Surgeon General

SG’s Message – Full Speed Ahead-After a Short Break…

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Esteemed Shipmates,

Labor Day typically marks the unofficial end of summer and a return to school for many; and this year, we are reminded that 2020 is anything but typical. What IS typical is your outstanding support of our war fighters and their families. So, before we secure for the holiday weekend I want to thank you for YOUR labors and the contributions you make to defend our freedoms. I’d especially like to recognize our shipmates who are “standing the watch” this weekend on behalf of Navy Medicine. Thank you for your selfless dedication and team spirit.

Since the early part of February, Navy Medicine has been operating at flank speed. We have and will continue to answer the call by responding to those we serve; our patients, our families, our warfighters, and in federal emergencies to our fellow citizens. No one can stay at flank speed indefinitely, so if possible this weekend, please throttle back, spend some quality time with friends and family (in a socially distanced way of course!) and recharge your batteries. Refreshed, we will be able to redouble our efforts against this implacable adversary.

In recent messages, I have highlighted the tremendous efforts we have made to rapidly deploy our medical capabilities, both at home and abroad, in support of the COVID-19 response. I have watched in admiration as the Navy Medicine team has demonstrated its power in incredibly agile and novel ways. The nation now knows what we have always known, and that is that we are always ready to answer the call and to provide a fully capable medical force no matter how challenging or unique the contingency.

Throughout the pandemic we have learned much about our strengths and have also identified areas where we can improve. We continue to gather these lessons learned and are committed to ensure they are lessons applied and don’t just get filed away. The COVID response has demonstrated the importance and value of rapid cycle feedback from “the deck plate” so I encourage you to share your insights, of both your successes and your challenges, with your leadership so we can use them to build a stronger and even more effective Navy Medicine.

Finally I wanted to reaffirm how appreciative I am of what you all are doing. Please know that it is not just me that is incredibly appreciative; it is the Secretary of the Navy, the CNO, and the Commandant of the Marine Corps. Vice Admiral Sawyer; who runs Operations for the Navy, has repeatedly stated how much he appreciates the support that we are providing by rising to the occasion, answering the mail, providing guidance for health protection; and when necessary, getting people out the door quickly…fully demonstrating the power of Navy Medicine!

It’s a privilege to be your Surgeon General and be in a position to support each of you, advocate for you, and to bask in your impressive successes. Wishing you all the best for a safe and restful holiday weekend. Come back from this well-deserved time off rested, recharged and ready to proceed full speed ahead!

With my continued respect and admiration, SG

Bruce L. Gillingham, MD, CPE, AOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

SG’s COVID Update – August 2020

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Here’s a link to the You Tube video:

SG’s Message – People are Our Strength

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Esteemed navy Medicine Colleagues,

This week I wanted to try something different.  Attached below are two links to a video all hands message.  My goal is for you to receive communication from me and other Navy Medicine senior leaders about every two weeks. Toward that end, the next message will come from the DSG…..

Admin Note: Two links appear below with the same video, the first is for a YouTube Link, if you cannot get to YouTube from your work computer, the second link is to MilTube which is only accessible with a CAC card, but should be accessible on DOD computers.  Same video at both links below.

YouTube Link: https://youtu.be/u1oy1eCUHCU

MilTube Link (CAC Required): https://www.milsuite.mil/video/33753

Thank you for all that you do every day-you are truly making a difference.

GO Navy-beat COVID!

 

SG Sends

Bruce L. Gillingham, MD, CPE, FAOA
RADM, MC, USN
Surgeon General, U.S. Navy
Chief, Bureau of Medicine and Surgery

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.

SG

Bruce L. Gillingham, MD, CPE, FAOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

SG’s Message – Words That Define Us

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Esteemed colleagues:

At this time last year we were happily awaiting the Fourth of July holiday, relishing the opportunity for outdoor recreation, barbecues, and relaxing with our friends and family.  Little did we know, a year later, we would be facing the prospect of a fifth month of restrictions in our daily life including social distancing, the need to wear facial coverings, and the loss of our cherished freedom of movement.

We begin this summer very different as we continue to face an adversary that shows no signs of backing down.  Recent trends, in fact, demonstrate a concerning increase in cases affecting all of our Navy and Marine Corps team, to include Navy Medicine personnel.  How will we respond to this ongoing challenge?  For me, four words that describe Navy medicine’s foundational characteristics provide the answer:  resolve, persistence, toughness, and resilience.

Resolve:  to decide firmly on a course of action.  As the Navy’s medical force, our war fighters and their families look to us to provide the expertise to protect them.  They also look to us as role models for how to behave and act in this challenging environment.  We must demonstrate the resolve to practice what we preach and become the standard-bearers for how to overcome this adversary.

