N2.35.6100.1-Q Novel Coronavirus Disease Response Plan_Rev 4_5-8-2020.pdf

Military Sealift Command Managers’ Internal Control- Quality Management System

Procedure

N2.35.6100.1-Q Revision 4 8 May 20

Endorsed by the QMS Steering Committee

Issued By: Date: SSIC: 6100

Steven C. Cade, SES Executive Director, MSC

8 May 2020 Page 1 of 38

NOVEL CORONAVIRUS DISEASE (COVID-19) COMMAND RESPONSE

PLAN AND MEDICAL GUIDANCE

REFERENCES

(a) SECDEF Memo “Modification and Reissuance of DoD Response to Coronavirus Disease 2019 – Travel Restrictions,” dated 20 Apr 2020

(b) Under SECDEF Memo Force Health Protection Guidance (Supplement 4), 11 Mar

(c) Under SECDEF Memo “Defense Industrial Base Essential Critical Infrastructure Workforce” dated 20 Mar 2020

(d) CUSFF/NAVNORTH Phase IV EXORD In Response to Novel Coronavirus Disease 2019 dated 292000Z APR 20

(e) COMPACFLT EXORD In Response to COVID-19, USINDOPACOM CONPLAN 5003 PHASE III Respond 030623Z APR 20

(f) COMPACFLT Maritime Operations Directives (MODs) (daily weekday publication, most recent is CPF MOD MAY-030)

(g) Secretary of the Navy ALNAV 049/20 “Modification to ALNAV 044/20 Reissuance of Department of the Navy Travel Restrictions in Response to Coronavirus Disease 2019” dated 222134Z APR 20

(h) NAVADMIN 116/20, Navy Mitigation Measures in Response to Coronavirus Outbreak Update 4, dated 212136Z APR 20

(i) NAVADMIN 113/20, Restriction of Movement (ROM) Guidance Update, dated

171541Z APR 20

(j) NAVADMIN 109/20, COVID-19 Update Guidance to Support Fleet Operations, dated 152039Z APR 20

(k) NAVADMIN 158-16 Sovereign Immunity Policy

(l) Center for Disease Control and Prevention (CDC) Travel Health Notices (THN) available at https://wwwnc.cdc.gov/travel/notices

(m) COMSC Instruction 6100.1 MSC Pandemic Influenza Plan

CADE.STEVEN.CH

ARLES.1075700365

Digitally signed by

CADE.STEVEN.CHARLES.1075

700365 Date: 2020.05.09 14:12:18 -04'00'

MSC Managers’ Internal Control-Quality Management System Procedure

N2.35.6100.1-Q Revision 4 8 May 20

NOVEL CORONAVIRUS DISEASE (COVID-19) COMMAND

RESPONSE PLAN AND MEDICAL GUIDANCE Page 2 of 38

(n) CMPI 630 Section 7 and Memorandum of Understanding Between MSC and IOMMP, MEBA,NMU, and SIU, 12 Jan 1998

(o) NMCPH Guidance for Underway Evaluation and Management of Suspected Persons Under Investigation of COVID-19

(p) Joint Travel Regulations

(q) BUMED General Guidance for Cleaning and Disinfecting for Non-Health

Care Settings

(r) COMPACFLT Underway Checklist for COVID-19 Environment, dated

17APR20

(s) MSC Safety Management System (SMS) Memo to Masters, Chief Engineers, and

Shore Staff, 162 (Series), “NAVSEA Supplemental Guidance for COVID-19 Disinfectant Products and Procedures,” most recent is 162.3 dated 28 Apr 2020

(t) Joint USFFC and PACFLT Message, “Deployed Maintenance Support – Bubble-to- Bubble Guidance” dated 141205ZAPR20

ENCLOSURES

(1) MSC COVID-19 screening questionnaire V2020.04.29

(2) Restriction of Movement Sample Order

(3) COVID-19 PPE Requirements by Ship Type

(4) IT Considerations for Telework (V.20200501)

(5) Pandemic Travel Request (TR) Form (Revision 1)

(6) CPF COVID-19 Travel Request Template

(7) MSC Guidance for Embarking and Disembarking Commercial Marine Pilots

(8) MSC Guidance Regarding Implementation of Bubble-to-Bubble Travel for

CIVMAR Crew Manning

(9) MSC Food Service COVID-19 Mitigation Plan and Procedures

(10) Handling and Disposal of Hazardous Material and Solid Waste

1 PURPOSE:

1.1 This document provides updated planning and response guidance for the 2019- 2020 Novel Coronavirus disease (COVID-19) threat as directed by the references. There have been substantial changes since Revision 3’s publication. This guidance focuses on the COVID- 19 outbreak and is not intended to supplant any guidance released by Military Sealift Command (MSC) regarding pandemic influenza response. The entire team must understand their role in minimizing the spread of COVID-19 among our ranks. MSC’s priority is to preserve the health of the force, ensure we do not spread the virus to the homeland or our partners, while maintaining our warfighting readiness.

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1.2 All MSC Personnel are strongly encouraged to seek early medical attention if they are experiencing any influenza-like illness (ILI) symptoms that might be linked to COVID-19.

ILI is defined as a fever (temperature >100oF/37.8oC), cough and/or sore throat without a known cause. If you do not feel good, contact a health care provider.

