COVID Grand Rounds Today at 1630 EST

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Sorry, but I just found out about this one, and it is today at 1630 EST. It is titled:

COVID-19 Therepeutics: “The 3-Legged Stool” Featuring Dr. Michael Joyner, of the Mayo Clinic

Details are in this PDF document.

SG’s Message – “Navy Medicine…Report to the Bridge!”

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Esteemed Colleagues,

“Anyone can hold the helm when the sea is calm. “ – Publilius Syrus.

For those of us who’ve had the privilege of getting underway in our great Navy can attest, the bridge attracts a lot of visitors when it is quiet at sea. It’s a much different scene however when situation get critical, as that is when the skilled, battle tested and steady hands are called to take over. But how did that “go to” team develop the proficiencies necessary to succeed in times of crisis? The answer can be found at the core of our Navy and Marine Corps team and the heart of what we do every day in Navy Medicine. It is the rare combination of being Brilliant on the Basics of our profession and at the same time, seeking those unique opportunities in our career to step out of our comfort zones, drawing confidence from our training, our mentors, our leaders and most importantly, ourselves to get the job done. Getting comfortable with being uncomfortable is a learned skill, and no one has set a better example of this principle in action than you…The amazing men and women of Navy Medicine.

We all have “comfort zones”; that behavioral space where our activities and behaviors fit a regular pattern. Routines can be stable and comforting, but they can also turn stale and confining over time. Doing something new and different helps stave off burnout and is good for our brains and bodies. Anyone who’s ever pushed themselves to get to the next level or accomplish something knows that when you really challenge yourself, you can achieve amazing results.

The idea of a comfort zone goes back to a classic experiment in psychology. In 1908, psychologists Robert Yerkes and John Dodson explained that a state of relative comfort created a steady level of performance. However, in order to maximize performance, one needs to reach a state where stress levels were slightly higher than normal. This space is called productive discomfort or optimal anxiety, and it exists just outside our comfort zone.

There are many examples of Navy Medicine personnel embracing the opportunity of operate outside their comfort zone to meet the challenge of the SARS-CoV-2 virus. For many it is overcoming the difficulties of continuing their demanding work remotely, without the proximate support of their co-workers. For others it is not just a change of venue, but of function. For example, our dental community, restricted from performing most of their operative procedures in order to limit spread of the virus, have contributed to the fight in ways they could not have imagined while they were in dental school. Here are just two of many examples:

  • LT Chris Wilde, NMRTC Yokosuka. A General Dentist, Chris stepped-up to orchestrate COVID-19 reporting for 223 commands across U.S. Forces Japan. He planned and executed multiple SWABEX evolutions and helped to test more than 6,000 people which prevented the spread a coronavirus outbreak on the base.
  • LCDR Geoffrey Ward, NMRTC San Diego. A prosthodontist, Geoff served as the command’s lead for COVID-19 operations and fleet testing. He helped to develop instructions for conducting drive-thru coronavirus testing, setting up tents for symptomatic and pre-operative testing, and co-authored standard operating procedures to provide consistent care and protect our Sailors and Marines.

One Navy Medicine’s willingness to move beyond our comfort zones remains a critical key to our success. Our ability to apply rapid-cycle feedback and lessons learned directly improves the quality, safety, and relevance in the care we provide.

For example, our experience in deploying Expeditionary Medical Facility (EMF)-Mike has taught us the value of smaller, rapid deployable units of highly skilled medical providers. This week 72 individuals attached to NMRTC Pensacola’s EMF-Lima (L) were sent to Texas as part of the newly established component platforms, the Acute Care Team (ACT) and Rapid Rural Response Teams (RRRT). The ACT is a 44-person team designed to support urban hospitals and RRRT’s are 7-person teams tailored to support patient surges. These Navy Medicine professionals are working on the front lines with the Federal Emergency Management Agency (FEMA) and local officials to serve as a relief valve for local hospital systems overburdened with COVID-19 cases. Rapidly and without hesitation they have selflessly stepped into the line of fire with local medical professionals to care for fellow Americans stricken by this relentless virus. In the coming weeks, we expect to provide additional aid to areas deeply impacted by the pandemic. Bravo Zulu to all who have and will answer this call. We are proud to call you our shipmates.

