U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE VERSION 4.0

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ROUTINE

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INFO SECNAV WASHINGTON DC
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NAVADMIN 037/21

MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/FEB//

SUBJ/U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE VERSION 4.0//

REF/A/NAVADMIN/OPNAV/042056ZNOV20//
REF/B/NAVADMIN/OPNAV/171541ZAPR20//
REF/C/NAVADMIN/OPNAV/021507ZJUL20//
REF/D/MEMO/OSD/13APR2020//
REF/E/MEMO/OSD/11JAN2021//
REF/F/INST/OSD/24AUG2020//
REF/G/MEMO/NMCPHC/24JUL2020//
REF/H/GUIDE/BUMED/17JUL2020//
REF/I/MEMO/NMCPHC/13APR2020//
REF/J/MEMO/BUMED/07AUG2020//
REF/K/NAVADMIN/OPNAV/241512ZAUG20//
REF/L/NAVADMIN/OPNAV/212043ZOCT20//
REF/M/NAVADMIN/OPNAV/082145ZJUL20//
REF/N/GENADMIN/JCS/211347ZAUG20//
REF/O/MEMO/OSD/05OCT2020//
REF/P/INST/OPNAV/16DEC2019//
REF/Q/MEMO/OSD/29DEC2020
REF/R/NAVADMIN/OPNAV/161751ZDEC20 //
REF/S/NAVADMIN/OPNAV/072031ZJAN21 //
REF/T/DOC/NMCPHC/19JAN2021//
REF/U/DOC/NMCPHC/05FEB2021//

NARR/REF A IS NAVADMIN 298/20, U.S. NAVY COVID-19 STANDARDIZED
OPERATIONAL GUIDANCE VERSION 3.1.
REF B IS NAVADMIN 113/20 RESTRICTION OF MOVEMENT (ROM) GUIDANCE UPDATE.
REF C IS NAVADMIN 189/20, NAVY MITIGATION MEASURES IN RESPONSE TO
CORONAVIRUS OUTBREAK UPDATE 6.
REF D IS USD P&R FHP SUPPLEMENT 8 - DOD GUIDANCE FOR PROTECTING
PERSONNEL IN WORKPLACES DURING THE RESPONSE TO THE COVID-19 PANDEMIC.
REF E IS USD P&R FORCE HEALTH PROTECTION (FHP) SUPPLEMENT 15 - DOD
GUIDANCE FOR COVID-19 CLINICAL LABORATORY DIAGNOSTIC TESTING SERVICES.
REF F IS DODI 6490.03, DEPLOYMENT HEALTH, 19JUN19.
REF G IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER MEMO EVALUATING CDC
20 JULY 2020 UPDATE ON RETURN TO WORK GUIDANCE AT CDC WEBSITE
WWW.CDC.GOV/CORONAVIRUS/2019-NCOV/HCP/DURATION-ISOLATION.HTML.
REF H IS CORONAVIRUS DISEASE READINESS GUIDE VERSION 1.1, 17JUL20. AT WEBSITE
ESPORTAL.MED.NAVY.MIL/BUMED/RH/M3/M34/CRG/DEFAULT.ASPX.
REF I IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER MEMO 2019 NOVEL 
CORONAVIRUS (COVID-19) CASE AND CONTACT INVESTIGATION GUIDE AT WEBSITE
ESPORTAL.MED.NAVY.MIL/SITES/NMCPHC/PPS/WPPC19/COVID19_CONTACT _INVESTIGATION
_CONTACT_TRACING_GUIDE.ASPX.
REF J IS BUMED MEMO FLEET CONTACT TRACING RING APPROACH AT WEBSITE
HTTPS://COMMUNITY.MAX.GOV/PAGES/VIEWPAGE.ACTIONPAGEID=2157064930&ATTACHMENTID
=2159706846.
REF K IS NAVADMIN 236/20, UPDATED PROCEDURES FOR FOREIGN VISIT REQUESTS TO 
U.S. NAVY COMMANDS DURING COVID-19 PANDEMIC.
REF L IS NAVADMIN 283/20 NAVY MITIGATION MEASURES IN RESPONSE TO
CORONAVIRUS OUTBREAK UPDATE 6 MODIFICATION 1.
REF M IS NAVADMIN 194/20 FACE COVERINGS IN UNIFORM.//
REF N IS GENADMIN COVID-19 TESTING INSTRUMENT REQUEST FOR INFORMATION AND
ENDURING REPORTING REQUIREMENTS.
REF O IS THE DEPUTY SECDEF MEMO FOR SENIOR PENTAGON LEADERSHIP REGARDING
APPROVAL AUTHORITY FOR ORDERING BIOFIRE TEST PANELS FOR SEVERE ACUTE
RESPIRATORY SYNDROME CORONAVIRUS-2.
REF P IS OPNAV INSTRUCTION 5726.8C, OUTREACH: AMERICAS NAVY DATED
16 DECEMBER 2019.
REF Q IS USD P&R FORCE HEALTH PROTECTION (FHP) SUPPLEMENT 12 - DOD GUIDANCE
FOR PERSONNEL TRAVELING DURING THE CORONAVIRUS DISEASE 2019 PANDEMIC.
REF R IS NAVADMIN 327/20 SARS-COV-2 VACCINATION AND REPORTING POLICY.
REF S IS NAVADMIN 03/21 DEPARTMENT OF DEFENSE COVID-19 TESTING PRIOR TO
OVERSEAS TRAVEL.
REF T IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER MODELING RESULTS FOR
US NAVY FORCE HEALTH PROTECTION CONSIDERATIONS WITH INCREASING COVID-19
IMMUNIZATION RATES.
REF U IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER SUPPLEMENTARY DATA
FOR US NAVY FORCE HEALTH PROTECTION CONSIDERATIONS WITH INCREASING SARS-COV-2
IMMUNIZATION RATES: 85% CREW VACCINATION AND CREW SIZE 500.

POC/RADM KARL THOMAS/OPNAV N3N5B/703-692-9291/KARL.O.THOMAS1(AT)NAVY.MIL//

RMKS/1.  [NEW] THIS MESSAGE UPDATES THE U.S. NAVY COVID-19 STANDARDIZED
OPERATIONAL GUIDANCE VERSION 3.1 ISSUED IN REF (A).  REF (A) IS CANCELLED.
NOTABLE CHANGES IN THIS UPDATE ARE:  (1) ADDS DEFINITIONS RELATED TO
VACCINATION AND IMMUNIZATION IN PARA 2; (2) LAYS FOUNDATION FOR UNITS
THAT HAVE HIGH PERCENTAGE OF IMMUNIZED MEMBERS (BEGINNING WITH 100%
IMMUNIZED UNITS IN PARA 3.C.1 AND 4.A.4) AND ENABLES NCCS TO ADJUST
ROM REQUIREMENTS FOR IMMUNIZED INDIVIDUALS IN PARAS 1.C.1, 3.B. AND

3.C.; (3) UPDATES QUARANTINE GUIDANCE IN PARA 2.G.2, 7.B AND 7.B.1
IN ACCORDANCE WITH CENTER FOR DISEASE CONTROL AND FORCE HEALTH
PROTECTION GUIDANCE 15 (REF (E)); (4) ALLOWS FLEET SURGEONS TO
CONSIDER DEPLOYING HIGH RISK INDIVIDUALS ON HIGHLY IMMUNIZED CREWS
IN PARA 3.A.2; (5) ADJUSTS PARA 3.B.2 AND 4.E. TO PROVIDE NCC A
RISK-INFORMED REDUCTION IN TRAVEL-ROM DURATION IAW FORCE HEALTH
PROTECTION GUIDANCE 14 (REF (Q)); (6) ALLOWS NCCS TO REDUCE ROM
REQUIREMENTS FOR IMMUNIZED SHIP RIDERS IN PARA 3.E.; (7) ADDS
T-AH/CVN/LHD/LHA TO MEDICAL CONSIDERATION IN 2.P, 3.C.1 AND PARA

4.B.1; (8) PROVIDES GENERAL GUIDANCE ON IMMUNIZATION THROUGHOUT AND
SPECIFICALLY IN PARA 12; (9) PROVIDES GUIDANCE FOR TIERED TESTING
(NON-DIAGNOSTIC TESTING) REQUESTS AND REPORTING IN PARA 13, AND (10)
PROVIDES GUIDANCE FOR COMMUNITY OUTREACH IN PARA 13.  ADDITIONAL
GRAMMATICAL AND ADMINISTRATIVE CORRECTIONS WITHIN THE SOG ARE MINOR
AND DO NOT CHANGE THE INTENT OF ANY PARAGRAPH.  TO ASSIST IN
UNDERSTANDING CHANGES TO SOG 4.0, NEW PARAGRAPHS HAVE [NEW] AT THE
BEGINNING AND PARAGRAPHS WITH CHANGES HAVE [MOD] AT THE BEGINNING.
NCC, FLEET, TYCOM AND OPERATIONAL COMMANDERS MAY ISSUE ADDITIONAL
GUIDANCE TO SUBORDINATE UNITS.
COVID-19 VACCINES ARE RAPIDLY BEING DEPLOYED ACROSS THE FLEET IAW
WITH DOD PRIORITY SCHEMES OUTLINED IN PARA 12.C.  VACCINATION WILL
SIGNIFICANTLY HELP PROTECT OUR SAILORS FROM THE RISK OF INFECTION,
AND IN THE UNLIKELY CHANCE A SAILOR BECOMES INFECTED AFTER
IMMUNIZATION (NO VACCINE IS 100% EFFECTIVE) SIGNIFICANTLY MINIMIZE
THE SEVERITY OF THE ILLNESS.  STUDIES ARE ONGOING TO UNDERSTAND IF
RECEIVING THE VACCINE ELIMINATESTHE ABILITY TO TRANSMIT THE VIRUS,
BUT UNTIL THERE IS MEDICAL VALIDATIONTO SUPPORT THIS PREMISE, MANY
SHIPBOARD SITUATIONS WILL REQUIRE A CONTINUATION OF RIGOROUS HEALTH
PROTECTION MEASURES AND BUBBLE GENERATION.  THERE WILL SOON BE
INSTANCES WHERE UNITS HAVE A HIGH PERCENTAGE OF IMMUNIZED SAILORS.
THIS NAVADMIN WILL INTRODUCE OPPORTUNITIES TO REDUCE ROM REQUIREMENTS
FOR IMMUNIZED INDIVIDUALS, ELIMINATE QUARANTINE FOR IMMUNIZED SAILORS
WHO RECEIVED THEIR FINAL DOSE WITHIN THE PAST THREE MONTHS, EXPAND
OPPORTUNITIES IN SAFE HAVEN PORTS FOR LIBERTY, REDUCE ROM FOR UNITS
AND INDIVIDUALS IN TRAINING TRACKS PREPARING TO DEPLOY OR WHILE
CONDUCTING PCS TO JOIN A UNIT.  IN SHORT, FULLY IMMUNIZED SAILORS WILL
ALLOW OUR NAVY TO BEGIN TO UNWIND THE LIMITATIONS THAT HAVE BEEN
PLACED ON OUR SAILORS AT SEA WHERE THERE ARE LIMITED THREAT VECTORS
BUT WHERE THE CONSEQUENCE OF PENETRATING A BUBBLE IS GREATEST.  THE
HIGHER THE PERCENTAGE OF THE CREW IMMUNIZED, THE LESS RISK THERE IS
TO A WIDESPREAD OUTBREAK.  HAVING KEY AND ESSENTIAL WATCHSTANDERS AND
PERSONNEL IMMUNIZED PROVIDES MISSION ASSURANCE AND INCREASES DEPTH
ON THE BENCH.  RAPID AND THOROUGH FORCE IMMUNIZATION WILL ALLOW
COMMANDERS GREATER LATITUDE TO MANAGE OPERATIONAL RISK.
CREWS WHO ACHIEVE 100% IMMUNIZATION MAY IMMEDIATELY TAKE ADVANTAGE OF
THIS BENEFIT BY ELIMINATING ROM-SEQUESTER, RELAXING HEALTH PROTECTION
MEASURES IAW PARA 3.C.1 AND OPERATING AT SEA WITH GREATER CONFIDENCE
AND CREW EFFICIENCY.  AS WE LEARN MORE ABOUT THE VACCINES AND THE
REDUCED RISK IT AFFORDS OUR SAILORS, THIS SOG WILL EVOLVE TO INCLUDE
CREWS WITH LOWER UNIT IMMUNIZATION LEVELS.

1.A.  TO INCREASE PROBABILITY OF A COVID-FREE MISSION READY CREW,
UNITS WILL ADHERE TO THE FOLLOWING STANDARDIZED OPERATIONAL GUIDANCE.
THESE DATA DRIVEN RISK MITIGATION MEASURES PROVIDE COMMANDERS THE TOOLS
TO PREVENT AND WHEN NECESSARY CONTAIN COVID-19, TO REDUCE THE IMPACT
TO OUR FORCE WHILE SAFELY AND CONFIDENTLY REMAINING ON MISSION.  THIS
GUIDANCE BUILDS ON REFS (B) AND (C) WHILE INCORPORATING GUIDANCE FROM
REFS (D) THROUGH (U).  IT WILL GUIDE INDIVIDUAL AND UNIT HEALTH
PROTECTION, PRESERVE OPERATIONAL READINESS, AND PROTECT SHIPMATES,
INSTALLATIONS, AND COMMUNITIES FROM COVID-19 TRANSMISSION.  ALTHOUGH
BIASED TOWARD THE SHIPBOARD ENVIRONMENT, THIS GUIDANCE APPLIES TO ALL
PERSONNEL AND UNITS DEPLOYING TO AND FROM HOMEPORT (ORIGINATING UNIT
LOCATION FOR RESERVE PERSONNEL) AS WELL AS ALL SHORE-BASED COMMANDS.
IT DOES NOT APPLY TO ROUTINE TRAVEL (E.G. PCS, TDY, TAD) UNLESS
THE TRAVELER IS A DEPLOYING INDIVIDUAL OR IS ASSIGNED TO OR WILL BE
WORKING ABOARD AN OPERATIONAL UNIT (SPECIFICALLY IN PARA 3.B.2 AND

4.E).

1.B.  ADHERENCE TO THIS GUIDANCE INCLUDES ACCOUNTING FOR SPECIFIC
CIRCUMSTANCES INVOLVING CIVILIAN EMPLOYEES OR CONTRACTORS PER
PARAGRAPH 10.

1.C.  COMMANDERS.  THERE IS NO SUBSTITUTE FOR COMMAND ENGAGEMENT TO
SUCCESSFULLY PREVENT AND MITIGATE COVID-19 WITHIN YOUR UNIT.  YOU SET
THE TONE AND MUST CONVEY THE IMPORTANCE OF EACH SAILORS ACTION AND
PERSONAL RESPONSIBILITY TO FOLLOW PUBLISHED HEALTH PROTECTION PROCEDURES
BOTH ON AND OFF DUTY, PROPERLY EXECUTE ROM-SEQUESTER IF REQUIRED, AND
HOLD THEMSELVES AND THEIR SHIPMATES ACCOUNTABLE FOR PERSONNEL AND
MISSION READINESS.  COMMAND ENGAGEMENT, CREW OWNERSHIP, INDIVIDUAL
ACCOUNTABILITY AND DISCIPLINED COMPLIANCE WITH EFFECTIVE HEALTH PROTECTION
MEASURES SUCH AS CLOTH FACE COVERING USE, SOCIAL DISTANCING, SELF
-MONITORING FOR ILLNESS AND AGGRESSIVE SPACE CLEANING ARE THE GREATEST
INFLUENCERS TO PREVENTING COVID-19 OUTBREAKS.  SOME GENERAL OBSERVATIONS
AND DISCUSSION POINTS FOR YOUR LEADERSHIP TEAMS FOLLOW:

1.C.1.  [MOD] WE HAVE DEPLOYED MISSION READY CARRIER STRIKE GROUPS, DEFENSE
SUPPORT OF CIVIL AUTHORITIES READY FORCES, STRATEGIC ASSETS AND INDEPENDENT
UNITS WITHIN THE COVID-19 ENVIRONMENT.  THE KEY ENABLER IS A DETAILED
ROM-SEQUESTER PLAN EXECUTED WITH RIGOROUS DISCIPLINE, COMPLIANCE, AND
LEADERSHIP OVERSIGHT.  THE GOLD STANDARD OF SINGLE OCCUPANCY BARRACKS OR
HOTEL ROOMS IS NOT ALWAYS ACHIEVABLE.  WHEN A CREW IS REQUIRED TO ROM-
SEQUESTER AT HOME, A DETAILED SUPPORT PLAN TO ELIMINATE THE NEED TO
INTERACT WITH THE PUBLIC IS ESSENTIAL.  ROM-SEQUESTER IN HOMES OR MULTIPLE
OCCUPANCY BARRACKS HAS BEEN SUCCESSFUL, BUT ONLY WITH STRICT COMPLIANCE
TO DETAILED HEALTH PROTECTION MEASURES.  AS MORE UNITS HAVE ACCESS TO
IMMUNIZATION PRIOR TO DEPLOYMENT, NCC COMMANDERS MAY ADJUST ROM SEQUESTER
PLANS TO ACCOUNT FOR THOSE WHO HAVE BEEN IMMUNIZED.   ADJUSTED ROM GUIDANCE
 IS LISTED IN PARA 3.B.

