U.S. NAVY COVID-19 STANDING GUIDANCE:

2 NAVADMINs are known that refer back to this one:
NAVADMIN ID Title
NAVADMIN 110/21 U.S. NAVY COVID-19 STANDING GUIDANCE UPDATE 1
NAVADMIN 060/22 CASUALTY AND MORTUARY AFFAIRS PROCESSES IN RESPONSE TO COVID-19 UPDATE THREE
UNCLASSIFIED//

ROUTINE

R 241900Z MAY 21 MID200000883789U

FM CNO WASHINGTON DC

TO NAVADMIN

INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC

BT
UNCLAS

NAVADMIN 099/21

MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/MAY//

SUBJ/U.S. NAVY COVID-19 STANDING GUIDANCE//

REF/A/NAVADMIN/OPNAV/160550ZFEB21//
REF/B/MEMO/OSD/12APR2021//
REF/C/NAVADMIN/OPNAV/042044ZMAY21//
REF/D/MEMO/OSD/04MAY2021//
REF/E/DOC/NMCPHC/14MAY2021//
REF/F/DOC/NMCPHC/19MAR2021//
REF/G/NAVADMIN/OPNAV/251655ZJUN20//
REF/H/MEMO/OSD/11JUN2020//
REF/I/DHA-IPM 20-004/6MAY2021//
REF/J/NAVADMIN/OPNAV/301952ZAPR21//
REF/K/NAVADMIN/OPNAV/051532ZAPR21//

NARR/REF A IS NAVADMIN 037/21, U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL 
GUIDANCE VERSION 4.0.
REF B IS USD P&R FORCE HEALTH PROTECTION (FHP) SUPPLEMENT 20 - DOD GUIDANCE 
FOR PERSONNEL TRAVELING DURING THE CORONAVIRUS DISEASE 2019 PANDEMIC 
AVAILABLE AT https://www.defense.gov/Explore/Spotlight/Coronavirus/Latest-
DOD-Guidance/.
REF C IS NAVADMIN 088/21 SARS-COV-2 VACCINATION AND REPORTING POLICY.
REF D IS USD P&R FORCE HEALTH PROTECTION (FHP) SUPPLEMENT 16 REVISION 1 DOD 
GUIDANCE FOR DEPLOYMENT AND REDEPLOYMENT OF INDIVIDUALS AND UNITS DURING 
CORONAVIRUS DISEASE 2019 PANDEMIC AVAILABLE AT 
https://www.defense.gov/Explore/Spotlight/Coronavirus/Latest-DOD-Guidance/.
REF E IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER U.S. NAVY FORCE HEALTH 
PROTECTION WITH CONSIDERATIONS FOR VACCINE EFFICACY.
REF F IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER DOCUMENT ASSESSING REAL
COVID-19 RISK.
REF G IS NAVADMIN 178/20, COVID-19 TESTING.
REF H IS USD P&R FHP SUPPLEMENT 11  GUIDANCE FOR CORONAVIRUS DISEASE 2019 
SURVEILLANCE AND SCREENING WITH TESTING.
REF I IS THE DEFENSE HEALTH AGENCY-INTERIM PROCEDURES MEMORANDUM ON THE 
DEPARTMENT OF DEFENSE CORONAVIRUS DISEASE 2019 VACCINATION PROGRAM 
IMPLEMENTATION.
REF J IS NAVADMIN 086/21, UPDATED GUIDANCE TO COMMANDERS ON ADJUSTING HEALTH 
PROTECTION CONDITIONS AND BASE SERVICES DURING COVID-19 PANDEMIC (CORRECTED 
COPY).
REF K IS NAVADMIN 073/21, NAVY MITIGATION MEASURES IN RESPONSE TO CORONAVIRUS 
OUTBREAK UPDATE 7 (CONDITIONS-BASED APPROACH TO COVID-19 PERSONNEL MOVEMENT 
AND TRAVEL RESTRICTIONS).//
POC/COVID-19 CRISIS ACTION TEAM /(703) 681-1125/EMAIL:
usn.ncr.bumedfchva.mbx.bumed-2019-ncov-response-cell@mail.mil.

