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IMMEDIATE
O 201856Z MAY 20 MID510001192418U
FM CNO WASHINGTON DC
TO NAVADMIN
INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC
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NAVADMIN 147/20

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

SUBJ/GUIDANCE TO COMMANDERS ON ADJUSTING HEALTH PROTECTION CONDITIONS AND 
BASE SERVICES//

REF/A/MEMO/OSD/19MAY2020//
REF/B/INST/OPNAV/19NOV2018//
REF/C/DIRECTIVE/OSD/28MAR2019//
REF/D/MEM/OSD/25FEB2020//

NARR/ REF A IS SECRETARY OF DEFENSE GUIDANCE FOR COMMANDERS ON RISK-BASED 
CHANGING OF HEALTH PROTECTION CONDITION (HPCON) LEVELS DURING THE COVID-19
PANDEMIC.   
REF B IS NAVY PANDEMIC INFLUENZA AND INFECTIOUS DISEASE POLICY.
REF C IS DOD DIRECTIVE 6200.03 PUBLIC HEALTH EMERGENCY MANAGEMENT WITHIN THE 
DOD.  
REF D IS OUSD PR FORCE HEALTH PROTECTION GUIDANCE (SUPPLEMENT 2).//

RMKS/1.  THIS NAVADMIN: (1) SUPPLEMENTS GUIDANCE IN REFERENCE (A) AND (B);
(2) PROVIDES ADDITIONAL GUIDANCE FOR COMMANDERS WHEN MAKING LOCAL DECISIONS 
TO ADJUST HPCON SERVICES ON INSTALLATIONS; AND (3) PROVIDES REPORTING 
REQUIREMENTS FOR HPCON AND INSTALLATION SERVICES STATUS.  THE NAVY WILL 
ADJUST HPCON/RESTRICTIONS ON INSTALLATIONS BY TAKING INTO ACCOUNT LOCAL 
ASSESSMENTS AND CONDITIONS BASED ON PUBLIC HEALTH SURVEILLANCE DATA, GUIDANCE 
FROM CENTERS FOR DISEASE CONTROL AND PREVENTION, COLLABORATION WITH STATE, 
TERRITORIAL AND LOCAL AUTHORITIES, AND ADVICE FROM THE COMMAND PUBLIC HEALTH 
EMERGENCY OFFICER (PHEO) AND LOCAL MILITARY TREATMENT FACILITY (MTF).  THESE 
DECISIONS AND ASSESSMENTS SHOULD BE COORDINATED WITH OTHER DOD INSTALLATIONS 
AND FACILITIES WITHIN THE SAME GEOGRAPHIC AREA TO ENABLE CONSISTENT DOD HPCON 
STATUS ACROSS SERVICES.  NAVAL COMPONENT AND REGION COMMANDERS MAY BE MORE OR 
LESS STRINGENT THAN SURROUNDING COMMUNITY REQUIREMENTS BASED ON MISSION AND 
RISK CONSIDERATIONS.

2.  MISSION.  NAVAL COMPONENT COMMANDERS (NCC) WILL COORDINATE HPCON CHANGES 
WITH COMBATANT COMMANDERS AND/OR SUBUNIFIED COMMANDERS AS APPROPRIATE.
COMMANDER, NAVAL INSTALLATIONS COMMAND (CNIC), REGIONAL COMMANDERS (REGCOM), 
AND LOCAL HEALTH OFFICIALS WILL INFORM THE RESPECTIVE NCC USING A METRICS-
BASED, RISK-INFORMED APPROACH TO ADJUSTING INSTALLATION SERVICES AND LOCAL 
FORCE HEALTH PROTECTION CONDITIONS.  THE GOAL IS TO METHODICALLY ENSURE 
SERVICES ARE RESTORED ON NAVY INSTALLATIONS IN A SAFE AND RESPONSIBLE MANNER 
WHEN CONDITIONS PERMIT, AND TO MONITOR HEALTH TRENDS SHOULD SERVICES OR HPCON 
WARRANT RECONSIDERATION.