1.C.2.  [MOD] TESTING CAN SUPPORT ROM-SEQUESTER RISK DECISIONS BUT TESTING
RESOURCES ARE CONSTANTLY CONSTRAINED AND MAY BECOME MORE CONSTRAINED
DURING THE HEIGHTENED COVID LEVELS ACROSS OUR NATION.  DEVELOP A DETAILED
PLAN EARLY AND COMMUNICATE CLEARLY AND REGULARLY UP ECHELON TO COORDINATE
YOUR PLAN AND ENSURE YOU RECEIVE PROPER TESTING SUPPORT AT THE APPROPRIATE
TIME.  IAW REF (N) AND PARA 13, NON-DIAGNOSTIC TESTING FOR UNITS MUST BE
REQUESTED 60 DAYS IN ADVANCE.  HAVE A PLAN IF TEST RESULTS ARE DELAYED.
DO NOT SECURE ROM-SEQUESTER FOR NON-IMMUNIZED INDIVIDUALS IF TEST RESULTS
ARE DELAYED. LEAVING ROM-SEQUESTER WITHOUT WAITING FOR RESULTS IS A THREAT
VECTOR DIRECTLY ATTRIBUTED TO COVID OUTBREAKS.  BE READY TO DEVELOP AND
EXECUTE A NEW PLAN.

1.C.3.  TO DATE NEARLY EVERY SHIP IN THE NAVY HAS HAD AT LEAST ONE CASE
ONBOARD.  IN THE MAJORITY OF THOSE CASES, AGGRESSIVE EARLY ACTION TO
ISOLATE, QUARANTINE, CONTACT TRACE, AND CONTINUE STRICT HEALTH PROTECTION
MEASURES HAS CONTAINED THE INCIDENCE RATE ONBOARD TO WELL LESS THAN FIVE
PERCENT, ALLOWING THOSE SHIPS TO FIGHT THROUGH AND REMAIN ON MISSION.
WITH THE INTRODUCTION OF COVID VACCINES, THE RISK OF AN OUTBREAK IS
FURTHER REDUCED.  THE KEY ENABLERS ARE A HIGHLY IMMUNIZED CREW, STRICT
COMPLIANCE WITH PERSONAL PROTECTIVE EQUIPMENT (PPE), AGGRESSIVE
SANITATION/CLEANING, MINIMIZING CREW INTERACTIONS THROUGH SOCIAL
DISTANCING, AND REDUCING USE OF CONFINED SPACES (E.G., GYMS, SMOKE
PITS).

1.C.4.  NUMEROUS STUDIES HAVE IDENTIFIED THE SPREADING AND CONTAGIOUS
NATURE OF COVID-19 IS OVER-DISPERSED OR NOT SPREAD EVENLY.  SAID
ANOTHER WAY, A FEW INDIVIDUALS ACCOUNT FOR A LARGE PORTION OF SPREADING.
SINCE IT IS NOT POSSIBLE TO IDENTIFY THESE HIGHLY CONTAGIOUS INDIVIDUALS
(WHO MAY BE ASYMPTOMATIC), THE BEST WAY TO AVOID OR PREVENT SUPER-SPREADING
CLUSTERS OF COVID-19 IS TO STAY AWAY FROM VENUES WITH PROLONGED CONTACT,
POOR VENTILATION, AND CROWDING.  THE MAJORITY OF THESE EVENTS OCCUR IN
POORLY VENTILATED, CROWDED INDOOR ENVIRONMENTS WHERE MANY PEOPLE CONGREGATE
OVER TIME.  COMMANDERS SHOULD BE AWARE OF THESE FACTORS AND HOW THEY APPLY
TO INDIVIDUAL UNITS WHILE OPERATING AND MAINTAINING THEIR SHIPS AND AIRCRAFT
IN A COVID-19 ENVIRONMENT, BUT NOT AT THE EXPENSE OF SAFE AND EFFECTIVE
OPERATIONS.  STRICT ENFORCEMENT OF TYCOM STANDARD OPERATING PROCEDURES,
USE OF PPE, AND PERSONAL RESPONSIBILITY MEASURES SUCH AS SOCIAL
DISTANCING, MINIMIZING IN PERSON EVENTS, AND LIMITING TIME OF GROUP
INTERACTIONS ARE HEALTH PROTECTION MEASURES THAT WILL REDUCE
LIKELIHOOD OF VIRUS TRANSMISSION.

1.C.5.  THE NAVY HAS EXPERIENCED A STRONG CORRELATION BETWEEN SAILOR
RATES OF INFECTION AND THE RATE OF INFECTION IN THE LOCAL AREA.
ROM-SEQUESTER CONOPS, LEAVE AND ALL TDY TRAVEL APPROVALS MUST ACCOUNT
FOR LOCAL COMMUNITY TRANSMISSION RATES AS DIRECTED IN REF (C) AND
MODIFIED BY REF (L).

1.C.6.  [MOD] WITHIN THE UNIFORMED NAVY POPULATION, MANY INFECTED
SAILORS EXHIBIT FEW TO NO SYMPTOMS.  THOSE WHO ARE IMMUNIZED ARE
EVEN LESS LIKELY TO EXHIBIT SYMPTOMS AND IF THEY DO EXPERIENCE
SYMPTOMS, THEY ARE MILDER.  THIS SHOULD BUILD CONFIDENCE IN A SHIPS
ABILITY TO FIGHT THROUGH OUTBREAKS, BUT IT SHOULD ALSO STRESS THE NEED
FOR STRICT ADHERENCE TO ROM-SEQUESTER PLANS AND TESTING.  TESTING IS
THE BEST WAY TO UNCOVER ASYMPTOMATIC SERVICE MEMBERS AMONG THE NON-IMMUNIZED
OR TO GAIN CONFIDENCE THAT A BUBBLE STILL EXISTS.

1.C.7.  [MOD] ASSUME COVID-19 IS ONBOARD.  THIS SHOULD BE THE NUMBER ONE
PLANNING FACTOR!  AVOID FALSE CONFIDENCE, COMPLACENCY, AND COVID FATIGUE
 WHICH CAN RESULT FROM ROM-SEQUESTER, OVER CONFIDENCE IN NEGATIVE COVID-19
TESTING, UNKNOWNS DUE TO ASYMPTOMATIC INDIVIDUALS, AND PARTIALLY IMMUNIZED
CREWS.  EVEN AFTER THE RIGOROUS EXECUTION OF A 14-DAY ROM-SEQUESTER,
CONTINUED EXECUTION OF FULL HEALTH PROTECTION MEASURES IS REQUIRED TO
REDUCE THE RISK OF ASYMPTOMATIC CARRIERS CAUSING UNCONTROLLABLE OUTBREAKS.
THIS INCLUDES CLOTH FACIAL COVERING USE, MANAGING THE CREW IN COHORTS,
MINIMIZING THE TIME SPENT WITHIN 6 FEET OF OTHERS, MAXIMIZING DISTANCING
WHENEVER AND WHEREVER POSSIBLE, AND AVOIDING UNNECESSARY CLOSE CONTACT
WITH OTHERS. UNITS WITH A HIGH PERCENTAGE OF MEMBERS IMMUNIZED WILL
GREATLY REDUCE THE PROBABILITY OF A WIDESPREAD OUTBREAK.

1.C.8.  MAXIMIZE SEPARATION BETWEEN CARETAKER CREW (DUTY CREW DURING
ROM-SEQUESTER PERIOD) AND OFF-SHIP ROM-SEQUESTER CREW TO PROTECT BOTH
GROUPS.  WE HAVE ACHIEVED TREMENDOUS SUCCESS IN DEPLOYING COVID-19
FREE WHEN THE CREW REMAINED SEQUESTERED FOR THE FULL 14 DAYS AND WERE
NOT MIXED TOGETHER UNTIL NEGATIVE TEST RESULTS WERE CONFIRMED.

1.C.9.  [MOD]  BERTHING.  SAILORS SHOULD ALTERNATE HEAD/FOOT WHERE
BERTHING CONFIGURATION ALLOWS TO MINIMIZE CLOSE CONTACT.  WHERE
POSSIBLE, SPREAD OUT SLEEPING ARRANGEMENTS.  IN CONGESTED BERTHINGS,
ENSURE SAILORS USE PERSONAL PILLOWS AND LINENS ARE REGULARLY
LAUNDERED.  THIS IS A BEST PRACTICE THAT TRANSCENDS THE CORONAVIRUS
DISEASE AND PROTECTS SAILORS AGAINST OTHER VIRAL OUTBREAKS.

1.C.10.  COMMANDERS MUST UNDERSTAND THE CURRENT HPCON LEVEL.  HPCON
LEVELS WILL REMAIN DYNAMIC, AS LOCAL AREAS STRUGGLE TO MAINTAIN PACE
WITH THIS ELUSIVE THREAT.  INDIVIDUAL SAILORS AND COMMANDS MUST SHOW
RESOLVE IN PRACTICING PROPER HEALTH PROTECTION MEASURES AND AVOID
UNNECESSARY RISK.  ADDITIONALLY, LIBERTY AND ALL TEMPORARY DUTY TRAVEL
APPROVAL PRIOR TO ROM-SEQUESTER MUST BE WEIGHED AGAINST RISK OF
CONTRACTING COVID.  THIS IS ESPECIALLY TRUE IF COVID-FREE WITH A PORT
CALL BETWEEN AT-SEA PERIODS.  REF (C) AS MODIFIED BY REF (L) PROVIDES
DETAILED TRAVEL APPROVAL GUIDANCE.

1.C.11.  FACE COVERINGS WITH AN EXHAUST VALVE AND BANDANNAS ARE
PROHIBITED. THESE TYPE OF FACE COVERINGS DO NOT ENTRAIN MOISTURE IN
EXHALED BREATH, FAILING TO REDUCE THE SPREAD OF THE COVID-19 VIRUS
AND FAILING TO PROTECT OTHER PERSONNEL.

1.C.12.  COMMANDS MAY ISSUE LOCAL GUIDANCE AUTHORIZING USE OF MULTI-LAYER
NECK GAITERS MEETING REF (M) AND ALL SAFETY REQUIREMENTS WHERE A SEPARATE
EAR STRAP OR NECK STRAP FACE COVERING IS NOT SUITABLE FOR THE OPERATIONAL
ENVIRONMENT.

1.D.  THE ECHELON TWO AND NAVAL COMPONENT COMMANDERS (NCC) ARE THE WAIVER
AUTHORITY TO DEVIATE FROM THIS GUIDANCE.

1.E.  CONTENTS.
PARAGRAPH 2 DEFINITIONS.
PARAGRAPH 3 MINIMUM ACTION REQUIRED PRIOR TO DEPLOYED OPERATIONS.
  3.A.  MEDICAL SCREENING.
  3.B.  ROM-SEQUESTER PRIOR TO DEPLOYMENT.
  3.C.  DEPLOYING UNITS.
  3.D.  SHIP RIDERS PRIOR TO BUBBLE ESTABLISHMENT.
  3.E.  SHIP RIDERS PENETRATING SHIP BUBBLE.
PARAGRAPH 4 MINIMUM REQUIRED ACTION FOR MAINTENANCE, BASIC,
ADVANCED/INTEGRATED, AND SUSTAINMENT PHASES.
  4.A.  MAINTENANCE PHASE.
  4.B.  BASIC/ADVANCED PHASE.
  4.C.  INTEGRATED PHASE.
  4.D.  SUSTAINMENT PHASE.
PARAGRAPH 5 GUIDANCE FOR FORWARD DEPLOYED NAVAL FORCES.
PARAGRAPH 6 EXEMPTIONS FOR AIRCREW AND AIRCRAFT MAINTAINERS.
PARAGRAPH 7 REQUIRED ACTION WHEN MEMBER EXHIBITS SYMPTOMS OF COVID-19.
  7.A.  ISOLATE AND DESIGNATE AS A PERSON UNDER INVESTIGATION (PUI).
  7.B.  IDENTIFY, QUARANTINE CLOSE CONTACTS.
  7.C.  PUI PROTOCOL.
  7.D.  RETURN TO WORK (RTW) GUIDANCE.
PARAGRAPH 8 UNDERWAY TESTING.
PARAGRAPH 9 POST-DEPLOYMENT/REDEPLOYMENT.
PARAGRAPH 10 OUTBREAK INVESTIGATION AND CONTACT TRACING WORKFORCE
TRAINING.
PARAGRAPH 11 ADDITIONAL ROM AND MEDICAL SCREENING CONSIDERATIONS.
PARAGRAPH 12 VACCINATION.
PARAGRAPH 13 TESTING AND REPORTING REQUIREMENTS.
PARAGRAPH 14 COMMUNITY OUTREACH GUIDANCE.

2.  DEFINITIONS.

2.A.  COVID-19 CASE:  A MEMBER DESIGNATED BY A MEDICAL PROVIDER BY
ONE OF TWO METHODS: 1) A POSITIVE COVID-19 LABORATORY TEST (CONFIRMED
CASE), OR 2) ASSESSED AS PRESUMED POSITIVE PER THE COUNCIL OF STATE
AND TERRITORIAL EPIDEMIOLOGIST (CSTE) CRITERIA FOR A PROBABLE CASE.

2.B.  PATIENT (OR PERSON) UNDER INVESTIGATION (PUI):  AN INDIVIDUAL
WITH SIGNS OR SYMPTOMS OF COVID-19 WHO HAS A TEST RESULT PENDING OR
WOULD HAVE BEEN TESTED HAD A TEST BEEN AVAILABLE.  ASYMPTOMATIC
INDIVIDUALS QUARANTINED DUE TO CLOSE CONTACT WITH A COVID-19 POSITIVE
MEMBER ARE NOT CLASSIFIED AS PUIS.  ASYMPTOMATIC INDIVIDUALS BEING
TESTED FOR COVID-19 ARE NOT CONSIDERED PUIS WHILE AWAITING TEST
RESULTS.

2.B.1.  [MOD] PUIS WHO RECEIVE A POSITIVE POLYMERASE CHAIN REACTION
(PCR) COVID-19 LAB TEST RESULT ARE CONSIDERED A CONFIRMED COVID-19
CASE AND APPROPRIATE REPORTING SHOULD TAKE PLACE.

2.B.2.  MEMBERS ARE NO LONGER CONSIDERED PUIS WHEN THEY RECEIVE A
NEGATIVE COVID-19 LAB TEST RESULT OR HAVE MET ALL CRITERIA FOR
RETURN TO WORK OUTLINED IN PARAGRAPH 7.D.

