OFFICE OF THE UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHINGTON, o.c. 203014000 .7 MAR i I 2020 PERSONNEL AND READINESS MEMORANDUM FOR CHIEF MANAGEMENT OFFICER OF THE DEPARTMENT OF DEFENSE SECRETARIES OF THE MILITARY DEPARTMENTS CHAIRMAN OF THE JOINT CHIEFS OF STAFF UNDER SECRETARIES OF DEFENSE CHIEF OF THE NATIONAL GUARD BUREAU GENERAL COUNSEL OF THE DEPARTMENT OF DEFENSE ASSISTANT SECRETARY OF DEFENSE FOR LEGISLATIVE AFFAIRS ASSISTANT TO THE SECRETARY OF DEFENSE FOR PUBLIC AFFAIRS DIRECTORS OF DEFENSE AGENCIES DIRECTORS OF DOD FIELD ACTIVITIES SUBJECT: Force Health Protection Guidance (Supplement 4) Department of Defense Guidance for Personnel Traveling During the Novel Coronavirus Outbreak This memorandum supplements requirements in DOD Instruction 6200.03 ?Public Health Emergency Management (PHEM) Within the March 28, 2019, with respect to coronavirus disease 2019 The COVID-19 outbreak continues to spread globally and as a result, the Centers for Disease Control and Prevention (CDC) is rapidly issuing Travel Health Notices (THNs) and guidance for persons with travel in countries or areas with COVID- 19 transmission. CDC THNs tier these locations as Level 3 (Widespread sustained (ongoing) transmission), Level 2 (Sustained (ongoing) community transmission) and Level 1 (Risk of limited community transmission), with associated monitoring guidance for returning travelers. The CDC THNs are at: This guidance applies to all DOD Components, except that it does not apply to air crew of military aircraft. All existing Novel Coronavirus Outbreak FHP guidance remains in effect and applies to all Components, including the Reserves and National Guard, and, as appropriate, foreign military personnel who are under DOD authority. The FHP guidance for China travelers (?Force Health Protection Guidance (Supplement 1) Department of Defense Guidance for Monitoring of Personnel Returning from China During the Novel Coronavirus Outbreak,? dated February 7, 2020), remains in effect. FHP documents are at: Individuals should continue to check the CDC COVID-19 website for additional updates at: ncov/ index.htm1. This document provides pre- and post-travel health guidance for all DOD travelers to enable mission assurance and Force Health Protection (FHP), utilizing the CDC THNs for DOD Component considerations. DOD Components may be more restrictive based on local risk assessment in consultation with public health authorities. Command location, local community transmission, risk to mission, and risk to force are all key considerations in DOD Component decision making. Actions for allTDoD travelers Actions prior to o?icial travel: I DOD Components shall incorporate CDC guidance into. the full scope. of planning for of?cial travel, to include the following: 0 Consider the risk pro?le of the traveler older individuals or those with underlying diseases). Limit. travel to those individuals who are healthy, to the greatest extent possible. For civilian personnel, these considerations must be consistent with the requirements of the RehabilitatiOn Act of 1973, as amended. 0 Coordinate with the receiving installation to ensure the post-travel requirements in this document can bra-implemented at thatlocation. Actions upon departure/exit screening: 0' DOD Components should emphasize each individual?s responsibility to avoid travel when sick. 0 For travel on military aircraft, Components should ensUre exit screening is conducted at the point of embarkation. At a minimum, this should consist of a questionnaireI to assess risk. of exposure, temperature check (fever is or per CDC), and. visual check for signs and feeling feverish,- coughing or. shortness of breath per CDC) of If. the screening yields concerns, a se?Condary mediCal' evaluation by a health professional should-be Conducted. Components should alSO be. prepared. toappropriately manage a patient under investigation if. such a determination is made, to include referral to the appropriatemedicai authority per CDC. guidance found at: http?sz/X gov/ co'ronavirus/ 201 index .html. 0- Travel on 00mmercial air carriers may-not include exit screening of travelers, Therefore, ?taking the appropriate action upon arrival is critical. Actions for all Service members Actions upon arrivol?'om CDC THN Le-Vel 3 or Level 2 location: Components should identify all Service members who travel or have traveled in. the prior 14 days to, through, or from THN Level 3 or Level 2. country. This includes travel by military or commercial means, as well as private conveyance, and. includes all forms of travel to include ?Permanent Change of Station, Temporary Duty, and leave. Components should place these Service members under a 14-day restriction of'movement (ROM). During the ROM (starting from the day of departure from the-Level 3 or'Leve'l 2 country): Guidance to support questionnaire development is at assessment.html '2 Service members should be restricted to their residence or other _-appro_priate domicile fOr 14 days and limit close contact (within 6 feet or 2' meters) with others during this 14-day period. Immediate supervisors will not require Service members to report to' their duty location or otherwise disregard the ROM. Service members shOuld self-monitor by taking their temperatures twice a day to check for fever, and remain. alert for cough or dif?culty breathing. If they feel feVerish- or develop a fever or per CDC), cough, or dif?culty breathing during the self?menitoring period, they should self?isolate, limit contact with others, notify their supervisor or chain of command, and seek advice-by telephone from the- appropriate healthcare provider to determine whether medical eValuation is needed. For any ineperson assessments of Service. members (including individuals), medical personnel should. apply CDC. guidance to include wearing appropriate personal protective equipment Service. members livingin open?bay settings, or rooms with shared bathrooms and/or kitchen facilities, should be placed in separate lodging to span the 14-day ROM period. The Component "to which the Service member is assigned Will arrange and fund the separate lodgingif needed. Service-members should separate themselves from other people in the home or dwelling if residing with roommates or family members and avoid sharing personal items. Service. members should not travel, visit public or crowded areas, or usepublic transportation and should avoid interaction with pets or other animals. Medical evaluation and care should be immediately arranged if the Service member displays fever or consistent with as per CDC. guidance- The Service member" should callaheadfbefOre going .to a medical treatment? facility, informing medical staff of his/her and travel history. 