3.  DEFINITIONS.  REF (A) TABLE 1 PROVIDES CONSIDERATIONS FOR CHANGING HPCON 
LEVELS.  WHEN CHANGING HPCON LEVELS, NCC WILL USE THE FOLLOWING DEFINITIONS:

3.A  WIDESPREAD TRANSMISSION: PERSISTENT ELEVATED CASES WITH EVIDENCE OF 
ONGOING DISEASE TRANSMISSION AFFECTING THE MAJORITY OF THE REGION.  IF NO 
LONGER WIDESPREAD TRANSMISSION, CONSIDER CHANGING FROM HPCON DELTA TO 
CHARLIE.

3.B  SUSTAINED TRANSMISSION: MULTIPLE CASES (GENERALLY >50 PER 100K PER WEEK) 
STILL PRESENT AMONG LOCAL RESIDENTS WITH NO EPIDEMIOLOGICAL LINK.  IF NO 
LONGER SUSTAINED TRANSMISSION, CONSIDER CHANGING FROM HPCON CHARLIE TO BRAVO.

4.  EXECUTION.

4.A CONCEPT OF OPERATION.  THE TRANSITIONS OUTLINED IN THIS NAVADMIN PROVIDES 
A FRAMEWORK TO ASSESS NAVY INSTALLATIONS AND/OR FACILITIES USING LOCAL 
COMMUNITY HEALTH CONDITIONS AND CRITERIA TO INCLUDE: (1) DOWNWARD TRAJECTORY 
OF REPORTED CASES OF INFLUENZA LIKE ILLNESSES (ILI) AND COVID-LIKE ILLNESS 
(CLI) CASES REPORTED OVER THE PRECEDING 14 DAYS; (2) DOWNWARD TRAJECTORY OF 
DOCUMENTED COVID-19 CASES OR OF POSITIVE TESTS AS A PERCENT OF TOTAL TESTS 
OVER THE PRECEDING 14 DAYS; (3) AND MTF AND/OR LOCAL HOSPITALS HAVE THE 
CAPACITY TO TREAT ALL PATIENTS WITHOUT SITUATIONAL STANDARDS OF CARE AS 
DEFINED IN REF (C) AND HAVE AN ESTABLISHED COVID-19 TESTING PROGRAM IN PLACE 
FOR AT-RISK HEALTHCARE WORKERS AND THOSE EXHIBITING ILI AND CLI SYMPTOMS.  AN 
ASSESSMENT OF THESE CONDITIONS AND CRITERIA WILL PROVIDE A LOCALLY DERIVED 
COMMON OPERATING PICTURE OF RISK TO FORCE. INTEGRATED DATA ANALYSIS IS 
AVAILABLE VIA THE ADVANA COVID-19 MODELING PLATFORM. FLEET AND INSTALLATIONS 
COMMANDERS CAN USE THIS PLATFORM TO ACCURATELY DEVELOP COVID-19 COMMON 
OPERATIONAL PICTURE TO BETTER ENABLE DATA INFORMED DECISION MAKING. THE 
ADVANA SYSTEM INCLUDES LIVE DATA UPDATES ON CASES, TESTING CAPACITY, BEDS, 
PERSONNEL, SUPPLY AND LOGISTICS GIVING COMMANDERS REAL-TIME SITUATIONAL 
AWARENESS WHILE PROJECTING IMPACTS TO READINESS. NCC WILL USE THIS TRANSITION 
FRAMEWORK TO INFORM DECISIONS WHICH BALANCE OPERATIONAL READINESS, 
MAINTENANCE, TRAINING, EDUCATION AND THE NEEDS OF INSTALLATION BENEFICIARY 
POPULATIONS.

4.B CRITERIA.  EACH INSTALLATION COMMANDER WILL USE THE FOLLOWING CRITERIA TO 
FACILITATE RISK-INFORMED DISCUSSIONS WITH REGCOM AND CNIC TO ENABLE NCC 
DECISIONS.