2.C.  HIGH-RISK PERSONNEL:  THOSE INDIVIDUALS, DESIGNATED BY A MEDICAL
PROVIDER, THAT MEET THE CENTERS FOR DISEASE CONTROL AND PREVENTION
(CDC) CRITERIA FOR INCREASED RISK OF SEVERE ILLNESS FROM COVID-19
AVAILABLE AT: HTTPS://WWW.CDC.GOV/CORONAVIRUS/2019-NCOV/NEED-EXTRA-
PRECAUTIONS/PEOPLE-AT -HIGHER-RISK.HTML.  THIS LIST EVOLVES AS KNOWLEDGE
OF COVID-19 GROWS AND SHOULD BE CHECKED FREQUENTLY.

2.C.1.  OPERATIONALLY AT-RISK PERSONNEL:  THOSE INDIVIDUALS, DESIGNATED
BY OPERATIONAL COMMANDERS, WHOSE DUTIES PLACE THEM AT A HIGHER RISK OF
EXPOSURE TO THE VIRUS, THEREBY INCREASING THE LIKELIHOOD OF INTRODUCING
COVID-19 INTO A BUBBLE.  EXPOSURE CAN OCCUR WHEN PARTICIPATING IN
OPERATIONS, ACTIVITIES, AND PORT CALLS IN COUNTRIES WITH ACTIVE COVID-19
CASES, ENGAGING WITH PERSONNEL FROM COUNTRIES WITH ACTIVE COVID-19
CASES, AND OPERATIONS THAT MAY RESULT IN ENVIRONMENTAL AND PERSON-TO-
PERSON TRANSMISSION, SUCH AS REPLENISHMENT AT SEA AND FOOD SERVICE.

2.D.  [MOD] CLOSE CONTACT:  INDIVIDUALS IDENTIFIED AS BEING WITHIN
APPROXIMATELY 6 FEET (2 METERS) OF A COVID-19 CASE FOR A PROLONGED
PERIOD OF TIME.  CDC GUIDANCE DEFINES PROLONGED PERIOD OF TIME AS A
CUMULATIVE FIFTEEN MINUTES DURING A SINGLE TWENTY-FOUR HOUR PERIOD
IN THE 48 HOURS PRIOR TO SYMPTOM ONSET OR FIRST POSITIVE TEST IF
ASYMPTOMATIC UNTIL THE TIME THE PERSON WAS PLACED IN ISOLATION.
CLOSE CONTACT CAN OCCUR WHILE CARING FOR, LIVING WITH, VISITING,
WORKING WITH, OR SHARING A DENSELY POPULATED SPACE WITH A COVID-19
CASE.  CLOSE CONTACT CAN ALSO BE ESTABLISHED VIA DIRECT CONTACT
(E.G., BEING COUGHED OR SNEEZED UPON BY A COVID-19 CASE).  UNDER
THESE CIRCUMSTANCES, AN INDIVIDUAL IS CONSIDERED A CLOSE CONTACT
EVEN IF THEY WERE WEARING A CLOTH FACE COVERING.  SOME EXAMPLES
SPECIFIC TO THE SHIPBOARD ENVIRONMENT INCLUDE: A) INDIVIDUALS WITHIN
THE COVID-19 CASE BERTHING AREA ASSIGNED AN ADJACENT RACK INCLUDING
DIRECTLY ACROSS A NARROW AISLE; B) PROLONGED INTERACTION WITHIN
RELATIVELY CONFINED SPACES INTERNAL TO THE SHIP (E.G. WORK SPACE,
GALLEY, GYM, SMOKING DECK, CHAPEL, ETC).  VACCINATED AND IMMUNIZED
INDIVIDUALS WILL BE CONSIDERED A CLOSE CONTACT FOR CONTACT TRACING
PURPOSES.  REFER TO PARA 7.B FOR ACTIONS TO TAKE FOR CLOSE CONTACTS.

2.E.  MEDICAL SCREENING:  COVID-19 MEDICAL SCREENING SHOULD INCLUDE
EVALUATION FOR THE FOLLOWING SYMPTOMS:  FEVER OR CHILLS, COUGH,
SHORTNESS OF BREATH OR DIFFICULTY BREATHING, FATIGUE, MUSCLE OR BODY
ACHES, HEADACHE, NEW LOSS OF TASTE OR SMELL, SORE THROAT, CONGESTION
OR RUNNY NOSE, NAUSEA OR VOMITING, AND DIARRHEA.  A COMPLETE LIST OF
COVID-19 SYMPTOMS CAN BE FOUND AT: HTTPS://WWW.CDC.GOV/CORONAVIRUS/
2019-NCOV/SYMPTOMS-TESTING/SYMPTOMS.HTML.  THE FLU AND COVID VACCINES
CAN BE ASSOCIATED WITH MILD SIDE EFFECTS SUCH AS SORENESS, REDNESS OR
SWELLING AT THE INJECTION SITE, LOW GRADE FEVER AND BODY ACHES.  THESE
 SYMPTOMS COULD BE CONFUSED WITH COVID LIKE SYMPTOMS SO HISTORY OF
VACCINATION SHOULD BE CONSIDERED WHEN EVALUATING COVID LIKE SYMPTOMS.

2.F.  SELF-MONITORING:  PER THE CDC, SELF-MONITORING INCLUDES ASSESSING
FOR COVID-19 SYMPTOMS PER PARAGRAPH 2.E.  INDIVIDUALS THAT DEVELOP
COVID-19 SYMPTOMS SHOULD IMMEDIATELY SELF-ISOLATE, AVOID CONTACT WITH
OTHERS, AND SEEK ADVICE FROM A HEALTHCARE PROVIDER TO DETERMINE IF
FURTHER MEDICAL EVALUATION IS REQUIRED.

2.G.  RESTRICTION OF MOVEMENT (ROM).  GENERAL DOD TERM FOR LIMITING
PERSONAL INTERACTION TO REDUCE RISK TO THE HEALTH, SAFETY AND WELFARE
OF A BROADER COHORT.  ROM IS USED TO MINIMIZE RISK OF INDIVIDUALS
ENCOUNTERING COVID-19 CONTAGIOUS INDIVIDUALS, AND TO PREVENT PERSONNEL
WHO HAVE BEEN IN A HIGHER RISK AREA FROM POTENTIALLY INFECTING OTHERS.
ROM INCLUDES ISOLATION, QUARANTINE AND ROM-SEQUESTER.  PERSONNEL
EXECUTING A ROM ARE CONSIDERED TO BE IN A DUTY STATUS AND ROM PERIODS
WILL NOT BE COUNTED AS ANNUAL LEAVE.

2.G.1.  ISOLATION:  MEDICAL TERM FOR THE STRICT SEPARATION OF
PERSONNEL FROM OTHERS DUE TO THE DEVELOPMENT OF POTENTIAL OR PROVEN
COVID-19 SYMPTOMS OR A POSITIVE COVID-19 TEST.

2.G.2. [MOD] QUARANTINE:  MEDICAL TERM FOR SEPARATING THOSE ASYMPTOMATIC
PEOPLE REASONABLY BELIEVED TO HAVE BEEN EXPOSED TO A COMMUNICABLE
DISEASE IN ORDER TO PREVENT THE POSSIBLE SPREAD OF THE COMMUNICABLE
DISEASE.  FOR THE COVID-19 PANDEMIC, PERSONNEL WITH NO COVID-19
SYMPTOMS WHO HAVE RECENTLY RETURNED FROM A HIGHER RISK LOCATION OR
HAD CLOSE CONTACT WITH A KNOWN COVID-19 POSITIVE PATIENT SHOULD BE
QUARANTINED.  THE QUARANTINE PERIOD FOR INDIVIDUALS ASSIGNED TO
OPERATIONAL UNITS IS 14-DAYS (NCCS MAY DETERMINE WHICH UNITS ARE
OPERATIONAL AND NON OPERATIONAL BASED ON PHASE OF OFRP SCHEDULE
AND EMPLOYMENT).  IAW REF (E), FOR ASYMPTOMATIC INDIVIDUALS ASSIGNED
TO NON-OPERATIONAL UNITS AND STAFFS, COMMANDERS HAVE THREE OPTIONS
FOR QUARANTINE DURATION BASED ON WORK ENVIRONMENT AND CIRCUMSTANCES
OF CLOSE CONTACT:  (1) QUARANTINE 14 DAYS (2) QUARANTINE 10 DAYS WITH
COMMANDERS RISK ASSESSMENT OR (3) QUARANTINE 7 DAYS WITH A NEGATIVE
TEST.  FOLLOWING 7 OR 10 DAY QUARANTINE, INDIVIDUALS SHOULD WATCH FOR
SYMPTOMS UNTIL 14 DAYS AFTER EXPOSURE AND IMMEDIATELY SELF-ISOLATE IF
THEY DEVELOP SYMPTOMS.  QUARANTINE OPTIONS (2) AND (3) RESULT IN
HIGHER POST-QUARANTINE TRANSMISSION RISKS THAN OPTION (1).   PERSONNEL
WHO HAVE TESTED POSITIVE FOR COVID-19 DO NOT NEED TO QUARANTINE OR
GET TESTED AGAIN FOR UP TO 3 MONTHS AS LONG AS THEY DO NOT DEVELOP
SYMPTOMS AGAIN.  THIS EXCEPTION IS DUE TO THE LIKELIHOOD OF SOME
IMMUNITY DEVELOPING AFTER INFECTION AND THE PRESENCE OF DEAD VIRAL
FRAGMENTS THAT ARE NO LONGER CONTAGIOUS BUT WILL LIKELY YIELD A
POSITIVE TEST RESULT.  IAW CDC GUIDANCE ALL IMMUNIZED PERSONNEL
(GREATER THAN TWO WEEKS AFTER FINAL DOSE OF VACCINE) WHO RECEIVED
THEIR LAST DOSE WITHIN THE PAST THREE MONTHS AND HAVE REMAINED
ASYMPTOMATIC DO NOT NEED TO QUARANTINE IF THEY ARE A CLOSE CONTACT,
BUT MUST FOLLOW STRICT HEALTH PROTECTION MEASURES.

2.G.3.  ROM-SEQUESTER:  U.S. NAVY TERM FOR PREEMPTIVE SEPARATION OF
FORCES TO REDUCE RISK OF INFECTION WHILE ATTEMPTING TO ESTABLISH A
COVID-FREE BUBBLE.  ROM-SEQUESTER CAN BE CONDUCTED ONBOARD SHIP, IN
CONTRACTED FACILITIES, OR IN PERSONAL RESIDENCE DEPENDENT ON UNIT-
SPECIFIC SCENARIOS.  DURING ROM-SEQUESTER, INTERACTION WITH
INDIVIDUALS MUST BE MINIMIZED, BY NECESSITY ONLY WITH ALL HEALTH
PROTECTION MEASURES IMPLEMENTED.  ASSUME EVERYONE HAS COVID.
INTERACTION WITHIN ROM-SEQUESTER LOCATION IS RESTRICTED TO NECESSITIES
SUCH AS FOOD DELIVERY, HEALTH AND WELFARE CHECKS, ETC.

2.H.  BUBBLE:  TERM FOR INDIVIDUALS, UNITS OR INSTALLATIONS THAT HAVE
ESTABLISHED LOW PROBABILITY OF COVID-19 INFECTION.  A CREW THAT HAS
BEEN UNDERWAY, OR ROM-SEQUESTERED, FOR GREATER THAN 14 DAYS WITHOUT
COVID-19 POSITIVE PERSONNEL AND NO COVID-19 SYMPTOMS IS CONSIDERED
TO BE WITHIN A BUBBLE.

2.I.  BUBBLE TO BUBBLE TRANSFER (B2BT):  TERM FOR MOVEMENT OF UNITS
OR PERSONNEL FROM ONE BUBBLE TO ANOTHER VIA CONTROLLED MEANS.  A WIDE
VARIETY OF MODES OR MEANS OF TRANSPORTATION CAN BE USED FOR B2BT.
THE KEY FACTOR IS THAT THE EVOLUTION IS CLOSELY CONTROLLED TO MINIMIZE
RISK OF COVID-19 EXPOSURE TO BOTH INDIVIDUALS AND UNITS WHO HAVE NOT
COMPLETED A ROM-SEQUESTER DURING TRANSFER.

2.J.  TESTING:  GENERAL TERM FOR THE INTENDED USE OF REAGENTS,
SUPPLIES, AND EQUIPMENT TO DETECT THE PRESENCE OF SARS-COV-2, THE
VIRUS THAT CAUSES COVID-19, IN SAMPLES COLLECTED FROM INDIVIDUALS.

2.J.1.  DIAGNOSTIC TESTING:  USE OF AN APPROVED TEST BY CERTIFIED
LABORATORIES, TO INCLUDE SHIPBOARD CERTIFIED LABS, TO DIAGNOSE
COVID-19 INFECTION IN AN INDIVIDUAL SUSPECTED OF BEING INFECTED.
INDIVIDUALS SUSPECTED OF BEING INFECTED INCLUDE SYMPTOMATIC INDIVIDUALS
WHO PRESENT TO A HEALTHCARE PROVIDER, AND INDIVIDUALS IDENTIFIED
THROUGH CONTACT TRACING.

2.J.2.  [MOD] SCREENING TESTING:  TESTING OF A POPULATION OR INDIVIDUAL
THAT IS USED TO RAPIDLY IDENTIFY UNRECOGNIZED DISEASE (ASYMPTOMATIC
PERSONS). SCREENING TESTS ARE NOT MEANT TO BE DIAGNOSTIC.  SCREENING
TESTS ARE USED TO INCREASE THE LIKELIHOOD THAT THE ENTIRE POPULATION
OR AN AT RISK SUB-POPULATION IS CLEAR OF INFECTION.  TYPICALLY DONE
IN CONJUNCTION WITH A RESTRICTION OF MOVEMENT TO ENSURE THE
POPULATION DID NOT HAVE AN OPPORTUNITY TO BECOME INFECTED OR THE
INFECTION HAD RUN ITS COURSE PRIOR TO BRINGING A GROUP TOGETHER.
MAY ALSO BE USED TO TEST CRITICAL WATCHSTANDERS UNDERWAY WHEN AN
INFECTION IS SUSPECTED OR IDENTIFIED IN THE GROUP.

2.J.3.  SURVEILLANCE TESTING:  TESTING OF RANDOM PORTIONS OF A
POPULATION TO SEARCH FOR AND IDENTIFY POTENTIAL SPREAD OF
ASYMPTOMATIC COVID-19 INFECTIONS.  SURVEILLANCE TESTING DOES NOT
IDENTIFY RESULTS TO A SPECIFIC INDIVIDUAL.

2.J.4.  NAVY SENTINEL SURVEILLANCE TESTING IS THE NAVY TESTING PROGRAM
TO SURVEIL APPROXIMATELY ONE PERCENT OF THE TOTAL NAVY MANPOWER AND
APPROXIMATELY 10 PERCENT OF HEALTHCARE WORKERS ON A BI-WEEKLY BASIS,
AS TESTING SUPPLIES AND CAPACITY SUPPORT.

2.K.  [MOD] INFLUENZA LIKE ILLNESS (ILI):  PER CDC, ILI IS DEFINED AS
FEVER (TEMPERATURE OF 100.4 DEGREES F [37.8 DEGREES C] OR GREATER)
AND A COUGH AND/OR A SORE THROAT WITHOUT A KNOWN CAUSE.  A PERSON MAY
BE CONTAGIOUS FOR UP TO 7 DAYS WITH THE FLU.  THERE ARE NO DEFINITIVE
SYMPTOMS THAT CAN BE USED AS DISCRIMINATORS TO DIAGNOSE AN INFECTION
AS FLU ONLY AND NOT COVID OR RULE OUT CO-INFECTION. INFECTION WITH FLU
DOES NOT PRECLUDE OR REDUCE THE GENERAL PROBABILITY THAT COVID
INFECTION IS PRESENT.  MANY CASES OF CO-INFECTION HAVE OCCURRED.  IT
MAY NOT BE POSSIBLE TO DISCRIMINATE BETWEEN THE FLU AND COVID-19. THE
RISK OF CO-INFECTION EMPHASIZES THE NEED TO ENSURE INFLUENZA
VACCINATION IS COMPLETED AS SOON AS POSSIBLE.