0 Medical staff shOuld follow CDC guidance when. assessing individuals displaying fever and consistent with COVID-19. 0 Components should appropriately reportan individual if identi?ed as a patient under investigation, per previously published Under Secretary'of Defense- for Personnel and. Readiness guidance, ?Force Health Protection Guidance for the. Novel Cor?onavirus Outbreak,? dated Jannary 30, 2020. La) Actions upon arrival from a non-CDC THN Level 2 or Level 3 0N US or OCON US location: DOD Components should identify and track all Service members who travel or have a history of travel in the prior 14 days to, through, or from a non-CDC THN Level 2 or Level 3 CONUS or OCONUS location. This includes travel by military or commercial means as well as private conveyance and includes all forms of travel to include Permanent Change of Station, Temporary Duty, and leave. Components should ensure that these Service members take the following actions for the next 14 days: 0 Implement self-observation, remain alert for fever, cough, or dif?culty breathing. 0 To the extent possible, implement social distancing, remain out of congregate settings, avoid mass gatherings, and maintain 6 feet or 2 meter distance from others when possible. 0 Immediately self-isolate, limit contact with others, and seek advice by telephone from the appropriate healthcare provider to determine whether medical evaluation is required, if individuals feel feverish or develop measured fever, cough, or dif?culty breathing. Actions for D01) civilian employees, contractor personnel, and family members strongly recommends that civilian employees, contractor personnel, and family members who travel to, through, and from countries with a CDC THN for COVID-19 follow this guidance, which is more stringent than CDC guidance. Components should restrict DOD workplace access for 14 days for DOD civilian employees and contractor personnel whose travel has included THN Level 2 and Level 3 locations. If these civilian employees and contractor personnel feel feverish or develop a fever, cough, or dif?culty breathing, they should notify their supervisor or chain of command. For all other travel, Components will encourage self-observation and accommodation of social distancing. To restrict access from the workplace and maximize telework options, Components shall implement the Under Secretary of Defense for Personnel and Readiness memorandum, ?Civilian Personnel Guidance for Components in Responding to Coronavirus Disease 2019,? dated March 3, 2020. For contractor personnel, Components should implement measures in consultation with the appropriate contracting of?ce. This guidance is effective March 13, 2020. My point of contact is COL Jennifer M. Kishimori, who may be reached at (703) 681-8179 or Alexis Lasselle Ross Performing the Duties of the Under Secretary of Defense for Personnel and Readiness Attachment: Quick?Reference for Travel during the COVID-19 Outbreak 4 Attachment 1. Quick Reference for Travel during. the COVID-19 Outbreak. CDC- THN CDC De?nitions Actions Upon MIL Actions Upon Arrival: Level:1 AIR Departure I 3. I Widespread sustained Risk Assessment: 0 Stay-at home for .14 days (ongoing) transmission 0 Questionnaire 0. Avoid non-essential travel. Temperature 0 Self?monitoring. Travelers should stay'home Checks for. 14 days - Vi5ual aSsessnient '2 Sustained (ongoing) signs. and I Stay at- home for 14 days community transmission at Practice social distancing 0 Special Precautions for . Self-monitoring. High-Risk Travelers Medical Team 1 0 Risk of Limited asseSSment (If - Ensure personnel tracking cemmunity transmission Indicated): a Practice social distancing for 14 days. 1 Practice usual precautions Health evaluation a Self-observation fer 14 days WA 0 All other countries/areas Transfer to 0 Ensure. personnel tracking command-health 0- Practice. social distancing for 14 days authority lf?neecled - Self-observation for 14 days lTram-:1 Health-Notice (THN), 2Doesnot apply to-air'crew. Actions prior to of?cial travel: 0 Components shall incorporate .CDC guidance intothe full scope of planning for of?cial travel. to include the following: 0 Consider the risk pro?le. of traveler older individUals. or those with'imderlying diseases). Limit. travel to those individuals to those who are healthy, to the greatest extent possible. For civilian personnel, these considerations. must. be consistent with the. requirements of?the Rehabilitation Act of 1973, as amended, 0' Coordinate with the. receiving installation to ensure the pest-travel requirements can be implemented at that "location. References: DOD 9 Homepage (includes all Force Health Protection Guidances): CDC COVID-19 Homepage (CDC authoritative information on COVID-19): Trav?elHealtli NoticeIInformation Country Level Notifications): /Www-.cdc. gov/ coronavirus/ 20:1 CDC Travel Precautions (includes such as fever, cough, shortness of. breath): . . gov/coronavirus/QO 1 CDC Healthcare Provider Information. (includes InfectiOn Control. information and Personal Protective Equipment Guidance): gov/core navirus/20 1 5