The U.S. Navy's response to the COVID-19 pandemic drew attention to the fissures in the service's readiness to respond to major medical events. Researchers highlight and discuss these shortfalls and consider other possible emergencies aboard a ship, such as mass-casualty events or the need for large-scale trauma care. The authors look at the challenges posed by the pandemic and the Navy's response to examine broader implications for readiness.
- How are ships and other units affected by both an outbreak of COVID-19 and the mitigation measures put in place to contain it?
- What is the status of higher-level strategic readiness?
Like the rest of the world, the U.S. Navy scrambled to react to the sweeping effects of the early months of the coronavirus pandemic and take steps to mitigate longer-term effects even as the service continued to meet its mission requirements. The early outbreak on the USS Theodore Roosevelt and how that situation was handled received a great deal of public attention. It illuminated fissures in the Navy's readiness to respond to major medical events. The shortfalls highlighted and discussed in this report apply not only to the spread of infectious disease aboard a ship but also to a mass-casualty event or large-scale trauma care — circumstances that may be a more likely outcome in future warfare than has been experienced in the recent past. Drawing from the challenges presented by COVID-19 and the Navy's response, the authors examine broader implications for readiness in the Navy.
- If the virus comes aboard the ship, the results can be devastating in terms of the ship's ability to complete its missions. The most immediate impact is on the ability to man watches in confined engineering spaces, but the cascading effect on training, maintenance, and repair can affect numerous readiness areas.
- The implications extend to other units that may have schedules disrupted. For instance, deployments could be extended because of the unavailability of the infected crew to meet commitments.
- Although the Navy clearly imposed mechanisms to control exposure, these mitigations affect other aspects of unit readiness, including schedule, maintenance, morale, retention, and mental health. This history is still being written, so the full effects are not yet known. It seems imprudent to assume that these extraordinary measures can be adopted as a matter of routine.
- The lessons of COVID-19 must be evaluated in terms of whether the Navy can successfully deal with an out-of-the-ordinary medical and/or mass-casualty event. This requires not just that procedures exist in writing but that they be tested above the unit level in training exercises. It also implies a degree of coherence between operational and medical priorities, which was clearly not present in the initial phases of the outbreak.
- Critically evaluate operational priorities. Ask, "Is the commitment essential?" Assess whether it is essential that the ship's mission is at a particular point that it must either continue with some number of people ill or be replaced by another ship.
- Use engineering and personnel controls to minimize spread. If the Navy determines that a ship must be underway to support a mission and cannot be replaced, the next step is to keep the crew healthy and minimize spread to the extent possible.
- Improve shipboard capability for coping with infectious disease outbreaks. Shipboard medical departments are generally oriented toward care of young people who might get injured, not toward containing widespread infection. This shortfall might be met with improved training for a ship's medical officers and independent duty corpsmen. It might also be improved by assigning enlisted personnel with specific infectious disease training on ships.
- Improve communications between medical and operational chains of command. Reconciling points of view among medical and operational chains of command will take more than a formal process for consultation. It will take actual effort to consolidate different viewpoints and to do it in a way that accurately captures the risks and priorities of each group.
- Improve theater medical evacuation and coordination plans. The Navy should not overlook the shortfalls revealed by the COVID-19 event and their applicability beyond the end of this pandemic.