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US Navy Shifts COVID-19 Policy; Detailed Report Released on Outbreak

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Theodore Roosevelt returning to sea on May 21m 2020 - U.S. Navy photo by Mass Communication Specialist Seaman Kaylianna Genier

By The Maritime Executive 06-10-2020 08:40:34

The U.S. Navy announced that it has incorporated lessons learned from the initial COVID-19 outbreaks onboard USS Theodore Roosevelt and USS Kidd into guidance to sustain underway operations while fighting the virus during future outbreaks at sea. The changes in policy came as a comprehensive report on the outbreak aboard the aircraft carrier was also released.

The Navy is undertaking a fleet-wide shift to a symptoms-based recovery strategy for COVID-19 instead of requiring PCR out-testing. It believes that the new strategy will allow ships and units with outbreaks to more quickly return to normal operations and prevent protracted recoveries.    

The decision to shift strategies was made after fleet surgeons, supported by a Navy medicine scientific panel of medical researchers, public health experts and laboratory specialists, were able to confirm that the Theodore Roosevelt sailors whose diagnostic (PCR) tests remained positive ten days or more after the onset of their symptoms were no longer infectious. This was combined with other independent scientific reports of persistent viral shedding.

“Protecting the total workforce remains our top priority,” said Vice Admiral Phillip Sawyer, the Navy’s operations chief in charge of coordinating the service’s response to COVID-19. “At the same time, the Navy is still answering the call to defend the nation, protect sea lanes, and assist those in need. The Navy will continue to operate in this ‘new normal’ environment with COVID, but won’t be limited in our ability to respond to whatever our Nation needs.”

Another lesson the Navy reports it learned from the Theodore Roosevelt was the value of strict ship-board protocols which help contain the spread of the virus if found onboard. Refined procedures and a better understanding of preventative and mitigation actions have been shown to be effective. Several ships have had a COVID+ case, but the Crew’s actions have enabled the virus to be contained to a relatively small group while the ship continues its planned operations.

Sawyer also spoke about the fleet commanders’ development of “Safe Haven” ports for ships to safely pull in and get some rest and relaxation for their crews as well as accomplishing logistical resupply and repairs. These ports would be designed to support and maintain the ships’ COVID-free “bubble.”

The Navy emphasized while adjusting its operating procedures throughout the fleet, sailors must continue to follow basic force health protection measures. Navy leadership is also committing to keep the fleet and their families informed on safely navigating forward during this pandemic and will continue to update operational guidance as its understanding of COVID-19 grows.

Theodore Roosevelt Report

The announcement of the new procedures came as the Navy and Marine Corps Public Health Center, in cooperation with the Centers for Disease Control and Prevention (CDC), released findings from a joint public health outbreak investigation into how the COVID-19 disease affected crew members aboard USS Theodore Roosevelt.  

The outbreak investigation included asking volunteers to complete a short survey and provide two specimens for laboratory testing (voluntary blood and nasal swab samples).  Antibody testing done on nearly 400 service members from the Roosevelt showed that nearly two thirds (62 percent) were infected with SARS-CoV-2 and that most were mildly ill. This is the first CDC published report on this specific demographic of young adults.

“This study paints a picture of current and prior SARS-CoV-2 infection among young adults living in close quarters,” said study CDC author Dan Payne, PhD. “This data will contribute to understanding COVID-19 in the U.S. military, as well as among young adults in other close communal environments.”

Other notable findings include:

  • Nearly two-thirds of service members in this sample had reactive antibodies.
  • 44 (18.5 percent) of service members who were identified as having a current or previous SARS-CoV-2 infection did not report any symptoms.
  • Among those who provided nasal swabs, just over one third tested positive for current infection.
  • Loss of taste or smell was the symptom most associated with current or previous infection; participants reporting these symptoms were 10 times more likely to have the infection than were those who did not.
  • Among 12 participants with antibodies that were detected longer than 40 days after symptom onset, eight remained neutralization positive including two participants who were tested 3 months after symptom onset.
  • Among all participants, current or previous infection was more common among males than females, but did not differ significantly by age, race, ethnicity, or history of a preexisting medical condition.
  • Current or previous infection was higher among participants who reported contact with someone known to have COVID-19 (64.2 percent) compared with those who did not (41.7 percent) and higher among service members who reported sharing a room with another service member that tested positive (65.6 percent)  compared with those who did not.
  • Service members who reported taking preventive measures compared to those who did not have a lower infection rate (wearing a face covering (55.8 percent versus 80.8 percent), avoiding common areas (53.8 percent versus 67.5 percent), and observing social distancing (54.7 percent versus 70.0 percent).

The Navy issued on May 27 its new Standard Operational Guidance, which provides direction for isolation, quarantine, and contact tracing upon an initial outbreak, to include ships at sea that cannot medically evacuate personnel because of geographic or operational concerns. 

“Everything that we’ve learned emphasizes that the fundamentals still count,” said Navy Surgeon General Rear Adm. Bruce Gillingham. “Our Sailors are demonstrating that they understand the importance of using public health preventative measures like hand washing, wearing face coverings, social distancing and reporting any symptoms they experience in order to protect the ship, their shipmates and their mission.”