As our nation faces this generational crisis, it is OUR team that has been called to the bridge and I have never been more confident that the ship is in the best hands possible. Everyone who has stepped out of their comfort zone to respond to the pandemic understands the meaning of the quote: “a ship in a harbor is safe but that is not what ships are designed for”. Thank you for courageously sailing away from your personal safe harbor to strengthen our response to COVID-19.

You are making a positive difference in a world that has never needed you more.


Bruce L. Gillingham, MD, CPE, FAOA


Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

Navy Updates Face Covering Rules: What You Need to Know

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By MC1 Mark D. Faram, Chief of Naval Personnel Public Affairs,

WASHINGTON (NNS) — Since April 5, the Navy has required the wearing of cloth face coverings for all military, Navy civilian and contractors as well as family members while on DoD property, installations and facilities when maintaining proper social distancing between people isn’t possible.

Those rules, laid out in NAVADMIN message 100/20, remain in effect. Now, the Navy’s top uniformed personnel official, Vice Adm. John B. Nowell has issued further guidance in NAVADMIN 194/20 on face coverings which can be worn in uniform and how to get them.

“Initial face covering guidance facilitated immediate wear and availability of face coverings as one of several COVID-19 protective measures,” Nowell wrote.  “Procurement, design and wear guidance was less defined pending the availability of more durable and conservative designed government procured face coverings.”

This initial flexibility was by necessity, Nowell said, to quickly put personal protective equipment (PPE) in the hands of Sailors and provided unit commanders flexibility in procuring face coverings through “multiple sources, designs, colors and durability,” allowing them to “rapidly field face coverings to their personnel.”

Since design type and configuration have been narrowed for wear with the uniform, here’s what you need to know about what can be worn and how to get them.

When worn in a Navy uniform, face coverings must still meet the standards set by the Centers for Disease Control and Prevention and can be purchased by individuals or issued by commands.

Functionally, they must be made of at least two layers of cloth fabric and fit snugly and comfortably, covering the chin and extending over the bridge of the nose. They must not interfere with wearing eyeglasses or cause them to fog. Single-layer face covering already available through Defense Logistics Agency and Navy Exchange Service Command are acceptable and meet standards.

Fastening devices must be neutral in color and made of elastic, cord, string and loop. They must tie around the back of the ears or back of the head. It’s ok to use face coverings with barrel lock devices but only in areas where safety and Foreign Object Debris restrictions aren’t an issue.

Face coverings worn in uniform must overall be conservative in appearance, non-offensive and exhibit nothing that will bring discredit upon the wearer or the Navy.

Only face coverings made of plain neutral colors — specifically black, brown, tan, white, grey, green, blue can be worn. No lettering/wording, logos, symbols, prints or patterns are authorized.

The only exception is the option to wear coverings with camouflage patterns that match the Navy’s existing camouflage pattern uniforms.

Commands have the option of buying face coverings through Defense Logistics Agency or through open purchase if those available through the supply system “do not meet mission requirements,” Nowell wrote.  Purchase through the Navy Exchange is also available.

For further details, see NAVADMIN 194/20 which contains stock numbers for face coverings in all seven authorized colors. In addition, the message contains contact information for both uniform and supply points of contact in this issue.

COVID-19 Life Support Training Update

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BLUF – The purpose of this memorandum is to update policy guidance within the Military Health System for American Red Cross life support training (First Aid/cardiopulmonary resuscitation (CPR)/automated external defibrillator (AED), Basic Life Support (BLS), Advanced Life Support (ALS), and Pediatric Advanced Life Support (PALS)). As military medical treatment facilities (MTFs) transition to normal operations, no further extensions for the above life support certifications will be granted after June 30, 2020. Personnel whose certifications expired between March and June 2020 have up to 120 days to get recertified. This also applies to providers who have American Heart Association cards.

Here’s the full memo.