RMKS/1.  THIS MESSAGE REPLACES U.S. NAVY COVID-19 STANDARDIZED OPERATIONAL 
GUIDANCE (SOG) VERSION 4.0 ISSUED IN REF (A) IN ITS ENTIRETY AND BECOMES 
STANDING GUIDANCE.  REF (A) IS CANCELLED.  WITH MORE THAN A YEAR OPERATING IN 
THE COVID-19 ENVIRONMENT, OUR SAILORS, CIVILIANS AND CONTRACTOR PERSONNEL 
HAVE ASSUMED PERSONAL RESPONSIBILITY AND GAINED SIGNIFICANT EXPERTISE IN 
MITIGATING AND PREVENTING THE SPREAD OF THE DISEASE AS DEMONSTRATED BY 
ACHIEVING THE LOWEST SERVICE COVID-19 CASE COUNT AND HIGHEST VACCINATION 
RATES.  WE MUST CONTINUE TO PURSUE FULL VACCINATION AND APPLY BEST HEALTH 
PROTECTION MEASURES BOTH AT HOME AND AT WORK TO SUSTAIN AND IMPROVE UPON THIS 
PERFORMANCE.  COMMANDING OFFICERS ARE ULTIMATELY RESPONSIBLE FOR THE HEALTH 
PROTECTION OF THEIR CREWS AND SHOULD APPLY THE GUIDANCE PROVIDED BELOW TO 
BEST FIT THEIR SPECIFIC OPERATIONAL SITUATION SUPPORTED BY THE MEDICAL 
COMMUNITY AND GUIDED BY THEIR CHAIN OF COMMAND.  IN THE ABSENCE OF OPNAV OR 
DEPARTMENT OF DEFENSE (DOD) GUIDANCE, FOLLOW THE CENTERS FOR DISEASE CONTROL 
(CDC) GUIDANCE.  WIDESPREAD IMMUNIZATION, COMMAND ENGAGEMENT, CREW OWNERSHIP, 
AND INDIVIDUAL ACCOUNTABILITY ARE THE CORNERSTONES TO OUR SUCCESS TO DATE.  
HEALTH PROTECTION MEASURES SUCH AS VACCINATION, THE CREATION OF A BUBBLE, 
FACE COVERINGS, PHYSICAL DISTANCING, STAYING OUT OF THE WORKSPACE WHEN 
FEELING ILL AND AGGRESSIVE SPACE CLEANING ARE THE GREATEST INFLUENCERS TO 
PREVENT AND ISOLATE COVID-19.  THE COVID-19 VACCINES AUTHORIZED BY THE U.S. 
FOOD AND DRUG ADMINISTRATION ARE SAFE, EFFECTIVE AND IN PARTICULAR, ARE VITAL 
TO PROTECTING RECIPIENTS FROM HOSPITALIZATION AND DEATH.  COMMANDING OFFICERS 
SHOULD MAKE EVERY EFFORT TO EDUCATE THEIR CREWS ON THE IMPORTANCE OF 
VACCINATION AND FACILITATE OPEN DISCUSSIONS WITH MEDICAL PERSONNEL IF THERE 
ARE QUESTIONS.  DOCUMENTED COVID-19 CASES AMONG IMMUNIZED PERSONNEL ARE VERY 
INFREQUENT AND ALL CASES HAVE BEEN MILD TO MODERATE.  CONSISTENT WITH REF 
(F), TO DATE NONE OF THE MORE THAN 230,000 FULLY IMMUNIZED NAVY AND MARINE 
CORPS MEMBERS HAVE BEEN HOSPITALIZED.

2.  DEFINITIONS.  COVID-19 CASE, CLOSE CONTACT, INFLUENZA LIKE ILLNESS (ILI), 
ISOLATION, QUARANTINE, TESTING (DIAGNOSTIC, SCREENING, AND SURVEILLANCE), AND 
OTHER DEFINITIONS ARE AVAILABLE ON THE CDC WEBSITE.  THE FOLLOWING NAVY 
DEFINITIONS ARE PROVIDED:

2.A.  PATIENT (OR PERSON) UNDER INVESTIGATION (PUI):  AN INDIVIDUAL WITH 
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.  HIGH-RISK PERSONNEL:  THOSE INDIVIDUALS, DESIGNATED BY A MEDICAL 
PROVIDER, WHO MEET THE CDC CRITERIA FOR INCREASED RISK OF SEVERE ILLNESS 
HTTPS://WWW.CDC.GOV/CORONAVIRUS/2019-NCOV/NEED-EXTRA-PRECAUTIONS/
PEOPLE-AT-HIGHER-RISK.HTML.

2.C.  RESTRICTION OF MOVEMENT (ROM):  GENERAL DOD TERM FOR LIMITING PERSONAL 
INTERACTION TO REDUCE RISK TO THE HEALTH, SAFETY AND WELFARE OF A BROADER 
COHORT.PERSONNEL EXECUTING A ROM ARE CONSIDERED TO BE IN A DUTY STATUS AND 
ROM PERIODS WILL NOT BE COUNTED AS LEAVE.

2.C.1.  ROM-SEQUESTER:  U.S. NAVY TERM FOR PREEMPTIVE SEPARATION OF FORCES TO 
REDUCE RISK OF INFECTION WHILE ATTEMPTING TO ESTABLISH A COVID-FREE BUBBLE.

2.D.  BUBBLE:  TERM FOR INDIVIDUALS, UNITS OR INSTALLATIONS THAT HAVE 
ESTABLISHED LOW PROBABILITY OF COVID-19 INFECTION DUE TO CREW IMMUNIZATION 
LEVEL AND/OR COMPLETION OF 14 DAY ROM-SEQUESTER FOR NON-IMMUNIZED 
INDIVIDUALS.

2.E.  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 PARTIAL OR FULL DOSES, RESPECTIVELY.

2.F.  IMMUNIZED / FULLY VACCINATED:  INTERCHANGEABLE TERMS FOR AN INDIVIDUAL 
WHO COMPLETED THE VACCINE SERIES AND IS CONSIDERED IMMUNE TWO WEEKS AFTER THE 
VACCINE SEQUENCE IS COMPLETE.  IMMUNITY DURATION WILL BE GUIDED BY CDC, BUT 
IS NO LESS THAN SEVEN MONTHS FOR THIS STANDING GUIDANCE.

