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Urgent Acquisition Effort Provides Safe COVID-19 Patient Transport in 95 Days - Department of Defense

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The Air Force, Air Mobility Command and U.S. Transportation Command have a new capability to bring large numbers of COVID-19 patients home via airlift without putting associated flight crews at risk — and the solution arrived quicker than expected.

The "Negatively Pressurized CONEX," or NPC, flew its first operational mission June 30 out of Ramstein Air Base, Germany, just 95 days after Transcom published a joint urgent operational need statement that spelled out a requirement to transport as many as 4,000 individuals a month who might be infected with COVID-19.

The NPC is a 40-foot metal container outfitted with air-handling and other equipment that can be carried aboard a C-17 transport jet. The NPC can be used to move 23 COVID-19 patents who need the attention of medical personnel. The system's onboard equipment ensures negative air pressure on the inside so that the aircrew responsible for transporting it and its patients won't be put at risk for infection.

The system also can be configured to hold as many as 30 ambulatory personnel who might potentially be infected with COVID-19 and need to be kept quarantined during an airlift operation, but who don't need the attention of medical personnel.

Navy Capt. Jeff Stebbins, deputy director of the Joint Rapid Acquisition Cell, commended the Joint Staff, Air Force, Air Mobility Command and Transcom for taking a requirement spelled out March 28 and turning it into a product that meets warfighter needs in just 95 days, when the process might normally take more than a year to complete.

"Our work with the Joint Staff and Transcom was done in parallel, not sequentially," Stebbins explained. "That allowed us to move faster."

Stebbins said Transcom sent the joint urgent operational need statement to the Joint Staff for validation on the same day that the Joint Rapid Acquisition Cell assigned it for execution to the Air Force.   

"Everybody was working together, and there was a lot of crosstalk," he said. "Because we all worked effectively together and in parallel across departments, across agencies, we were able to move all of the authorities necessary to execute this mission quickly."

Within the Air Force, it was Air Force Lt. Col. Paul Hendrickson, the materiel leader for chemical, biological, radiological and nuclear defense, who first conceived of the NPC.

"When the COVID crisis kicked off, Transcom and Air Mobility Command began to see a need for the transport of COVID patients," Hendrickson said. "They took a look at their inventory. And the only system that they had readily available was the 'transportable isolation system,' or TIS. It was developed through a JUON for the Ebola crisis."

The TIS, Hendrickson said, is basically a wire frame with plastic sheeting over the top. It's fragile, and it can accommodate only about six people.

Another option was the Portable Bio-Containment Module, a product of the State Department, Hendrickson said. At the time, the Joint Program Executive Office was working to get the PCBM its flight-worthiness certification for transport on the C-17 aircraft. The PCBM carries only three people, only four of the systems exist, and it would take a long time to get more of them purchased, he said.

Neither solution was ideal to meet the needs to move so many COVID-19 patients.

Hendrickson said his office was working on a solution for "collective protection" to provide CBRN protection to groups of people. For example, he said, airmen who perform aircraft maintenance while required to wear the full array of individual chemical protection equipment might eventually suffer exhaustion due to the heat burden. They would need a place to go between tasks where they could be safe from a chemical attack, but at the same time be able to remove their individual chemical protection suits so they could recover.

"We had been working with Osan Air Base and the 51st Aircraft Maintenance Squadron [in South Korea] to figure out how to get them more agile collective protection," he said. "We were working on a rapid technology demo of what we call the 'Collective Protection CONEX,' which is taking a 40-foot ISO container and retrofitting it to be a collective protection facility."

The "Collective Protection CONEX" or CoPro CONEX, was conceived to keep people inside it safe from dangers that might be outside.

The concept of the CoPro CONEX might be flipped on its head, Hendrickson thought, to keep people on the outside safe from people on the inside who might be contagious. He asked one of the officers within his own agency if such a thing could be done — and within just a few hours, he said, there was a mock-up of what would eventually be the NPC.

Air Mobility Command liked the idea, he said, and briefed it to the Joint Rapid Acquisition Cell. They approved the plan and by April 7 Air Mobility Command awarded a contract using the "other transaction authority" process.

Hendrickson cited the contractors involved in building the NPC, along with the C-17 program office; the Air Force Lifecycle Management Center's engineering directorate; personnel at Joint Base Charleston, South Carolina; members of Detachment 2, Air Force Operational Test and Evaluation Center; the 28th Test and Evaluation Squadron out of Eglin Air Force Base; the Air Mobility Command surgeon general and aeromedical standards evaluation shop; three bio-containment pathologists and others as being instrumental in getting the NPC developed, and then proven airworthy and safe to fly.

The NPC was delivered to Joint Base Charleston, South Carolina, on June 7, where it was subjected to a rigorous series of tests, Hendrickson said. It had its test flight June 15, and flew its first operational mission June 30.

Only one NPC exists, but officials expect that the Air Force will get 30 of the systems and that the first of those will roll off the assembly line in mid-July. Hendrickson said he thinks the manufacturer could produce at a rate of one NPC every eight days.

In addition to the NPC, there will also be 30 "NPC-Light" models, which will be about 12 feet shorter than the NPC, carry fewer passengers, and will fit on the smaller C-130 aircraft. The NPCL, he said, is expected to move patients inside a theater of operations, while the NPC will be used to move patients out of theater.

"The Air Force and what Lieutenant Colonel Hendricks' team has done is a phenomenal job at developing an initial capability," Stebbins said. "We believe this serves as an excellent case study for urgent capability acquisition — that when a combatant command has an urgent need, we use every tool available to rapidly develop and field a capability."

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