4.B.1 SYMPTOM TRAJECTORY.  DOWNWARD TRAJECTORY OF ILI AND CLI CASES REPORTED 
OVER THE PRECEDING 14 DAYS.  ASSESSMENTS MUST INCLUDE BOTH THE INSTALLATION 
AND SURROUNDING COMMUNITY TO INCLUDE LOCALITIES SHARING ADJOINING BOUNDARIES, 
AND LOCALITIES WHERE THE MAJORITY OF THE INSTALLATIONS POPULATION RESIDES.
PHEOS IN CONCERT WITH MTF COMMANDERS AND INSTALLATION COMMANDERS WILL 
DETERMINE THE BEST LOCAL SOURCE OF DATA PER REF (C).  E.G., USE THE FEMA 
EARLY INDICATOR DAILY REPORT OR ADVANA.  DEPENDING ON THE TRAJECTORY OF THE 
SYMPTOMS, INSTALLATION COMMANDERS WILL REPORT THE INSTALLATION AS GREEN 
(SUSTAINED REDUCTION FOR 14 OR MORE DAYS OR STABLE AT VERY LOW LEVELS), 
YELLOW (SUSTAINED REDUCTION FOR 7-13 DAYS OR SHIFT UPWARD OF 1 TO 4 
CONSECUTIVE DAYS) OR RED (SUSTAINED REDUCTION FOR 0-6 DAYS OR IF THE 
TRAJECTORY SHIFTS UPWARD FOR 5 CONSECUTIVE DAYS).

4.B.2. COVID-19 CASE AND TESTING TRAJECTORY.  DOWNWARD TRAJECTORY OF 
DOCUMENTED COVID-19 CASES OR POSITIVE TESTS AS A PERCENT OF TOTAL TESTS OVER 
THE PRECEDING 14-DAY PERIOD.  ASSESSMENTS MUST INCLUDE BOTH THE INSTALLATION 
AND SURROUNDING COMMUNITY TO INCLUDE LOCALITIES SHARING ADJOINING BOUNDARIES, 
AND LOCALITIES WHERE THE MAJORITY OF THE INSTALLATIONS POPULATION RESIDES.  
MTF COMMANDERS AND INSTALLATION COMMANDERS WILL DETERMINE THE BEST LOCAL 
SOURCE OF DATA PER REF (C).  E.G., USE FEMAS EARLY INDICATOR DAILY REPORT OR 
ADVANA.  DEPENDING ON THE TRAJECTORY OF THE CASE AND TESTING RATES, 
INSTALLATION COMMANDERS WILL REPORT THE INSTALLATION AS GREEN (SUSTAINED 
REDUCTION FOR 14 OR MORE DAYS OR STABLE AT VERY LOW LEVELS), YELLOW 
(SUSTAINED REDUCTION FOR 7-13 DAYS OR SHIFT UPWARD OF 1 TO 4 CONSECUTIVE 
DAYS) OR RED (SUSTAINED REDUCTION FOR 0-6 DAYS OR IF THE TRAJECTORY SHIFTS 
UPWARD FOR 5 CONSECUTIVE DAYS).

4.B.3.  CAPACITY TO TREAT AND HEALTHCARE WORKER TESTING PROGRAM.  MTF AND/OR 
LOCAL HOSPITALS CAPACITY TO TREAT ALL PATIENTS WITHOUT SITUATIONAL STANDARDS 
OF CARE AND HAVE A COVID-19 TESTING PROGRAM IN PLACE FOR AT-RISK HEALTHCARE 
WORKERS AND THOSE EXHIBITING ILI AND CLI SYMPTOMS.  DURING NORMAL OPERATIONS, 
MTFS AND HEALTHCARE NETWORKS ARE RESOURCED TO PROVIDE CARE TO ALL 
BENEFICIARIES.
MTF COMMANDERS WILL ASSESS THEIR COVID-19 TESTING PROGRAM FOR AT-RISK 
HEALTHCARE WORKERS AND CAPACITY TO TREAT THEIR POPULATION WITHOUT SITUATIONAL 
STANDARDS OF CARE, BASED ON ICU BEDS AND VENTILATORS, ASSOCIATED STAFF AND 
PPE AVAILABLE PER 10K BENEFICIARIES.  DEPENDING ON TREATMENT CAPACITY, 
COMMANDERS WILL REPORT THE INSTALLATION AS GREEN (COVID-19 TESTING PROGRAM 
FOR AT-RISK HEALTHCARE WORKERS IN PLACE AND ABILITY TO EXPAND TO 6 OR MORE 
ICU BEDS PER 10K OF THE BENEFICIARY POPULATION), YELLOW (COVID-19 TESTING 
PROGRAM FOR HEALTHCARE WORKERS IN PLACE AND ABILITY TO EXPAND TO 3-5 ICU BEDS 
PER 10K OF THE BENEFICIARY POPULATION), OR RED (2 OR LESS ICU BEDS PER 10K OF 
THE BENEFICIARY POPULATION OR NO COVID-19 TESTING PROGRAM FOR AT-RISK 
HEALTHCARE WORKERS).