2.G.  DEFERRED:  AN INDIVIDUAL WHO WAS OFFERED AN AUTHORIZED VACCINE, BUT

DECLINED OR WAS UNABLE TO RECEIVE IT FOR ANY REASON.  THESE INDIVIDUALS ARE 
ENCOURAGED AND ALLOWED TO CHOOSE, AT ANY TIME, TO RECEIVE THE VACCINE UNLESS 
MEDICALLY CONTRAINDICATED.  AFTER RECEIVING A VACCINE DOSE, AN INDIVIDUAL 
WILL NO LONGER BE LISTED AS DEFERRED.

2.H.  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.I.  HEALTH PROTECTION MEASURES (HPM):  TERM FOR MEASURES TAKEN TO DECREASE 
RISK OF COVID-19 IN AN OPERATIONAL SETTING.  THIS INCLUDES PHYSICAL 
DISTANCING, WEARING OF FACEMASKS, AND ENHANCED ENVIRONMENTAL CLEANING.  FULLY 
IMMUNIZED INDIVIDUALS ARE NOT REQUIRED TO WEAR FACEMASKS OR PHYSICALLY 
DISTANCE FROM OTHERS.  EXCEPTIONS ARE THAT FACEMASKS ARE STILL REQUIRED FOR 
ALL MEDICAL AND DENTAL PERSONNEL WHEN PROVIDING HEALTH CARE AND FOR ALL 
INDIVIDUALS UNDERGOING TRAVEL ABOARD PUBLIC TRANSPORTATION TO JOIN A CREW 
ALREADY UNDERWAY, REGARDLESS OF IMMUNIZATION STATUS.

3.  CLOSE CONTACTS AND SYMPTOMATIC PERSONNEL.

3.A.  CLOSE CONTACTS WHO HAVE BEEN FULLY VACCINATED AND INDIVIDUALS WHO HAVE 
TESTED POSITIVE IN THE PAST THREE MONTHS DO NOT NEED TO QUARANTINE.  
ASYMPTOMATIC PERSONNEL WHO ARE NOT IMMUNIZED AND ARE SUSPECTED OF EXPOSURE 
SHALL QUARANTINE IN ACCORDANCE WITH (IAW) CDC AND LOCAL MEDICAL GUIDANCE.

3.B.  SYMPTOMATIC PERSONNEL REGARDLESS OF IMMUNIZATION STATUS SHALL FOLLOW 
LOCAL MEDICAL AND CDC GUIDANCE ON WHAT TO DO WHEN YOU ARE SICK.

3.C.  A NON-IMMUNIZED PATIENT WITH SUSPECTED COVID-LIKE ILLNESS (CLI) OR ILI 
WHO HAS TESTED NEGATIVE FOR COVID-19 MAY RETURN TO WORK AFTER:  (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.  IMMUNIZED PATIENTS WITH SUSPECTED CLI/ILI SHOULD CONSULT 
THEIR MEDICAL PROVIDER BEFORE RETURNING TO WORK.

3.D.  COVID-19 CASES MAY CONTINUE TO TEST POSITIVE FOR UP TO THREE MONTHS DUE 
TO THE PRESENCE OF PERSISTENT NON-INFECTIOUS VIRAL FRAGMENTS AND THEREFORE 
EXEMPT FROM TESTING PROTOCOL FOR THREE MONTHS FROM THE EARLIER OF SYMPTOM 
ONSET OR FIRST POSITIVE TEST.  INDIVIDUALS WHO EXHIBIT NEW OR PERSISTENT 
SYMPTOMS DURING THAT THREE MONTH PERIOD SHOULD BE EVALUATED BY A MEDICAL 
PROVIDER.

3.E.  OUTBREAK INVESTIGATION AND CONTACT TRACING WORKFORCE TRAINING.  EACH 
COMMAND WILL MAINTAIN THE ABILITY TO EXECUTE CONTACT TRACING FOR ASSIGNED 
PERSONNEL BY HAVING AN APPROPRIATE NUMBER OF PERSONNEL TRAINED (NO LESS THAN 
TWO) BASED ON UNIT IMMUNIZATION LEVEL.  NAVY E-LEARNING: CONTACT TRACING 
TRAINING FOR SAILORS AND MARINES CFHP-NMFSC-CTSM-01 OR TEST-OUT ASSESSMENT 
FOR CONTACT TRACING TRAINING FOR SAILORS AND MARINES CFHP-NMFSC-CTSMTA-01.

4.  DEPLOYED OPERATIONS

4.A.  PRE-DEPLOYMENT SCREENING.  SCREENING FOR ALL PERSONNEL WILL CONSIST OF 
AN ASSESSMENT OF EXPOSURE HISTORY, A REVIEW OF ANY PAST TESTING AND A 
THOROUGH EVALUATION OF THE MEMBERS RISK FACTORS FOR SEVERE ILLNESS FROM 
COVID-19.  THE DECISION TO DEPLOY A HIGH RISK INDIVIDUAL MUST BE MADE, AT A 
MINIMUM, BY THE COMMANDING OFFICER IN CONSULTATION WITH MEDICAL PROVIDERS.  
MILITARY SEALIFT COMMAND (MSC) WILL MEDICALLY SCREEN CIVIL SERVICE AND 
CONTRACT PERSONNEL FOR DEPLOYMENT ON MSC VESSELS IAW EXISTING MSC 
INSTRUCTIONS AND CONTRACTS.  IMMUNIZATION STATUS SHOULD BE PART OF THE 
DECISION TO DEPLOY HIGH RISK PERSONNEL ALONG WITH THE PERCENT OF THE UNIT 
IMMUNIZED, THE PROXIMITY TO AN MILITARY TREATMENT FACILITY (MTF) OR AFLOAT 
MEDICAL FACILITY WITH COVID THERAPEUTICS AND ICU CAPABILITIES, AND MEDICAL 
PROVIDER CONSULTATION.

