ROUTINE R 191436Z OCT 22 MID600052386622U FM CNO WASHINGTON DC TO NAVADMIN INFO SECNAV WASHINGTON DC CNO WASHINGTON DC BT UNCLAS NAVADMIN 234/22 (CORRECTED COPY) MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/OCT// SUBJ/U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE 7.0 (CORRECTED COPY)// REF/A/MSG/CNO/111536ZAPR22// REF/B/DOC/USD(PR)/29AUG2022// REF/C/DOC/NMCPHC/27DEC2021// REF/D/DOC/NMCPHC/14MAY2021// REF/E/DOC/NMCPHC/19MAR2021// REF/F/MSG/CNO/041827ZAUG21// REF/G/MSG/CNO/231718ZAUG21// REF/H/OPNAVINST F3100.6K/10AUG21// NARR/REF A is NAVADMIN 093/22, U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL GUIDANCE 6.0 (CORRECTED COPY). REF B 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/ (Select "Health Protection Guidance" tab from the site menu on the left). REF C is NAVY AND MARINE CORPS PUBLIC HEALTH CENTER COVID-19 OMICRON VARIANT AND BOOSTER EFFECTIVENESS. REF D is NAVY AND MARINE CORPS PUBLIC HEALTH CENTER U.S. NAVY FORCE HEALTH PROTECTION WITH CONSIDERATIONS FOR VACCINE EFFICACY. REF E is NAVY AND MARINE CORPS PUBLIC HEALTH CENTER DOCUMENT ASSESSING REAL COVID-19 RISK. REF F is NAVADMIN 165/21, SOVEREIGN IMMUNITY POLICY. REF G is NAVADMIN 180/21, UPDATE 3 TO NAVY COVID-19 REPORTING REQUIREMENTS. REF H is OPNAVINST F3100.6K, SPECIAL INCIDENT REPORTING PROCEDURES. POC/OPNAV/COVID CELL TEAM LEAD, (703) 571-2822//EMAIL: OPNAV_COVID_CRISIS_RESPONSE_CELL@US.NAVY.MIL. RMKS/ 1. Purpose. This NAVADMIN provides updated COVID-19 Standardized Operational Guidance (SOG 7.0) and replaces reference (a). 2. Summary. SOG 7.0 driving objectives remain the health and safety of our Sailors and civilians while preserving operational readiness. The virus is still with us and it is still dangerous, and the combination of vaccines, boosters, command engagement and personal accountability continue to be our best defense. SOG 7.0 should be read in its entirety. Clarifying edits based upon fleet feedback have been incorporated throughout. Notable changes include guidance for training personnel (paragraph 5.e), definition of close contacts (paragraph 5.j), use of N3N5 as Navy Component Commander (NCC) for commands with non-operational reporting chains (paragraph 5.e), guidance on meetings with greater than 50 participants (paragraph 8.k), and cancels reference (g) (Update 3 to Navy COVID-19 Reporting Requirements) (paragraph 10). 3. Applicability. SOG 7.0 applies to all service members (active duty and ready reserve) assigned to or supporting operational units as defined in paragraph 5.e below (Operational and Non-Operational Forces). 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, and seek policy clarification via local command Human Resource channels. 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 Chief of Naval Operations (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 when specifically referred to the CDC website (e.g., booster approval and guidance), evolving CDC guidance related to virus behavior and mitigations 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. CDC definitions regarding COVID-19 are kept current on the CDC website (https://www.cdc.gov). The following additional DoD definitions are provided: 5.a. Fully Vaccinated: Term for an individual who has completed a primary COVID-19 vaccine series as defined in reference (b). 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 vaccine dose(s), including booster dose(s), if 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 and promulgated 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. Personnel conducting training in underway or operational airborne Navy platforms are considered operational forces. OPNAV N3N5 shall act as the NCC for units that do not report via an operational NCC (e.g., USS CONSTITUTION, USNA, ROTC units, etc.). 5.f. Restriction of Movement (ROM): 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. Because of the Navy vaccination policy, ROM and ROM-sequester are now rare, but may be required in specific cases or in concert with movement to a foreign country. For tracking and trending purposes, report instances of ROM and ROM-sequester to N3N5 via the POC listed above. 5.g. Isolation. The separation of an individual or group infected or believed to be infected with a communicable disease from those who are healthy in such a place and manner to prevent the spread of the communicable disease. 5.h. Health Protection Measures (HPM): Comprehensive term for mitigation measures that reduce the spread of COVID-19. This includes physical distancing, wearing masks, and enhanced environmental cleaning and disinfection. Recommended HPMs are included on the CDC website and in paragraph 8 below. 5.i. Viral Test: For the purposes of this NAVADMIN viral test may refer to either a test that measures the antigens (antigen test) or a test that measures viral RNA (nucleic acid amplification test (NAAT) to include Polymerase Chain Reaction (PCR) test). 