement last month.
