Transport guidance has changed frequently and is ever changing with the current environment. Check with local Operations cell to ensure most current guidance is followed. As of the date of this publication:

- All patients with symptoms severe enough to require admission to a medical facility for symptom management and/or supplemental oxygen should be considered for evacuation.
- Host Nation admitted patients may remain in hospital at commander’s discretion.
- Navy Afloat remains on ship unless ship’s capability is in danger of being exceeded (either by volume or the severity of the patient.)
- Asymptomatic COVID+ or mildly symptomatic patients should stay but a commander may decide to evacuate.

For patients with a new (+) COVID test within 72 hours of patient transport by AF Aeromedical Evacuation (AE/CCATT) or civilian air ambulance, in addition to usual contact tracing procedures, please notify the regional TRANSCOM Patient Movement Requirements Center (TPMRC) that services that MTF (TPMRC-A DSN (312) 779-4200, TPMRC-E DSN (314) 480-8040, TPMRC-W DSN (315) 448-1609); the U.S. Transportation Command (USTRANSCOM) Instruction 41-02, 11 July 2019 outlines Patient Movement of Contagious and potentially exposed casualties. This playbook is a summary that pertains specifically to COVID-19. The guidance for movement and evacuation of COVID-19 positive patients is rapidly evolving. Early and close coordination of these movement requests with Theater Patient Movement Requirements Center East (TPMRC-E) and next higher headquarters is crucial.

To ensure correct resource allocation and transport prioritization, units should refrain from using locally derived patient categorization. Patient classification should remain IAW DAFI 48-107, EN ROUTE CARE DOCUMENTATION, Volume 3, 17 December 2020.

Movement of multiple COVID-19 patients will be performed using a DoD certified and approved contagious patient movement system. Planning considerations must take into account downtime for decontamination of aircraft following COVID-19 patient evacuation. Upon consultation and appropriate approvals, capabilities developed outside of the DoD for moving patients exposed to or infected with COVID-19 may be used for approved missions via commercial aircraft. The sending MTF must coordinate movement with TPMRC-E for both intra and inter-theater PM.

Refer to local, CJTF, Component, and USCENTCOM guidance for specific knowledge on Operational Planning assumptions, considerations and guidance located on the USCENTCOM Surgeon (CCSG) SharePoint.