1.3 COVID-19 is a serious public health threat. Recognizing persons at risk for COVID-19 is a critical component of identifying cases and preventing further transmission.

Individual action is the most important element of pandemic response. It is the responsibility of each MSC person to take precautions to prevent the spread of infection to others.

1.4 This is revision (4) to the original procedure published. It incorporates changes issued via the Interim Change Notice (ICN) process and supersedes ICNs (1) through (4). Future updates to this procedure may be promulgated on short notice via e-mail or record message traffic based on changing conditions and Fleet requirements.

2 BACKGROUND / OBJECTIVES / APPLICABILITY

2.1 Background

2.1.1 The COVID-19 outbreak continues to expand globally. COVID-19 presents challenges to our forward deployed forces as well as our forces and force generation teams at home.

2.1.2 For confirmed COVID-19 cases, reported illnesses have ranged from mild symptoms to severe illness and death. Symptoms may include fever, cough, and shortness of breath. CDC believes that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure, based on the incubation periods of other coronaviruses. The complete clinical picture with regard to COVID-19 is not fully understood. Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness. There is currently no vaccine to prevent COVID-19.

The best way to prevent illness is to avoid being exposed to this virus.

2.2 Objectives: We must view and execute combating this virus as a military operation. This is not business as usual. All efforts should be taken to stop the spread of the virus. We must review every engagement, operation, exercise, TAD, training event, leave, etc. through the lens of: (1) Mission accomplishment; (2) Mission essential; (3) Risk to mission/risk to force; and (4) Mission assurance and maintaining warfighting readiness.

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2.2.1 MSC supports higher headquarter plans to protect against the spreading COVID-19 infection to both U.S. forces and allies and partners, and ensure warfighting readiness to execute assigned missions. These plans have a scheme of maneuver with the following five phases: Phase I – Protect; Phase II – Mitigate; Phase III – Respond;

Phase IV – Stabilize; and Phase V – transition. Per reference (d), we have transitioned to Phase IV.

2.2.2 This procedure defines MSC Commodore, ship Master, and MSC Headquarters Staff duties and responsibilities with respect to protection of the force and management of a possible case of COVID-19 infection. All MSC personnel will take action to mitigate the spread of COVID-19 and adhere to the policies and requirements in this procedure.

2.2.3 Mission Essential Activity/Continuity of Operations. COMSC retains authority for determination of mission essential activity for purposes of denying or approving movement of personnel, prioritizing and executing actions in support of MSC missions, functions and tasks, or deviating from established policy and directives. Actions by all personnel shall be biased toward mission execution, unless otherwise restricted by higher guidance or prior decision.

2.3 Applicability: This procedure is applicable to Military Sealift Command personnel worldwide and all MSC ships. For purposes of this procedure, MSC ships are those vessels entitled to sovereign immunity, including: USNS, to include all U.S. Government-owned vessels; privately-owned U.S. flag vessels under time-charter to MSC; and the U.S. Maritime Administration’s National Defense Reserve Fleet and its Ready Reserve Force, when activated and assigned to MSC.

2.3.1 MSC ships that are under a military commander’s operational control (OPCON) or tactical control (TACON) will follow that commander’s COVID-19 guidance in addition to the guidance contained in this procedure. In the event of any conflict between an OPCON/TACON Commander’s guidance and MSC’s guidance, then the Master of the ship will resolve the conflict by dual reporting and applying the more restrictive and/or higher standard.

2.3.2 The MSC Director of Contracts is responsible for communicating to all MSC Contractors regarding when and how to apply this procedure. This QMS procedure is not a “change order” and does not alter, modify, or change the terms and conditions of any contract or purchase order awarded by MSC. This QMS procedure does not provide the basis for a contractor to seek a contract price adjustment. Only the Contracting Officer has the authority to

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3 TRAVEL / LEAVE / LIBERTY

3.1 Travel Restrictions: Restrictions on travel continue to be dynamic. Review references (a) and (g). While DoD continues to follow the lead of the Center for Disease Control and Prevention (CDC) travel health advisories for overseas, when needed additional measures are authorized to mitigate risk to DoD personnel. Within MSC, only the Commander, MSC (COMSC) or an MSC Commodore can determine to restrict travel to a greater degree than already restricted by higher echelons within DoD.

3.2 Official Travel

3.2.1 All MSC personnel will stop official travel until further notice, unless authorized by COMSC. Exceptions to this stop movement order may be granted for travel that is: (1) determined to be mission essential; (2) necessary for humanitarian reasons; or (3) warranted due to extreme hardship. MSC personnel granted an exception shall carefully plan travel to avoid, if possible, flights that transit through or originate in high-risk locations. MSC personnel shall incorporate CDC guidance into the full scope of planning for overseas official travel. See reference (l) for additional information.

3.2.2 Mission Essential Travel can continue with COMSC approval. The process for submission and approval of mission essential travel requests are outlined in Section 7 of this procedure. COMSC may further delegate this approval to other Flag Officer or Senior Executive Service (SES) level by separate correspondence. Mission essential travel refers to work that must be performed to ensure the continued operations of MSC’s mission essential functions. Any MSC personnel traveling outside the continental United States (OCONUS) must liaise with the applicable MSC Commodore before scheduling travel and inform the Commodore of their specific travel plans, via the member’s supervisor, prior to beginning travel. Any MSC personnel on official travel to an MSC ship in the continental United States (CONUS) must liaise with the MSC Commodore. MSC personnel will raise any health and safety concerns regarding mission essential travel to their supervisor.

