UNCLASSIFIED// ROUTINE R 251655Z JUN 20 MID510001339613U FM CNO WASHINGTON DC TO NAVADMIN INFO SECNAV WASHINGTON DC CNO WASHINGTON DC BT UNCLAS NAVADMIN 178/20 PASS TO OFFICE CODES: INFO SECNAV WASHINGTON DC//CNO// MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/JUN// SUBJ/COVID-19 TESTING// REF/A/MEMO/OSD/18MAY20// REF/B/MSG/172057ZZJUN20// REF/C/MEMO/OSD/11JUN20// REF/D/MEMO/OSD/11JUN20// REF/E/MSG/201856ZMAY20// NARR/REF A IS DOD COVID-19 TASK FORCE MEMORANDUM, TESTING AND REPORTING OF DOD COVID-19 SCREENING. REF B IS NAVADMIN 173/20, U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE VERSION 2. REF C IS USD P&R FORCE HEALTH PROTECTION GUIDANCE SUPP 10, DOD GUIDANCE FOR COVID-19 CLINICAL LABORATORY DIAGNOSTIC TESTING SERVICES. REF D IS USD P&R FORCE HEALTH PROTECTION GUIDANCE SUPP 11, DOD GUIDANCE FOR COVID-19 SURVEILLANCE SCREENING AND TESTING. REF E IS NAVADMIN 147/20, GUIDANCE TO COMMANDERS ON ADJUSTING HEALTH PROTECTION CONDITIONS AND BASE SERVICES.// POC/RADM KARL THOMAS/OPNAV N3N5B/703-692-9291/KARL.O.THOMAS1(AT)NAVY.MIL// RMKS/1. THIS NAVADMIN PROMULGATES NAVYS SENTINEL SURVEILLANCE TESTING (SST) STRATEGY FOR COVID-19. IT FORMALIZES THE PROCESS TO REQUEST DOD TESTING CAPACITY FOR NAVY FORCES AND THE REQUIREMENT TO REPORT THE USE OF THOSE REQUESTED TESTS PER REF A. THIS NAVADMIN SHOULD BE USED IN CONJUNCTION WITH REF B (COVID-19 STANDARDIZED OPERATIONAL GUIDANCE (SOG) VERSION 2.0), AS TOGETHER THEY SUPPORT REF C AND NAVYS DIAGNOSTIC TESTING APPROACH. IT FORMALIZES SURVEILLANCE TESTING AS DIRECTED IN REF D, AND PROVIDES SUPPLEMENTAL GUIDANCE TO REF E, PARAGRAPH 4.C.4. TESTING FOR COVID-19 HAS THREE PRIMARY BENEFITS: (1) TESTING CAN UNCOVER ASYMPTOMATIC COVID-POSITIVE INDIVIDUALS WHO COULD UNWITTINGLY SPREAD THE VIRUS, (2) TESTING CAN ASSIST IN BOUNDING AN OUTBREAK, AND (3) SURVEILLANCE TESTING CAN BE USED TO DETECT DISEASE EARLY (A SECOND WAVE OR RESURGENCE). TESTING ALSO REINFORCES PUBLIC HEALTH MITIGATION MEASURES AND INFORMS OUR UNDERSTANDING OF COVID-19 TRANSMISSION. 