FORCE HEALTH PROTECTION

Force Health Protection (FHP) assets which include the public health emergency officer (PHEO), public health, preventive medicine, and veterinary services are important stakeholders and subject matter experts on issues of infectious disease control (including zoonotic disease), sanitation, food protection and safety, and water systems protection and safety. Veterinary Services (VS) are equally important subject matter experts in animal medicine and husbandry, human-animal bond, and agricultural systems. Where available, FHP personnel should be consulted regarding these issues; there are now extensive Force Health Protection (FHP) Guidance documents published by the DoD available here: https://www.defense.gov/Explore/Spotlight/Coronavirus/Latest-DOD-Guidance/

A series of continually updated supplemental guidance documents outline the DoD position on all aspects of force health protection related to COVID-19 to include: testing, restriction of movement, diagnosis, recovery, travel restrictions, patient movement, non-pharmaceutical interventions (mask wear, social distancing, building occupancy restrictions, etc.), return to work criteria, and health protection conditions (HPCON). These FHP supplements are updated to include the evolving understanding about COVID-19 and changes in CDC and FDA recommendations and regulations. USCENTCOM policy is closely aligned with the DoD FHP documents but health care personnel must be familiar with both and should look to the link above regularly for updated information.

This information in this section is intended to supplement not supersede the USCENTCOM/Component and TRANSCOM policy and guidance. Any operational issues or challenges regarding FHP or the movement and care of authorized animals and animal-care personnel should be resolved through local, ARCENT, and USCENTCOM Command leadership.

Contact tracing is a critical part of COVID-19 mitigation, and must be supported by the command group. COVID Trace Team members will be required to complete training (see Appendix B: Additional Training and Resources). All positive cases will be contact traced and all individuals identified as a close contact will be placed in quarantine based on current USCENTCOM policy and DoD FHP guidance supplements. All confirmed cases will be contact traced and identified; close contacts will be placed in quarantine. Release from quarantine and isolation should follow current DoD and USCENTCOM policy but local commanders may impose more restrictive measures.

Field Sanitation and Isolation

In many cases, isolation facilities will need to be rapidly established that may require alternative waste and hygiene approaches to protect the uninfected general population (e.g. alternative showering facilities, pit latrines, bed cans). FHP assets should be consulted to ensure best possible practices are being implemented and that all safety and handling precautions are implemented.

RESOURCE:

Management of COVID-19 in Austere Operational Environments v3.0, 23 Apr 2021

Central Command Regulation 40-2 08 Nov 2017, Deployment Force Health Protection (SIPRNet)

CDC Sanitation & Hygiene

DoDD 6200.04, Force Health Protection, Oct 2004

ATP 4-02.8, Force Health Protection, Mar 2016

Training Circular 4-02.3, Field Hygiene and Sanitation

Health Service Support Casualty Prevention for Expeditionary Operations, AFTTP 3-42.2, 2004

Food Safety and Food Service

There is still no evidence for concern that food and food packaging serves any role in transmission of COVID-19. Protection in dining facilities will focus on protection against direct human-to-human transmission and should include the following considerations.

- A la carte dining options (e.g., deli and sandwich stations, omelet stations) should be suspended during the pandemic.
- Fresh fruits and vegetables and deserts should not be presented in a salad bar format. These foods should be cleanly prepared and packaged in covered food containers.
- Meal lines and dining areas should consider social distancing. Seating should be placed in appropriate distances and/or limitations on capacity should be implemented. Consider outdoor dining options and take out approaches.
- Consider implementing servers – designated personnel that are screened for fever and symptoms at the start of each shift - instead of self-serve approaches or pre-plating or packaging meals to reduce contact during the serving process.

RESOURCE:

DoD Veterinary Services COVID-19 Resource Page Provides white papers, external links, situation reports and other operational guidance related to food safety and protection, FHP, and animal medicine/animal health during the COVID-19 pandemic.

FDA Best Practices for Retail Food Stores, Restaurants, and Food Pick-Up/Delivery Services During the COVID-19 Pandemic

Veterinary Care

Government owned animals (GOAs) and authorized privately owned animals (POAs) should continue to receive veterinary medical care in accordance with DoD and contact specific guidelines at local VS locations (veterinary treatment facility or similar). Any currently understood possibility of zoonotic transmission DOES NOT exceed the harm caused by not ensuring care for these animals. Elective procedures and veterinary medical care activities should be cancelled for the duration, but standards of care for public health and readiness should be maintained in accordance with applicable policy, health certificate requirements, and best practice guidelines (e.g. vaccination, emergency care, retail/distribution of medication and preventatives, etc.).

RESOURCES

DoD Veterinary Services COVID-19 Resource Page

CDC COVID-19 and Animals

American Veterinary Medical Association (AVMA) COVID-19 webpage

Animal to Human Transmission

The COVID-19 virus is known to have zoonotic origins, believed to originate at a live animal and wet market in Wuhan, China. It appears that in rare situations, COVID-19 infected persons can spread the virus to animals. The virus has been detected in felids (domestic cats, lions, tigers, snow leopards, and cougar), canids (domestic dogs), non-human primates (gorillas), and mustelids (ferrets, farmed mink and wild mink). It is unlikely that this virus will cause significant clinical disease in healthy domestic animals. There is no evidence to suggest domestic animals serve any significant epidemiological role in transmission of the virus to humans. Human-to-human transmission remains the primary source of transmission. However, given the possibility for zoonotic transmission of the COVID-19 virus, the following recommendations should be implemented:

- Commanders should strictly enforce USCENTCOM General Order (GO) 1C (paragraph 2.g) that prohibits the adoption of unauthorized pets or mascots of any kind on DoD installations. Exceptions to this policy include authorized GOAs, including military working dogs (MWDs) and DoD Contracted Working Dogs, and installations where personnel live off-base and are authorized POAs.
- It is not recommended to routinely test animals for COVID-19 using BioFire or any other testing platform. The CDC provides guidance on testing animals for COVID-19. The CCSG team and CENTCOM Command Veterinarian should be consulted PRIOR to any testing of animal patients for COVID-19.

RESOURCES

USCENTCOM General Order 1C (para. 2g), 21 May 2013

AVMA Interim recommendations for intake of companion animals from households where humans with COVID-19 are present

NASPHV Compendium of Measures to Prevent Disease Associated with Animals in Public Settings

Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response

CDC Evaluation for SARS CoV-2 Testing in Animals

DoD Guidance for Coronavirus Disease 2019 and Animals

Considerations for Animal Care Personnel

VS personnel should routinely implement and train local non-VS animal care personnel in the principles and standards of infection control outlined in the NASPHV Compendium of Measures to Prevent Disease Associated with Animals in Public Settings and applicable infection control policy and best practices. Elective veterinary visits and procedures should be cancelled through the pandemic. Animal care personnel should remain aware of current shortages and high demand of PPE for their human medical counterparts and practice prudent PPE implementation when treating animals, conducting laboratory procedures, and routine husbandry practices during the COVID-19 pandemic. The CDC makes recommendation on their website for PPE use when caring for animals. Working dog handlers that require isolation or quarantine should NOT conduct daily care for their dog. The Kennel Master, trainer, or other handlers should provide routine care for that dog until the assigned handler can return to duty.

RESOURCES:

CDC Interim Guidance for Public Health Professionals Managing People With COVID-19 in Home Care and Isolation Who Have Pets or Other Animals

NASPHV Compendium of Measures to Prevent Disease Associated with Animals in Public Settings