3.2.3 Crew-relief. Unless directed otherwise by COMSC, crew-reliefs require face-to-face contact for government-owned, government-operated ships (GOGOs).

(1) MSC funded travel for CIVMARS going to a ship assignment will be approved by COMSC in accordance with the procedures in Section 7 below. For a “walk-on”

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(2) After contact relief, when a CIVMAR is detaching from the ship, MSC TFM/N1 is authorized to approve CIVMAR leave, travel, or “cash-in lieu” payment for travel, as part of the CIVMAR force regeneration process. Any CIVMAR leave or travel without contact relief requires COMSC approval via the MSC Commodore and TFM/N1.

(3) Masters shall report all crewmembers not onboard via their “Crew Change Report” and indicate the type of leave status for the crewmember. Masters shall also ensure the appropriate MSC Commodore is aware of any crewmember off ship in their AOR.

(4) CIVMARS who are away from their ship and unable to return due to foreign government travel restrictions may be placed on administrative leave (weather and safety) pending resolution of their situation.

(5) CIVMARS who are on administrative leave (weather and safety) in CONUS and unable to return to their assigned ship due to foreign government travel restrictions can be directed by TFM to detach from their assigned ship and report to CIVMAR Support Unit (CSU) East or West for possible re-assignment.

3.2.4 Additional Travel Procedures. For procedures regarding Bubble-to- Bubble (B2B) travel, see enclosure (8). For official travel outside of B2B, Supervisors shall ensure travelers use the following procedures: Travelers shall only travel between official work sites, or between work site and lodging. Private owned vehicles, company vehicles, and rental cars are considered appropriate forms of ground transportation. Use of public transportation, taxis, ride-sharing, and other commercial ground transportation is not authorized. Travelers shall not dine in restaurants, but instead shall use food delivery or food take-out services. Travelers shall not use public gyms and shall avoid crowds and public areas.

3.2.5 Travel between two ships at sea, from an underway ship to shore, or from shore to an underway ship requires review and approval by COMSC. All movements will follow established mitigation measures to maintain a virus-free ship.

3.2.6 Pre- and Post- Travel Screening and Reception. Those travelers approved for mission-essential travel shall comply with the guidance below in Section 7 for pre- and post-travel screening and reception procedures.

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3.2.7 Permanent Change of Station (PCS). The Navy has published extensive guidance on the status of PCS for service members and Navy civilians. See reference (h) for details.

3.2.8 Non-Mission Essential Travel. Non-mission essential travel shall stop until further notice. Supervisors will consider teleconferences, and other means to accomplish the objectives.

3.3 Leave: Opportunities for leave shall continue to be afforded for all personnel, to the extent practical to assure the safety and health of the workforce balanced against mission requirements. All personnel requesting leave shall notify their supervisor of planned destination and while on leave shall abide social distance advisories avoid large gatherings and stay away from known or publicized COVID-19 clusters within their local area.

3.3.1 Service Members. Leave or personal travel outside of the local area requires permission from the first Flag Officer or SES member in the individual’s chain of command. Local area is defined by the local MSC Commodore. For MSC Headquarters, it is defined by the MSC Chief of Staff in paragraph 9.12 below.

3.3.2 Ashore Navy civilian employees. Off-duty travel to COVID-19 high-risk areas (i.e., CDC Level 3, Level 2, and out of area) is highly discouraged for civilian employees. Annual leave outside of the local area requires permission from the first Flag Officer or SES member in the individual’s supervisory chain. Any personal travel not requiring approved leave that involves going outside the local area requires supervisor notification. Local area is defined by the local MSC Commodore. For MSC Headquarters, it is defined in paragraph

9.12 below. Supervisors may disapprove leave based on potential mission requirements. An expectation of restriction of movement (ROM) following a period of leave may be deemed by supervisors to impact mission and be the basis for denying leave to any personnel.

3.3.3 Civil Service Mariners (CIVMARS). CIVMAR leave or travel without contact relief requires COMSC approval via the MSC Commodore and TFM/N1.

3.3.4 Post-Travel Screening. MSC supervisors, MSC TFM/N1, and other appropriate MSC authorities, shall screen all MSC personnel returning from personal travel outside the local area using an MSC-approved COVID-19 screening questionnaire. Screening can be done verbally using enclosure (1). MSC Commodores may authorized the use of an AOR-specific form. Identified personnel ashore, to include CIVMARs, will be placed under a ROM and prevented from accessing MSC work sites and ships for health and safety reasons for 14 days or until cleared by medical authority (see enclosure (2)).

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3.4 Mariner Liberty:

3.4.1 Pursuant to reference (n), CIVMAR liberty in port may be restricted without premium pay where conditions to transit from the ship or ashore in the port concerned are obviously and abnormally unsafe due to civil strife, military action, outlawry or natural causes. Such restrictions include the restriction of movement to certain cities, locations, countries, and regions. The Master will deny liberty without premium pay when competent commanders and port authorities order the crew’s restriction.