2. REF B, U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE (SOG) VERSION 2.0, PROVIDES GUIDANCE FOR DEPLOYING FORCES THROUGHOUT THE OPTIMIZED FLEET RESPONSE PLAN (OFRP). THE GOAL IS TO MINIMIZE THE TRANSMISSION OF COVID-19 ACROSS THE FORCE AND ULTIMATELY CREATE A COVID FREE BUBBLE AROUND UNITS PRIOR TO AND WHILE DEPLOYED. REF B AND MANY OF OUR PREVENTATIVE EFFORTS HAVE BEEN FOCUSED ON COVID-FREE DEPLOYABLE UNITS. WE NOW HAVE SUFFICIENT TESTING CAPACITY TO EXPAND OUR EFFORTS MORE BROADLY ACROSS OUR NAVY. THIS EXPANDED EFFORT TO PROTECT OUR FORCE INVOLVES TESTING ASYMPTOMATIC POPULATIONS TO DETECT DISEASE EARLY AND FOCUS PUBLIC HEALTH ACTIONS. THIS IS TERMED SENTINEL SURVEILLANCE TESTING (SST). 3. SST IS DESIGNED TO BREAK THE CHAIN OF DISEASE TRANSMISSION. IN ADDITION TO THE ROM-SEQUESTER TESTING FOR DEPLOYING OPERATIONAL FORCES AND ACCESSIONS, OUR NAVY WILL EXPAND TESTING INTO OTHER ASYMPTOMATIC POPULATIONS WITH A FOCUS ON THOSE WHO HAVE A HIGHER LIKELIHOOD OF INFECTION. 3.A. REF D DIRECTS DOD COMPONENTS TO TEST: (1) 10 PERCENT OF CLINICAL HEALTH CARE PERSONNEL EVERY 14 DAYS (20 PERCENT PER MONTH); (2) 10 PERCENT OF SELECTED POPULATIONS LIVING IN CLOSE SETTINGS EVERY 14 DAYS (20 PERCENT PER MONTH) AND (3) AS TESTING RESOURCES INCREASE 1 PERCENT, OF INSTALLATION/UNIT POPULATIONS EVERY 14 DAYS. 3.B. NAVY WILL PHASE INTO THE ABOVE PERCENTAGES AS TESTING CAPACITY BECOMES AVAILABLE AND OUR PROCESSES ARE REFINED. WE WILL START BY FOCUSING ON POPULATIONS WITH HIGHER RISK FOR INFECTION AND TRANSMISSION. 3.C. FDA EMERGENCY USE AUTHORIZATION FOR REVERSE TRANSCRIPTION-POLYMERASE CHAIN REACTION TESTING IS AUTHORIZED FOR USE IN EXECUTION OF SST. 4. SST CONCEPT OF OPERATIONS. 4.A. TESTING POPULATIONS. NAVY WILL TEST: 4.A.1. THOSE POPULATIONS WITH AN INCREASED RISK OF INFECTION AND SUBSEQUENT TRANSMISSION TO INCLUDE HEALTH CARE WORKERS, TEAMS WHO FREQUENTLY VISIT A VARIETY OF COMMANDS (E.G. ATG, NPEB, DGSIT ETC.), SECURITY FORCE PERSONNEL AT ENTRY CONTROL POINTS, CDC WORKERS, GALLEY EMPLOYEES, BRIGS (STAFF AND PERSONNEL) ETC. 4.A.2. LEARNING CENTERS AND SCHOOL HOUSES (INSTRUCTORS AND STUDENTS), NAVSEA FLEET ACTIVITIES AND AVIATION FLEET READINESS CENTERS. 4.A.3. OPERATIONAL UNIT POPULATIONS DURING MAINTENANCE, BASIC AND SUSTAINMENT PHASES OF OFRP. 4.A.4. HIGH DENSITY OFFICE PERSONNEL (E.G. OPNAV STAFF, FLEET HQS, TYCOM HQ, NAVSEA AND NAVAIR). 