5.j. Close Contact: The definition of a close contact has become more discretionary (no longer strictly within 6 feet for greater than 15 min within 24 hrs). Per reference (b), a close contact is now identified through contact tracing and exposure risks. Exposure risks are based upon multiple factors that can result in higher transmission risk, including: length of time and distance from an infected person; if that infected person was coughing, singing, shouting, or breathing heavily; if that infected person had symptoms at the time of exposure; if either or both persons were wearing a mask or respirator; and, how well-ventilated the space was. 6. ACTION: Per reference (b), all personnel assigned to operational Navy units shall be fully vaccinated against COVID-19. To ensure continuing protection, all personnel assigned to operational units are encouraged to remain UTD on vaccinations. Unvaccinated personnel shall not execute orders to operational Navy units. Commanders of operational units shall temporarily reassign unvaccinated personnel from their commands with the concurrence of the first flag officer in the operational chain of command (or OPNAV N3N5, as applicable per paragraph 5.e). Exceptions will be managed case-by-case by the applicable NCC and reported to the POC listed above. 6.a. Actions for personnel suspected of being infected: 6.a.1. Symptomatic. Test immediately those individuals exhibiting COVID-19 symptoms. If positive, isolate the individual per paragraph 6.a.3. and identify close contacts per reference (b). 6.a.2. Close Contact. Remain on duty, but wear a mask for 10-days starting on the day identified as a close contact. If symptoms develop, isolate until tested and carry out the actions of paragraph 6.a.1. 6.a.3. Isolation. Isolate individuals who test positive for five days or until symptoms are clearing, whichever is longer, including 24 hours with no fever and without fever-reducing medication (day zero 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 five days (minimum 10 days total). No exit testing is required. 6.b. Actions for Unvaccinated Personnel. In addition to the actions in paragraphs 6.a above, if a person develops symptoms who is unvaccinated, partially vaccinated, or unwilling to disclose their vaccination status or is identified as a close contact (e.g., during the transfer process), refer the individual to medical providers. 7. COVID-19 Testing. 7.a. Test Procurement. Demand for testing supplies remains high. To ensure uninterrupted operations, and as feasible, commands should 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 anticipated port calls. 7.b. Testing of Persons Previously Infected with COVID-19. Because of lingering non-infectious virus activity, persons have tested positive for up to 90-days following diagnosis. Accordingly, viral retesting is neither required nor recommended within 90 days of initial diagnosis. If symptoms develop at any time during this same 90-day period, isolate until evaluated by a medical provider. 7.c. Surveillance / Command-Wide Testing. Surveillance or command-wide testing is not required or recommended and has previously identified large numbers of asymptomatic persistent false positives. 7.d. Testing Priority. Personnel exhibiting COVID-19 symptoms are the highest priority for testing. If testing asymptomatic close contacts per paragraph 6.a.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 regardless of their vaccination status. 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. The guidance in this section endeavors to balance risk to force and risk to mission with the risk of operating in a COVID-threat environment. Broad latitude is afforded both NCCs and their subordinate Commanders. 8.a. Up-to-date (UTD) COVID-19 Vaccination. Commanders should encourage UTD COVID-19 vaccination of personnel at least 30-days prior to deployment-related movements or operations. 8.b. Medical Screening. Medically screen newly reported personnel and conduct a command-wide monthly data review and assessment in high-transmission areas, as directed by the NCC. Complete an additional pre-deployment screening seven days prior to deployment. 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). Commander MSC will exercise such exceptions and mitigations regarding Civil Service Mariners (CIVMARs) and contract personnel, in accordance with existing MSC Quality Management System processes and procedures. 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 three days prior to embarking. 8.e. Pre-Deployment ROM-sequester. Fully vaccinated personnel should not normally ROM-sequester ahead of planned operations. However, Geographic Combatant Commanders (GCC) and some host nations may direct ROM-sequester prior to deploying to specific areas of operation. Per paragraph 5.f, and for tracking and trending purposes, report instances of ROM and ROM-sequester to N3N5 via the POC listed above. 