3.4.2 The COVID-19 threat is the same for all persons across the enterprise, regardless of status. MSC leadership expects contracting companies and ship Masters to apply the same bases for liberty restriction discussed in paragraph 3.4.1 to contracted mariners (CONMAR) on MSC vessels. Additionally, the Master of an in-service MSC ship shall similarly restrict the liberty of all other embarked personnel on an MSC vessel (military, government civilian, DoD contractor, or other) when CIVMAR or CONMAR liberty is restricted. MSC Commodores must work with their Fleet counterparts to ensure there is consistency in application to the greatest extent possible. Exceptions to this policy or other restrictions issues will be raised through the applicable MSC Commodore to MSC Headquarters for resolution.

3.4.3 When liberty is restricted, the Master must work closely with the applicable MSC Commodore to coordinate movement that is required on and off the ship, such as crew reliefs or addressing medical requirements. Advance notice must be given to the MSC Commodore to coordinate with appropriate shore-side authorities. Ship Masters can seek authority from their Commodore for non-liberty exceptions to go ashore. Commodores can approve requests for reasons such as medical visits and shipboard logistics, including trips to obtain basic health and comfort items. Masters shall ensure MSC Force Surgeon’s office is consulted for all proposed medical visits. Commodores will only approve requests when Masters have consolidated requirements, and put appropriate risk mitigation measures in place to include mechanisms to minimize outside contact.

3.4.4 MSC Commodores shall notify the MSC Battle Watch of any liberty restrictions imposed by host nation authorities, port authorities, and Fleet commanders for MSC ships in their AOR. As required, N1/TFM will ensure unions are notified of restrictions placed on CIVMAR liberty.

4 AFLOAT PROCEDURES / PROCESSES

4.1 General Guidance.

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4.1.1 Combatant Commander and Fleet Guidance. MSC ships, as defined in paragraph 2.3 above, that are under a military commander’s operational control (OPCON) or tactical control (TACON) will follow that commander’s COVID-19 guidance in addition to the guidance contained in this procedure. In the event of any conflict between an OPCON/TACON Commander’s guidance and MSC’s guidance, then the Master of the ship will resolve the conflict by dual reporting and applying the more restrictive and/or higher standard. MSC Commander retains OPCON of Transportation Command (TRANSCOM) missions.

4.1.2 MSC Commodores will publish updated area specific COVID-19 procedures and processes to all MSC ships in their AOR, including contractor operated ships, on a weekly basis until further notice. These procedures will include the latest copy of the most current AOR-specific COVID-19 screening questionnaire. In the absence of an AOR-specific COVID-19 screening questionnaire, MSC ships will use enclosure (1).

4.1.3 Measures to Minimize the Spread of COVID 19. MSC Commodores and ship Masters shall take aggressive action to minimize the spread of the virus and protect the health of the crew and other personnel. This is not business as usual. Such actions include:

(1) Execute lengthier fast cruises prior to getting underway to ensure units are virus-free. Send ships to anchor instead of keeping them pier side.

(2) Exercise strict control of access on and off the ship, and control access to certain areas of the ship. This includes limiting or securing access by personnel not embarked on the ship to retain the integrity of a virus-free shipboard environment.

(3) Limit the movement on and off the ship of crewmembers and other personnel embarked, to retain the integrity of a virus-free shipboard environment.

(4) Limit contact between personnel on board the ship. If duties require interaction with others, execute social distancing. If necessary, sequester low-density mission critical personnel.

(5) Execute aggressive cleaning. Exercise decontamination and response plans. Utilize references (r) and (s) for guidance on cleaning and disinfecting.

(6) Conduct daily medical screenings of personnel onboard.

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(7) Crew should monitor their health, self-isolate, and inform the onboard MSO or MDR immediately if they develop a fever (100oF / 37.8oC or higher), begin to feel feverish, or develop other signs or symptoms of sickness. Advise crew of the importance of covering coughs and sneezes appropriately (i.e. cough/sneeze into elbow).

Dispose used tissues immediately in a disposable container (e.g., plastic bag) or a washable trashcan. MSOs and MDRs should post signs and send emails reminding passengers and crewmembers to wash their hands preferably with soap and water, especially after coughing or sneezing. If soap and water are not available, they can use a hand sanitizer containing 60%-95% alcohol.

(8) Leave all zebra Quick Acting Watertight Doors (QAWTD) open unless condition zebra is set, or otherwise required for damage control, noise abatement, safety, or ventilation system constraints to minimize touching of door handles.

(9) Leave all non-tight doors pinned open (unless required for privacy in berthing spaces) to minimize touching of door knobs.

4.1.4 14-Days Underway. An additional measure to minimize the spread of the virus is extending time at sea allows ships to assess crew health, while remaining removed from population centers. In all AORs, MSC ships under NAVTRANS operational control, including contractor-operated ships, shall be scheduled for a minimum of 14 days underway between port visits to permit adequate time for surveillance and monitoring for development of symptoms consistent with COVID-19. The 14-day requirement is not required if the ship is returning to the same port it most recently departed, however such underway periods shall be minimized through consolidation of missions and events. MSC Commodores are delegated waiver authority for the 14-day underway requirement for NAVTRANS missions under the following conditions:

(1) MSC Commodores shall submit notification of waiver, “5W “format (Who What Where, When and Why) as soon as a potential need of waiver is identified, but NLT 96 hours prior to desired execution via email to MSC Battle Watch MSCHQ.BWC.fct@navy.mil, cc david.j.pearson1@navy.mil; james.f.hughes1@navy.mil

(2) Subject line should read: “MSC (or NAVTRANS) 14-day Waiver Notification.”