4.B. CONDUCT OF TESTING. THE TESTING SHOULD BE CONDUCTED AND REPORTED IN 14 DAY INCREMENTS. IDEALLY, TESTING WILL BE SPREAD ACROSS THE REPORTING PERIOD AND GEOGRAPHICALLY DIVERSE TO GIVE THE WIDEST OPPORTUNITY TO SENSE TRENDS. IF LOGISTICS DICTATE, THE POPULATION BEING TESTED MAY ALL BE TESTED IN ONE DAY, SPLIT UNIFORMLY ACROSS THE 14 DAYS, OR ANY VARIATION AS LONG AS THE TARGET SURVEILLANCE NUMBER IS ATTAINED AND RESULTS REPORTED EVERY 14 DAYS. 4.C. PHASED APPROACH TO DOD GOAL. TO REFINE THE EXECUTION OF THIS EFFORT, NAVY WILL PHASE-IN THE EXECUTION TO ALLOW COLLECTING AND PROMULGATING LESSONS LEARNED. 5. SST EXECUTION. 5.A. SST PHASE 1. 25 JUNE - 23 JULY; REPORTS DUE 9 JULY AND 23 JULY (14 DAY INTERVALS). OBJECTIVE IS 900 TESTS ACROSS THE NAVY ENTERPRISE EVERY TWO WEEKS. 5.A.1. OPNAV WILL TEST 20 PERSONNEL WITHIN N3N5. 5.A.2. BUMED WILL TEST 150 CLINICAL HEALTHCARE WORKERS AT 3 MTFS WITHIN EACH MEDFOR REGION. 5.A.3. CNIC WILL TEST 100 SECURITY FORCE PERSONNEL ACROSS 2 CNIC REGIONS. 5.A.4. CPF AND FFC WILL EACH TEST 190 PERSONNEL FROM AT LEAST 6 SHIPS/SUBS/ AVIATION SQUADRONS/CSU POOLS WHO ARE IN THE MAINTENANCE, BASIC OR SUSTAINMENT PHASE OF OFRP AND 1 TEAM DESCRIBED IN PARA 4.A.1. 5.A.5. THE CHIEF OF NAVAL PERSONNEL (CNP) WILL TEST 200 PERSONNEL FROM STAFF/INSTRUCTORS AT SCHOOLHOUSESAND LEARNING CENTERS IN FLEET CONCENTRATION AREAS AND BRIGS (STAFF AND PRISONERS). 5.A.6. NAVSEA WILL CONDUCT 30 TESTS AT NAVSEA FIELD ACTIVITIES/HQ STAFFS AND NAVAIR WILL CONDUCT 20 TESTS AT FLEET READINESS CENTERS (FRC)/HQ STAFFS. 5.B. SST PHASE 2. 23 JULY - 6 AUGUST; REPORTS DUE 6 AUGUST (SINGLE 14 DAY INTERVAL). OBJECTIVE IS 1720 TESTS ACROSS THE NAVY ENTERPRISE. 5.B.1. OPNAV WILL TEST 50 PERSONNEL WITHIN N2N6, N4, AND N9. 5.B.2. BUMED WILL TEST 700 CLINICAL HEALTHCARE WORKERS ACROSS ALL MTFS. 5.B.3. CNIC WILL TEST 100 SECURITY FORCE PERSONNEL ACROSS 2 CNIC REGIONS. 5.B.4. CPF AND FFC WILL EACH TEST 20 PERSONNEL FROM 1 TEAM DESCRIBED IN PARA 4.A.1 AND 30 PERSONNEL WITHIN HQ STAFFS. 5.B.5. CNP WILL TEST 320 PERSONNEL FROM WITHIN STAFF/INSTRUCTORS AT SCHOOLHOUSES AND LEARNING CENTERS IN FLEET CONCENTRATION AREAS, HIGH INTENSITY COURSES, AND BRIGS (STAFF AND PRISONERS). 5.B.6. NAVCENT AND NAVEUR WILL EACH TEST 10 PERSONNEL WITHIN HQ STAFFS AND 160 PERSONNEL TOTAL FROM IN-PORT OPERATIONAL UNITS. 5.B.7. NAVSEA WILL CONDUCT 180 TESTS AT NAVSEA FIELD ACTIVITIES/HQ STAFFS AND NAVAIR WILL CONDUCT 120 TESTS AT FRCS/HQ STAFFS. 