2.L.  [MOD] POOLED TESTING:  TESTING APPROACH COMBINING INDIVIDUAL
SAMPLES TO TEST PRESENCE OF INFECTION IN THE COMBINED POOL.  USED IN
A SCREENING OR SURVEILLANCE STRATEGY TO EXPAND A LABORATORY CAPACITY
TO PERFORM SARS-COV-2 TESTING.  POOLED TESTING FACILITATES
DETERMINATION OF POPULATION HEALTH WHILE CONSERVING TESTING RESOURCES.
DO NOT POOL TEST IMMUNIZED PERSONNEL.

2.M. [NEW] VACCINATED: AN INDIVIDUAL WHO HAS RECEIVED THE FIRST SHOT
IN A SERIES OF TWO SHOTS OF COVID-19 VACCINE.  WHILE NOT USED IN THE
TRADITIONAL MEDICAL CONTEXT, THE TERMS VACCINATED AND IMMUNIZED
WILL BE USED TO DIFFERENTIATE THOSE WHO HAVE RECEIVED 1 OR 2 DOSES,
RESPECTIVELY.

2.N. [NEW] IMMUNIZED:  AN INDIVIDUAL WHO HAS COMPLETED THE VACCINE
SERIES AND IS CONSIDERED IMMUNE (TO THE LEVEL OF EFFICACY OF THE
VACCINE) **AT LEAST TWO WEEKS POST SECOND VACCINE**. NO VACCINE IS
100% EFFECTIVE AND THERE IS STILL A CHANCE AN INDIVIDUAL CAN BECOME
INFECTED, BUT RECEIVING THE VACCINE SIGNIFICANTLY REDUCES THE RISK OF
SYMPTOMATIC INFECTION AND SEVERE ILLNESS.  INDIVIDUALS ARE HIGHLY
ENCOURAGED TO RECEIVE THE VACCINE TO PROTECT THEMSELVES FROM INFECTION.
NOTE: IT IS LIKELY THAT THERE WILL SOON BE COMMERCIALLY AVAILABLE
COVID-19 VACCINES WHOSE FDA EMERGENCY USE AUTHORIZATION ONLY REQUIRES
A SINGLE DOSE. IN THAT SCENARIO, TWO WEEKS FOLLOWING THE SINGLE DOSE
WOULD MEET THE DEFINITION OF IMMUNIZED.

2.O. [NEW] DEFERRED:  AS ANNOTATED IN THE MEDICAL READINESS REPORTING
SYSTEM, AN INDIVIDUAL WHO WAS OFFERED THE VACCINE BUT DECLINED OR HAD
A MEDICAL CONTRAINDICATION OR TEMPORARY REASON TO NOT RECEIVE THE
VACCINE IS CONSIDERED DEFERRED. THESE INDIVIDUALS ARE ALLOWED TO
CHOOSE, AT ANY TIME, TO RECEIVE THE VACCINE IF IT IS AVAILABLE. AFTER
RECEIVING A VACCINE DOSE, AN INDIVIDUAL WILL NO LONGER BE LISTED AS
DEFERRED.

2.P. [NEW] AFLOAT MTF:  AS UTILIZED IN THIS SOG TO TREAT COVID-19 AND
BE AN AFLOAT MTF (PARA 3.C.1), MEDICAL CAPABILITY ON CVN/LHA/LHD/T-AH
PLATFORMS SHALL BE CAPABLE OF ORGANICALLY TREATING ADVERSE COVID-19
REACTIONS UNDERWAY WITH BASIC LIFE SUPPORT (BLS), ADVANCED CARDIAC
LIFE SUPPORT, A PRIVILEGED CLINICIAN CAPABLE OF TREATING A CRITICALLY
ILL PATIENT IN AN INTENSIVE CARE UNIT (SUCH AS A FAMILY MEDICINE,
INTERNAL MEDICINE, CRITICAL CARE MEDICINE PHYSICIAN OR GENERAL SURGEON),
A CRITICAL CARE NURSE, AN ANESTHESIA PROVIDER, A LABORATORY TECHNICIAN
AND A RADIOLOGY TECHNICIAN.  REQUIRED EQUIPMENT INCLUDES ICU BEDS (TO
INCLUDE MONITORS, IV PUMPS AND VENTILATORS), GENERAL WARD BEDS, A
FUNCTIONING LABORATORY AND X-RAY, SUFFICIENT OXYGEN TANK STORES AND
A PROPERLY STOCKED PHARMACY TO INCLUDE CRITICAL CARE MEDICINES (TO
INCLUDE THOSE TO TREAT ANAPHYLAXIS SUCH AS EPINEPHRINE AND
DIPHENHYDRAMINE). SAFE MEDEVAC AS NEEDED. FOR THE TREATMENT OF SEVERELY
ILL COVID-19 PATIENTS UNTIL MEDEVAC IS AVAILABLE, REQUIREMENTS IN
ADDITION TO THE CRITICAL CARE REQUIREMENTS ABOVE WOULD BE AN OPERATING
ROOM, GENERAL SURGEON (E.G. TO OPEN A SURGICAL AIRWAY) AND ADDITIONAL
COVID-19 DIAGNOSTIC CAPABILITY (ORGANIC SARS-COV-2 TESTING CAPABILITY)
AND TREATMENTS SUCH AS STEROIDS, REMDESIVIR, AND COVID-19 CONVALESCENT
PLASMA.

3.  MINIMUM ACTION REQUIRED PRIOR TO DEPLOYED/DSCA READY FORCE OPERATIONS.

3.A.  MANDATORY MEDICAL SCREENING BY A MEDICAL PROVIDER.

3.A.1.  PRE-DEPLOYMENT SCREENING FOR ALL PERSONNEL WILL CONSIST OF AN
ASSESSMENT OF COVID-19 EXPOSURE HISTORY, A TEMPERATURE CHECK, A CHECK
FOR COVID-19 SIGNS AND SYMPTOMS LISTED IN PARA 2.E. FOR MILITARY
MEMBERS, IT WILL ALSO INCLUDE A REVIEW OF ANY PAST COVID-19 TESTING
AND A THOROUGH EVALUATION OF THE MEMBERS RISK FACTORS FOR SEVERE
ILLNESS FROM COVID-19.

3.A.2.  [MOD]  DEPLOYMENT OF HIGH-RISK INDIVIDUALS SHOULD BE UNCOMMON
AND GUIDED BY MEDICAL RECOMMENDATIONS FOUND IN REF (H).  THE DECISION
TO DEPLOY THE INDIVIDUAL MUST BE MADE, AT A MINIMUM, BY THE ISIC.
MILITARY SEALIFT COMMAND (MSC) WILL MEDICALLY SCREEN CIVIL SERVICE
AND CONTRACT PERSONNEL FOR DEPLOYMENT ON MSC VESSELS IN ACCORDANCE
WITH EXISTING MSC INSTRUCTIONS AND CONTRACTS.  COMMANDERS ARE
ENCOURAGED TO INCORPORATE IMMUNIZATION IN THEIR DECISION TO DEPLOY
HIGH RISK PERSONNEL AND SHOULD BASE DECISION ON THE PERCENT OF THE
UNIT IMMUNIZED, THE PROXIMITY TO A MTF OR AFLOAT MEDICAL FACILITY
WITH COVID THERAPEUTICS AND ICU CAPABILITIES, AND MEDICAL PROVIDER
CONSULTATION.

3.B.  [NEW] ROM-SEQUESTER FOR SHIPS, SUBMARINES AND ORGANIC SQUADRONS.
FOR IMMUNIZED INDIVIDUALS, ROM-SEQUESTER IS NOT REQUIRED.  A HOME TO
WORK SCHEDULE MINIMIZING EXTERNAL CONTACT SHOULD BE EMPLOYED VICE
PRE-DEPLOYMENT ROM-SEQUESTER.  FOR NON-IMMUNIZED INDIVIDUALS, CONDUCT
A MINIMUM 14-DAY ROM-SEQUESTER WITH TEST-IN TEST-OUT PRIOR TO DEPLOYMENT.
DEPENDING ON SCHEDULED AND PLANNED OPERATIONS, THE NCC WILL DETERMINE
IF ROM-SEQUESTER IS REQUIRED PRIOR TO INTEGRATED PHASE.

3.B.1.  CONDUCT ENHANCED DAILY PERSONNEL MEDICAL SCREENING (QUESTIONNAIRE AND
TEMPERATURE CHECKS).

3.B.2.  [MOD] ROM SEQUESTER PRIOR TO DEPLOYMENT FOR OTHER MEANS OF
TRANSPORTATION.  PERSONNEL DEPLOYING OUTSIDE THE UNITED STATES WILL UNDERGO
A 14-DAY ROM-SEQUESTER PRIOR TO DEPLOYMENT UNLESS COMBATANT COMMAND MANDATES
IN-COUNTRY ROM.  IAW REF (Q), NCC MAY DELEGATE TO FIRST FLAG OFFICER/SES IN
CHAIN OF COMMAND THE AUTHORIZATION TO REDUCE THIS ROM TIMELINE TO AS FEW AS 7
DAYS IF OPERATIONALLY NECESSARY WITH A NEGATIVE PCR TEST ADMINISTERED NO
EARLIER THAN 5 DAYS AFTER START OF ROM.  INDIVIDUALS WHO HAVE HAD COVID-19 IN
THE PAST 3 MONTHS ARE EXEMPT FROM ROM.  IF TRAVELING OCONUS AND THE HOST 
NATION
REQUIRES 14-DAY IN-COUNTRY ROM, CONUS PRE-DEPLOYMENT ROM-SEQUESTER IS NOT
REQUIRED UNLESS THE HOST NATION OR COMBATANT COMMAND EXPLICITLY MANDATES 
BOTH.
CONSULT FOREIGN CLEARANCE GUIDANCE FOR MOST CURRENT REQUIREMENTS APPLICABLE 
TO
ALL TRAVELERS, AVAILABLE AT HTTPS://WWW.FCG.PENTAGON.MIL.

3.B.3.  [MOD] ACCEPTABLE ROM-SEQUESTER FACILITIES FOR NON-IMMUNIZED SAILORS 
ARE:
SHIP BERTHING, LIVING BARGE, BARRACKS/HOTEL ROOMS, OR PERSONAL RESIDENCE
(LIMITED CONTACT WITH OTHER RESIDENTS).  EACH HAS PROS AND CONS THAT MUST BE
WEIGHED AGAINST UNIT-SPECIFIC CIRCUMSTANCES AND RISK.  MINIMIZING CONTACT 
WITH OTHERS AND FOLLOWING HEALTH PROTECTION MEASURES IS CRITICAL TO 
SUCCESSFUL ROM-SEQUESTER.

3.B.4.  PRACTICE SOCIAL DISTANCING AND SANITIZE MORE FREQUENTLY WHILE MANNING
ESSENTIAL WATCH STATIONS, COMPLETING REQUIRED MAINTENANCE, AND CONDUCTING
REQUIRED UNDERWAY PREPARATION (LOGISTICS, TRAINING, ETC.).

3.B.5.  [MOD] DEVELOP OPERATIONAL BENCH FOR REDLINE PERSONNEL THROUGH
UNIT TRAINING AND QUALIFICATION PROGRAMS TO MAINTAIN MISSION ESSENTIAL
OPERATIONS (NUCLEAR POWER PLANT, BRIDGE, COMBAT INFORMATION CENTER, CWC
WATCHES, MEDICAL PROVIDERS, ETC).   REDLINE PERSONNEL SHOULD BE
PRIORITIZED FOR IMMUNIZATION.

3.C.  [NEW] DEPLOYING UNITS.  ROM-SEQUESTER PER FLEET APPROVED COMMUNITY
CONOPS.  FOR NON-IMMUNIZED SAILORS, ROM-SEQUESTERS WILL BE A MINIMUM OF
14 DAYS IN LENGTH AND REQUIRE TEST-IN AND TEST-OUT.  ROM SEQUESTER IN
NON-CONGREGATE FACILITIES MAY COMMENCE PRIOR TO RECEIVING A NEGATIVE TEST
RESULT.  PREVIOUSLY POSITIVE INDIVIDUALS WITHIN PAST (3) MONTHS SHOULD
NOT BE RETESTED.  NCC COMMANDERS MAY ADJUST ROM SEQUESTER PLANS TO ACCOUNT
FOR THOSE WHO HAVE BEEN IMMUNIZED.

3.C.1 [NEW] 100% FULLY IMMUNIZED CREWS.  FOR CREWS WHO ARE 100% IMMUNIZED,
REFS (T) AND REF (U) MODELING SHOWS THE RISK OF INFECTION IS EXTREMELY
LOW.  ON THE CHANCE AN IMMUNIZED INDIVIDUAL CONTRACTS COVID-19, THE
VACCINES SIGNIFICANTLY REDUCE THE RISK OF A NEGATIVE OUTCOME.  THEREFORE,
ROM-SEQUESTER IS NOT REQUIRED.  MEDIUM SIZED UNITS (300-999) SHOULD
OPERATE WITHIN 72 HOURS OF AN MTF OR AFLOAT MTF THE FIRST 4 DAYS AT SEA
ON THE REMOTE CHANCE AN IMMUNIZED INDIVIDUAL HAS COVID-19.  SMALLER
UNITS (<300) MAY PROCEED IMMEDIATELY ON MISSION BASED ON VERY LOW RISK
OF AN IMMUNIZED INDIVIDUAL HAVING COVID-19 IN THESE SMALLER POPULATIONS.
IN ORDER TO IMPROVE OPERATIONAL EFFICIENCY, FULLY IMMUNIZED CREWS MAY
RELAX HEALTH PROTECTION MEASURES AT 14 DAYS (CREW SIZE GREATER THAN 1,000),
4 DAYS (CREW SIZE 300-999) AND AFTER 1 DAY (CREW SIZE LESS THAN 300).
FOR FULLY IMMUNIZED CREWS, ALL HEALTH PROTECTION MEASURES CONTINUE TO BE
REQUIRED IF NON-IMMUNIZED INDIVIDUALS PENETRATE THE IMMUNIZED UNIT AND FOR
ALL IMMUNIZED UNIT PERSONNEL INTERACTING WITH NON-IMMUNIZED PERSONNEL WHILE
ONBOARD.  FULL HPM ARE REQUIRED ASHORE.  3.C.2.  [MOD] ROM-SEQUESTER
CONDUCTED ASHORE:  REQUIRES ISOLATION PER CDC GUIDANCE (IDEALLY SEPARATE
ROOM, NO SHARED BATHROOM).  A SECOND TEST SHALL BE CONDUCTED ON OR AFTER
DAY 14 FOR NON-IMMUNIZED PERSONNEL.  A NEGATIVE COVID TEST RESULT IS
REQUIRED TO EMBARK IF NON-IMMUNIZED.

3.C.3.  ROM-SEQUESTERS CONDUCTED ONBOARD A VESSEL OR IN A GROUP SETTING 
ASHORE
(I.E., NOT ISOLATED PER CDC GUIDANCE):  THE NCC WILL DIRECT EXACT TIMING
OF THE SECOND TEST, BUT THE SECOND TEST SHALL BE NO EARLIER THAN DAY SEVEN.
SERVICE MEMBERS TESTING POSITIVE WILL BE IMMEDIATELY ISOLATED TO MITIGATE
COVID-19 VIRUS SPREAD.