(3) Intent of the notification is to inform COMSC of the waiver and outline the justification and the mitigations required. MSC N3 will brief waiver notifications received at the following morning Commanders Update brief (CUB) and provide MSC Commodores feedback as required.

mailto:MSCHQ.BWC.fct@navy.mil mailto:james.f.hughes1@navy.mil

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(4) If the ship has been “gangway up” with the crew restricted from going on liberty for a time preceding the underway, provide that information as part of the justification. However, take into account the timing of embarkation for any mission personnel or crew reliefs.

(5) Command-by-negation concept will be used. If the MSC Commodore does not receive a reply, they shall execute to plan.

For all other MSC missions where the MSC Commodore is seeking a waiver from a Fleet underway requirement, notify the MSC Battle Watch (cc: david.j.pearson1@navy.mil;

james.f.hughes1@navy.mil) for MSC HQ situational awareness.

4.1.5 Food Service. COVID-19 poses additional challenges regarding food supplies, food preparation, and maintaining a sanitary environment to prevent, mitigate, and eliminate the spread of the virus. Masters shall enforce the standards set forth in enclosure (9) for galley operations, scullery, dining areas, provisions handling, staterooms, laundry, and lounges.

4.2 Afloat Force Health Protection Measures. All ship’s Masters are responsible for the force health protection of their ship. Masters shall maintain awareness of all relevant MSC policy and guidance related to COVID-19. Contact the respective MSC Commodore with any questions.

4.2.1 Restriction of Movement (ROM) Sequester Requirement: Unless exempted below, all personnel coming on board an MSC government-owned ship shall complete a 14-day ROM sequester immediately prior to boarding, or must have maintained “clean status” since completing a 14-day ROM sequester.

(1) For the purposes of this section, a ROM sequester is typically a 14-day period in clean berthing off the ship, or in a MSC Commodore approved clean area, followed by answering questions from an approved COVID-19 screening questionnaire and a temperature check. Personnel completing a 14-day ROM sequester achieve “clean status” for purposes of COVID-19 risk assessments.

(2) To maintain “clean status”, travel from the ROM sequester location to a “clean” ship or area must be done in a clean manner. This is the “bubble-to-bubble” (B2B) concept. Military air (including AMC channel, SAAM, NALO, and other service organic

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(3) If travel requires an overnight stay, travelers must stay in clean berthing that includes a method of food delivery that maintains clean personnel status.

(4) This ROM sequester requirement applies to personnel coming on board government-owned ships for Voyage Repairs (VR), Emergent Work, and Onboard Technical Assistance (OBTA). To support the maintenance enterprise in minimizing risk to its technical experts, MSC personnel shall first exhaust distance support such that bringing personnel on board is the only course of action remaining.

(5) This ROM sequester requirement does not apply to government-owned ships in an overhaul or availability (ROH, MTA, PSA, EDD). Other precautions to mitigate the risk of COVID-19 exposure shall be taken. ROM sequester is also not required for embarking a commercial marine pilot; instead follow the procedures set forth in enclosure (7).

(6) Government-owned/Contractor Operated (GOCO) Vessels and Commercial Helicopter Detachment (Comm Helo Det). If required, Requirements Owners shall update the applicable Performance Work Statements (PWS) and new/revised Contract Data Requirements List (CDRL) to establish procedures for contractors to submit ROM sequester plans to include ROM sequester location, means of clean transportation satisfying above requirements, and other mitigating measures for coordination with the Program Manager and approval by the Contracting Officer.

(7) Commercially-Owned/Contractor-Operated (COCO) Vessels. This ROM sequester requirement only applies to chartered vessels after notification from the Contracting Officer. Such notice shall only be given after the Program Manager has obtained approval of the sponsor, to include identification of necessary funding to support contractual obligations. This ROM sequester requirement does not apply to chartered vessels where there are inadequate crew facilities (e.g., harbor tugs).

(8) Where compliance with this ROM sequester requirement is determined to be impractical, an alternative mitigation plan shall be submitted for COMSC approval via the appropriate MSC SES member. Other onboard mitigations shall include maximum social distancing, extra PPE worn by the person coming on board and shipboard personnel (the term "PPE" is not intended to mandate N95-level masks; any reasonable and generally-accepted face covering is sufficient), extra cleaning and additional screening points.

Mess hours for personnel without “clean status” shall be different from ship’s force. If overnight

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4.2.2 Screening. Masters shall screen all personnel accessing the ship or embarked on the ship using an MSC Commodore authorized AOR-specific COVID-19 screening questionnaire or enclosure (1). Screening can be done verbally. Masters will not allow personnel identified by the screening as at risk for COVID-19 exposure (“identified personnel”) to access the ship. If the identified personnel are already on board, and the ship is in port, the Master will direct the identified personnel ashore, follow the direction in paragraph 4.3 below for CIVMARs, and make immediate contact with the applicable MSC Commodore. If the ship is underway, see paragraph 4.4 below. Any paper copies of COVID-19 screening questionnaires shall be destroyed daily to prevent the retention of personally identifiable information and health information.