5.C. SST PHASE 3 (FULL IMPLEMENTATION). COMMENCES 6 AUGUST. REPORTS DUE EVERY 14 DAYS UNTIL TERMINATED. OBJECTIVE IS 3000 TESTS ACROSS NAVY ENTERPRISE EVERY TWO WEEKS. 5.C.1. OPNAV WILL TEST 20 PERSONNEL WITHIN 1 DIRECTORATE. 5.C.2. BUMED WILL TEST 700 CLINICAL HEALTHCARE WORKERS ACROSS ALL MTFS. 5.C.3. CNIC WILL TEST 300 SECURITY FORCE PERSONNEL ACROSS ALL CNIC REGIONS AND TEST 100 MISSION CRITICAL OR HIGH RISK PERSONNEL ACROSS ALL REGIONS. 5.C.4. CPF AND FFC WILL EACH TEST 250-300 PERSONNEL FROM AT LEAST 10 SHIPS/SUBS/AVIATION SQUADRONS/CSU POOLS WHO ARE IN THE MAINTENANCE, BASIC OR SUSTAINMENT PHASE OF OFRP AND 30-80 PERSONNEL FROM THE POPULATIONS DESCRIBED IN PARA 4.A.1 AND 4.A.4. 5.C.5. CNP WILL TEST 500 PERSONNEL FROM WITHIN STAFF/INSTRUCTORS AT SCHOOLHOUSES AND LEARNING CENTERS IN FLEET CONCENTRATION AREAS, HIGH INTENSITY COURSES, BRIGS (STAFF AND PRISONERS) AND RECRUITING PERSONNEL. 5.C.6. NAVCENT AND NAVEUR WILL EACH TEST 20 PERSONNEL WITHIN HQ STAFFS AND 160 PERSONNEL FROM IN-PORT OPERATIONAL UNITS. 5.C.7. NAVSEA WILL CONDUCT 300 TESTS AT NAVSEA FIELD ACTIVITIES/HQ STAFFS AND NAVAIR WILL CONDUCT 220 TESTS AT FRCS/HQ STAFFS. 6. SPECIAL CONSIDERATIONS. 6.A. TESTING CAPACITY. ALTHOUGH AVAILABLE AT THE DOD LEVEL, NAVY ACKNOWLEDGES CAPABILITY AND CAPACITY FOR SURVEILLANCE TESTING AND MONITORING PROGRAMS VARIES AMONG INSTALLATIONS AND UNITS DUE TO CURRENT LIMITATIONS ON EQUIPMENT, SUPPLIES, AND PERSONNEL RESOURCES. TEST CAPACITY SHOULD BE PRIORITIZED FOR TIER 0 SITUATIONS (CLINICAL CARE AND OUTBREAK RESPONSE). 6.A.1. LOGISTICS AND TRANSPORT. FOR REMOTE, DEPLOYED, OR UNDERWAY UNITS WITHOUT INTRINSIC TESTING CAPABILITIES BUT WITH THE ABILITY TO COLLECT SAMPLES, SURVEILLENCE TESTING PERIODICITY MAY BE ADJUSTED TO REFLECT THE TIMING AND AVAILABILITY OF COLD-CHAIN TRANSPORT OF SAMPLES TO THE TESTING FACILITIES. 6.B. INDIVIDUALS WHO WERE PREVIOUSLY COVID-POSITIVE. VIROLOGY TESTING HAS DEMONSTRATED AN INDIVIDUAL PREVIOUSLY INFECTED WITH COVID-19 WITHIN THE PAST EIGHT WEEKS MAY TEST POSITIVE FOR COVID-19 EVEN AFTER THE VIRUS IS DEAD (NON- CONTAGIOUS). THESE INDIVIDUALS SHOULD NOT BE TESTED WITHIN THIS TWO MONTH PERIOD GIVEN THE POTENTIAL FOR A FALSE POSITIVE TEST. 6.C. ELIGIBILITY FOR TESTING. PER REF C, SERVICE MEMBERS MAY BE