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A Look at the “Invisible Corps” Documentary

By Dale Dauten, Syndicated Columnist

Imagine being one of the American medical personnel sent to West Africa during the early days of Ebola, the stuff of horror films: We don’t know much about this thing but we do know it will kill you… gruesomely. Go and figure out how to save the healthcare workers from getting infected, and, while you’re at it, prevent it from coming to the USA. There’s a plane waiting.

Or think back to the earliest and scariest days of Covid and imagine being one of the people assigned to screen people coming in from Wuhan. Here’s how one of the people who headed that operation, Dr. Brett Giroir, describes the reception from the soldiers they had come to support:  When we showed up at Joint Base San Antonio to repatriate people from Wuhan, they had no idea who we were. But they were damn glad to see us, because these Army, Marine, Air Force, they’d charge a hill with RPGs and bombs and everything else, but they don’t want to get close to a person with an unknown infectious disease. That’s what we do.

The “we” in “that’s what we do” is the Commissioned Corps of the U.S. Public Health Service, a not-catchy name. (The acronym is worse: USPHSCC. Try pronouncing that). These are health care professionals – doctors, nurses, pharmacists, dentists, veterinarians and more – who are also military officers (that’s the commissioned part) and they are scattered throughout the medical system, and beyond.

From my very informal survey, nobody has ever heard of these folks, and after offering folks a brief description, the first reaction tended to be some version of, “Why do we need military officers running around the health care system?” I’d say we just answered that question when talking about Ebola and Wuhan: the country needs people who aren’t just asked to go, but, in military terms, deployed.

I only know of the Commissioned Corps because of a new documentary. It’s on PBS and you can watch it now. (Link at end)

The filmmaker was Chris Schueler and we asked him about the project and what he concluded after two-and-a-half years immersed in the topic. He said, “It gives me hope for the country that there is a link connecting all these agencies — the NIH, the CDC, all the rest, 20 agencies in 80 locations around the world – a link that brings the lens of public health to them all. And all are dedicated to keeping us healthy. It’s a health army. They wouldn’t call it that, but that’s how I think of it: a health army.”

(Photo: traveling to Hurricane Maria)

As armies go, not that big: around 6,000. Knowing the leaders are Admirals, you might assume it’s a branch of the Navy. No, it is its own corps, one of the eight uniformed corps of the United States. (See if you can name the other seven. Answer at end.) But there is a naval connection: The roots of the USPHSCC go back to 1798 when President John Adams signed the Act for the Relief of Sick and Disabled Seamen, which created the Marine Hospital Service.

Even then, once you have a group of medical professionals at your command, you begin to see other uses. Here’s how Vice Adm. Dr. Jerome Adams explains the evolution of the Corps: “And that’s how the origins of the Public Health Service got started, really centered around healthcare, not public health, but around healthcare for sick and disabled seamen. Throughout the years, many years, that mission has evolved and has grown. But also public health became part of this. Why? Because you had the plague because you had smallpox, you had infectious diseases. And so it shifted from healthcare to really infectious disease control.”

An example from the film is hookworm. Here’s historian Alexandra Lord, PhD.: “We tend to forget how important sanitation is in preventing disease. One of the diseases that was really prevalent in the United States during this period was hookworm. Hookworm occurs when there are feces and an individual who might be barefoot, for example, is walking and the infection enters the skin. So they led campaigns to understand the causes of hookworm, but also to build better privies.”

Better privies. Who knew? And if you have four minutes, here’s a clip where you can hear about another of the Corps’ successes, taking on smoking. (If you don’t have time, when the first Surgeon General’s report was issued, in the 1960s, 42% of adults were smokers. Just thinking about it makes you want to cough, no?  It’s now around 12%.)

And, worthy of a first-rate documentary, there’s a lot to learn, including those Really? moments. For instance, we learn why the CDC happens to be based in Atlanta. Why? Because it evolved out of a malaria control office.

Moreover, we quickly understand why the film includes a veterinarian, Rear Admiral Dr. Michael Blackwell, when he tells us, “65% of infectious diseases that I can get as a human are zoonotic. That means the microbe, the organism, can be found in one or more species of animals passed on to a human. 65%. This is a very intimate connection that people and animals have in a shared environment.” Yes, he’s in the Corps.

Turns out there are Corps officers scattered throughout the government, even the National Park Service. (That started when the head of the National Park Service asked for help in ensuring that Yellowstone had safe drinking water.) Note the word “scattered.” That is the strength of the Corps, bringing public health to the public. But it also helps explain why almost no one knows about the Corps. Indeed, that’s why Schueler ended up calling his documentary “Invisible Corps.”

(Photo by Will Allen-Dupraw:  Schueler setting up for one of dozens of interviews)

Near the end of the film, Captain Sara Newman says,  But really you wonder, how is it possible with the impact the United States Public Health Service Commission Corp has had, for over 200 years that we’re still invisible to the American people? How is that possible? And sometimes I think, ‘Well it’s because we do a great job. They would hear about us if we didn’t.’ But we’re the silent warriors.”

And, we’re glad they weren’t silent in the documentary. Seeing it will make you grateful and proud and, if you’re like me, feeling that you’ve just been reminded of what’s best about America. So let’s close with an uplifting 18-seconds on the Corps:

And when you’re ready for the full hour, here is the link to PBS’s portal to view “Invisible Corps”

https://portal.knme.org/show/invisible-corps/

The eight uniformed services: Army, Marines, Air Force, Navy, Coast Guard, Space Force, National Oceanic and Atmospheric Administration Commissioned Officer Corps, and the US Public Health Service Commissioned Corps

First and second photos are stills taken from the documentary

STATS OF THE MONTH

Trading Places: America’s favorite pastime?

By Bill Davenhall, Geomedicine Analyst

During the pandemic of 2021-2022 more than half (58%) of America’s 3,142 counties gained population, and domestic migration was the major component of change in 90% of those counties. Natural change (the difference between births and deaths), domestic migration and international migration all contribute to how an area’s population changes over time. Some have grown mostly through domestic migration while others have traditionally grown more through natural increase (more births than deaths).  According to the US Census Bureau, however, in recent years the national pattern has shifted in substantial ways. As the COVID-19 pandemic continues to amplify existing trends of decreasing births, increasing deaths, and slowing international migration, shifts in the remaining component — domestic migration — have become more prominent and are noticeably altering county growth patterns across the nation.

Every year, the Census Bureau’s Population Estimates Program (PEP) measures population change since the date of the last decennial census, using administrative records and other data. Population changes for a given county result from a combination of natural change (the difference between births and deaths) as well as international and domestic migration.

The National Association of Realtors provides some interesting insights for us to better understand who is migrating, domestically, and why.

According to the Realtors Association,

“Based on this generational trend, it is not surprising that those who moved more than 470 miles from their past residence were more likely to be repeat home buyers. Just 11% were first-time buyers. This dispels one potential myth that has abounded in the last year: that first-time buyers are the ones making the move to find their first property far from their rental unit. It does happen, but it is more likely a repeat buyer who is making the distance move”.

Here is an interesting challenge for the immunization ecosystem:

Using the USPS NCOALINK (Change of Address) system, keep up with the approximate 40 million new household movers each year, processed daily – automatically advising them on how to keep their household immunizations current and their immunization records close in hand. Moving even a mile down the road can be very stressful and possibly disruptive to even those who try to keep their immunizations current.

As always, I appreciate 2nd opinions.