4.2.3 Masters may classify other individuals as “identified personnel” based on other risks for exposure. However, Masters shall use medical advice as part of their analysis of risk. For purposes of analyzing risk, Masters will apply the CDC definition for “close contact” which is defined as: (1) Being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; the current recommended threshold is 10 minutes. Close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case; or (2) Having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).

4.2.4 Face Coverings. Until declared a “Clean Ship,” all crew and embarked personnel shall wear cloth face coverings unless eating, sleeping, conducting personal hygiene, or participating in activity that would make covering unsafe (e.g. conflicts with other mandatory PPE, rotating machinery, etc.) Once declared a “Clean Ship,” Masters may relax the face covering requirement, however shall continue to require them to be used when engaging with personnel who are not part of the crew or embarked. Masters shall work with the supply system to procure acceptable face coverings. N95 and surgical masks should be reserved for medical personnel.

4.2.5 Masters will be prepared to extend their underway time to adjust to possible dynamic impacts caused by COVID-19 such as port closures and quarantines, or the need to demonstrate that there are no COVID-19 infections onboard.

4.2.6 Establishing Clean Ship and Bubble Status. For the first 14 days underway, or during a 14-day period pierside where the crew is restricted to the ship, Masters will institute crew social distancing to the greatest extent possible, to include

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(1) Clean Ship Status. “Clean Ship” status is controlled by the ship’s Master. Once a ship’s crew and embarked personnel have been free of symptoms for a minimum of 14 days, Masters will notify the applicable MSC Commodore that they have obtained Clean Ship status. Once “Clean Ship” is declared, the Master may relax some of the crew social distancing measures, such as permitting gyms or crew lounges to be used. Clean Ship status does not terminate if new crew or embarked personnel arrive after completing a 14-day ROM sequester. “Clean Ship” is automatically revoked and the 14-day clock is reset if a crewmember or embarked personnel present with ILI symptoms.

(2) Bubble Status. A “bubble” is a location where risk of contracting COVID-19 is mitigated to the lowest practicable level. “Bubble status” is controlled by the applicable MSC Commodore. For ships, Bubble status requires an additional risk assessment once the Master has declared Clean Ship status. Once satisfied that the ship has a low probability of COVID-19 infection, the applicable MSC Commodore will designate the ship as a “Bubble” for purposes of “Bubble-to-Bubble” travel, such as laid out in enclosure (8). At the discretion of the Commodore, Bubble status may be removed when the ship undergoes evolutions that increase the risk of COVID-19 exposure, such as voyage repairs. If Clean Ship status is revoked, that automatically terminates Bubble status.

4.2.7 Medical Training. Masters will ensure medical training to crew members on COVID 19. Stress the importance to the crew of reporting to MSO/MDR if they have influenza-like illness (ILI) symptoms and history of recent travel to an at-risk country or close personal contact with an individual infected with COVID-19.

4.2.8 Commercial Marine Pilots. Masters shall follow the procedures set forth in enclosure (7) when embarking or disembarking a commercial marine pilot.

4.2.9 Air Operations. Masters shall ensure compliance with the following procedures:

(1) Flight deck crew shall wear appropriate PPE, including face covering, gloves, and eye protection.

(2) Passenger operations: Screen departing passengers prior to Helo embark. Screen embarking passengers at flight deck upon arrival. Be sure to understand context of the passengers’ travel (e.g., coming from a “clean” environment or not).

(3) Cargo operations: Only the flight deck crew will unload the

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Helo, the aircrew shall not assist. The flight deck crew will stage the cargo in an appropriate area and spray with disinfectant, and then wait ten minutes before further handling.

(4) Aircrew Segregation. For embarked aircrew, consider dividing into two teams to prevent the potential for infection. For civilian helicopter detachments were flying and maintenance are performed by the same personnel, segregate detachment personnel and ship’s crew to the maximum extent possible.

(5) Aircraft Divert Concerns. Do not delay divert or execution of emergency procedures due to COVID-19 concerns. Once the aircraft is safely on deck, aircrew and ship’s crew should take appropriate steps to minimize exposure and, if necessary, sanitize aircraft and aircrew.

4.2.10 Hazardous Material and Solid Waste. Enclosure (10) contains procedures for MSC Ships on the handling and disposal of Hazardous Material and Solid Waste produced from COVID-19 decontamination activities, including personal protective equipment, cleaning materials and other wastes. Each geographic Area of Responsibility (AOR) may have more specific requirements for disposal ashore. Ships must check with the Regional Environmental Coordinator (REC) for area specific guidance and regulations.

4.3 Identified Personnel and Civil Service Mariner (CIVMAR) Restriction of Movement (ROM). Masters will place ashore any identified personnel who are on board and then file a report articulating the “5 Ws” (Who, What, Where, When, Why) on the circumstances with the respective MSC Commodore, the MSC Battle Watch, and MSC Medical (MSC_Medical_COVID19@navy.mil). Avoid the use of personally identifiable information (PII) in the report. Pass PII by voice report or encrypted email.

