Dr. Rex Monif of Tekamah is coming back home after a two-month stint fighting the COVID-19 virus in the New York City borough of The Bronx. Monif was part of the Department of Defense’s support of the Federal Emergency Management Agency’s whole-of-nation response.
Lt. Col. Monif is a 19-year veteran of the U.S. Army Reserve. He was assigned to the 452nd Combat Support Hospital through U.S. Army North. His unit was allocated to Jacobi Medical Center.
“We received a 48-hour notification that we were being mobilized,” Monif said. “Nobody was told what the living conditions were going to be. So, we packed everything.”
Fortunately, tent city was not their destination and they wound up being billeted in a hotel. “They” being the Urban Augmentation Medical Task Force consisting of 85 medical professionals of all types from across the U.S.
“I was honored to be a part of the DoD response to the COVID outbreak,” Monif said. “I was proud to support America’s heroes on the front line of the pandemic fight.”
At home, Dr. Monif is the chief dental officer at the Winnebago Dental Clinic. The clinic has been very supportive of his Reserve duties and he is grateful and honored to work for them, he said.
The sector to which the 452nd CSH was attached was populated primarily by homeless people, Monif said. This led to a very high influx of COVID-19 patients with underlying health issues.
“We did some really cool things in New York,” he said. “We helped patients and helped the hospital staff. We kept busy.”
While the majority of those in the 452nd had primary duties, all 85 of them spent time going around the hospital asking if they could lend a hand. Spending time with those suffering became a critical part of their mission, as well.
“No job was unimportant,” Monif said. “The Soldiers did their duties well and did them with honor.”
Patients were six to a room, Monif said. The Reserve medical team helped lift the spirits of those in recovery. The team provided iPads to patients for “phone home” sessions. This allowed patients to keep in touch with their loved ones or to say a final goodbye. There were those who were never going to recover. The staff spent as much time as they could with them.
“We saw the fragility of life. Some of those dying were scared; some were not,” Monif said. “You could see in their eyes they were resigned to their fate. For those we stayed close so they would not die alone.”
In one instance the team made national news. This was when George Crouch, a 96-year-old World War 2 and Korean War veteran, entered the hospital with his wife in May. Both had COVID-19 and they shared a room. His wife passed away shortly afterwards. Crouch gave up on life and was refusing treatment.
Capt. Eric Dungan challenged Crouch to live. He said a member of the Greatest Generation is a national treasure and couldn’t just let him give up. Crouch showed the strength and fortitude of his generation when he rallied and recovered.
The 452nd also had an impact on the survival rate in New York, Monif said. The medical officers discovered that there was a higher mortality rate with patients being put on ventilators. During the examination of this phenomena, the doctors discovered that too much pressure was being put on the patients’ lungs. The cadre began to implement prone positioning. A method of patient body positioning which decreases the pressure on the lungs and helps breathing without intubation.
“I’m proud of what we did as a team,” Monif said.
In the Army, Lt. Col. Monif is also a dentist. He normally works in a MASH-type setting. With the restrictions placed on dental care due to the COVID pandemic, Monif said he was wondering what role he would be taking with the medical group in New York. When he arrived at Jacobi he asked where they needed help the most.
He learned that the crucial area in which help was needed was frontline doctors and nurses. As he was not qualified to fill either of those functions, he was told where the second biggest problem was located—the morgue.
“It was interesting,” Monif said of his experience as morgue supervisor. After serving in Iraq and Afghanistan, he had seen dead bodies. Another dentist assigned to the mortuary had difficulty handling that. He was able to assist with food service, instead. As Monif put it – no job was too small for the Army personnel.
The Jacobi morgue has the capacity to hold 12 cadavers. There were 177 bodies in the morgue when Monif’s team arrived. The unit had to bring in four refrigerated trucks to help store the overflow. At one point, one of the trucks malfunctioned. That was unpleasant for everyone involved, he said.
The primary job as morgue supervisor was inventory. So, Monif created an inventory system. Unfortunately, the overwhelmed morgue staff had not been diligent in this area. Monif and his troops set about conducting a re-inventory of all the bodies. Many of which were in various stages of decomposition. This was also quite unpleasant.
New York law allows families 14 days to claim a body for proper disposal. The amount of deaths, sometimes including multiple family members, caused a strain on the local funeral homes. Combine that with government restrictions on holding gatherings, such as funerals, and it was not surprising that a queue was forming 30-days or more deep.
At first, the city government had simply taken the bodies to Hart Island, a 101-acre strip that lies in Long Island Sound. There the remains were interred in mass graves. Most bodies from Jacobi were cremated, Monif said.
“It was heart-breaking dealing with families trying to get bodies released for funerals,” he said. “Either no funeral homes had openings or the family didn’t have the money.”
To work around the restrictive red tape, Monif and his people would maneuver things to keep the bureaucratic buzzards at bay so that the families would have more time to bury their loved ones with respect.
“When a body was picked up by a funeral home we felt better,” Monif said. “We felt they received a more dignified ending to their life.”
Another matter of pride for the 452nd was the fact that they went home as a group. None of the 85 members came down with COVID-19 and had to be dismissed.
“Every day for hours we were swimming in the virus; between patients and dead bodies,” Monif said. “The military is very serious with infection control. None of us ever got sick.”
To demonstrate how serious the military is, Monif said before he could be sent back to Nebraska he was tested for antibodies and had the COVID swab test. Since returning, he was placed in complete lockdown quarantine for two weeks. The Nebraska National Guard is in charge of the confinement.
“I get my temperature taken at 9 a.m., and at 6 p.m., every day,” he said. “That 20 seconds is the only human contact I have had for two weeks.”
He also had no television. He did have his laptop, so he has been catching up on his Professional Military Education courses. He may come out of quarantine a full bird colonel, he said.
In his two decades of service, Monif has been to Central America, Iraq and Afghanistan – he thought this one may be different, but it wasn’t, he said.
“I’ve learned from every deployment. This one was also a broadening experience,” he said. “It makes you appreciate what we have back home.”
He is very happy to be back home, too. He longs to see his family, including his dog and cats, he said. He is also anxious to get back to his practice.
“I can’t wait to get back to work,” Monif said.
The only worry he has been experiencing is the stigma some may place on him for having worked in a COVID hot zone. He is concerned it will come back on his children and grandchild. He hopes people will not ostracize them based on his having been in New York helping people.
The entire group of 85 medical personnel will receive the Army Commendation Medal for their “sustained acts of meritorious service.”