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MHS prepared to support interagency coronavirus response

Airmen assist one another in donning their personal protective equipment, while on-board an Air Force C-17 Globemaster III during transportation isolation system training at Joint Base Charleston, South Carolina. Engineered and implemented after the Ebola virus outbreak in 2014, the TIS is an enclosure the Department of Defense can use to safely transport patients with diseases like novel coronavirus. (U.S. Air Force photo by Senior Airman Cody R. Miller) Airmen assist one another in donning their personal protective equipment, while on-board an Air Force C-17 Globemaster III during transportation isolation system training at Joint Base Charleston, South Carolina. Engineered and implemented after the Ebola virus outbreak in 2014, the TIS is an enclosure the Department of Defense can use to safely transport patients with diseases like novel coronavirus. (U.S. Air Force photo by Senior Airman Cody R. Miller)

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The novel coronavirus (2019-nCoV) now affects more than 28 countries, with more than 28,000 cases worldwide. The Military Health System and Defense Health Agency remain prepared to support combatant commanders to protect our service members, other Department of Defense personnel, and their families in the United States and around the globe.

U.S. Army Col. (Dr.) Jennifer Kishimori, director, Chemical, Biological, Radiological, and Nuclear Medical Countermeasures Policy, Office of the Assistant Secretary of Defense for Health Affairs, recently briefed a U.S. Government interagency panel and health industry stakeholders on MHS actions and responsibilities. Foremost, Kishimori explained the DoD follows the guidance of the Centers for Disease Control and Prevention as the U.S. government medical lead.

“DoD is in support of the interagency for preparedness and response efforts against the novel coronavirus outbreak,” Kishimori said. “This is a new virus. Information is emerging and changing daily. Our Military Health System, which comprises the medical assets within the DoD, works to keep pace with CDC and interagency guidance in this fluid situation.”

Earlier, Acting Under Secretary of Defense for Personnel and Readiness Matthew P. Donovan released a guidance letter for force health protection specifically relating to the novel coronavirus. In it, Donovan stated that DoD will follow CDC guidance and provide specific instructions for DoD personnel and military health care professionals. While DoD personnel are not specifically at risk of exposure to the 2019-nCoV, the fact that DoD personnel and their families travel internationally and throughout the U.S. means they should take additional precautions to avoid risk.

Kishimori further explained DoD, through DHA, is distributing CDC-based guidance to health care providers and military families at all military treatment facilities. “Though our executing organizations such as the Defense Health Agency, we are working to communicate current CDC guidance for public health, hospital preparedness, patient evaluation, infection control, laboratory testing and health risk communication, in coordination with the Joint Staff.”

Specifically, DHA’s Medical Affairs directorate released information for health care providers to ensure any patient with a risk of infection receives the proper care and testing and that public health authorities are notified of all cases.

Kishimori outlined MHS’ unique capabilities to monitor and respond to 2019-nCoV for both surveillance and research and development.

  • The Center for Laboratory Medicine Services and the Executive Secretariat, DoD Laboratory Network synchronizes laboratory capability across the MHS and works with interagency partners to ensure supported network laboratories have the necessary detection and characterization capabilities in place to support 2019-nCoV-related activities across the globe.
  • DHA Armed Forces Health Surveillance Division and Global Emerging Infections Surveillance monitor daily the status of the outbreak.
  • Naval Medical Research Unit-2 in Phnom Penh, Cambodia, continues increased surveillance for the coronavirus at the China border.
  • The Armed Forces Research Institute of Medical Sciences in Thailand is also in a forward position to identify and characterize virus isolates.

The MHS also has a robust research capability with specific expertise in coronaviruses. Kishimori explained that the DoD has scientists and clinicians with experience in rapidly executing pre-clinical studies and virus vaccine clinical trials with infectious disease clinicians through DoD laboratories.

The CDC recommends simple measures to protect yourself from illness:

  • Avoid close contact with sick people.
  • While sick, limit contact with others as much as possible.
  • Stay home if you are sick.
  • Cover your nose and mouth when you cough or sneeze. Avoid touching your eyes, nose and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated with germs.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand rub with at least 60 percent alcohol.

“Force Health Protection is our top priority in Health Affairs and the Department of Defense,” Kishimori explained. “The MHS continues to coordinate with DoD partners and the interagency to optimize preparedness and response efforts against the nCoV.”

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DoD COVID-19 Practice Management Guide Version 5

Technical Document
7/30/2020

This Practice Management Guide does not supersede DoD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

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