3.C.4.  [MOD] THE NCC (COMMANDER MSC FOR CIVIL SERVICE AND CONTRACT
MARINERS) MAY APPROVE DEVIATIONS TO ROM-SEQUESTER PLANS DUE TO EMERGENT
TASKING, TESTING LIMITS OR A HIGH PERCENTAGE OF IMMUNIZED CREW IAW REF
(T) AND REF (U).  THE NCC CAN ALSO ELECT TO BE MORE RESTRICTIVE IN THEIR
TESTING PROTOCOLS PROVIDED TESTING CAPACITY SUPPORTS.

3.C.5.  TESTING IS THE BEST WAY TO IDENTIFY ASYMPTOMATIC COVID-19
POSITIVE INDIVIDUALS.  HOWEVER, TESTING DOES NOT GUARANTEE A COVID-FREE
UNIT DUE TO THE POTENTIAL FOR FALSE NEGATIVE TEST RESULTS.  COMMANDERS
SHALL ASSUME COVID IS ON THEIR SHIPS AND SUBMARINES AND ENSURE STRICT
COMPLIANCE TO HEALTH PROTECTION MEASURES UNTIL SUFFICIENT COVID-FREE
UNDERWAY TIME HAS ELAPSED AND BUBBLE INTEGRITY HAS BEEN MAINTAINED.

3.C.6.  USE OPERATIONAL UNIT RETURN TO WORK (RTW) GUIDANCE, PARA.

7.D.1 TO CLEAR COVID POSITIVE INDIVIDUALS.

3.D.  SHIP RIDERS (E.G. CONTRACTORS, TECH REPS, INSPECTION TEAMS, ETC.),
DIRECT SUPPORT PERSONNEL, AND ALL OTHERS ASSISTING COMMANDS PRIOR TO
BUBBLE ESTABLISHMENT WILL ADHERE TO LOCAL FORCE HEALTH PROTECTION
REQUIREMENTS (DAILY COVID-19 SCREENING QUESTIONNAIRE, TEMPERATURE CHECKS,
SOCIAL DISTANCING, PPE USAGE, RESTRICTED SHIPBOARD MOVEMENT, SANITIZATION,
ETC.).  WHEN INVOLVED IN MOVEMENT TO SEQUENTIAL COMMANDS, IT MAY BE
ADVISABLE TO ROM-SEQUESTER COHORTS, USE B2BT, AND/OR TEST PERIODICALLY.

3.E.  [MOD] SHIP RIDERS (E.G. CONTRACTORS, TECH REPS, INSPECTION TEAMS,
ETC.), DIRECT SUPPORT PERSONNEL, AND ALL OTHERS (E.G. PCS PERSONNEL)
PENETRATING AN ESTABLISHED BUBBLE WILL COMPLETE A 14-DAY ROM-SEQUESTER
WITH A NEGATIVE TEST PRIOR TO EMBARKING.  A NEGATIVE TEST IS NOT REQUIRED
FOR PERSONNEL WHO RECOVERED FROM COVID-19 WITHIN THE PAST 90 DAYS (DUE TO
THE POSSIBILITY OF PERSISTENT POSITIVE RESULTS IN NON-INFECTIOUS PERSONS).
IMMUNIZED PCS AND SHIP RIDERS WHO ARE ASYMPTOMATIC DO NOT NEED TO CONDUCT
ROM PRIOR TO VISITING A 100% IMMUNIZED SHIP, BUT SHOULD HAVE A NEGATIVE
TEST WITHIN PAST 72 HOURS BEFORE EMBARKING A PARTIALLY IMMUNIZED SHIP.
ALL INDIVIDUALS MUST MAINTAIN HEALTH PROTECTION MEASURES UNTIL MORE IS
UNDERSTOOD ABOUT AN IMMUNIZED INDIVIDUALS ABILITY TO TRANSMIT THE DISEASE.
USE OPERATIONAL UNIT RTW GUIDANCE TO CLEAR COVID POSITIVE PERSONNEL, PARA.

7.D.1. MITIGATION PLANS TO PENETRATE AN ESTABLISHED BUBBLE WITHOUT A 14 DAY
ROM-SEQUESTER AND/OR TEST DUE TO EMERGENT OPERATIONAL REQUIREMENTS MUST BE
APPROVED BY THE NCC OR NCC-DESIGNATED APPROVAL AUTHORITIES.

4.  MINIMUM REQUIRED ACTION FOR MAINTENANCE, BASIC, ADVANCED/INTEGRATED,
AND SUSTAINMENT PHASES.

4.A.  MAINTENANCE PHASE.  AGGRESSIVE AWARENESS, SELF-MONITORING, TIMELY
DIAGNOSIS AND THOROUGH CONTACT TRACING ARE ALL CRITICAL TO COMBATTING
COVID-19.  COMMANDERS MUST REMAIN ALERT TO SIGNS OF COVID SPREAD BY
ASYMPTOMATIC SAILORS.  SIGNS MAY BE SAILORS FROM DIFFERENT DEPARTMENTS
WITHOUT KNOWN COVID POSITIVE SAILORS SUDDENLY EXHIBITING SYMPTOMS. THE
FOLLOWING MINIMUM MEASURES APPLY:

4.A.1.  COMPLY WITH LOCAL HPCON REQUIREMENTS, HEALTH PROTECTION MEASURES
AND BE AWARE OF LOCAL COMMUNITY TRANSMISSION RATES.  EMPHASIZE PERSONAL
RESPONSIBILITY (FREQUENT HAND WASHING, CLOTH FACE COVERINGS, SOCIAL
DISTANCING, AVOIDING LOCAL AREAS WITH HIGH POPULATION DENSITY, SELF-
MONITOR, ETC.) EVEN IN THE ABSENCE OF A KNOWN OUTBREAK OR IN AN ESTABLISHED
BUBBLE.  REPORT AND ISOLATE PERSONNEL WITH COVID-19 SYMPTOMS.  SCREEN ALL
INDIVIDUALS DAILY PRIOR TO ENTERING THE WORK CENTER IN ACCORDANCE WITH CDC
GUIDANCE, AVAILABLE AT HTTPS://WWW.CDC.GOV/SCREENING/INDEX.HTML.  CLEAN AND
DISINFECT SPACES DAILY IAW NAVSEA CLEANING GUIDANCE.  CONSIDER ADDITIONAL
COVID-19 OPERATIONAL RISK MANAGEMENT (ORM) MEASURES FOR MAJOR EVENTS (E.G.,
SHIPBOARD DRILLS).

4.A.2.  [MOD] SUPPORT ORGANIZATION COMMANDERS (E.G. SHIPYARD PERSONNEL,
CONTRACT SUPPORT, TRAINING TEAMS) CONSIDER FACTORS SUCH AS THE CURRENT
HPCON, CDC THREAT LEVEL, METHOD/MODE OF TRAVEL, IMMUNIZATION STATUS, ETC.
WHEN ASSESSING RISK AND DETERMINING WHETHER ROM-SEQUESTER IS WARRANTED.
VISITORS SHOULD FOLLOW THE SAME DAILY SCREENING PROCEDURES, SELF-MONITORING,
TEMPERATURE CHECKS, SOCIAL DISTANCING, PPE USAGE, AND PERSONAL RESPONSIBILITY
PROTOCOLS AS SHIP FORCE.

4.A.3.  AIRCRAFT SQUADRON COMMANDERS SHOULD CONSIDER THE CURRENT RISK
LEVEL PER PARAGRAPH 4.A.2 TO DETERMINE IF ROM-SEQUESTER IS REQUIRED FOR
TRAINING DETACHMENTS.  FOR EXAMPLE, A SAILOR MAY USE A PERSONAL VEHICLE
TO DRIVE FROM MILITARY BASE TO MILITARY BASE WITH INFREQUENT GAS OR FOOD
STOPS TO MAINTAIN A MODIFIED BUBBLE.  REGARDLESS, TRAVELERS SHOULD FOLLOW
THE SAME DAILY SCREENING PROCEDURES, SELF-MONITORING, TEMPERATURE CHECKS,
SOCIAL DISTANCING, PPE, AND PERSONAL RESPONSIBILITY PROTOCOLS DICTATED BY
 LOCAL HPCON CONDITIONS.

4.A.4.  FULLY IMMUNIZED UNITS.  FULLY IMMUNIZED UNITS MAY TAKE ADVANTAGE
OF THE RELAXATIONS AFFORDED DEPLOYING UNITS IN PARA 3.C.1 THROUGHOUT THE
OFRP CYCLE.

4.B.  BASIC AND ADVANCED PHASES. INCLUDES SAME MEASURES AS THE
MAINTENANCE PHASE, PLUS:

4.B.1.  [MOD] UNDERWAY OPERATIONS WITH SHORE BASED MEDICAL TREATMENT
FACILITY (MTF) SUPPORT OR AFLOAT MTF (T-AH/CVN/LHA/LHD) WITHIN 72
HOURS:  SCREEN HIGH RISK SAILORS AND ENSURE PPE LOADOUT MEETS FLEET
GUIDANCE. CONDUCT DAILY SCREENING PROCEDURES FOR COVID-19 SYMPTOMS.
FOLLOW PLATFORM SPECIFIC COVID-19 CONOPS AND STANDARD OPERATING
PROCEDURES (SOPS).

4.B.2.  UNDERWAY OPERATIONS WHEN MTF SUPPORT WILL NOT BE AVAILABLE
WITHIN 72 HOURS:  SAME MEASURES AS LOCAL OPERATIONS, PLUS, IAW FLEET
COMMANDER GUIDANCE, CONSIDER MEDICAL TEAM AUGMENT, MEDEVAC AUGMENT/HELO
CAPABILITY, AND/OR SHIPBOARD TESTING CAPABILITY.

4.C.  INTEGRATED PHASE:  SAME MEASURES AS MAINTENANCE AND BASIC AND
ADVANCED PHASES, PLUS:

4.C.1.  IF DEPLOYING IMMEDIATELY AFTER INTEGRATED PHASE (E.G.,
COMPTUEX(C2X), ARGMEUEX) OR PRE-OVERSEAS MOVEMENT EVALUATION (POMEVAL),
FOLLOW THE GUIDANCE IN PARAGRAPH 3.

4.D.  SUSTAINMENT PHASE.

4.D.1.  UNDERWAY:  MAINTAIN BUBBLE PER PARAGRAPHS 3.D AND 3.E.

4.D.2.  PIER-SIDE:  FOLLOWING DEPLOYMENT, FOLLOW BASIC PHASE GUIDANCE.
OPERATIONAL COMMANDERS MAY ELECT TO SHIFT TO PARAGRAPH 3 GUIDANCE
DEPENDING ON LIKELIHOOD OF CONTINGENCY OPERATIONS.

4.E.  [MOD] FOR SHORE BASED COMMANDS SENDING PERSONNEL TO AFLOAT UNITS,
FOLLOW THE GUIDANCE THAT APPLIES TO THE PHASE OF THE RECEIVING UNIT.
FOR ALL OPERATIONAL UNIT PERSONNEL TRAVELING TO SHORE COMMANDS (E.G.,
SCHOOLS, TDY), FOLLOW MAINTENANCE PHASE CRITERIA OF PARA 4.A. AND
REQUIREMENTS OF REF (C) AS MODIFIED BY REF (L).   INDIVIDUALS WHO ARE
IMMUNIZED AND CONDUCTING A SHORE BASED TRAINING TRACK WITH MULTIPLE
STOPS DO NOT NEED TO ROM BEFORE OR IN BETWEEN STOPS, BUT MUST MAINTAIN
HEALTH PROTECTION MEASURES IAW CDC GUIDANCE.

4.F.  [MOD] FOR ALL PHASES, DISCIPLINED INDIVIDUAL AND ORGANIZATIONAL
PUBLIC HEALTH PROTECTION MEASURES ARE THE BEDROCK OF RISK REDUCTION
AND RISK MITIGATION.  COVID-19 MITIGATION PROTOCOL, WHERE APPROPRIATE,
SHOULD CONSIDER ADDITIONAL SUPPORT FOR HIGH RISK PERSONNEL.  COMMANDERS
ARE RESPONSIBLE FOR DEVELOPING, MANAGING, OVERSEEING AND IMPLEMENTING
PROTOCOLS FOR THEIR UNITS. INDIVIDUALS ARE RESPONSIBLE FOR EXECUTING
THOSE PROTOCOLS.  TESTING IS THE ONLY METHOD TO DETECT ASYMPTOMATIC
TRANSMISSION WITHIN THE NON-IMMUNIZED FORCE.  CONSIDER SCREENING TESTS
DURING OFRP CYCLE TO IDENTIFY COVID-19 EARLY AND BREAK TRANSMISSION
CYCLE WITHIN THE FLEET.  ANTIGEN BASED TESTS HAVE PROVEN EFFECTIVE IF
EMPLOYED SERIALLY AND WITH RT-PCR BASED TESTS TO CONFIRM POSITIVE RESULTS.

5.  DUE TO THE UNIQUE NATURE OF FORWARD DEPLOYED NAVAL FORCES (FDNF)
AND THEIR HOST NATION RELATIONSHIP, THE NCC WILL DEFINE OPERATIONAL
REQUIREMENTS FOR FDNF UNITS BASED ON PARAGRAPHS 3 AND 4.

6.  COMMANDERS MAY NEED TO EXEMPT AIRCREW AND AIRCRAFT MAINTAINERS
FROM THIS GUIDANCE TO MEET EMERGENT OPERATIONAL OR NATOPS CURRENCY
REQUIREMENTS.  MITIGATION PLANS MUST BE APPROVED BY THE NCC.  FOR
AVIATION UNITS EMBARKED ON SURFACE UNITS, MITIGATION PLANS WILL BE
INCLUDED AND APPROVED AS PART OF THE OVERALL SHIP HEALTH PROTECTION
PLAN.

7.  REQUIRED ACTION WHEN ANY MILITARY, CIVILIAN, OR CONTRACTOR
EXHIBITS SIGNS OR SYMPTOMS OF COVID-19 INFECTION.

7.A.  [MOD] ISOLATE, MEDICALLY SCREEN AND DESIGNATE AS A PUI OR
PROBABLE COVID-19 CASE. RESTRICT CONTACT AND PRESERVE THE CAPABILITY
TO CONDUCT MISSION ESSENTIAL OPERATIONS.

7.A.1.  IF ISOLATED ABOARD SHIP, USE SMALL BERTHING AREAS (E.G.,
STATEROOMS, PREFERABLY WITH HEADS) FOR SEPARATION. WHEN ADEQUATE
SHIPBOARD ISOLATION CAPACITY IS EXHAUSTED, CONSIDER TRANSFERRING
PUIS TO UNITS WITH REMAINING CAPACITY OR ASHORE IAW FLEET COMMANDER
GUIDANCE, IF FEASIBLE AND MISSION ALLOWS.

7.A.2.  IF ISOLATED ASHORE, PROVIDE NECESSARY MEDICAL TREATMENT
UNTIL CLINICALLY IMPROVED.

7.B.  [MOD] IDENTIFY, QUARANTINE, AND MEDICALLY SCREEN CLOSE
CONTACTS OF COVID-19 CASES.  ISOLATE SYMPTOMATIC PUIS AS DEFINED
IN PARAGRAPHS 2.A AND 2.B AS SOON AS POSSIBLE.  MINIMUM SCREENING
SHOULD INCLUDE USE OF CDC COVID-19 QUESTIONNAIRE, CDC FACILITIES
COVID-19 SCREENING, AVAILABLE AT HTTPS://WWW.CDC.GOV/SCREENING/PAPER-
VERSION.PDF TO ASSESS RISK.  TEST ALL CLOSE CONTACTS OF CONFIRMED OR
PROBABLE COVID-19 PATIENTS. PEOPLE WHO HAVE PREVIOUSLY TESTED POSITIVE
FOR COVID-19 DO NOT NEED TO QUARANTINE OR GET TESTED AGAIN FOR 3 MONTHS
(DUE TO VIRAL SHEDDING), BUT MUST CONTINUE PHYSICAL DISTANCING AND
CLOTH FACE COVERING USE.  IAW CDC GUIDANCE ALL IMMUNIZED PERSONNEL
(GREATER THAN TWO WEEKS AFTER FINAL DOSE OF VACCINE) WHO RECEIVED THEIR
 LAST DOSE WITHIN THE PAST THREE MONTHS AND HAVE REMAINED ASYMPTOMATIC
 DO NOT NEED TO QUARANTINE IF THEY ARE A CLOSE CONTACT, BUT MUST FOLLOW
STRICT HEALTH PROTECTION MEASURES. WHEN ADEQUATE SHIPBOARD QUARANTINE
CAPACITY IS EXHAUSTED, CONSIDER TRANSFERRING CLOSE CONTACTS TO UNITS
WITH REMAINING CAPACITY OR ASHORE, IF FEASIBLE AND MISSION ALLOWS.
IF QUARANTINE SPACE IS LIMITED, PRIORITIZE NON-IMMUNIZED INDIVIDUALS.

