New Hospital Ships are Needed

The arrival of the Navy’s hospital ships, the USNS Mercy (T-AH-19) in Los Angeles and the USNS Comfort (T-AH 20) in New York City, provided one of the few uplifting moments in a time of national emergency. With the country beset by the COVID-19 pandemic, and the medical facilities in those two metropolitan areas in danger of overload, the President authorized the activation and deployment of the ships. Each ship is manned by civilian merchant mariners from the Military Sealift Command, with medical personnel drawn from Navy hospitals and the Navy Reserve, and has the capacity to handle 1,000 patients. In a press conference on 1 April, the President stated, “This [deployment of the hospital ships] has worked out well so we’re looking at doing two brand new ones.”

The 2020 long-range shipbuilding plan projects the construction of two new hospital ships, one in 2033 and another in 2034, with delivery three years later. Part of the Common-Hull Auxiliary Multi-Mission Platform (CHAMP) series, their prospects do not appear particularly good. In December, the White House Office of Management and Budget called on the department to come up with a more cost-effective plan to recapitalize its sealift fleet.¹

However, if the military is serious about replacing the ships, which are 44 years old and powered by obsolete steam plants, there are options.

The first, and fastest, would be to acquire existing passenger liners. The COVID-19 outbreak has sidelined the entire cruise ship industry, and the three largest operators—Carnival, Royal Caribbean, and Norwegian—find themselves with large fleets of empty ships, new ones on the construction ways, and an uncertain future. The United States, which is looking to the commercial market for some new sealift ships to supplement the surge fleet, could make a similar offer to the cruise lines.

Passenger ships have several features that make them well suited for conversion. They typically operate with diesel-electric engines and therefore have significant generator capability, ideal to power a hospital. They also have robust water purifying and waste disposal systems to accommodate large passenger capacities. The spaces allocated for shops, casinos, restaurants, and common areas could be converted into surgical suites and medical labs, and the cabins typically are modular, with standard hookups that allow for modifications. The pools are reinforced to handle extra weight and could be modified to take a helicopter platform. The British learned this during the 1982 Falklands War when the Royal Navy took in hand the liners Uganda, Canberra, and Queen Elizabeth 2.

A second option is new construction, but the main question here is what the new ship’s capability should be. The current hospital ships were designed to move patients from battlefields, hence their large capacity. However, this has been done only twice. In 1990, both the Comfort and Mercy deployed in support of Operations Desert Shield/Storm, and in 2003 the Comfort deployed to support Operation Iraqi Freedom. All other deployments and exercises have been in the role of humanitarian assistance and disaster relief.

If the requirement is for 1,000-bed hospital ships, the new ships could be based on the specifications the Comfort and Mercy were built to in the mid-1970s. The ships are modified San Clemente–class oil tankers, built and converted at NASSCO in San Diego.

Currently, NASSCO is building two variants of its Alaska-class tankers. The tankers have been modified into the Montford Point–class expeditionary support dock (ESD) and the Lewis B. Puller–class expeditionary support base (ESB) platforms. With several ESBs in the pipeline, NASSCO could take that hull form and insert a large center body section that could house the auxiliary machinery and hospital spaces needed for a 1,000-bed hospital.

If the plan is instead for a smaller vessel similar to China’s 500-bed Peace Ark or Britain’s Argus, several designs are available. NASSCO has built tankers smaller than the Alaska class, known as ECOs. These ships, with twice the carrying capacity of a John L. Lewis–class oiler, could be modified in a similar method to their larger brethren.

Another possible variant is the new National Security Multi-Mission Vessel (NSMV) being procured by the Maritime Administration for the state maritime academies, which train new merchant mariners. These colleges have training ships that are sorely in need of replacement, as some are more than 50 years old. With the first contract about to be awarded, the NSMVs could be modified into 500-bed hospital ships. These purpose-built hospital ships could be supported by the state maritime academies’ ships for lesser contingencies or as support vessels. The commonality of the classes would make ordering—and later maintaining—these vessels more economical. The NSMV also could be the basis for other Navy classes, such as tenders and command ships.

The images of the Mercy sailing past the Battleship USS Iowa Museum into Los Angeles and the Comfort steaming past the Statue of Liberty and up the west side of Manhattan demonstrate the soft-power application of sea power. While carriers, submarines, fighters, and special operators get the lion’s share of praise and funding from the Navy, the need for hospital ships to dispense care to the nation’s military and civilian population should not be overlooked, and their replacement ought not be delayed.