Research Paper Title

US Navy’s Response to a Shipboard Coronavirus Outbreak: Considerations for a Medical Management Plan at Sea.

Background

The authors observe with interest the ongoing management of the 2019 coronavirus (COVID-19) pandemic and its impact on the US Navy. The Navy is in a unique position of needing to balance operational readiness with the management of a highly contagious and morbid respiratory virus while working in close proximity and in confined spaces at sea or in preparations for sea. The widely accepted components of pandemic control include social distancing, isolation of sick patients, and quarantine of exposed persons. These components are almost entirely inconsistent with life at sea on a warship. The tight quarters and close interactions of over 5,000 personnel onboard a US Navy aircraft carrier (CVN) make prevention of respiratory virus transmission unusually difficult. Any attempts to evaluate, manage, isolate, and transport infected personnel within or off the ship would be made more challenging by operational requirements as well as limited ambulatory space, lavatory areas, berthing spaces, mess halls, supplies, medevac capabilities, and medical capacity. Further, unlike the US Navy’s prior experience in managing shipboard noncritically ill patients with gastrointestinal or respiratory infections, the management of an infectious respiratory outbreak with numerous seriously ill patients aboard a large US Navy vessel has not been defined to the authors’ knowledge before COVID-19. Although the challenges seem overwhelming, the US military has extensive experience in infectious disease, preventive medicine, and providing critical care in austere environments. Herein, the authors apply the known challenges of COVID-19 management to describe a potential model of a shipboard outbreak and illustrate the clinical strain on existing ship’s resources as well as describe the means necessary to mitigate the morbidity and mortality of such an outbreak.

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Reference

Vicente, D., Maves, R., Elster, E. & Shwayhat, A. (2020) U.S. Navy’s Response to a Shipboard Coronavirus Outbreak: Considerations for a Medical Management Plan at Sea. Military Medicine. https://doi.org/10.1093/milmed/usaa455.