POLICY BRIEFING – WEEK IN REVIEW

Amidst a renewed surge of covid-19 cases, contact tracer programs are finding themselves overwhelmed and undermanned. One immense challenge the efforts face are a lack of trust and compliance on the part of infected patients. In some cases, individuals who test positive wait multiple days before responding to calls from their local health department, while others believe that they and their contacts are low risk, negating the need for tracing in the first place. Amidst this, a new wave of asymptomatic infections in younger patients who tend to avoid care, further challenges and stretches the capabilities of contact tracing programs. Despite the increased need, many parts of the country do not have adequate funding to supplement their existing tracer force, with some enlisting the National Guard to pick up the slack. In other countries, contact tracers were recruited and trained well in advance. Conversely, testing capabilities continue to increase, as the Department of Health and Human Services has announced a partnership with a group of private retailers. In association with CVS Health, Rite Aid, Walgreens Boots Alliance, Kroger and Walmart, DHS will increase ambulatory testing capabilities by over six hundred sites nationally. Various. 2 July 2020.

As covid-19 cases continue to increase throughout the southern United States, one frequent source of infection clusters is becoming more clear: churches. Last month, President Trump stated that all in-person religious services should be allowed to resume despite the ongoing pandemic. Since that time, several outbreaks have been linked to services including at a Pentecostal church in Oregon and churches in West Virginia and Texas. Some of these outbreaks have forced local officials to dial back their plans for reopening. The situation has been made more difficult by concerns from many that religious organizations are being treated differently than other public spaces; in some states, the US Department of Justice has intervened on behalf of aggrieved churches. Previous guidance from the Centers for Disease Control and Prevention encouraged limiting recitations and singing, halting any Eucharist (mass/communion) and other shared servings. However, concerns were raised that these policies might infringe upon freedom of religion rights guaranteed by the First Amendment of the US Constitution. On Sunday, a masked Vice President Pence attended a worship service at a large Dallas megachurch. A large choir behind him wore masks but removed them when it came time to sing. Singing is known to project droplets much further than breathing or conversational speech. Meanwhile, Texas continues to see an uptick in SARS-CoV-2 cases and hospitalization rates have also risen dramatically in recent days. The Texas Medical Center, the largest concentration of health care institutions in the world, announced last week that they had reached 100 percent capacity in their intensive care units. Politico. 30 June 2020.

In late May, the Pentagon issued travel restrictions that applied to all employees of the Department of Defense in an attempt to limit spread of the coronavirus, with relaxation possible once the US Centers for Disease Control and Prevention (CDC) and White House guidelines had been met. This week, the Pentagon has updated that status, effectively removing the travel ban in all states except Michigan, Florida, and California, due to their recent uptick in cases. Additionally, normal movement was granted for many service members stationed internationally. What remains to be seen is how the US Navy will respond to this decision, having recently implemented significant movement restrictions on all North American forces. Various. 3 July 2020.

This past week the US Navy released a new fragmentary order (FRAGO) outlining new restrictions for active duty Naval personnel stationed in North America. Despite easing of restrictions in some parts of the country, the Navy will continue to maintain strict guidelines to prevent the spread of covid-19 within their ranks. Citing the need to maintain a deployment-ready fleet, the memo states, "The easing of community restrictions is not aligned with the Navy imperative to maintain Covid infection as low as possible across the force." In addition to guidelines for their own service members, the FRAGO strongly encourages civilian employees of the Navy, such as contractors and family members, to abide by the same guidelines in order to limit the possible spread of coronavirus within the Navy community. In a system that is analogous to the Defense Readiness Conditions (DEFCON), the Department of Defense uses Health Protection Condition (HPCON) levels in response to public health emergencies. With the release of the current FRAGO, all North American forces are now under "HPCON Charlie minus," which details the following restrictions. On installations (Navy bases, stations and schools) all unit and installation sponsored events, as well as large group gatherings are cancelled. Virtual work opportunities are to be maximized. Personal behavior guidelines instruct service members to maintain six feet of separation when around individuals for fifteen minutes or greater; to wear masks to the maximum extent possible if unable to maintain six feet during these interactions; to the maximum extent possible, limit gatherings to no more than ten people; limitation of travel to and from home and work to essential business. Among the list of things service members are prohibited from participating or visiting include recreational swimming pools, gyms, fitness centers, exercise classes, saunas, spas, salons, tattoo/piercing parlors, barbershops, hair and/or nail salons, massage parlors, theaters, participation in team/organized sports, dine-in restaurants, bars, night clubs, casinos, conferences, sporting events, concerts, public celebrations, parades, public beaches, amusement parks, indoor religious services, outdoor recreation areas with common equipment if six feet of separation cannot be assured and shopping malls. While conducting essential tasks, service members are to practice social distancing and wear cloth masks. Covered activities include, but are not limited to mass transit, auto repair, maintenance and annual inspection, curbside and drive through service, banking, pet care, in-home service, post office and laundry. While all North American facilities have been placed at HPCON Charlie minus simultaneously, reduction to lower statuses can occur asynchronously based on local coronavirus restrictions. Department of the Navy. 29 June 2020.