UNCLASSIFIED ROUTINE R 111536Z APR 22 MID200001660830U FM CNO WASHINGTON DC TO NAVADMIN INFO SECNAV WASHINGTON DC CNO WASHINGTON DC BT UNCLAS NAVADMIN 093/22 MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/APR// SUBJ/U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE 6.0(CORRECTED COPY)// REF/A/MSG/CNO/152351ZJAN22// REF/B/MSG/CNO/292217ZJUL21// REF/C/MSG/CNO/301952ZAPR21// REF/D/DOC/USD(PR)/04APR2022// REF/E/ASN(MRA)/03MAR2022// REF/F/MSG/CNO/221712ZDEC21// REF/G/MSG/CNO/241805ZNOV21// REF/H/DOC/NMCPHC/27DEC2021// REF/I/DOC/NMCPHC/14MAY2021// REF/J/DOC/NMCPHC/19MAR2021// REF/K/MSG/CNO/041827ZAUG21// REF/L/MSG/CNO/231718ZAUG21// NARR/REF A IS NAVADMIN 007/22, U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE 5.0. REF B IS NAVADMIN 161/21, UPDATED MASK GUIDANCE FOR ALL DOD INSTALLATIONS AND OTHER FACILITIES. REF C IS NAVADMIN 086/21, UPDATED GUIDANCE TO COMMANDERS ON ADJUSTING HEALTH PROTECTION CONDITIONS AND BASE SERVICES DURING COVID-19 PANDEMIC (CORRECTED COPY). REF D IS USD P&R CONSOLIDATED DEPARTMENT OF DEFENSE CORONAVIRUS DISEASE 2019 FORCE HEALTH PROTECTION GUIDANCE AVAILABLE AT https://www.defense.gov/Explore/Spotlight/Coronavirus/Latest-DOD-Guidance/. REF E IS ASN M&RA MEMORANDUM ON DEPARTMENT OF THE NAVY GUIDANCE ON COVID-19 COMMUNITY LEVELS AND WORKPLACE SAFETY PROTOCOLS. REF F IS NAVADMIN 289/21, GUIDANCE ENCOURAGING COVID-19 VACCINE BOOSTER. REF G IS NAVADMIN 268/21, REQUIRED COVID-19 TESTING FOR UNVACCINATED SERVICE MEMBERS. REF H IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER COVID-19 OMICRON VARIANT AND BOOSTER EFFECTIVENESS. REF I IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER U.S. NAVY FORCE HEALTH PROTECTION WITH CONSIDERATIONS FOR VACCINE EFFICACY. REF J IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER DOCUMENT ASSESSING REAL COVID-19 RISK. REF K IS NAVADMIN 165/21, SOVEREIGN IMMUNITY POLICY. REF L IS NAVADMIN 180/21, UPDATE TO COVID-19 REPORTING REQUIREMENTS. POC/OPNAV/CAPT SHARIF CALFEE, (703) 571-2822//EMAIL: SHARIF.H.CALFEE.MIL(AT)US.NAVY.MIL RMKS/ 1. Purpose. This NAVADMIN provides updated COVID-19 Standing Operational Guidance (SOG 6.0), replaces reference (A) and cancels references (B) and (C). 2. SUMMARY: SOG 6.0 should be read in its entirety. Notable updates include guidance for unvaccinated personnel, actions taken for COVID-19 infected personnel and close contacts, and guidance for mask wearing underway. All units shall refer to references (D) and (E) for Health Protection Condition and masking guidance not contained in this NAVADMIN. Personnel safety of our sailors and civilians remains our driving focus. Vaccinations, vaccine boosters, command engagement, and personal accountability continue to form the foundation of our success. Every member of every command must take personal ownership and responsibility of the promulgated measures required to keep COVID-19 in check. 3. Applicability. This guidance applies to all service members (active duty and ready reserve) assigned to, or supporting, operational units as defined in paragraph 5.e below. Additionally, paragraph 7 (COVID-19 Testing) applies to all commands and paragraph 8 (Operating in a COVID-19 Environment) applies to all personnel onboard operational platforms. Non- operational forces, civilian employees and contractor personnel should follow the latest Department of Defense (DOD) Force Health Protection, Centers for Disease Control and Prevention (CDC), and state/local area guidance. Additionally, higher echelon Commanders guidance may apply. 4. Evolving Guidance. The CDC is the authority for COVID-19 measures on behalf of the general public. The Navy Surgeon General remains as the authority for Navy COVID-19 measures and advises the CNO on how best to apply CDC guidance across the spectrum of unique Navy operating environments, and may include additional measures not required by the general public. Accordingly, and except as noted below in this NAVADMIN, evolving CDC guidance related to virus behavior shall first be evaluated by the Navy Surgeon General prior to Fleet implementation. Questions regarding applicable COVID-19 measures may be directed to the point of contact (POC) listed above. 