4.B.  PRE-DEPLOYMENT ROM-SEQUESTER.  ROM-SEQUESTER IS NOT REQUIRED FOR 
IMMUNIZED INDIVIDUALS ATTACHED TO SHIPS OR SUBMARINES, NOR FOR IMMUNIZED 
INDIVIDUALS TRAVELING BY AIRCRAFT UNLESS OTHERWISE REQUIRED BY GCC AS MEANS 
OF RESPECTING HN LAW OR BY A MORE RESTRICTIVE DOD POLICY.  FOR NON-IMMUNIZED 
INDIVIDUALS ONLY, 14-DAY ROM-SEQUESTER WITH TEST-IN AND TEST-OUT IS REQUIRED 
PRIOR TO DEPLOYMENT.
DURING ROM-SEQUESTER, CONDUCT ENHANCED DAILY PERSONNEL MEDICAL SCREENING.

4.B.1.  IAW REF (D), NON-IMMUNIZED PERSONNEL DEPLOYING OUTSIDE THE UNITED 
STATES NOT USING MILITARY/CHARTERED TRANSPORTATION WILL CONDUCT A 14-DAY ROM 
PRIOR TO DEPLOYMENT UNLESS COMBATANT COMMAND MANDATES IN-COUNTRY ROM.  IAW 
REF (B), NCC MAY DELEGATE TO FIRST FLAG OFFICER/SES IN CHAIN OF COMMAND THE 
AUTHORIZATION TO REDUCE THIS ROM TIMELINE TO AS FEW AS SEVEN DAYS IF 
OPERATIONALLY NECESSARY WITH A NEGATIVE PCR TEST ADMINISTERED ONE TO THREE 
DAYS PRIOR TO EMBARKATION.
INDIVIDUALS WHO HAVE HAD COVID-19 IN THE PAST THREE MONTHS ARE EXEMPT FROM 
ROM.
IF TRAVELING OCONUS AND THE HOST NATION REQUIRES IN-COUNTRY ROM, CONUS PRE-
DEPLOYMENT ROM-SEQUESTER IS NOT REQUIRED UNLESS THE HOST NATION OR COMBATANT 
COMMAND EXPLICITLY MANDATES BOTH.  IMMUNIZED AND NON-IMMUNIZED PERSONNEL MUST 
CONSULT FOREIGN CLEARANCE GUIDANCE FOR MOST CURRENT REQUIREMENTS APPLICABLE 
TO ALL TRAVELERS, AVAILABLE AT HTTPS://WWW.FCG.PENTAGON.MIL.

4.B.2.  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 AN OPERATIONAL UNIT IF NON-IMMUNIZED, OR 
IAW WITH NCC APPROVED COMMUNITY CONOPS (E.G., SSN/SSBN).

4.C.  UNDERWAY HEALTH PROTECTION MEASURES (HPM).  BASED ON A YEAR OF 
EXPERIENCE AND EXTENSIVE MODELING BY NAVY AND MARINE CORPS PUBLIC HEALTH 
CENTER INCORPORATING BASELINE NATURAL IMMUNITY, COVID PREVALENCE AND VACCINE 
EFFECTIVENESS WHICH IS CONTAINED IN REFS (E) AND (F), RECOMMEND UNDERWAY HPM 
IMPLEMENTATION AS FOLLOWS:
-- LARGE DECKS WITH MEDICAL CAPABILITY (LPD/LHD/LHA/CVNS) AFTER NON-IMMUNIZED 
INDIVIDUALS COMPLETE QUALITY 14 DAY PRE-DEPLOYMENT ROM AND HAVE A NEGATIVE 
PCR TEST PRIOR TO EMBARKING:  NCCS MAY RELAX HPM FOR ALL CREWMEMBERS ONCE 
UNDERWAY PROVIDED IMMUNIZATION RATE OF COMBINED CREW IS GREATER THAN 70%.  IF 
IMMUNIZATION RATE IS LESS THAN 70%, NON-IMMUNIZED CREWMEMBERS MUST PRACTICE 
HPM FOR AT LEAST 14 DAYS UNDERWAY.  IF NO CASES FOR AT LEAST 14 DAYS, THEN 
NCCS MAY RELAX HPM.
-- SMALLER SHIPS OR THOSE WITH LESS ON-BOARD MEDICAL CAPABILITY (LHD/LHA/LPDS 
WITHOUT FLEET SURGICAL TEAM OR BOARD CERTIFIED MEDICAL OFFICER EMBARKED), 
AFTER NON-IMMUNIZED INDIVIDUALS COMPLETE QUALITY 14 DAY PRE-DEPLOYMENT ROM 
AND HAVE A NEGATIVE PCR TEST PRIOR TO EMBARK:  NCCS MAY RELAX UNDERWAY HPM 
FOR ALL CREWMEMBERS ONCE UNDERWAY IF CREW IMMUNIZATION RATE IS GREATER THAN 
80% (DUE TO LESS ONBOARD MEDICAL CAPABILITY).  IF IMMUNIZATION RATE IS LESS 
THAN 80%, NON-IMMUNIZED CREWMEMBERS MUST PRACTICE HPM FOR AT LEAST 14 DAYS 
UNDERWAY.
IF NO CASES FOR AT LEAST 14 DAYS, THEN NCCS MAY RELAX HPM.
-- FOR ALL UNITS REGARDLESS OF TYPE WHEN NON-IMMUNIZED INDIVIDUALS HAVE NOT 
COMPLETED PRE-DEPLOYMENT ROM (E.G., LOCAL OPS, GROUP SAIL OR C2X):  NCCS MAY 
RELAX UNDERWAY HPM FOR ALL CREWMEMBERS PROVIDED COMBINED IMMUNIZATION RATE IS 
AT LEAST 90%.  IF IMMUNIZATION RATE IS LESS THAN 90%, NON-IMMUNIZED 
CREWMEMBERS MUST PRACTICE HPM FOR AT LEAST 14 DAYS UNDERWAY.  IF NO CASES FOR 
AT LEAST 14 DAYS, THEN NCCS MAY RELAX HPM.
-- HPM MEASURES MAY BE TEMPORARILY RELAXED WHERE OPERATIONALLY NECESSARY.
-- IT IS ALWAYS GOOD PRACTICE FOR ALL CREWMEMBERS TO PRACTICE HPM WHENEVER 
PRACTICAL REGARDLESS OF VACCINATION STATUS TO HELP PREVENT A WIDE VARIETY OF 
SHIPBORNE DISEASES.