TESTED WHEN IN A TITLE 10 OR TITLE 32 DUTY STATUS. CIVILIAN EMPLOYEES MAY BE OFFERED TESTING IF THEIR SUPERVISOR DETERMINES THEIR PRESENCE IS URGENTLY REQUIRED WITHIN THEIR WORKPLACE. FAMILY MEMBERS ELIGIBLE FOR MILITARY HEALTH SYSTEM BENEFITS MAY BE OFFERED TESTING. EMPLOYEES OF DOD CONTRACTORS WILL USE THE PROCESSES FOR MEDICAL CARE TO ACCESS TESTING AS SET FORTH IN THE TERMS OF THE CONTRACT UNDER WHICH THEY ARE PERFORMING. NAVY CIVILIAN EMPLOYEES AND FAMILIES OF UNIFORMED MEMBERS WILL NOT BE REQUIRED TO SUBMIT TO A COVID-19 SURVEILLANCE TEST IF THEY DO NOT DESIRE TO PARTICIPATE. HOWEVER, VOLUNTEERS ARE ENCOURAGED AND WELCOME TO DO SO. 6.D. COMMANDERS ARE ENCOURAGED TO SELECT TESTING POPULATIONS THAT BEST BENEFIT THEIR THREAT AWARENESS, COHORT PROTECTION, AND SST NEEDS. AMONGST THE CHOSEN POPULATIONS, SPECIFIC INDIVIDUALS SHOULD BE SELECTED AT RANDOM. IF AN INDIVIDUAL IS RANDOMLY SELECTED MORE THAN ONCE, COMMANDERS MAY PICK ALTERNATIVES OR SUBSTITUTES TO REPLACE THESE INDIVIDUALS. 6.E. PER REF C, ENSURE APPROPRIATE INFECTION PREVENTION AND CONTROL PROCEDURES ARE FOLLOWED THROUGHOUT THE ENTIRE TESTING PROCESS. THIS INCLUDES EMPLOYING THE APPROPRIATE BIOSAFETY PRECAUTIONS WHEN COLLECTING, HANDLING AND TRANSPORTING SPECIMENS, CONSISTENT WITH CDC GUIDANCE. 6.F. PER REF D, SERVICE MEMBERS WHO ARE TESTED WILL RECEIVE THEIR TEST RESULTS. COVID-19 POSITIVE TEST RESULTS WILL BE REPORTED IN ACCORDANCE WITH ALL APPLICABLE FEDERAL, STATE, LOCAL AND DOD REQUIREMENTS AND RECORDED IN MEMBERS ELECTRONIC HEALTH RECORD. 6.G. OPERATIONAL UNITS THAT HAVE DEVELOPED A COVID-FREE BUBBLE NEED NOT CONDUCT SURVEILLANCE TESTING AS LONG AS BUBBLE-TO-BUBBLE TRANSFERS AND RIGOROUS PREVENTATIVE PUBLIC HEALTH MITIGATION MEASURES HAVE BEEN IMPLEMENTED. 7. HPCON AND TESTING. BROAD IMPLEMENTATION OF ASYMPTOMATIC SURVEILLANCE TESTINGIS NOT REQUIRED TO BEGIN LOWERING HPCON LEVELS PER REF E, PARAGRAPH 4.C.4. AS TESTING CAPACITY INCREASES, A ROBUST SST AND MONITORING PROGRAM WILL CONTRIBUTE OBJECTIVE DATA ON COVID-19 PREVALENCE AND ASSISTS IN PRESERVING FORCE READINESS AND ASSESSING HPCON LEVELS. NAVAL COMPONENT COMMANDERS (NCCS) REMAIN RESPONSIBLE FOR DETERMINING APPROPRIATE HPCON LEVELS AND MEASURES GIVEN THE LOCAL OPERATING AND HEALTHCARE THREAT ENVIRONMENT. VIGILANT ACTIVE AND PASSIVE SURVEILLANCE OF INFLUENZA-LIKE ILLNESS AND COVID-19-LIKE ILLNESS IS SUFFICIENT UNTIL RESOURCES AND ADDITIONAL DATA PERMIT IMPLEMENTATION OF WIDESPREAD SST AND MONITORING PROGRAMS. 