5. Definitions. All CDC definitions regarding COVID-19 apply and are kept current on the CDC website (https://www.cdc.gov). The following additional Navy definitions are provided: 5.a. Fully Vaccinated: Term for an individual who has completed a primary COVID-19 vaccine series as defined in reference (F). Term applies two weeks after the final dose is received. During the time period from initial dose until two weeks after the final dose, an individual is considered partially vaccinated. 5.b. Up-to-Date (UTD) COVID-19 Vaccination: Term for an individual who has received all CDC recommended COVID-19 vaccines, including booster dose(s) when eligible. UTD COVID-19 Vaccine and booster guidance is subject to change and is available on the CDC website. 5.c. High-Risk Personnel: Those individuals designated by a medical provider who meet CDC criteria for increased risk of severe illness. Qualifying conditions are included on the CDC website. 5.d. Commander: For the purposes of this NAVADMIN, the term Commander includes Commanding Officers, Officers-in-Charge, Masters, and Aircraft Commanders. 5.e. Operational and Non-Operational Forces: For the purposes of this NAVADMIN, operational forces and non-operational forces are defined by the applicable NCC. For operational forces, this might include deployed forces, forces in sustainment, or other operational elements that the NCC determines to fall within the intent and context of this NAVADMIN. 5.f. Restriction of Movement (ROM): DOD term for limiting personal interaction to reduce risk to a broader population. Personnel executing directed ROM remain in a duty status and will not be charged leave. ROM-sequester, when directed, is the Navy term for preemptive ROM in order to reduce risk of infection in advance of movement. 5.g. Health Protection Measures (HPM): Comprehensive term for mitigation measures that reduce the spread of COVID-19. This includes physical distancing, wearing of masks, and enhanced environmental cleaning and disinfection. Recommended HPMs are included on the CDC website. 5.h. Viral Test: For the purposes of this NAVADMIN, unless specifically stated otherwise, viral test may refer to either a test that measures the antigens (antigen test) or a test that measures viral RNA (Polymerase Chain Reaction (PCR) test). 5.i. Close Contact: A person who was less than 6 feet away from an infected person (laboratory-confirmed or a clinical diagnosis) for a cumulative total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes). 6. COVID-19 Infected Personnel and Close Contacts. 6.a. Actions for Personnel Suspected of Being Infected. 6.a.1. Symptomatic. Test immediately those individuals exhibiting COVID-19 symptoms. If symptomatic and positive, isolate the individual per paragraph 6.a.3 and identify close contacts per reference (D). 6.a.2. Close Contacts. Asymptomatic close contacts who have not received a vaccine booster should be tested 5 days after exposure, if testing is available (see paragraph 6). If COVID-19 positive, refer to paragraph 6.a.3. If the asymptomatic close contact has received a vaccine booster, testing is not required. Close contacts who do not test positive for COVID-19 may remain on duty but must wear a mask for 10 days. If symptoms develop, test per paragraph 6.a.1. 6.a.3. Isolation. Isolate individuals who test positive for 5 days or until symptoms are clearing, whichever is longer, including 24 hours with no fever and without fever-reducing medication (day 0 is date of positive test or symptom onset, whichever occurred first). Isolation may be conducted either ashore or afloat. Once released, individuals will wear a mask for an additional 5 days (minimum 10 days total). No exit testing is required and, absent symptoms, prior positives should not be PCR-tested again for 90 days (per paragraph 7.c). 6.b. Actions for Unvaccinated Personnel. 6.b.1. To maintain Fleet readiness, all personnel assigned to operational Navy units shall be fully vaccinated. Unvaccinated personnel shall not execute orders to operational Navy units. Unvaccinated personnel shall not embark underway Navy vessels or aircraft; commanders of operational units shall temporarily reassign unvaccinated personnel from their commands with the concurrence of the first flag officer in the chain of command. Exceptions, if any, will be managed case-by-case by the applicable NCC and reported to the POC of this instruction. 