4.C. ADDITIONAL TRANSITION REQUIREMENTS.

4.C.1.  HIGH-RISK INDIVIDUALS.  ALL COMMANDERS WILL IDENTIFY THOSE WITHIN 
THEIR COMMAND WHO ARE VULNERABLE AND AT INCREASED RISK OF AN ADVERSE OUTCOME 
SHOULD THEY BECOME INFECTED COVID-19.  IT IS EXPECTED THAT THOSE INDIVIDUALS 
WILL BE GIVEN WIDE LATITUDE TO TELEWORK AND ONLY RETURN TO WORK WHEN 
CONDITIONS PERMIT.

4.C.2.  MINIMUM PUBLIC HEALTH MITIGATION MEASURES TO PRACTICE WHILE PHASING 
IN HEALTH PROTECTION CONDITIONS OR OPENING RESTRICTED SERVICES:
- WHEN DECIDING TO OPEN COMMON AREAS WHERE PERSONNEL ARE LIKELY TO CONGREGATE
  (E.G., FITNESS CENTERS OR BARBER SHOPS), ENFORCE STRICT PHYSICAL 
DISTANCING,
  SANITATION PROTOCOLS AND LIMIT PATRONAGE. REFER TO THE NAVY AND
  MARINE CORPS PUBLIC HEALTH CENTER COVID-19 WEB PORTAL FOR GUIDANCE AT:
  HTTPS://WWW.MED.NAVY.MIL/SITES/NMCPHC/PROGRAM-AND-POLICY-
SUPPORT/PAGES/NOVEL
  -CORONAVIRUS.ASPX#T2
- CONTINUE TO PRACTICE PHYSICAL DISTANCING AND USE PRECAUTIONARY MEASURES
  (CLOTH FACE COVERINGS) WHEN WITHIN 6 FEET OF OTHER INDIVIDUALS.
- LIMIT SIZE AND FREQUENCY OF ALL GATHERINGS.
- CONTINUE TO ENCOURAGE TELEWORK AND CONSIDER SPLIT SHIFTS WHEN FEASIBLE.
- CONDUCT FREQUENT HAND-WASHING.
- CONDUCT ROUTINE INTENSIVE WORKPLACE CLEANING.
- IF ILL, STAY AT HOME UNTIL CLEARED BY A MEDICAL PROVIDER..

4.C.3.  TESTING AND RESTRICTION OF MOVEMENT PLANS.  CONCURRENT WITH ANY HPCON 
CHANGE, COMMANDERS SHOULD HAVE ESTABLISHED PLANS AND READY CAPACITY TO 
CONDUCT
COVID-19 TESTING, CONTACT TRACING, RESTRICTION OF MOVEMENT OF THOSE 
INDIVIDUALS RETURNING FROM HIGH-EXPOSURE LOCATIONS, EXHIBITING SYMPTOMS, OR 
THOSE EXPOSED TO POSITIVE COVID-19 CASES.

4.C.4.  SENTINEL SURVEILLANCE TESTING AND MONITORING PROGRAMS. IN 
CONSULTATION WITH PHEOS AND LOCAL MTFS, INSTALLATION COMMANDERS WILL ENSURE 
SENTINEL SURVEILLANCE TESTING AND MONITORING PROGRAMS ARE IN PLACE TO HELP 
INFORM HPCON LEVEL CHANGES. AS LAB TESTING CAPACITY INCREASES AND ALLOWS, 
THESE SURVEILLANCE PROGRAMS SHOULD INCLUDE MONITORING FOR ILI AND CLI IN DODS 
ELECTRONIC SURVEILLANCE SYSTEM FOR EARLY NOTIFICATION OF COMMUNITY-BASED 
EPIDEMICS (ESSENCE).