7.B.1.  [NEW] CLOSE CONTACTS WHO SUBSEQUENTLY TEST POSITIVE WILL BE
ISOLATED AND TREATED UNDER COVID-19 CASE PROTOCOLS.  CLOSE CONTACTS
ATTACHED TO OPERATIONAL UNITS MUST REMAIN IN QUARANTINE FOR 14 DAYS
EVEN IF THEY TEST NEGATIVE. SOME INDIVIDUALS MAY TEST NEGATIVE FOR
SEVERAL DAYS AFTER EXPOSURE AND IT MAY TAKE UP TO 14 DAYS TO BECOME
COVID-19 POSITIVE OR EXHIBIT SYMPTOMS.  IAW REF (E), COMMANDERS OF
CLOSE CONTACTS ATTACHED TO NON-OPERATIONAL UNITS AND STAFFS HAVE
THREE POSSIBLE QUARANTINE DURATIONS BASED ON WORK ENVIRONMENT AND
CIRCUMSTANCES OF CLOSE CONTACT: (1) QUARANTINE 14 DAYS (2) QUARANTINE
10 DAYS OR (3) QUARANTINE 7 DAYS WITH A NEGATIVE TEST ON OR AFTER DAY
5 FOLLOWING CLOSE CONTACT EXPOSURE.  QUARANTINE DURATIONS LESS THAN
14 DAYS INCREASE THE RISK OF POST QUARANTINE TRANSMISSION OF INFECTIONS.
FOLLOWING 7 OR 10 DAY QUARANTINE, INDIVIDUALS SHOULD WATCH FOR SYMPTOMS
UNTIL 14 DAYS AFTER EXPOSURE AND IMMEDIATELY SELF-ISOLATE IF THEY
DEVELOP SYMPTOMS.

7.B.2.  ASYMPTOMATIC INDIVIDUALS QUARANTINED DUE TO CLOSE CONTACT ARE
NOT CONSIDERED A PUI, PER PARAGRAPH 2.B.

7.B.3.  IF A CLOSE CONTACT BECOMES SYMPTOMATIC - FOLLOW PUI PROTOCOL.

7.B.4.  SPECIFIC TO NAVAL SPECIAL WARFARE INITIAL ACCESSIONS TRAINING
ONLY, INCLUSIVE OF THE SEAL/SWCC PIPELINES.  BOAT TEAMS WHO ARE CLOSE
CONTACTS OF A COVID-19 CASE MAY CONTINUE TO EXECUTE TRAINING AS A
 COHORT, PHYSICALLY DISTANCED FROM OTHER BOAT CREWS IAW A TRAINING
CONOPS APPROVED BY NAVSPECWARCOM.

7.C.  PROTOCOL FOR PUI.

7.C.1.  ISOLATE AND TEST ALL PUIS.

7.C.2.  IF TEST RESULT IS POSITIVE - CONTINUE ISOLATION AND FOLLOW
PARAGRAPH 7.D.  CONDUCT COVID-19 CONTACT TRACING PER PARAGRAPH 10.D.

7.C.3.  IF TEST RESULT IS NEGATIVE - CONTINUE TO ISOLATE AND FOLLOW
PARAGRAPH 7.D.  PROVIDE MEDICAL TREATMENT UNTIL CLINICALLY IMPROVED.
IF A KNOWN COVID-19 OUTBREAK IS OCCURRING, CONTINUE TO ISOLATE AND
FOLLOW PARAGRAPH 10.D.

7.C.4.  IF TEST RESULT IS NEGATIVE AND PUI DOES NOT IMPROVE -
CONTINUE TO ISOLATE AND FOLLOW PARAGRAPH 7.D. IF A KNOWN COVID-19
OUTBREAK IS OCCURRING, CONDUCT COVID-19 CONTACT TRACING PER
PARAGRAPH 10.D.

7.C.5.  IF NO TEST IS PERFORMED - CONTINUE TO ISOLATE.  MEDICALLY
SCREEN TWICE A DAY AT A MINIMUM AND, IF SYMPTOMS WORSEN, CONSULT
MEDICAL ISIC AND FLEET/TYCOM SURGEON REGARDING TRANSFER TO MEDICAL
TREATMENT FACILITY.  AT SEA, TRANSFER ASHORE IAW FLEET COMMANDERS
GUIDANCE.  FOLLOW PARAGRAPH 7.D.  IF A KNOWN OR SUSPECTED COVID-19
OUTBREAK IS OCCURRING, CONDUCT COVID-19 CONTACT TRACING PER
PARAGRAPH 10.D.

7.D.  RETURN TO WORK (RTW) GUIDANCE FOR COVID-19 CASES AND PUIS.

7.D.1.  OPERATIONAL UNITS. COVID-19 CASES AND PUIS MUST MEET ALL OF
THE FOLLOWING CRITERIA TO RTW: (1) AT LEAST 24 HOURS HAVE PASSED
SINCE RESOLUTION OF FEVER WITHOUT THE USE OF FEVER REDUCING
MEDICATION; (2) PROGRESSIVE IMPROVEMENT IN OTHER COVID-19 SYMPTOMS
AS DETERMINED BY A MEDICAL PROVIDER; AND (3) AT LEAST 14 DAYS HAVE
ELAPSED SINCE THE SYMPTOMS FIRST APPEARED OR SINCE THE DATE OF THE
FIRST POSITIVE RT-PCR TEST IF ASYMPTOMATIC.

7.D.2.  ALL OTHER UNITS AND STAFFS.  COVID-19 CASES AND PUIS MUST
MEET ALL OF THE FOLLOWING CRITERIA TO RTW: (1) AT LEAST 24 HOURS
HAVE PASSED SINCE RESOLUTION OF FEVER WITHOUT THE USE OF FEVER
REDUCING MEDICATION; (2) IMPROVEMENT IN OTHER COVID-19 SYMPTOMS;
AND (3) AT LEAST 10 DAYS HAVE ELAPSED SINCE THE SYMPTOMS FIRST
APPEARED OR RT-PCR TEST DATE IF ASYMPTOMATIC.

7.D.3.  FOR SEVERE CASES WHERE INDIVIDUALS REQUIRED HOSPITALIZATION,
EXTEND THE DURATION OF ISOLATION SUCH THAT RTW IS NO EARLIER THAN
DAY 21 (20 DAYS SINCE SYMPTOM ONSET) AS SOME PERSONS WITH SEVERE
COVID-19 ILLNESS MAY REMAIN INFECTIOUS FOR SLIGHTLY LONGER PERIODS
OF TIME.

7.D.4.  RETURN TO PHYSICAL EXERCISE.  THE RTW GUIDANCE IN 7.D.1
THROUGH 7.D.3 IS BASED ON RESOLUTION OF INFECTIVITY.  BASED ON
SEVERITY OF ILLNESS, SOME PERSONNEL MAY REQUIRE TIME TO GRADUALLY
RETURN TO INTENSE EXERCISE. REF (H) CONTAINS RETURN TO EXERCISE
RECOMMENDATIONS.

7.D.5.  NCC MAY ELECT TO TREAT CRITICAL OPERATIONAL ENABLERS, SUCH
 AS INSPECTION AND CERTIFICATION TEAMS, AS OPERATIONAL UNITS PER
PARA. 7.D.1.

7.D.6.  A TEST-BASED STRATEGY IS NO LONGER RECOMMENDED TO DETERMINE
 RTW BECAUSE IN THE MAJORITY OF CASES IT RESULTS IN IDENTIFYING THOSE
 WHO CONTINUE TO SHED DETECTABLE SARS-COV-2 RNA BUT ARE NO LONGER
INFECTIOUS.  A COMBINATION OF BOTH SYMPTOM RESOLUTION AND TESTING
CRITERIA IS NOT RECOMMENDED AS IT WILL LIKELY EXTEND RTW WITH NO
CORRESPONDING DECREASE OF INFECTION TRANSMISSION.

7.D.7.  COVID LIKE ILLNESS (CLI)/INFLUENZA LIKE ILLNESS (ILI).
INDIVIDUALS WITH ILI OR CLI SHOULD BE EVALUATED BY A PROVIDER AND
IN THE CONTEXT OF IMMUNIZATION SHOULD BE DIRECTED TO THE APPROPRIATE
ISOLATION, QUARANTINE, OR SICK-IN-QUARTERS RECOMMENDATION.

7.D.7.A.  A PATIENT WITH SUSPECTED CLI/ILI WHO HAS TESTED NEGATIVE
FOR COVID-19 MAY RETURN TO WORK AFTER THE FOLLOWING CRITERIA HAVE
BEEN MET: (1) AT LEAST 24 HOURS AFTER THE RESOLUTION OF FEVER WITHOUT
THE USE OF FEVER REDUCING MEDICATION; (2) IMPROVEMENT IN SYMPTOMS AND
(3) AT LEAST 10 DAYS SINCE THE ONSET OF SYMPTOMS.

7.D.7.B.  THE SYMPTOMS OF ILI (THE FLU) ARE SIMILAR TO CLI SYMPTOMS,
AND THE ABSENCE OF COVID-SPECIFIC SYMPTOMS, OR TESTING POSITIVE FOR
ANOTHER ILLNESS SUCH AS INFLUENZA, DOES NOT ELIMINATE THE POSSIBILITY
F COVID INFECTION.  THE RISK OF COVID AND ILI CO-INFECTION EXISTS
AND THE CDC RECOMMENDS EXECUTING THE FULL COVID ISOLATION PERIOD FOR
ALL SYMPTOMATIC INDIVIDUALS, EVEN WHEN TESTING NEGATIVE FOR COVID-19.
THEREFORE, RETURN TO WORK CRITERIA FOR ILI AND CLI ARE THE SAME.  A
NCC WITH MEDICAL CONCURRENCE MAY, WHEN REQUIRED BY OPERATIONAL
DEMANDS, REDUCE THE RETURN TO WORK DURATION OF SUSPECTED FLU WITH A
NEGATIVE COVID TEST TO 24 HOURS AFTER RESOLUTION OF FEVER WITHOUT THE
USE OF FEVER REDUCING MEDICATION, IMPROVEMENT IN SYMPTOMS AND 7 DAYS
(VICE 10) SINCE ONSET OF SYMPTOMS.  A NCC WITH MEDICAL CONCURRENCE MAY
RETURN AN IMMUNIZED INDIVIDUAL TO WORK WITH A NEGATIVE COVID TEST.
THESE ARE NCC RISK DECISIONS THAT SHOULD BE MADE ONLY UNDER OPERATIONAL
NECESSITY.

7.E.  COVID-19 CASES MAY CONTINUE TO TEST POSITIVE FOR UP TO THREE
MONTHS DUE TO THE PRESENCE OF PERSISTENT NON-INFECTIOUS VIRAL FRAGMENTS.
THEREFORE, COVID-19 CASES ARE EXEMPT FROM ANY REQUIRED TESTING PROTOCOL
FOR THREE MONTHS FOLLOWING ANY POSITIVE TEST.  INDIVIDUALS THAT EXHIBIT
NEW OR PERSISTENT SYMPTOMS DURING THAT THREE MONTH PERIOD SHOULD BE
EVALUATED BY A MEDICAL PROVIDER.  STUDIES HAVE NOT FOUND EVIDENCE THAT
CLINICALLY RECOVERED PERSONS WITH PERSISTENCE OF VIRAL RNA HAVE
TRANSMITTED COVID-19 TO OTHERS.

7.E.1.  RECOVERED PERSONS MUST CONTINUE TO WEAR CLOTH FACE COVERINGS
AND SOCIAL DISTANCE INFECTION PRECAUTIONS MUST CONTINUE TO BE TAKEN
AFTER RTW IS APPROVED.

7.F.  ANTIBODY TESTING AND VIRAL CULTURE.  ANTIBODY TESTING OR VIRAL
CULTURE SHOULD NOT BE USED AS A PRIMARY OR STAND-ALONE RETURN TO WORK
CRITERION.  HOWEVER, IF EITHER HAVE BEEN OBTAINED DURING A COVID CASE
CLINICAL EVALUATION, RESULTS MAY BE USED AS SUPPLEMENTAL CRITERIA FOR
PARTICULARLY CHALLENGING CASES OR FOR PUBLIC HEALTH OUTBREAK
MANAGEMENT PURPOSES.

7.G.  COMMAND AND MEMBER NOTIFICATION.  THE INDIVIDUAL SICK SLIP
(DD FORM 689) MUST BE USED TO NOTIFY BOTH THE MEMBER AND THE CHAIN OF
COMMAND OF ANY TEST-CONFIRMED OR PRESUMPTIVE COVID ILLNESS, WHETHER
SYMPTOMATIC OR NOT.  SECTION 11 (DISPOSITION) AND SECTION 12 (REMARKS)
MUST CLEARLY INDICATE THE MEDICALLY-RECOMMENDED DISPOSITION, FOLLOW UP,
AND QUARANTINE/ISOLATION REQUIREMENTS IN ACCORDANCE WITH THIS GUIDANCE.
THE SICK SLIP MUST ALSO BE USED TO NOTIFY ASYMPTOMATIC MEMBERS AND THE
CHAIN OF COMMAND OF ANY PUI OR CLOSE CONTACT, QUARANTINE, OR ISOLATION
REQUIREMENTS IN ACCORDANCE WITH THIS GUIDANCE.  BEGINNING AND ENDING
DATES OF THE QUARANTINE/ISOLATION PERIOD, SYMPTOM-FREE REQUIREMENTS,
AND MEDICAL FOLLOW UP MUST BE CLEARLY INDICATED IN SECTION 12
(REMARKS).

8.  UNDERWAY TESTING.

8.A.  [MOD] UNDERWAY OPERATIONS SHOULD CONTINUOUSLY ASSESS THE
INTEGRITY OF A BUBBLE THROUGH CLI/ILI SCREENING OF NON-IMMUNIZED
PERSONNEL. FOR PLATFORMS WITH EXPANDED TESTING CAPABILITY, TESTING
STRATEGIES MAY BE EMPLOYED AS PART OF THE HEALTH PROTECTION MEASURES
IN 1.C.1 THROUGH 10, TO INCLUDE SYMPTOMATIC TESTING (DIAGNOSTIC)
FOR EVERYONE AND TARGETED CREW TESTING (SCREENING) FOR NON-IMMUNIZED
SAILORS.

8.B.  [MOD] OPERATIONS, ACTIVITIES, AND ENGAGEMENTS DURING DEPLOYMENT
MAY NOT ALLOW FOR PERSONNEL TO COMPLETE A 14-DAY ROM/SEQUESTRATION
PRIOR TO EMBARKING/RE-EMBARKING A SHIP.  COVID-19 SCREENING TESTING
OF NON-IMMUNIZED OPERATIONALLY AT-RISK PERSONNEL AND MISSION CRITICAL
POPULATIONS MAY DETECT COVID-19 INFECTIONS EARLY AND PRESERVE MISSION
EFFECTIVENESS.

