In the three-and-a-half months since the first COVID-19 case was diagnosed in the U.S., the state of Montana has the second lowest number of total cases, and the lowest number of cases per capita of any state in the country. Those low numbers did not stop the state’s leaders from enlisting the U.S. Army Corps of Engineers, Omaha District, to prepare for the future fight against the virus.On April 17, the state of Montana requested FEMA to task the U.S. Army Corps of Engineers-Omaha District, with building an Alternate Care Facility in Kalispell in the northwest corner of the state."As Montana begins the process of reopening, we remain vulnerable to a potential spike in cases," said Maj. Gen. Matthew Quinn, the Adjutant General for Montana and leader of the Montana Coronavirus Task Force. "The extra capability this facility will provide to hospitals throughout the region is critical to ensuring the continued safety of our population. We must make sure that we take every step now to prepare for a potential second wave later in the year."The ACF is being built on the vacant, undeveloped, third floor of Montana Children’s, the new pediatric facility of the Kalispell Regional Medical Center. The facility signed the lease May 4, which allowed USACE to issue the $2,643,703.12 contract the following day, which started the clock ticking.“After award is given, the contractor has 21 days to mobilize to the area, and to complete the entire build out of the alternate care facility,” said Ryan Field, Kalispell ACF project manager, USACE-Omaha. “That in and of itself is unique.”Work on the project began May 11. Within four days, what was a 26,250-square foot empty shell was transformed into a recognizable framework of patient care spaces that could be used in the fight against the COVID-19 pandemic. When completed, it will have 98 patient care rooms, seven nurse’s station, four restrooms, three pharmacies and a medical supply storage room.“It's an expansive open space,” Field explained. “Some of the biggest challenges so far have been that one, there are no utilities here. The utilities stop at least one floor below us, so we have to pipe utilities up to the third floor.“A second challenge has been getting materials to the third floor without the use of elevators. The elevators the hospital has don’t have load capacity we need. We have to take out windows and bring everything in through the windows from the parking lot below,” he said.Each day more than 50 contractors work 12-hour days to lay framework, hang sheet rock, and install the electrical and plumbing utilities. It is a project that many hope will never have to be used."The Omaha District is leveraging our extensive construction capability and expertise to build the additional bed space capacity in support of the request by the State of Montana and FEMA,” said Col. John Hudson, commander, USACE-Omaha District. “Ultimately, we hope these additional bed spaces will not be needed. But, if they are, the spaces will be ready and available to support the greater Kalispell community."That is a sentiment Field echoes.“There’s a personal touch with this project,” he contemplated. “It's different if you're working on a levee or a dam or a tornado and you know where the danger is, you know where the hazard is, you know where the impact is. You don't know where this is. So, you know, it is a great project to be on knowing that you hope it is never used. But knowing that if it is used, that you help the people in this region.”The ACF is scheduled to be completed before the end of May. When the pandemic ends, the state of Montana will remove the patient pods and equipmen,t and store them at a State facility for other future ACF needs.