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 unlikely, and modeling contained in references (c), (d), and (e) 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, combined with the isolation requirements of paragraph 6.a.3., can result in unmanageable numbers of even mild illnesses, and increased risk to force or risk to mission. The following HPM, at a minimum, are required as practicable: 8.f.1. Medical screening as outlined above in paragraph 8.b. 8.f.2. Masks. Following inport periods, Commanders should consult with medical providers regarding the inport threat environment and may consider wearing masks for the first 10-days at sea following departure from port. Similarly, Commanders may consider wearing masks in response to the onset of onboard COVID-19 cases until the spread is bounded and the impact is assessed. 8.f.3. Educate and reinforce the importance of both self-monitoring for symptoms and prompt reporting. 8.f.4. Educate and reinforce the importance of frequent hand-washing or sanitizing 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 in support of operational safety and effectiveness and retain the latitude to temporarily apply alternate HPM in lieu of isolation. 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. In the presence of onboard COVID 19, if less than 75% of the total eligible crew is UTD for vaccinations (meaning more than 25% of the crew meets the criteria for, but has not received a vaccine booster, implement the requirements of 8.f.2 (mask wearing) until the impact and trend (8.g.1) are determined. 8.g.3. Proximity to shore or afloat Medical Treatment Facilities, balanced with HPM and onboard trend. For example, crews that are 100 percent fully vaccinated with a manageable COVID-19 case load may choose to operate in locations within a one week timeline to a Medical Treatment Facility, while crews with a growing caseload may more prudently move to a 72-hour or less timeline. 8.h. Port Visits. Liberty is an important mission and should be pursued within the context of this NAVADMIN. Geographic Navy Component Commanders (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, Squadron Commanders may exempt aircrews and aircraft maintainers from this guidance in order to meet emergent operational or NATOPS currency requirements. Exemptions and mitigation plans must be approved by the Squadron Commander. This authority may be delegated to Officers in Charge of deployed detachments. 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 or Master. 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 countries, subject to sovereign immunity concerns (paragraph 9 below). Updated travel information is on the following website: https://travel.state.gov. 8.k. 50+ Participant Meetings. Reference (b) directs additional approval requirements for Navy sponsored in-person gatherings with more than 50 participants. When local installation HPCON level is "Charlie" or greater, Under Secretary of the Navy approval is required. All meeting organizers should require all attendees to follow requirements of exposure risk, including distancing. Meeting requests for Under Secretary of the Navy approval shall be routed through the resource owner to the Director of Navy Staff. Reference (b) exempts military training and exercise events from this requirement. NCCs shall use discretion when exercising this exemption, balancing the health and safety of participants with the potential elevated risk posed by the exemption. 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 (f) 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 (or on a separate U.S. generated document accompanying the NAVMED 6210/3 (e.g., Command Letterhead) that their unit is 100% UTD vaccinated, those disembarking have tested negative within the required timeframe, or that those disembarking have received a vaccine booster. GNCCs may delegate concurrence authority no lower than numbered fleet Commanders. 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 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 five days ahead of need. To avoid precedence beyond COVID-19, an 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. Reference (g) is cancelled. All COVID-19 cases for Navy service members, dependents, civilian employees, and contractors shall be reported to Senior Navy Leadership via the OPNAV COVID-19 SharePoint; access and instructions are available at [https://portal.secnav.navy.mil/cop/crc/COVID]. OPREP-3 Navy Blue messages are required for: 1) COVID-19 related deaths; 2) Service Member MEDEVACs associated with COVID-19; 3) COVID-19 media interest events, and 4) Significant operational impacts due to COVID-19. Format messages IAW Reference (h). 11. Released by VADM W. R. Merz, Deputy Chief of Naval Operations for Operations, Plans and Strategy, OPNAV N3N5.// BT #0001 NNNN UNCLASSIFIED//