8. DEPLOYED DIAGNOSTIC TESTING. NAVY HAS DEPLOYED BIOFIRE TESTING CAPABILITY ONBOARD CVNS/LHAS/LHDS/SSBNS AND SOME LPDS. THESE MACHINES SHOULD BE USED FOR DIAGNOSTIC TESTING OF SYMPTOMATIC INDIVIDUALS. 9. RAPID RESPONSE FLY-AWAY TEAMS. NAVY HAS POSITIONED ABBOTT ID NOW RAPID TESTING MACHINES WITH NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNITS AND/OR PUBLIC HEALTH MEDICAL READINESS RESPONSE TEAMS AT SELECTED LOCATIONS AROUND THE GLOBE. SHOULD AN OPERATIONAL SHIP OR SUBMARINE HAVE AN OUTBREAK THAT REQUIRES EXTERNAL ASSISTANCE, NCCS HAVE THE AUTHORITY TO UTILIZE THESE MACHINES WITH LOCAL MEDICAL TEAMS TO EXECUTE A RAPID RESPONSE. 10. REQUESTING TESTING AND REPORTING REQUIREMENTS. 10.A.1. TIER 1-3 FORCES. PROCESSES ARE IN PLACE FOR NCCS TO REQUEST DOD TESTING CAPACITY THROUGH THE CNO BWC TO THE JCS COVID TESTING CELL PER REF A. REQUESTS FOR OPERATIONAL TESTING ACROSS THE NEXT60 DAYS WILL BE PROVIDED TO THE CNO BWC EACH FRIDAY, WHERE THEY WILL BE AGGREGATED AND SUBMITTED TO THE DOD COVID-19 TASK FORCE TESTING LINE OF EFFORT (CVTF-D&T). SIMILARLY, TESTS ACCOMPLISHED THE PRIOR WEEK WILL ALSO BE SUBMITTED TO THE CNO BWC FOR AGGREGATION AND FORWARDING TO CVTF-D&T. TESTS THAT ARE REQUESTED SHOULD BE UTILIZED TO ASSIST IN BALANCING TEST DISTRIBUTION AND EFFICIENT USE OF LIMITED ASSETS. THIS BECOMES EVEN MORE IMPORTANT WITH THE IMPLEMENTATION OF SST. 10.A.2. SST REPORTING DEADLINES. NCCS, BUMED, N1, AND CNIC WILL PROVIDE SST REQUIREMENTS AND TESTING COMPLETED EVERY THURSDAY NLT 1400 EST TO CNO BWC FOR CONSOLIDATION WITH TIER 1-3 INPUTS. 11. MEDICAL TESTING QUESTIONS: BUMED WATCH 703-681-1087/1125 OR NIPR EMAIL: USN.NCR.BUMEDFCHVA.LIST.BUMED---2019-NCOV-RESPONSE-CELL(AT)MAIL.MIL. TEST REQUEST OR REPORTING QUESTIONS: OPNAV BATTLE WATCH CAPTAIN AT 703-692-9284, DSN 222-9284 OR BWC.PTGN(AT)NAVY.MIL. SURVEILLANCE TESTING FEEDBACK: RADM KARL THOMAS, KARL.O.THOMAS1(AT)NAVY.MIL OR CAPT RON STOWE, RONALD.STOWE(AT)NAVY.MIL. 12. RELEASED BY VADM P. G. SAWYER, DEPUTY CHIEF OF NAVAL OPERATIONS FOR OPERATIONS, PLANS AND STRATEGY N3/N5// BT #0001 NNNN UNCLASSIFIED//