4.C.1.  DISEASE SEVERITY AND VACCINES.  GIVEN FDA AUTHORIZED VACCINES PROTECT 
AGAINST DISEASE SEVERITY, EVEN IN THE VERY SMALL PERCENT OF PEOPLE WHO MAY 
POTENTIALLY STILL GET COVID-19 INFECTION, THE RISK OF HAVING TO MEDEVAC AN 
IMMUNIZED COVID-19 INFECTED INDIVIDUAL IS EXTREMELY LOW.  REDUCING THE 
LIKELIHOOD OF SEVERE ILLNESS IS A KEY OUTCOME MEASURE THAT SPEAKS TO THE 
ABILITY TO MAINTAIN OPERATIONS AT SEA WITHIN EXISTING MEDICAL CAPABILITIES.

4.D.  PENETRATING A BUBBLE.  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 MEASURES.  WHEN INVOLVED IN MOVEMENT TO SEQUENTIAL COMMANDS, IT 
MAY BE ADVISABLE TO ROM-SEQUESTER NON-IMMUNIZED COHORTS, USE BUBBLE TO BUBBLE 
TRANSPORTATION, AND/OR TEST NON-IMMUNIZED INDIVIDUALS PERIODICALLY.  
IMMUNIZED INDIVIDUALS ARE NOT REQUIRED TO ROM-SEQUESTER.  NCCS MAY REQUIRE 
NON-IMMUNIZED SHIP RIDERS PENETRATING AN ESTABLISHED BUBBLE TO COMPLETE A 14-
DAY ROM-SEQUESTER WITH TEST-IN AND TEST-OUT PRIOR TO EMBARKING DEPENDENT ON 
CREW IMMUNIZATION LEVEL.  A TEST IS NOT REQUIRED FOR PERSONNEL WHO HAVE 
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 
EMBARKING A SHIP.  MITIGATION PLANS FOR NON-IMMUNIZED INDIVIDUALS TO 
PENETRATE AN ESTABLISHED BUBBLE WITHOUT A
14 DAY ROM-SEQUESTER AND/OR TEST DUE TO EMERGENT OPERATIONAL REQUIREMENTS 
MUST BE APPROVED BY THE COMMANDING OFFICER.

4.E.  PORT VISITS.  COMMANDING OFFICERS 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) TO 
TAKE ADVANTAGE OF BASE SERVICES.  GEOGRAPHIC NCCS (DELEGABLE TO NUMBERED 
FLEET COMMANDERS) WILL CONTROL FOREIGN PORT VISIT OFF-BASE LIBERTY FOR ALL 
INDIVIDUALS IN COORDINATION WITH COUNTRY TEAMS AND LOCAL AUTHORITIES TAKING 
INTO ACCOUNT INDIVIDUAL AND CREW IMMUNIZATION STATUS, COUNTRY COVID 
PREVALENCE AND MISSION REQUIREMENTS.

4.F.  AIRCRAFT OPERATIONS.  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 
COMMANDING OFFICER.
FOR AVIATION UNITS EMBARKED ON SURFACE UNITS, MITIGATION PLANS WILL BE 
INCLUDED AND APPROVED AS PART OF THE OVERALL SHIP HEALTH PROTECTION PLAN.

