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Dr. Bertolli, left, is shown with Capt. Clifford Brown, O.D., at the 2008 Association of Military Surgeons of the U.S. in San Antonio. Dr. Bertolli was a lecturer at the conference.

E. Robert Bertolli, O.D., of Branford, Conn., is a volunteer on the frontline of the Medical Reserve Corps, which is housed in the Office of the Surgeon General and is a partner program with the White House’s Freedom Corps and the Department of Homeland Security’s Citizen Corps.

The Medical Reserve Corps is activated by request when local public health authorities require support to:

v Provide medical care, administer vaccines and dispense medications
v Provide health education as part of a local public health initiative
v Provide counseling for victims, families and responders
v Promote preparedness
v Provide administrative, logistical and communications support.

Classroom and online training prepares volunteers for drills and for mobilization. Face-to-face training allows the volunteers to be familiar with one another.

The Medical Reserve Corps follows the National Incident Management System (NIMS) and Incident Command Structure (ICS).

“NIMS is based upon ‘a balance of flexibility and standardization’ in that someone in a particular capacity from one jurisdiction may be inserted in another jurisdiction and be qualified and capable to perform in a familiar universal structure,” according to Dr. Bertolli. “Flexibility is inherent in that the response is adjustable to manage any type, size or location of domestic incident.”

More information about the NIMS is available at www.fema.gov/emergency/nims/AboutNIMS.shtm.

Dr. Bertolli recently participated in a full-scale anthrax drill as part of his involvement in the Medical Reserve Corps.

As part of the drill, the Medical Reserve Corps was activated and sworn in for a five-town region after the simulated release of an anthrax bioweapon.

Within four hours, all critical staff and their family members, numbering more than 2,300, were designed to have prophylactic antibiotics distributed. The rest of the area population would have a 10-day supply of pharmaceuticals within 48 hours.

“Health care practitioners, pharmacists, law enforcement, public health and other personnel, through teamwork, allowed the drill to progress smoothly with distribution ahead of time,” said Dr. Bertolli. “This is the ‘First Meds Full-Scale Exercise’ involving the Medical Reserve Corps for a local health region, under the direction of the Connecticut Public Health System and Department of Emergency Management and Homeland Security. Although this drill was originally designed as response to an anthrax release, the H1N1 situation began unfolding shortly prior to the exercise, thus demonstrating potential and possibly impending application of the system.”

In addition to his Medical Service Corps work, Dr. Bertolli is on the Executive Advisory Board for Certification in Homeland Security and an adjunct speaker for the Connecticut Police Academy on the medical aspects of Horizontal Gaze Nystagmus (HGN) and the use of vision science in detecting alcohol and drug impairment for driving under the influence enforcement.

Connecticut police surgeon and HGN court expert Gus Forkiotis, O.D., taught Dr. Bertolli the vision science behind the Standard Field Sobriety Test nearly a decade ago.

“With HGN and other physiological testing, impairment from alcohol and/or drugs may be determined,” said Dr. Bertolli. “From there, I joined Dr. D. Robert Pannone and Dr. Forkiotis in teaching the medical aspects of HGN at the Connecticut Police Academy for in-service officers and troopers. Since eye signs can reveal drug impairment, I thought that why not look at eye findings in WMD (weapons of mass destruction) exposure and assemble a program for officer safety. I put together a guide for rapidly determining exposure to some of the faster-acting, more deadly WMDs such as for nerve agent, botulism, etc. At the time of the writing, domestic terrorism was thought to be a possibility. Dr. Forkiotis and I wrote an article describing these ocular findings and submitted it to an optometric journal. The editor thought it was interesting, but did not fit a need in optometric practice. This was spring 2001. Then on Sept. 11, 2001, four aircraft were used as mobile incendiary devices and caused much destruction and heartache, reverberating to this day. After that dark day, the editor published our paper.” 

In addition to several other articles published for forensic and counter-terrorism organizations, Dr. Bertolli also wrote a book, “Shields Against Terrorism: Guarding Against Unconventional Attack,” with Dr. Forkiotis and Hazel Dawkins. 

“During the research that went into the book and papers, I became aware of certain unfriendly countries that had a history of using WMDs and currently possessed some very dangerous weapons such as anthrax and smallpox,” said Dr. Bertolli. “I wanted to be available locally to respond if an incident occurred, so I joined the local health district’s smallpox emergency response team, where we were trained in administering the smallpox vaccine. Iraq was one of the unfriendly states that intelligence believed to have smallpox, botulism and anthrax. After the U.S. secured Iraq, the ‘fever’ for smallpox vaccination response dwindled. The teams were evolved into Emergency Response Teams for natural and manmade events and then later became part of the Medical Reserve Corps.”

Dr. Bertolli stressed the need for optometrists in the Medical Reserve Corps.

  “We hope that many of our optometry brothers and sisters will contact the local health department and ask about the MRC,” said Dr. Bertolli.

“The MRC needs more volunteers. Optometrists can demonstrate the concern for public safety and also find reason to expand the scope of practice. Members of the AOA are encouraged to learn about the MRC, speak with the local public health departments, and see if they may wish to represent optometry in this arena.”

“For the optometric physician, the tasks are limited to the scope of practice allowed in that state,” Dr. Bertolli explained.

“For example, the Connecticut optometrist may train to administer the smallpox vaccine, but may not perform the actual vaccination since injectables are not part of scope of practice. Distributing antibiotics is allowed since therapeutics is a part of the scope of practice for the qualified Connecticut optometrist. Optometry should consider participating in the MRC for the reasons of supporting the public and public health and to demonstrate the need for legislation for expanded scope. In an actual public health emergency, the system’s capabilities will be overwhelmed. Capable professionals with the needed tools will be essential—optometry should be there and be allowed to deliver for the public.”

For more information about the Medical Reserve Corps or to volunteer, visit www.medicalreservecorps.gov/.