4.C.5.  RESURGENCE IN COVID-19 CASES.  AS WITH MANY PANDEMICS, THERE IS A 
POSSIBILITY OF A COVID RESURGENCE OR SECOND WAVE. IF COVID-19 ILLNESS 
TRAJECTORY INCREASES OR MEDICAL FACILITIES BECOME SIGNIFICANTLY BURDENED BY 
THE TREATMENT OF COVID-19 ILLNESS IN A PARTICULAR GEOGRAPHIC AREA, COMMANDERS 
SHOULD CONSIDER INCREASING HPCON LEVEL AND CLOSING SERVICES.  IT IS IMPORTANT 
TO LOOK AT THE TREND NOT JUST A SINGLE DAY CHANGE.  REF (D) PROVIDES ACTIONS 
FOR COMMANDERS TO CONSIDER WHEN ELEVATING THE HPCON LEVEL.

5.  REPORTING REQUIREMENTS.  NCC WILL USE THE CRITERIA IDENTIFIED IN PARA 
4.B.
TO DEVELOP A VISUAL REPORTING DASHBOARD/SUMMARY IN COORDINATION WITH REGION 
COMMANDERS/CNIC TO ALLOW EACH NCC TO MONITOR THE STATUS OF EACH INSTALLATION.
NCC WILL CONSOLIDATE THESE REPORTS AND PROVIDE THEM BY REGION TO THE CNO 
BATTLE WATCH ON A WEEKLY BASIS (EACH WEDNESDAY BY 1000EST BEGINNING 27 MAY 
20).
THE FOLLOWING SERVICES WILL BE INCLUDED IN EACH REPORT: FITNESS CENTERS, 
GALLEYS, CHILD DEVELOPMENT CENTERS, FLEET AND FAMILY SUPPORT CENTERS, NGIS 
AND NAVY LODGES, MWR FACILITIES/SAILOR CENTERS, BARBERSHOPS/BEAUTY SALONS, 
CHAPELS, HOUSING SERVICES, AND COMMISSARY/EXCHANGE FACILITIES.  NCC SHOULD 
ALSO INCLUDE SIMILAR SERVICES, UNIQUE TO THEIR INSTALLATIONS (E.G., CHILD 
YOUTH PROGRAMS, DODEA SCHOOLS, RESTAURANTS AND FOOD COURTS, ETC.) AS THE NCC 
DEEMS APPROPRIATE.
USE THE FOLLOWING LEGENDS: GREEN-FULLY OPEN; YELLOW-OPEN WITH MITIGATION 
MEASURES; BLUE-VIRTUAL SERVICES ONLY; RED-CLOSED.

6.  THERE WILL BE A NATURAL YET HEALTHY TENSION BETWEEN KEEPING SERVICES 
SECURED TO PROTECT OUR WORK FORCE AND ENSURING WE PROVIDE SERVICES TO OUR 
WORK FORCE DURING THIS ENDURING PANDEMIC.  COMMANDERS ARE EXPECTED TO TAKE A 
MEASURED RISK-INFORMED APPROACH, AND ALL HANDS ARE EXPECTED TO FOLLOW PUBLIC 
HEALTH MEASURES TO FACILITATE THE BALANCE OF RISK TO MISSION AND RISK TO 
FORCE.
THESE CONCEPTS ARE NOT MUTUALLY EXCLUSIVE.  WE HAVE LEARNED HOW TO PRACTICE 
PUBLIC HEALTH MEASURES AND BUILD THEM INTO OUR DAILY ROUTINE.  LOCAL 
COMMANDERS MAINTAIN THE INHERENT RIGHT TO SHUT DOWN SERVICES WHEN GUIDANCE IS 
NOT BEING FOLLOWED.  THROUGH AN ALL HANDS EFFORT, WE CAN RETURN BASIC 
SERVICES TO OUR WORK FORCE AS WE OPEN UP OUR NAVY AND OPERATE IN THIS NEW 
NORMAL.

7.  RELEASED BY ADM R. P. BURKE, VICE CHIEF OF NAVAL OPERATIONS.//

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