4.G.  TESTING.  TESTING IS THE ONLY METHOD TO DETECT ASYMPTOMATIC 
TRANSMISSION WITHIN THE NON-IMMUNIZED FORCE.  CONSIDER SCREENING TESTS FOR 
NON-IMMUNIZED INDIVIDUALS DURING OFRP CYCLE TO IDENTIFY COVID-19 EARLY AND TO 
BREAK THE TRANSMISSION CYCLE.  CONTINUOUSLY ASSESS THE INTEGRITY OF A BUBBLE 
THROUGH CLI/ILI SCREENING OF NON-IMMUNIZED PERSONNEL.  PLATFORMS WITH TESTING 
CAPABILITY SHOULD EMPLOY SYMPTOMATIC TESTING (DIAGNOSTIC) FOR EVERYONE AND 
TARGETED CREW TESTING (SCREENING) FOR NON-IMMUNIZED SAILORS.  ALL COVID-19 
DIAGNOSTIC TESTS MUST BE ENTERED IN THE MEDICAL RECORD.  SCREENING AND 
SURVEILLANCE TESTS THAT ARE INDIVIDUALLY IDENTIFIABLE MUST BE ENTERED INTO 
THE MEDICAL RECORD.
DIAGNOSTIC POOLED TESTING UNDERWAY IS ALLOWED FOR MODERATE COMPLEXITY LABS 
USING BIOFIRE AND CEPHEID AND 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.

4.H.  POST-DEPLOYMENT.  IAW CDC GUIDANCE, NON-IMMUNIZED PERSONNEL RETURNING 
TO CONUS FROM DEPLOYMENT ARE REQUIRED TO HAVE A NEGATIVE VIRAL TEST RESULT NO 
MORE THAN THREE DAYS BEFORE TRAVEL INTO THE U.S.; BE TESTED 3-5 DAYS AFTER 
ARRIVAL AND STAY HOME AND SELF-QUARANTINE FOR SEVEN FULL DAYS, EVEN IF THE 
TEST IS NEGATIVE.  POST DEPLOYMENT ROM AND TESTING IS NOT REQUIRED FOR 
PERSONNEL WHO HAVE RECOVERED FROM COVID-19 WITHIN THE PAST 90 DAYS (DUE TO 
THE POSSIBILITY OF PERSISTENT POSITIVE RESULTS IN NON-INFECTIOUS PERSONS), 
AND DOES NOT APPLY TO SHIPS, THEIR EMBARKED AIRCRAFT OR SUBMARINES RETURNING 
TO PORT PROVIDED THERE HAVE BEEN NO ACTIVE COVID-19 CASES OR POTENTIAL 
CONTACT WITH INFECTED PERSONNEL DURING THE LAST 14 DAYS OF DEPLOYMENT.
NON-IMMUNIZED INDIVIDUALS WHO DO NOT GET TESTED MUST STAY HOME AND SELF -
QUARANTINE FOR 10 DAYS AFTER TRAVEL.  NON-IMMUNIZED SERVICE MEMBERS 
REDEPLOYING FROM, ORTHROUGH, A FOREIGN COUNTRY, UPON ARRIVAL AT THE 
DESTINATION DOMICILE WILL ROM AT THEIR PERSONAL RESIDENCE (OR APPROPRIATE 
DOMICILE) FOR AT LEAST 10 DAYS WITHOUT TESTING OR AFTER AN APPROPRIATE RISK 
ASSESSMENT BY THE FIRST FLAG OFFICER IN THE CHAIN OF COMMAND FOR SEVEN DAYS 
WITH A NEGATIVE COVID-19 TEST WITHIN 48 HOURS PRIOR TO THE END OF THE SEVEN 
DAY ROM.  SERVICE MEMBERS REQUIRED TO ROM ARE RESTRICTED TO THEIR RESIDENCE 
AND MUST LIMIT CLOSE CONTACTS FOR THE DURATION OF ROM.

4.H.1. IMMUNIZED PERSONNEL HAVE NO ROM OR TESTING REQUIREMENTS POST-
DEPLOYMENT.

4.H.2.  AT THE COMPLETION OF DEPLOYMENT, MILITARY PERSONNEL WILL COMPLETE A 
POST-DEPLOYMENT HEALTH ASSESSMENT (DD FORM 2796) AND POST-DEPLOYMENT HEALTH 
REASSESSMENT (DD FORM 2900) IAW REF (D).

5.  ALL UNITS, STAFFS AND SHORE COMMANDS.

5.A. HPM.  FOLLOW LATEST DOD FORCE HEALTH PROTECTION, CDC AND STATE/LOCAL 
AREA GUIDANCE TO ENSURE THE HEALTH OF THE FORCE.

5.B.  SEE REF (J) NAVADMIN FOR LATEST GUIDANCE ON ADJUSTING HEALTH PROTECTION 
CONDITIONS AND BASE SERVICES.

5.C.  SEE REF (K) NAVADMIN UPDATES FOR LATEST GUIDANCE ON CONDITIONS BASED 
APPROACHES TO PERSONNEL MOVEMENT AND TRAVEL RESTRICTIONS.

6.  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.

6.A.  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.

7.  PROVISION OF CREW HEALTH INFORMATION DURING PORT VISITS.  THIS PARAGRAPH 
ALSO APPLIES TO USNS, U.S. GOVERNMENT-OWNED VESSELS, AND U.S.-FLAGGED
TIME- AND BAREBOAT-CHARTERED VESSELS, AS WELL AS SOVEREIGN IMMUNE AIRCRAFT.