8.B.1.  [MOD] OPERATIONALLY AT-RISK PERSONNEL, SUCH AS AIR CREW AND
INDIVIDUALS ASHORE IN A COUNTRY WITH ACTIVE COVID-19 INFECTIONS, ARE
AT THE GREATEST RISK OF EXPOSURE TO THE VIRUS.  IF NOT IMMUNIZED,
QUARANTINE THESE GROUPS FROM THE REMAINING CREW WHEN RE-ENTERING THE
BUBBLE, INCREASE MEDICAL SCREENING AND SELF-MONITORING EFFORTS AND
WHEN AVAILABLE, TEST THESE INDIVIDUALS INTO AND OUT OF THE 14-DAY
QUARANTINE, EFFECTIVELY CONDUCTING ROM-SEQUESTER AND SCREENING TESTING
ONBOARD FOR NON-IMMUNIZED SAILORS.

8.B.2.  [MOD] COVID-19 INFECTION IN PERSONNEL WHO ARE CONSIDERED
MISSION CRITICAL, SUCH AS CRITICAL CARETAKER CREW, AIR OPERATIONS
CREW, AND REACTOR PERSONNEL, MAY DEGRADE OPERATIONS AND IMPACT THE
MISSION.  PRIORITIZE IMMUNIZATION FOR THESE INDIVIDUALS.  WHEN THERE
IS A RISK OF INFECTION ONBOARD, PRIORITIZE MISSION CRITICAL NON-
IMMUNIZED CREW MEMBERS IN AN AFLOAT TESTING STRATEGY.

8.B.3.  [MOD] WIDESPREAD IMMUNIZATION IS THE ONLY SUBSTITUTE FOR AN
EFFECTIVE TEST-ROM SEQUESTER-TEST STRATEGY PROCESS TO ESTABLISH AND
MAINTAIN THE BUBBLE.  DURING UNDERWAY OPERATIONS, BRIEF STOPS FOR
PERSONNEL (BSP) OR EMBARKING PERSONNEL FROM FOREIGN PORTS MAY PRECLUDE
THE ABILITY TO COMPLETE A 14-DAY ROM-SEQUESTER.  IF NOT IMMUNIZED,
QUARANTINE THESE PERSONNEL FROM THE REMAINING CREW MEMBERS FOR AT LEAST
14 DAYS, INCREASE MEDICAL SCREENING AND SELF-MONITORING EFFORTS, AND,
WHEN AVAILABLE, TEST THESE INDIVIDUALS INTO AND OUT OF THE 14-DAY
QUARANTINE.   IAW CDC GUIDANCE ALL IMMUNIZED PERSONNEL (GREATER THAN
TWO WEEKS AFTER FINAL DOSE OF VACCINE) WHO RECEIVED THEIR LAST DOSE
WITHIN THE PAST THREE MONTHS AND HAVE REMAINED ASYMPTOMATIC DO NOT
NEED TO QUARANTINE IF THEY ARE A CLOSE CONTACT, BUT MUST FOLLOW STRICT
HEALTH PROTECTION MEASURES.

8.C.  POOLED TESTING UNDERWAY.  POOLED TESTING UNDERWAY WILL ONLY BE
CONDUCTED IN DIRECT COORDINATION WITH NAVAL HEALTH RESEARCH CENTER AND
REQUIRES NOTIFICATION OF BUMED SURGEON GENERAL OR DEPUTY SURGEON
GENERALS OFFICE BY THE FLEET SURGEON.

8.D.  [MOD] FLU AND COVID-19 VACCINE.

8.D.1.  [MOD] RECEIVING ANY VACCINE MAY CAUSE SOME SYMPTOMS SIMILAR
TO COVID-19.

8.D.1.A.  [MOD] POSSIBLE FLU OR COVID-19 VACCINE SYMPTOMS MAY INCLUDE
 MYALGIA, MILD FEVER, CHILLS AND INJECTION SITE SORENESS.

8.D.1.B.  [MOD] IF INDIVIDUAL RECEIVES THE FLU OR COVID-19 VACCINE AND
EXPERIENCES SYMPTOMS BEYOND 72 HOURS OR SYMPTOMS NOT CONSISTENT WITH
THE FLU VACCINE (SUCH AS LOSS OF TASTE OR SMELL, SORE THROAT, CHEST
PAIN, TEMPERATURE GREATER THAN 101, OR COUGH), THEY SHOULD BE EVALUATED
BY A HEALTHCARE PROVIDER.  MAXIMAL PROTECTION IS ONLY PROVIDED
APPROXIMATELY 14 DAYS AFTER COMPLETION OF THE SERIES.  IT IS STILL
POSSIBLE TO CONTRACT THE VIRUS AFTER THE FIRST OR SECOND DOSE OF
COVID-19 VACCINE.

8.D.1.C.  [NEW] CO-INFECTION WITH COVID-19 AND INFLUENZA IS OCCURRING.
UNLIKE THE COVID-19 VACCINE, THE INFLUENZA VACCINE IS A READINESS
REQUIREMENT.  EFFORTS MUST BE MADE TO ENSURE THAT ALL INDIVIDUALS
RECEIVE THE INFLUENZA VACCINATION.

9.  POST-DEPLOYMENT AND REDEPLOYMENT.

9.A.  [MOD] MILITARY MEMBERS RETURNING TO CONUS FROM DEPLOYMENT WILL
COMPLETE A 14-DAY ROM AT HOME STATION.  MEMBERS RETURNING VIA SHIP OR
MILAIR WITH NO ACTIVE COVID-19 CASES WITHIN THEIR UNIT IN THE LAST 14
DAYS, MAY COUNT TRANSIT TIME (BEGINNING ON THE DAY OF DEPARTURE FROM
THE LAST PORT OR AIRFIELD) TOWARD THE ROM REQUIREMENT.  SERVICE MEMBERS
ON POST-DEPLOYMENT ROM ARE RESTRICTED TO THEIR PERSONAL RESIDENCE OR
OTHER APPROPRIATE DOMICILE AND MUST LIMIT CLOSE CONTACTS.  IMMUNIZED
INDIVIDUALS HAVE NO POST-DEPLOYMENT ROM REQUIREMENTS BUT MUST LIMIT
CLOSE INTERACTIONS AND FOLLOW STRICT HEALTH PROTECTION MEASURES IAW
CDC GUIDANCE.

9.B.  REDEPLOYING INDIVIDUALS MUST BE SCREENED AT THE ASSIGNED PLACE
OF DUTY OR POINT OF EMBARKATION.  AT A MINIMUM, SCREENING WILL CONSIST
 OF COVID-19 QUESTIONNAIRE, ASSESSMENT OF EXPOSURE HISTORY, TEMPERATURE
 CHECK, CHECK FOR COVID-19 SIGNS AND SYMPTOMS LISTED IN PARAGRAPH 2.E.,
 AND REVIEW OF ANY PAST COVID-19 TESTING.

9.C.  AT THE COMPLETION OF DEPLOYMENT, ALL PERSONNEL WILL COMPLETE A
POST-DEPLOYMENT HEALTH ASSESSMENT (DD FORM 2796) AND POST-DEPLOYMENT
HEALTH REASSESSMENT (DD FORM 2900) IN ACCORDANCE WITH REF (F).

9.D.  ALL COVID-19 DIAGNOSTIC TESTS AND VACCINATIONS MUST BE ENTERED
IN THE MEDICAL RECORD.  SCREENING AND SURVEILLANCE TESTS THAT ARE
INDIVIDUALLY IDENTIFIABLE MUST BE ENTERED INTO THE MEDICAL RECORD.

10.  OUTBREAK INVESTIGATION AND CONTACT TRACING WORKFORCE TRAINING.

10.A.  RAPID AND THOROUGH CONTACT TRACING MINIMIZES OUTBREAKS AND IS
CRITICAL TO MISSION SUCCESS.  BELOW IS A TOOLKIT TO ASSIST WITH THE
INVESTIGATION OF CASES OR AN OUTBREAK OF COVID-19 AND CONTAINS LINKS
TO CONTACT TRACING TRAINING.  THIS INFORMATION CAN BE USED BY MEDICAL
AND NON-MEDICAL PERSONNEL TO WORK TOGETHER TO STOP THE SPREAD OF
COVID-19.

10.B.  ALL UNITS WILL TRAIN A MINIMUM OF TWO PERSONNEL FOR EVERY 100
PERSONNEL AT THEIR COMMAND.  COMMANDS OF MORE THAN 500 PERSONNEL MUST
TRAIN AT LEAST 10 PEOPLE.  SMALL UNITS MUST TRAIN A MINIMUM OF TWO
INDIVIDUALS.  MSC TRAIN CONTACT TRACERS FOR MSC VESSELS IN ACCORDANCE
WITH EXISTING MSC INSTRUCTIONS AND CONTRACTS.

10.C.  THE FOLLOWING COMPRISES THE CONTACT TRACING TRAINING:

10.C.1.  NAVY VIDEO ON CONTACT TRACING AT: HTTPS://WWW.MILSUITE.MIL
AND SEARCH FOR VIDEO 29421.

10.C.2.  JOINT KNOWLEDGE ONLINE (JKO) COURSE HIPAA AND PRIVACY ACT
TRAINING COURSE NUMBER DHA-US001 HIPAA AND PRIVACY ACT TRAINING ON
JKO AT HTTPS://JKO.JTEN.MIL/ (1.5 HOURS).  THE HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) WAS INSTITUTED TO
PROTECT THE PRIVACY AND SECURITY OF CERTAIN HEALTH INFORMATION.

10.C.3.  [NEW] ONLINE COVID-19 CONTACT TRACING IS AVAILABLE THROUGH
NAVY E-LEARNING.  COURSE IS TITLED CONTACT TRACING FOR SAILORS AND
MARINES [CFHP-NMFSC-CTSM-01].

10.C.4.  IF UNDERWAY OR DO NOT HAVE INTERNET BANDWIDTH TO COMPLETE
ONLINE TRAINING, A POWERPOINT VERSION OF CONTACT TRACING TRAINING CAN
BE ACCESSED AT: HTTPS://ESPORTAL.MED.NAVY.MIL/SITES/NMCPHC/PPS/WPPC19/
COVID-19_CONTACT_TRACING_TRAINING.ASPX.

10.C.5.  AFTER FINISHING THE TRAINING, THE TRAINED MEMBER WILL CONTACT
THE PUBLIC HEALTH OFFICER AT THE NEAREST NAVY MEDICINE READINESS AND
TRAINING COMMAND (NAVMEDREADTRNCMD), OR THE COMMAND LOCAL MEDICAL
PERSONNEL IF ASSOCIATED WITH A NAVMEDREADTRNCMD/OPERATIONAL UNIT, TO
IDENTIFY A MENTOR FOR QUESTIONS, GUIDE ACTIVITIES RELATED TO CONTACT
TRACING, AND ENSURE COMPLIANCE WITH RELEVANT MEDICAL AUTHORITY (E.G.,
COMUSFLTFORCOM SURGEON, COMPACFLT SURGEON, OR COMNAVSPECWARCOM SURGEON)
GUIDANCE AND PROCEDURES WITH RESPECT TO CONTACT TRACING.  THE RELEVANT
MEDICAL AUTHORITY AND FACILITY MAY HAVE SPECIFIC FORMS OR PROCEDURES
THAT ARE UNIQUE TO THEIR ENVIRONMENT.  IT IS IMPORTANT THAT CONTACT
TRACING BE A COORDINATED EFFORT BETWEEN THE TRAINED MEMBER AND THE
LOCAL NAVMEDREADTRNCMD PUBLIC HEALTH OFFICE WHEN IN GARRISON OR THE
COGNIZANT TYCOM FOR OPERATIONAL UNITS.  ADDITIONALLY, TIMELY ENGAGEMENT
 OF THE ASSOCIATED NAVY AND ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT
(NEPMU) IS RECOMMENDED FOR AN EFFECTIVE RESPONSE TO A LARGE OUTBREAK.

10.D.  THE FOLLOWING IS THE COVID-19 CASE INVESTIGATION CHECKLIST
(APPLIES TO ALL CLINICALLY SUSPECTED OR CONFIRMED CASES).

10.D.1.  IMMEDIATE STEPS:
   (1) IMPLEMENT APPROPRIATE CONTROL MEASURES.
   (2) SEPARATE THE CASE FROM OTHER PERSONNEL.
   (3) PLACE THE CASE IN ISOLATION (AS SOON AS POSSIBLE).
   (4) FOR SHIPS THAT ARE PIER-SIDE, ONCE MEDICAL EVALUATION AND
DISPOSITION HAS OCCURRED, ISOLATE CASES OFF OF THE SHIP WHENEVER
POSSIBLE.
   (5) FOR SHIPS THAT ARE UNDERWAY, ISOLATE CASES IN DESIGNATED
SPACES, CONSISTENT WITH TYCOM/FLEET/COMMAND DIRECTION AND FLEET
 COMMANDER PUBLISHED COVID UNDERWAY GUIDANCE SOP.

10.D.2.  WEAR APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT (PPE) AS
DIRECTED BY YOUR LOCAL MEDICAL AUTHORITY DURING ALL FACE-TO-FACE
INTERACTION WITH THE CASE.  COVID-19 SPECIFIC PPE INCLUDES (WHEN
AVAILABLE) GOWN, GLOVES, NIOSH-CERTIFIED DISPOSABLE N95 RESPIRATOR,
AND EYE PROTECTION.  CFCS CAN BE USED IF MAINTAINING APPROPRIATE
SOCIAL DISTANCING RECOMMENDATIONS.

10.D.3.  NOTIFY CHAIN OF COMMAND.

10.D.4.  NOTIFY SENIOR MEDICAL DEPARTMENT REPRESENTATIVE, DEPARTMENT
OF DEFENSE (DOD) PREVENTIVE MEDICINE AUTHORITY, AND LOCAL CIVILIAN
HEALTH DEPARTMENT (IF APPLICABLE) OF ANY CONFIRMED COVID-19 CASE.

10.D.5.  IF THE CASE(S) HAS BEEN ONBOARD THE SHIP DURING THE
INFECTIOUS PERIOD (48 HOURS BEFORE SYMPTOM ONSET OR POSITIVE LAB UP
TO THE TIME OF ISOLATION), ALL AREAS VISITED (WORKSPACE, HEADS,
BERTHING, GYMS, ETC.) SHOULD BE CLOSED OFF IN ORDER TO MINIMIZE POTENTIAL
EXPOSURE TO AEROSOLIZED VIRUS.  WAIT 24 HOURS (OR AS LONG AS PRACTICAL)
FROM THE TIME THE CASE WAS LAST PRESENT IN SPACES BEFORE REENTERING
THOSE AREAS TO CLEAN AND DISINFECT.

10.D.6.  BEGIN A CASE INVESTIGATION AS SOON AS A PERSON PRESENTS WITH
COVID-19 LIKE ILLNESS (PUI).  INTERVIEW THE CASE(S) OR PUI(S) AND
REVIEW MEDICAL RECORDS (IF APPLICABLE) TO ASSESS VALIDITY OF THE
DIAGNOSIS AND DETERMINE FOLLOW-UP RESPONSE MEASURES.
   (1) IF DETERMINED NOT TO BE VALID, RESPONSE STOPS. CLOSED-OFF AREAS
MAY BE RE-OPENED.
   (2) IF DETERMINED TO BE A VALID CLINICALLY-SUSPECTED OR CONFIRMED
CASE, PROCEED.