4.3.1 The Master shall place identified personnel who are CIVMARS under a ROM ashore for 14 days. These personnel will remain in a duty status and be given an order directing the appropriate self-isolation or quarantine procedures. See section 9 below for a full description of ROM. Enclosure (2) is a sample ROM order. If unable to leave an identified CIVMAR ashore, (e.g. prevented by host nation authorities) place the CIVMAR in quarantine/isolation on board per procedures for ill-persons below.

4.3.2 CIVMARS will be restricted from shipboard assignment for a 14-day period, starting from the day of departure from a designated area or contact with a known infected person. CIVMARS shall not be allowed to return to shipboard duties without record of a medical assessment provided to and validated by MSC Force Medical.

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4.3.3 CIVMARS left ashore shall be assisted by the Master of the ship and the appropriate MSC Commodore. Consideration will be given to providing a non-medical escort to assist. Questions regarding the duty or leave-status of identified personnel will be referred to MSC N1/TFM.

4.3.4 If an individual is already more than 14 days past traveling to a designated area and is asymptomatic for 14 days, there is no need to restrict that individual’s movement.

4.4 Infection Control of Ill-Persons in shipboard setting.

4.4.1 Ill-persons, as defined in section 9 below, shall be isolated/quarantined in a single-person room with the door kept closed until other appropriate means of isolation can be coordinated with the applicable MSC Commodore. For smaller vessels without single state-person room, the Master will identify the best possible space for isolation. The ill-person will not be allowed access to crew areas such as mess decks, gym and lounges. The ill-person will be directed to avoid close personal contact of 6 feet or closer to another crewmember. The ill-person will be required to wear a medically approved mask covering their nose and mouth. Compliance with isolation and safe physical distance measures will be monitored by the Master and shipboard medical personnel. See reference (o) for further details.

4.4.2 The suspected ill-person shall not share lavatory spaces. The ill-person should wash hands frequently and follow respiratory hygiene practices, to include consistent use of a medically approved mask. Other persons should sterilize cups and other utensils used by the ill-person before use. Disposable plates and utensils should be used instead, if available. Any trash generated by the ill-person does not necessarily need to be segregated. Refer to enclosure (10) for additional details.

4.4.3 The ill-person will remain in isolation for a minimum of 14 days, plus three days of being asymptomatic, and must be approved for release by authorized medical personnel. If available, testing for COVID-19 will be used as part of the medical determination.

4.4.4 Mitigation and Recovery. When an ill-person has been identified on board, immediate steps must be taken for force health protection and mission assurance.

The general guiding principle is to consider, plan for, and implement any reasonable measures (mission permitting) that mitigate the spread of respiratory pathogens beyond the initial case or cluster of cases aboard ship. Don’t give up the ship!

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(1) As soon as possible, Master or MSO will contact MSC Force

Surgeon to discuss mitigation and recovery strategy.

(2) Contact tracing will immediately be initiated – 100% accountability, quickly.

(3) Personnel exhibiting symptoms will be immediately isolated as soon as possible. Prioritize the most restrictive available isolation/separation for patients who are most actively symptomatic.

(4) Label all points of entry accordingly (e.g., “RESTRICTED ENTRY: Patient in isolation. Authorized personnel only”).

(5) Clean and disinfect the ship. Prioritize cleaning and disinfection of isolation/separation rooms and spaces, ensuring those spaces are frequently cleaned and disinfected. Cleaning and disinfection should be conducted at least daily, and/or prior to use by another patient. Prioritize cleaning and disinfecting high-touch surfaces and equipment in the immediate vicinity of the patient.

4.4.5 Individual plans for repatriation shall be coordinated on a case-by-case basis with MSC Force Medical, and MSC N1/Total Force Management (TFM). If underway and a medical situation is determined to be life-threatening, use existing MEDEVAC procedures at earliest opportunity. All MEDEVACs shall be reported to the MSC Battle Watch.

4.4.6 An MSC ship that has an ill-person on board will likely be required to work with foreign authorities through the appropriate MSC Commodore to determine the disposition of the individual in an effort to remove the ill-person from the shipboard environment. The Master will cooperate with foreign authorities to the greatest extent possible, while simultaneously protecting the sovereign immune status of the ship, pursuant to paragraph 4.9 below. The ship’s Master should expect that the result of identifying an ill-person and transferring them ashore is that the ship may not be allowed into port, or that the remainder of the crew may be restricted to the ship while in port at the direction of foreign authorities.

4.5 Ship Maintenance, Overhauls, Availabilities.

4.5.1 To the greatest extent possible, maintenance, overhauls, and

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This includes U.S. shipyards with DoD contracts and their workers. These shipyards are expected to maintain their normal work schedules.

4.5.2 MSC Commodores shall make recommendations to COMSC

regarding COVID-19 mitigations, crew status, liberty restrictions, and crew berthing during upcoming maintenance, overhauls, and availabilities.

4.5.3 Shipyard workers, technical representatives, and others shall be screened pursuant to section 5.1.3 and approved COVID-19 questionnaire such as enclosure (1). Refer to paragraph 4.2.1 for applicable ROM guidance.