7.A.  IT IS ANTICIPATED THAT SOME COUNTRIES TO WHICH A PORT VISIT MAY BE 
PLANNED WILL REQUEST DETAILED INFORMATION ABOUT THE HEALTH OF THE CREW 
ONBOARD, INCLUDING TEST RESULTS, PROOF OF VACCINATION, ETC., AS A CONDITION 
OF ENTRY.
IT IS DOD AND DEPARTMENT OF THE NAVY POLICY TO PRESERVE THE SOVEREIGN 
IMMUNITY OF WARSHIPS, NAVAL AUXILIARIES, AND SOVEREIGN IMMUNE AIRCRAFT, 
INCLUDING PROTECTING CREW INFORMATION, TO THE MAXIMUM EXTENT POSSIBLE.  THE 
NAVY

DECLARATION OF HEALTH (NAVMED 6210/3) REMAINS THE ONLY AUTHORIZED MEANS FOR 
PROVIDING HEALTH INFORMATION OF THE CREW TO FOREIGN OFFICIALS.  PROVIDING ANY 
INFORMATION BEYOND THE NAVMED 6210/3 EXCEEDS THE U.S. REQUIREMENTS UNDER 
INTERNATIONAL LAW AND ADVANCES A POSITION THE EXECUTIVE BRANCH HAS NOT 
AUTHORIZED.  SHOULD A HOST NATION REQUIRE INFORMATION BEYOND THE NAVMED 
6210/3, CONSULT WITH THE APPLICABLE GEOGRAPHIC NAVAL COMPONENT COMMAND 
(GNCC).

7.B.  COMMANDING OFFICERS, MASTERS, AND AIRCRAFT COMMANDERS SHALL COMPLY WITH 
ALL DOMESTIC AND FOREIGN QUARANTINE REGULATIONS FOR ENTRY INTO PORT, AND MAY 
DOCUMENT SUCH COMPLIANCE ON THE NAVMED 6210/3.  IF REQUIRED BY THE HOST 
NATION TO EXIT THE PIER/AIRPORT FACILITY AND ENTER THE COUNTRY, THE GNCCS, IN 
CONJUNCTION WITH THE COUNTRY TEAM, MAY ASSERT THAT ONLY VACCINATED 
INDIVIDUALS WILL BE ALLOWED LIBERTY WITHIN THE HOST NATION, BUT MAY NOT 
PROVIDE THE PERCENTAGE OF THE CREW THAT HAS BEEN VACCINATED.  OTHER ALLOWABLE 
MEASURES INCLUDE SUBMITTING TO A TEMPERATURE SCAN UPON ENTERING/EXITING THE 
PIER OR THE AIRPORT.
THESE ASSERTIONS AND MEASURES SHOULD NOT BE ALLOWED FOR PERSONNEL SOLELY 
USING PIER FACILITIES IN SUPPORT OF PORT VISITS (E.G., INSIDE AN ECP OR SAFE-
HAVEN
ARRANGEMENT) AND NOT ENTERING THE HOST NATION.

7.C.  COMMANDING OFFICERS, MASTERS, AND AIRCRAFT COMMANDERS SHALL NOT PROVIDE 
ANY INDIVIDUAL OR COLLECTIVE MEDICAL DATA OR COPIES OF WRITTEN 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.  UNLESS ENGAGED IN PREAUTHORIZED OR 
EMERGENT HEALTHCARE, SERVICE MEMBERS AND THE CREWS OF NAVAL AUXILIARIES WILL 
NOT SUBMIT TO HOST NATION COVID -19 TESTING AS A REQUIREMENT OF PORT ENTRY.
HOST NATION OFFICIALS SHALL NOT BE PERMITTED TO REQUIRE PRODUCTION OF, OR 
TAKE A PHOTOCOPY OF, SERVICE MEMBERS PROOF OF VACCINATION.

7.D.  ANY ACTION THAT MAY CONSTITUTE A WAIVER OR POTENTIAL WAIVER OF 
SOVEREIGN IMMUNITY OR THAT MAY RESULT IN COMPROMISE OF OPERATIONAL SECURITY 
(OPSEC) MUST BE COORDINATED WITH N3N5 PRIOR TO ACTION BEING TAKEN ON THE 
MATTER.  IAW NAVY POLICY, GNCCS SHALL PROVIDE AS LITTLE INFORMATION AS 
POSSIBLE IN ORDER TO MEET ESSENTIAL OPERATIONAL REQUIREMENTS AND SHOULD NOT 
SUBMIT TO ANY REQUIREMENT THAT THE U.S. WOULD NOT REQUIRE OF VISITORS IN A 
SIMILAR CATEGORY.  EVERY EFFORT WILL BE MADE TO DETERMINE IN ADVANCE WHETHER 
A HOST NATION WILL REQUIRE SUCH INFORMATION, AND SHIPS, AND AIRCRAFT MAY BE 
DIVERTED IF NECESSARY, TO AVOID THOSE REQUIREMENTS.

7.E.  GNCCS WILL ENSURE APPROPRIATE TRAINING ON THE PROTECTION OF HEALTH 
INFORMATION AS PART OF OPSEC/PERSONAL SECURITY AND ON THE IMPORTANCE OF 
VIGOROUSLY DEFENDING THE ABSOLUTE SOVEREIGN IMMUNITY OF WARSHIPS AND THE 
SOVEREIGN IMMUNITY OF OTHER STATE VESSELS AND AIRCRAFT.