6.b.2. Refer to medical providers unvaccinated individuals exhibiting COVID- 19 symptoms for follow-on care. Identify close contacts per reference (D). Similarly, refer unvaccinated close contacts to medical providers. Treat vaccinated close contacts per paragraphs 6.a.2 above. 7. COVID-19 Testing. 7.a. Test Procurement. To ensure uninterrupted operations, and as feasible, commands will coordinate with their supporting supply activities to obtain testing supplies 60 days in advance of need. This should include additional tests required for U.S. testing of personnel during any anticipated port calls. 7.b. Testing of Unvaccinated Personnel. Unvaccinated personnel shall follow the testing requirements of reference (G), as amended in reference (D) and below in paragraph 7.c. 7.c. Testing of Individuals Previously Infected with COVID-19. Individuals previously infected with COVID-19 may be asymptomatic and continue to test positive by PCR test for up to 90 days from date of initial diagnosis due to the presence of persistent non-infectious viral fragments. Therefore, prior COVID-19 positives are exempt from testing protocols for 90 days from the earlier of symptom onset or first positive test (90-day rule). Individuals who exhibit new or persistent symptoms during that three-month period should be evaluated by a medical provider. 7.d. Surveillance / Ship-Wide Testing. Surveillance or ship-wide testing is not required or recommended and has previously identified large numbers of asymptomatic persistent positives. 7.e. Testing Priority. Personnel exhibiting COVID-19 like symptoms are the highest priority for testing. If testing asymptomatic close contacts per paragraph 6.a.2 or 8.g.2 will stress testing supplies, or if operations preclude testing (e.g., small, remote teams or depleted testing supplies), Commanders are authorized to forego testing asymptomatic close contacts. This prioritization is consistent with CDC guidance (https://www.cdc.gov/coronavirus/2019-ncov/php/ contact-tracing/contact-tracing-plan/prioritization.html). 8. Operating in a COVID-19 Environment. 8.a. Up-to-date (UTD) COVID-19 Vaccination. Commanders should encourage UTD COVID-19 Vaccination of personnel at least 30-days prior to DEPORD movements or inter-fleet transfers. 8.b. Medical Screening. Medical screening will include newly reporting personnel and a command-wide monthly data review and assessment, as directed by the NCC. An additional pre- deployment screening will be completed 7 days prior to deployment. Medical screening shall be conducted by medical providers and reported to the unit Commander to assist in assessing risk and mitigations. Screening will include, at a minimum, vaccination and vaccine booster status, review and assessment of COVID-19 exposure history (those under the 90-day rule), and underlying risk factors. 8.c. Military Sealift Command (MSC). MSC shall medically screen Civil Service Mariners (CIVMARs) and contract personnel for deployment on MSC vessels in accordance with existing MSC Quality Management System processes and procedures. Unvaccinated CIVMARs and contract personnel should not be assigned to operational units. Exceptions and associated mitigations will be approved by Commander, MSC. 8.d. Fully vaccinated High-Risk Personnel. The decision to operate and deploy with fully vaccinated high-risk personnel rests with the Commander, as advised by medical providers, who must report intentions to their immediate superior in command. High-risk personnel shall be PCR viral tested within 3 days prior to embarking. 8.e. Pre-Deployment ROM-sequester. Fully vaccinated personnel should not normally be required to ROM-sequester ahead of planned operations. ROM- sequester may be directed by the applicable NCC based upon Geographic Combatant Commander guidance and applicable host nation requirements. 