10.D.7.  CONDUCT A DETAILED CASE INTERVIEW.  AS SOON AS POSSIBLE
(IDEALLY WHEN CASE PRESENTS TO MEDICAL OR WITHIN 24 HOURS), COMPLETE
THE CASE INTERVIEW AND CONTACT TRACING FORM AND CONTACT LIST FOR EACH
CASE. KEY ASPECTS OF THE CASE INTERVIEW INCLUDE:
   (1) ANY KNOWN HIGH-RISK EXPOSURE THAT THE CASE HAD (E.G., TRAVEL,
CONTACT WITH A CONFIRMED COVID-19 CASE), AND TIMELINE OF EXPOSURE.
   (2) SYMPTOM HISTORY (INCLUDING EXACT DATE OF ONSET OF ANY SYMPTOMS
AND LIST OF SYMPTOMS).
   (3) LIST OF ALL POSSIBLE CLOSE CONTACTS (PER DEFINITION ABOVE) WHO
WERE EXPOSED TO THE CASE BETWEEN 48 HOURS PRIOR TO ONSET OF SYMPTOMS
AND THE TIME HE/SHE WAS ISOLATED, OR 48 HOURS PRIOR TO A POSITIVE TEST
IF THE CASE IS ASYMPTOMATIC.  CONTACTS OF CONTACTS ARE NOT CONSIDERED
EXPOSED TO COVID-19.  THERE IS NO REQUIREMENT TO MONITOR OR QUARANTINE
CONTACTS OF CONTACTS, UNLESS THE INITIAL CONTACT LATER DEVELOPS
SYMPTOMS AND BECOMES A CASE.
   (4) DATE OF ISOLATION.  ENSURE NO CONTINUED EXPOSURES ARE OCCURRING,
ESPECIALLY WITH HOUSEHOLD CONTACTS.

10.D.8.  [MOD] QUARANTINE ALL CLOSE CONTACTS AS SOON AS POSSIBLE AFTER
EXPOSURE TO THE CASE HAS BEEN VERIFIED.  PEOPLE WHO HAVE PREVIOUSLY
TESTED POSITIVE FOR COVID-19 DO NOT NEED TO QUARANTINE FOR UP TO 3 MONTHS
AS LONG AS THEY DO NOT DEVELOP SYMPTOMS AGAIN.  IAW CDC GUIDANCE ALL
IMMUNIZED PERSONNEL (GREATER THAN TWO WEEKS AFTER FINAL DOSE OF VACCINE)
WHO RECEIVED THEIR LAST DOSE WITHIN THE PAST THREE MONTHS AND HAVE REMAINED
ASYMPTOMATIC DO NOT NEED TO QUARANTINE IF THEY ARE A CLOSE CONTACT, BUT
MUST FOLLOW STRICT HEALTH PROTECTION MEASURES.

10.D.9.  IF INDICATED, COLLECT AND SHIP LABORATORY SPECIMENS TO THE
APPROPRIATE DOD, COMMERCIAL, OR PUBLIC HEALTH LABORATORY CERTIFIED TO
PERFORM COVID-19 TESTING (CHOSEN LAB AND SHIPPING PROCEDURES WILL BE
DETERMINED BY LOCAL PROTOCOLS).  DOCUMENT TEST RESULTS FOR ANY OTHER
RESPIRATORY PATHOGENS (E.G. RAPID FLU, RESPIRATORY PANEL).
   (1) FOR SHORE-BASED UNITS OR SHIPS THAT ARE PIER-SIDE IN HOMEPORT,
FOLLOW SUPPORTING MILITARY TREATMENT FACILITY (MTF) OR LOCAL CIVILIAN
PROCEDURES FOR COVID-19 TESTING.
   (2) FOR SHIPS THAT ARE UNDERWAY, SHIP CAPABILITIES AND FLEET POLICIES
WILL DETERMINE TESTING PRACTICES. EVERY EFFORT SHOULD BE MADE TO TEST
AND CONFIRM THE PATHOGEN IF AN OUTBREAK IS SUSPECTED.

11.  ADDITIONAL ROM AND MEDICAL SCREENING CONSIDERATIONS.

11.A.  CIVILIAN EMPLOYEES.  COMMANDERS MUST ENSURE ROM AND MEDICAL
SCREENING GUIDANCE GIVEN TO DOD CIVILIAN EMPLOYEES CAN BE APPLIED
CONSISTENT WITH APPLICABLE CIVILIAN PERSONNEL LAW, REGULATION, AND
POLICY.  COMMANDERS SHOULD CONSIDER TELEWORK, OR AS A LAST RESORT,
WEATHER AND SAFETY LEAVE AS OPTIONS TO FACILITATE DOD CIVILIAN
COMPLETION OF ROM.  COMMANDERS ARE ENCOURAGED TO CONSULT THEIR
SERVICING OGC COUNSEL, STAFF JUDGE ADVOCATES, AND/OR HUMAN RESOURCE
OFFICE FOR CASE-SPECIFIC GUIDANCE.

11.B.  CONTRACTOR PERSONNEL.  THIS GUIDANCE DOES NOT ALTER, MODIFY,
OR CHANGE THE TERMS AND CONDITIONS OF ANY DOD CONTRACT.  COMMANDERS
MUST ENSURE ROM AND MEDICAL SCREENING GUIDANCE GIVEN TO DOD
CONTRACTOR PERSONNEL CAN BE APPLIED CONSISTENT WITH THE PERTINENT
CONTRACT AND APPLICABLE PROCUREMENT LAW, REGULATION, AND POLICY.
COMMANDERS ARE ENCOURAGED TO CONSULT THEIR SERVICING OGC COUNSEL,
STAFF JUDGE ADVOCATES, AND/OR CONTRACTING PERSONNEL FOR CASE-SPECIFIC
 GUIDANCE.  ONLY WARRANTED CONTRACTING OFFICERS CAN ALTER TERMS AND
CONDITIONS OF A DOD CONTRACT, INCLUDING PROVISIONS FOR PAYMENT OF
COSTS ASSOCIATED WITH DOD CONTRACTOR ROM.

12.  [NEW] COVID-19 VACCINATION AND IMMUNIZATION.

12.A.  [NEW] WIDESPREAD IMMUNIZATION.  ALTHOUGH COVID-19 VACCINES
ARE AVAILABLE AND BEING WIDELY ADMINISTERED THROUGHOUT THE NAVY IAW
THE DOD PRIORITIZATION SCHEMA, IT WILL TAKE TIME TO ACHIEVE
WIDESPREAD FORCE AND NATION IMMUNIZATION.  SOME COVID VACCINES
DEMONSTRATED A HIGH LEVEL OF EFFICACY (95%) DURING CLINICAL TRIALS
AND REDUCE INDIVIDUAL RISK FROM THE DISEASE AND HOSPITALIZATION RELATED
TO COVID INFECTION.  THEY HAVE MET RIGOROUS SAFETY CRITERIA AND
INDIVIDUALS ARE HIGHLY ENCOURAGED TO GET THE VACCINE TO PROTECT
THEMSELVES, THEIR SHIPMATES AND THEIR FAMILY.  AN INDIVIDUAL DOES NOT
ACHIEVE IMMUNITY IMMEDIATELY AND RESEARCH IS ONGOING TO UNDERSTAND
WHEN PEAK IMMUNITY OCCURS AND HOW LONG IT LASTS.  THE CDC WEB SITE IS
THE BEST SOURCE OF CURRENT INFORMATION REGARDING VACCINES.

12.B.  [NEW] SAFE HAVEN PORTS.  NCCS MAY ALLOW IMMUNIZED INDIVIDUALS
ON UNITS MAKING PORT CALLS IN OVERSEAS SAFE HAVEN PORTS WHERE THERE
IS U.S. PRESENCE AND BASE FACILITIES (E.G. GUAM, BAHRAIN, YOKOSUKA,
ROTA, SASEBO, ETC.) TO TAKE ADVANTAGE OF BASE SERVICES.  COMMANDERS
SHOULD TAKE INTO ACCOUNT A PORTS PREVALENCE OF COVID-19 AND UTILIZE
BEST AVAILABLE MEDICAL DATA WHEN DETERMINING HEALTH PROTECTION
STRATEGY FOR THOSE WHO ARE NOT IMMUNIZED.

12.C.  [NEW] SECOND DOSE VACCINATION TIMING.  CURRENT COVID-19
VACCINATIONS ARE TWO DOSE SERIES.  THE SECOND DOSE SHOULD BE
ADMINISTERED AS CLOSE TO THE EUA RECOMMENDED INTERVAL AS POSSIBLE
(DAY 21 FOR PFIZER AND DAY 28 FOR MODERNA).  TO SUPPORT PLANNING
FLEXIBILITY THE SECOND DOSE MAY BE ADMINISTERED WITHIN 4 DAYS PRIOR
AND 7 DAYS AFTER THE RECOMMENDED INTERVAL.  IF IT IS NOT FEASIBLE TO
ADHERE TO THE RECOMMENDED INTERVAL DUE TO EXTENUATING CIRCUMSTANCES,
THE SECOND DOSE MAY BE ADMINISTERED UP TO 42 DAYS AFTER THE FIRST
DOSE.  WHEN ADMINISTERING TO BOTH FIRST DOSE AND SECOND DOSE RECIPIENTS
ON THE SAME DAY, COMPLETING THE SECOND DOSE SHOULD IDEALLY TAKE
PRIORITY OVER ADMINISTERING FIRST DOSE BASED ON VACCINE AVAILABILITY.
COMMANDERS MUST ENSURE SECOND DOSE TIMING IS PLANNED AND OPERATIONAL
COMMITMENTS SUPPORT INITIATING THE VACCINE SEQUENCE.  INDIVIDUALS
SHOULD PLAN TO RECEIVE THE VACCINE SEQUENCE AT THE SAME MTF TO EASE
LOGISTICS.

12.D.  [NEW] READINESS VACCINATION PRIORITY.  CURRENTLY, COVID-19
IMMUNIZATION IS NOT A READINESS REQUIREMENT AND UNTIL THESE VACCINES
ARE LICENSED OR THE PRESIDENT MANDATES, RECEIPT OF THE COVID-19 VACCINE
WILL NOT BE CONSIDERED A READINESS REQUIREMENT.  IN THIS CONTEXT,
VACCINES THAT ARE REQUIRED FOR READINESS (E.G., FLU VACCINE) ARE
CONSIDERED PRIORITY FOR INDIVIDUAL VACCINATIONS.  IN CONSIDERING
TIMING OF COVID-19 VACCINATIONS AND READINESS REQUIRED VACCINES, THE
READINESS VACCINE WILL TAKE PRIORITY.

12.E.  [NEW] CONTRACTOR VACCINATION.  CONTRACTORS WHO ARE NOT NORMALLY
OFFERED INFLUENZA VACCINES THROUGH A LOCAL MTF, BUT WHO ARE IDENTIFIED
BY THEIR COMMANDERS AS PROVIDING CRITICAL MISSION ESSENTIAL FUNCTIONS
ON DOD INSTALLATIONS OR IN AN OPERATIONAL ENVIRONMENT, AND WHO ARE
APPROVED BY THE FIRST FLAG OR SES IN THEIR CHAIN OF COMMAND MAY BE
OFFERED VACCINATION.

12.F.  [NEW] OTHER REQUIREMENTS.  VACCINE ADMINISTRATION, REPORTING,
AND GOALS ARE OUTLINED IN REF (R).

13.  [NEW] TESTING AND REPORTING REQUIREMENTS.

13.A.  [NEW] THE DOD COVID-19 TASK FORCE  DIAGNOSTICS AND TESTING
LINE OF EFFORT (CVTF-D&T) IS RESPONSIBLE FOR MAINTAINING THE COVID-19
LABORATORY TESTING COMMON OPERATING PICTURE (COP) TO ENSURE CLINICAL
TESTING CAPABILITIES AND MITIGATE RISK TO MISSION.  CVTF-D&T PROVIDES
ASSISTANCE TO THE SERVICES AND COMBATANT COMMANDS IN PRIORITIZATION AND
ALLOCATION OF LIMITED COVID-19 TESTING INSTRUMENTS, TEST KITS, AND
ASSOCIATED TESTING SUPPLIES AS PER REF (N).

13.B.  [NEW] THE OPNAV COVID-19 CRISIS ACTION TEAM (CAT) CONSOLIDATES
SERVICE TESTING REQUIREMENTS FOR ALL NON-DIAGNOSTIC TESTING WITHIN THE
US NAVY AND REPORTS TO THE CVTF-D&T ON A WEEKLY BASIS.  ECHELON 2 AND
ECHELON 3 COMMANDERS CONSOLIDATE SUBMITTED REQUESTS FOR ALL SUBORDINATE
TESTING AND REPORTED COMPLETION OF PREVIOUSLY REQUESTED TESTING
REQUIREMENTS TO THE OPNAV COVID-19 CAT NO LATER THAN 1400R EACH THURSDAY.
REPORTING IS REQUIRED FOR ALL NON-DIAGNOSTIC TESTING, TO INCLUDE TESTING
PERFORMED ABOARD SHIP USING DEPLOYED EQUIPMENT.

13.C.  [NEW] UNITS SHALL MAINTAIN AND SUBMIT A ROLLING, 60-DAY FORECAST
FOR ASYMPTOMATIC TESTING.  ANY UNIT REQUESTING UNPLANNED TESTING WITHIN
THREE WEEKS OF THE EXECUTION DATE REQUIRES FIRST FLAG APPROVAL.
UNITS SHOULD COORDINATE SPECIFIC DETAILS OF TESTING EVOLUTIONS DIRECTLY
WITH THE TESTING FACILITY ASSIGNED BY THE CVTF-D&T.  DUE TO THE DYNAMIC
NATURE OF THIS PUBLIC HEALTH CRISIS, ASSIGNED TESTING FACILITIES MAY NOT
ALWAYS BE ABLE TO ACCOMMODATE REQUESTS, SO ANY UNIT WHO BECOMES AWARE OF
A CONFLICT SHOULD REPORT THE DISCREPANCY TO THE OPNAV COVID-19 CAT WHO
WILL WORK WITH THE CVTF-D&T TO ASSIGN AN ALTERNATE TESTING LOCATION.

13.D.  [NEW]  DUE TO AVAILABILITY LIMITATIONS FOR BIOFIRE TEST PANELS,
ALL DOD COMPONENT REQUESTS TO PURCHASE BIOFIRE TEST PANELS, INCLUDING
THOSE WITH EXISTING CONTRACTS WITH BIOFIRE, WILL SUBMIT NEW COVID-19
TESTING ACQUISITION REQUIREMENTS EXCLUSIVELY THROUGH THE DLA ECAT
PROCESS AS PER REF (O).

14.  [NEW] COMMUNITY OUTREACH GUIDANCE

14.A.  [NEW] REF (P) ESTABLISHES POLICY AND ANNUAL REQUIREMENTS FOR
NAVY COMMUNITY OUTREACH STAKEHOLDERS.  DOD HPCON LEVELS, AS WELL AS
GUIDELINES IMPOSED BY THE CDC AND LOCAL CIVILIAN AUTHORITIES,
CURRENTLY PREVENT THE EXECUTION OF THESE REQUIREMENTS.  COMMANDS ARE
ENCOURAGED, HOWEVER, TO USE EXISTING VIRTUAL IT PLATFORMS TO ENGAGE
WITH THE PUBLIC WHEN SOCIAL DISTANCING PROTOCOLS AND SIMILAR PUBLIC
HEALTH MEASURES RESTRICT FACE-TO-FACE ENGAGEMENTS.  NAVY OFFICE OF
COMMUNITY OUTREACH (NAVCO) IS STANDING BY TO ASSIST COMMANDS WITH
THESE EFFORTS.  (POC:  CDR JOHN FAGE. JOHN.E.FAGE@NAVY.MIL)

14.B.  [NEW] THE RESUMPTION OF IN-PERSON COMMUNITY ENGAGEMENT
REQUIREMENTS SPECIFIED IN REF (P), (PUBLIC TOURS; DISTINGUISHED
VISITORS EMBARKS; PORT VISITS; FLEET WEEKS; AIR SHOWS; ETC.) WILL
BE CONSIDERED BY COMMANDERS WHEN HPCON LEVELS AND CDC GUIDELINES
INDICATE COVID-19 NO LONGER THREATENS THE SAFETY AND READINESS OF
THE FORCE.

15.  RELEASED BY VADM P. G. SAWYER, DEPUTY CHIEF OF NAVAL OPERATIONS
FOR OPERATIONS, PLANS AND STRATEGY, OPNAV N3/N5.//

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