8.  TESTING.  REF (G) IS CANCELLED AND REPLACED WITH THE FOLLOWING GUIDANCE.

8.A.  ASYMPTOMATIC TESTING REQUESTS AND COORDINATION.  COMMANDS WILL 
COORDINATE TESTING NEEDS WITH THEIR SUPPORTING MTF 60 DAYS IN ADVANCE FOR 
PLANNED SHIP / SQUADRON / UNIT MOVEMENTS.  ADVANCED PLANNING IS REQUIRED TO 
ENSURE TESTING CAPACITY IS AVAILABLE TO SUPPORT OPERATIONAL DEMANDS.

8.A.1.  ISIC AND TYPE COMMANDERS WILL ENSURE TESTING IS PLANNED AND 
COORDINATED IN ADVANCE.

8.A.2.  ISIC AND TYPE COMMANDERS WILL COORDINATE WITH THE APPROPRIATE NAVY 
MEDICAL REGION TO SUPPORT SHORT NOTICE (LESS THAN TWO WEEKS ADVANCED 
PLANNING) TESTING.

8.B.  SENTINEL SURVEILLANCE TESTING (SST) IS REQUIRED PER REF (H).  SST IS 
DESIGNED TO DETECT AND PREVENT ASYMPTOMATIC SPREAD OF COVID-19.  COMMANDS 
WITH GREATER THAN 75% FULLY IMMUNIZED PERSONNEL WILL TEST THE DESIGNATED 
PERCENTAGES IN PARAGRAPH 8.B.1 AND 8.B.2 MONTHLY VICE EVERY 14 DAYS DUE TO 
HIGHER VACCINATION RATES.  COMMANDS WITH GREATER THAN 85% IMMUNIZATION DO NOT 
REQUIRE SST.  COMMANDS WHO ARE TESTING THEIR INSTALLATION/UNIT POPULATION TO 
MEET TRAVEL/HOST NATION/FHP 16 TRAVEL REQUIREMENTS CAN INCLUDE THOSE TESTS IN 
THEIR SST CALCULATIONS.

8.B.1.  COMMANDS WILL TEST 1% OF NON-IMMUNIZED CREW/STAFF EVERY 14 DAYS.
COMMANDS WITHOUT ORGANIC TESTING CAPABILITY WILL COORDINATE WITH THEIR 
SERVICING MTF.

8.B.2.  MEDICAL COMMANDS UNDER THE AUTHORITY, DIRECTION AND CONTROL OF THE 
NAVY WILL TEST TEN PERCENT OF NON-IMMUNIZED PERSONNEL EVERY 14 DAYS.

9.  VACCINE ORDERING AND ADMINISTRATION.  AMPLIFYING GUIDANCE TO REF (C).

9.A.  NEW COVID VACCINATION SITES MUST COMPLETE TRAINING, LOGISTICS, AND 
PREPAREDNESS FOR VACCINE ADVERSE REACTIONS IAW REF (I), COMPLETE A READY TO 
RECEIVE CHECKLIST AND SUBMIT TO TYCOM FOR REVIEW.

9.A.1.  COMMANDING OFFICERS OF NEW VACCINATION SITES WILL ENSURE VACCINATION 
PERSONNEL COMPLETE TRAINING REQUIRED BY REF (I) AS PART OF THE READY TO 
RECEIVE CHECKLIST.

9.A.2.  COMMANDING OFFICERS OF NEW VACCINATION SITES WILL ENSURE APPROPRIATE 
COLD STORAGE CONDITIONS ARE AVAILABLE, TEMPERATURE CONDITIONS ARE SPECIFIC TO 
EACH VACCINE AND AVAILABLE FROM THE US FDA FOR AUTHORIZED AND LICENSED 
VACCINES.

9.B.  ONLY SHIPS WITH ROLE TWO CAPABILITIES EMBARKED ARE AUTHORIZED TO 
ADMINISTER VACCINE WHILE AT SEA.  ALL FLEET PLATFORMS WHO HAVE COMPLETED 
REQUIREMENTS IAW REF (I) ARE AUTHORIZED TO ORDER AND ADMINISTER VACCINE PIER 
-SIDE WHEN ACCESS TO ROLE TWO OR EMERGENCY MANAGEMENT SERVICES SUPPORT IS 
READILY AVAILABLE.

10.  EXTERNAL NAVY VACCINE REPORTING.  ACTIVE DUTY AND RESERVE PERSONNEL 
VACCINATED AT A COMMERCIAL OR GOVERNMENT VACCINATION SITE OUTSIDE THE DEFENSE 
HEALTH AGENCY NETWORK WILL PROVIDE VACCINATION DOCUMENTATION TO THEIR UNIT
MEDICAL REPRESENTATIVE FOR INCLUSION IN ELECTRONIC HEALTH RECORDS.   UNITS
WITHOUT ORGANIC MEDICAL PERSONNEL WILL PROVIDE VACCINATION DOCUMENTATION TO 
THE LOCAL MILITARY TREATMENT FACILITY ORCLINIC WHERE THEIR PRIMARY CARE IS 
PROVIDED.  RESERVE UNITS WILL ACTIVELY VERIFY VACCINATION STATUS AT EACH 
VIRTUAL OR IN PERSON DRILL WEEKEND AND RESERVISTS WILL TURN IN THEIR VACCINE 
DOCUMENTATION AT THEIR NEXT WORKDAY/DRILL DAY FOR INCLUSION IN THEIR HEALTH 
RECORD.

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

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