8.f. Underway HPM. As a result of demonstrated vaccine effectiveness, a 100% fully vaccinated operational force and a healthy demographic, serious illness or death resulting from COVID-19 for fully vaccinated individuals is statistically very unlikely, and modeling contained in references (H), (I), and (J) indicates this will continue in the context of current variants. UTD COVID-19 Vaccination reduces the risk even further. However, the increasing contagious nature of evolving variants can result in unmanageable numbers of even mild symptomatic positives and may impose general health and operational unit risk, i.e. risk to force or risk to mission, regardless of symptom severity. The following HPM, at a minimum, are required: 8.f.1. Medical screening as outlined above in paragraph 8.b. 8.f.2. Masks. Following all inport periods, if less than 75% of the crew is UTD COVID-19 Vaccination Commanders should consult with medical professionals and consider mask wear for the first 10-days at sea. Similarly, Commanders should consider mask wear in response to the onset of onboard COVID-19. 8.f.3. Educate and reinforce the importance of self-monitoring for symptoms and prompt reporting. 8.f.4. Educate and reinforce the importance of frequent handwashing and social distancing, when possible. 8.f.5. Aggressively isolate COVID-19 positive individuals per paragraph 6 above. 8.f.6. Ensure adequate ventilation in spaces routinely manned. 8.f.7. Educate and reinforce focused cleaning efforts on high-touch surfaces, at least daily or more frequently, depending upon usage (e.g., tables, hatch latches, ladderwells, phones, watch console keyboards and buttons, toilets, faucets, sinks, etc.). Although remote, there is evidence of surface spread of COVID-19 and other viruses with similar symptoms. 8.g. Considerations for Adding or Relaxing HPM. NCCs and Commanders should consider for any unit the operational impact resulting from the number of sailors in isolation, either ashore or afloat, regardless of percentage of immunized personnel, UTD COVID-19 Vaccinations, or severity of symptoms. Commanders may elevate or relax HPM at any time, and retain the latitude to temporarily apply alternate HPM in lieu of isolation to support safe operations. An example might be a rapid spread that compels a Commander to employ asymptomatic or mildly symptomatic positives to manage watch-bill impact while recovering others in isolation, applying additional alternate measures as needed to minimize spread. The following should be considered before adjusting HPM: 8.g.1. Overall number of individuals in isolation and trend. The general rule of thumb for a COVID-19 outbreak trending in a favorable direction is that the number of those exiting isolation matches (flattening curve) or exceeds (lowering curve) those entering isolation, combined with the assessment that the total number of symptomatic individuals is manageable and improving, and watch-bill (operational) impact is manageable and improving. 8.g.2. If less than 75% of the total eligible crew is UTD COVID-19 Vaccinations, implement the requirements of 8.f.2. and consider a 5 day viral test for all close contacts per paragraph 6.a.2., regardless of vaccination status. 8.g.3. Proximity of a units access to shore and afloat Medical Treatment Facilities (MTF) within a medically relevant timeline, balanced with paragraph 7.e HPM and onboard trend. Rule of thumb is within 1-week of an MTF for 100 percent fully vaccinated crew with manageable case load, moving to a more restrictive 72 hours or less if a growing or concerning caseload, and moving to a less restrictive beyond 1-week, if small or no caseload. 8.h. Port Visits. Liberty is an important mission and should be pursued within the context of this NAVADMIN. Geographic NCCs (GNCC) will set conditions for foreign port off-base liberty in coordination with country teams and local authorities, taking into account host country requirements, vaccination and booster status, sovereign immunity per paragraph 9 below, COVID-19 prevalence and mission requirements. 8.i. Aircraft Operations. On a case-by-case basis, aircrews and aircraft maintainers may be exempt from this guidance in order to meet emergent operational or NATOPS currency requirements. Exemptions and mitigation plans must be approved by the Squadron Commander. For aviation units embarked on surface ships, mitigation plans will be coordinated with the ships health protection plan and approved by the ships Commanding Officer. 