4.5.4 MSC Program Managers and Contracting Officers shall engage with shipyards and other contractors coming onboard for maintenance to follow CDC best practices to reduce the spread of COVID-19 and to report to MSC when there are any shipyard or other contractor personnel who have tested positive for COVID-19 or are Patients Under Investigation (PUI) for COVID-19.

4.5.5 There will be situations at shipyards and other maintenance facilities where reports are made that shipyard workers and other individuals in the facility may have tested positive for COVID-19 or are PUI. The risk presented by such situations is very factually dependent and therefore it is important to gather information working with our industry partners and management officials. Report all known information to the applicable MSC Commodore, the MSC Force Surgeon, and MSC N7.

4.6 Ship Inspections, Certifications and Training.

4.6.1 Mission Essential Ship Inspections, Certifications and Afloat Training Events. Government-owned ship inspections, certifications and afloat training events deemed mission-essential will continue in the continental United States (CONUS). Personnel performing these functions will follow the provisions of paragraph 4.2.1 prior to embarking.

4.6.2 Outside the continental United States (OCONUS), or for those events not deemed mission-essential within CONUS, ship inspections, certifications and Afloat Training will be self-directed or rescheduled to the greatest extent possible.

4.7 Underway Replenishment (UNREP) and Cargo Loading. Underway

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Masters shall follow guidance in reference (s).

4.8 Contractor-Operated Ships

4.8.1 MSC’s contractor operated ships and contracted mariners (CONMAR) are part of the nation’s Critical Infrastructure Sector, as discussed in reference (c). As such, there is a special responsibility to maintain a normal work schedule and contract performance. It is critical for contractors to develop plans for dealing with possible COVID-19 impacts to their contracts and supporting personnel, and communicate those plans with the Contracting Officer frequently.

4.8.2 Contracting Officers shall direct commercial partners to follow applicable portions of this MSC COVID-19 Command Response Plan. Sovereign immune Contractor-Operated ships shall follow the guidance of OPCON/TACON Commander along with MSC COVID-19 response policies.

4.8.3 Contracting Officers shall direct commercial partners to provide an estimate of any costs they believe were not anticipated at contract award. Contractors Officers shall provide guidance regarding reimbursable expenses under the contract or requests for equitable adjustment with supporting documentation.

4.8.4 Contracting Officer Representatives (CORs) shall require Contractors to determine what CONMARs are returning from designated areas affected by an outbreak of COVID-19, as defined in Section 9 below. Contracting Officers shall inform Contractors that access will not be provided to the work site for health and safety reasons for these identified individuals until the individual has already been asymptomatic for 14 days since returning from a designated area affected by a COVID-19 outbreak, or a medical doctor or other competent medical authority has conducted the necessary medical testing and provided a written medical report/certification stating the individual either does not have the corona virus, is no longer contagious, or does not present a threat to others of being contagious with the corona virus. These identified individuals shall consult with their Contractor for return to work instructions.

4.8.5 Finally, nothing in this Procedure is intended to be, or should be understood or relied upon, as direction or authority to deviate from, or otherwise change, in

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4.9 Sovereign Immunity.

4.9.1 MSC ships entitled to sovereign immunity must continue to follow appropriate guidance. Masters can only provide health information pursuant to NAVMED 6210-3. Under no circumstances will port authorities be given access to individual health records, and no health or sanitary inspection will be permitted. However, Masters shall normally comply with all quarantine regulations and restrictions for the port or area within which the ship is located. Masters shall consult with applicable MSC Area Command Counsel to determine appropriate responses to health inquiries by foreign authorities.

4.9.2 Certain requests for information by foreign authorities may have to be resolved through the relevant U.S. Embassy and U.S. Defense Attaché engagements.

Crewmembers who go ashore in a foreign state ordinarily will be subject to local immigration and health requirements. For example, unless there is a SOFA or some other agreement to the contrary, it is acceptable for crewmembers to fill out a host nation's health form as they go through immigration/customs as they depart the ship on liberty (i.e. leaving the pier). That is distinguishable from crewmembers that need to go down onto the pier to inspect the ship, lines, utilities, etc. – the sovereign immunity and DIPCLEAR of the ship is expected to cover those individuals.

4.10 Repatriation. Travel restrictions continue to increase as part of the COVID-19 response, making crew reliefs more difficult. Therefore, requests for crew repatriation (repat) will only be made once all local remedies are exhausted. Personnel considered temporarily not fit for duty based on medical concerns will not be approved for repat until on board sick-in- quarters and other light duty protocols have been examined as alternatives.

Sick leave is used when a CIVMAR becomes ill or injured and is unable to perform light duty. Consult with MSC TFM and MSC Force Surgeon’s office on a case-by-case basis.

4.11 Chemical, Biological, Radiation, Nuclear Decontamination (CBRN-D) Supplies. MSC shipboard CBRN-D supplies can only be used for COVID-19 response as a last resort. Such circumstances include: (1) Depletion of all on board BUMED approved cleaning supplies; or (2) Major outbreak of COVID-19 infection onboard requiring gross decontamination of the ship. During use of Calcium Hypochlorite (HTH)/Detergent must be mixed IAW NSTM 470 for correct dilution, as in the incorrect dilution is highly corrosive.

All safety equipment shall be used…