8.j. Post-Deployment. Personnel returning to homeports from deployment shall follow CDC and U.S. Department of State travel and testing requirements. If return travel includes foreign countries, personnel shall follow the travel and testing requirements for those individual nations, subject to sovereign immunity concerns (see below). Updated travel information is on the following website: https://travel.state.gov. 9. Sovereign Immunity. 9.a. It is U.S. Government policy to protect the sovereign immunity of warships, naval auxiliaries, and aircraft, including protecting crew information to the maximum extent possible. Within the context of COVID-19, host nations may request or require crew or ship information that exceeds that authorized by U.S. policy or international law. NCCs will ensure appropriate training and guidance on protecting U.S. sovereign immunity and on the protection of health information as part of OPSEC/personal security. 9.b. GNCCs should endeavor to determine in advance those host nations that may challenge U.S. sovereign immunity and, as able, avoid them. See reference (K) for additional guidance. In all cases, GNCCs shall authorize the minimum information necessary in order to meet operational requirements. The Navy Declaration of Health (NAVMED 6210/3) is the only authorized form for providing health information to foreign officials. If required by the host nation, and with GNCC concurrence, Commanders, at their discretion, may include on the NAVMED 6210/3 that their unit is 100% vaccinated, those disembarking have tested negative within the required timeframe, and/or that those disembarking have received a vaccine booster. 9.c. Exceptions to Policy (ETP). On a case-by-case basis, and to support operations, OPNAV N3N5 may grant an ETP to mitigate the operational impact of host nation COVID-19 requirements. Any action that may constitute or require a waiver of sovereign immunity must be coordinated by the applicable GNCC with OPNAV N3N5 for ETP approval no later than 5 days ahead of need. To avoid precedence beyond COVID-19, any ETP will be messaged to the host nation as explicitly linked to the pandemic. Requests shall include justification for port selection; host nation mitigation and testing requirements; alternate port options; impact to mission if the request is denied; medical, legal, collection and privacy risk; and feedback from country team coordination. Notifications and requests may be sent via record message traffic, email to the POC provided above, or both. 9.d. Guidance for Commanders. Per the direction of their GNCCs, Commanders shall comply with domestic and foreign quarantine regulations for port entry and document compliance on NAVMED 6210/3. Absent GNCC approval in advance, Commanders will not submit to host nation COVID-19 testing nor provide individual or collective medical data, copies of health records, nor any supplementary or locally-demanded health forms, and shall not grant access to ship or crew health records or allow the same to be searched or inspected by host nations. If compelling circumstances require a Commander to acquiesce to additional host nation requirements without obtaining an ETP or GNCC concurrence (e.g., personnel emergency, weather avoidance), report the event and circumstances as soon as practicable to OPNAV N3N5 via the chain of command. 10. Reporting Procedures. Reporting procedures are amended as follows and will be incorporated in the next revision of reference (L). OPREP-3 Navy Blue messages for COVID-19 cases that do not result in death, request for assistance, or operational impact may instead be reported via SharePoint. If unable to report via SharePoint, a single daily OPREP-3 Navy Unit SITREP summarizing all COVID-19 cases onboard is required. SharePoint information is used to produce daily reports to Senior Navy Leadership. 11. Released by VADM W. R. Merz, Deputy Chief of Naval Operations for Operations, Plans, and Strategy, OPNAV N3/N5.// BT #0001 NNNN UNCLASSIFIED//