Persistence:  firm or obstinate continuance in a course of action in spite of difficulty or opposition.  Time and again, Navy Medical personnel have demonstrated the ability to fight through adversity to complete their mission.  We are no strangers to sustained, superior performance.  Now more than ever, staying the course, even in the face of what may seem like overwhelming odds and insurmountable challenges, is critically important.

Toughness:  the ability to deal with hardship or to cope in difficult situations.  Toughness is a core Navy attribute.  We relish the opportunity to show others that we have what it takes, no matter the circumstance.  When the going gets tough, Navy Medicine gets going.  As our Navy motto attributes – Semper Fortis.

Resilience:  the capacity to recover quickly from difficulties.  A key characteristic of high reliability organizations is that they take a hit and come back stronger.  SARS-CoV-2 has hit us hard, but much like the USS Constitution, we are built of sterner stuff.  As a learning organization, we know knowledge is power and each encounter with our adversary has made us stronger.  Every day the insights gained by our scientists, public health experts, and medical teams have made us more powerful.  We use this power for the benefit of those that we have the privilege of protecting.  We thrive on the opportunity to grow and adapt.

Resolve, persistence, toughness, and resilience…these words define our incredible team and the characteristics that will see us through this challenge.  As our Nation finds itself in the midst of this generational struggle, know that you are the living embodiment of these words, and it is you who gives Navy Medicine its power to prevail.  Thank you for all you do and please know what a privilege it is to serve alongside you.

With my continued respect and admiration,

SG

Bruce L. Gillingham, MD, CPE, FAOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

Message from the SG – Brilliant on the Basics

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Esteemed Navy Medicine Shipmates,

Michael Jordan once said, “Get the fundamentals down and the level of everything you do will rise.” The fundamentals are the basics. They are not always the most exciting thing to learn or do, but they are usually the most important. People, teams, and organizations who achieve greatness, do so by mastering the fundamentals – and then sticking to them. You have probably heard me say – we all need to be brilliant on the basics.

There is currently no vaccine to prevent us from contracting this disease; however, when it comes to our collective battle against COVID-19, we need to continue to practice and encourage others to follow the fundamentals of force health protection to prevent illness and avoid exposure to this virus. Continue to cover your mouth and nose with a cloth face cover when around others, wash your hands often and avoid touching your face, clean and disinfect frequently touched surfaces, monitor your health for symptoms, and enforce restriction of moment.

As medical professionals, we must continue to educate and advise our Sailors, Marines, and family members to stay the course. To help turn fundamentals into habits requires repetitive action. I’m reminded of a basic teaching formula: you hear, you forget; you see, you remember; you do, you understand. And when you truly understand, that is when the basics become part of our DNA. Think muscle memory!

This week marked the 122nd anniversary of the Hospital Corps. As we continue to adapt and confront the challenges posed by this pandemic, the men and women of our Hospital Corps remain a powerful presence on all fronts in the fight against COVID-19. Whether serving as IDCs on surface ships, subs, or diving units; as preventive medicine and laboratory technicians, as general duty Corpsmen at MTFs, or the 8404s embedded with Marine units, our ability to project Medical Power continues to rest on the shoulders of these brave and dedicated Corpsmen.

The recent exploits of Corpsmen during the pandemic have only added luster to the distinguished history of the Corps:

  • The quick thinking of the USS KIDD’s IDC and his two fellow “docs” in medevac’ing a suspected case of COVID and implementing newly developed mitigation procedures helped reduce the impact of the disease aboard the warship.
  • Five HMs attached to the Naval Hospital Jacksonville’s Rapid Response Team helped ensure the success of an unprecedented mission, conducting testing of the USS KIDD’s crew while helping to provide vital medical support 24/7 in a COVID exposure environment.
  • Corpsmen serving with forward deployed preventive medicine teams have remained an early, active, and ever-present force in novel coronavirus surveillance efforts at sea.

And whether contact tracing, onsite testing, administering to patients, or helping to enforce DoD and CDC COVID-19 guidance, our Corpsmen remain at the vanguard of ensuring warfighter readiness across the Department of the Navy.

This month also offers a palpable reminder that Summer is in full-swing and many may be eager to travel or enjoy recreational activities since restrictions have loosened up across the country. Before executing any plans, please take a moment to review NAVADMIN 168/20 regarding our current leave, liberty, and TDY restrictions; as well as the Naval Safety Center, 101 Critical Days of Summer found here.

Please continue to use good judgement, follow existing guidelines, remain vigilant, and most importantly stay safe.

It is important that we all take time to step away from our jobs to decompress, and all of us are eagerly anticipating returning to a sense of normalcy. However, as we try to rediscover what has been lost, let us not forget everything that we have learned along the way. If I had one wish, it would be that you could see the organization from my perspective, as the brilliance you have all demonstrated on the basics have been the building blocks of all that Navy Medicine has accomplished. I am truly humbled to be part of this amazing team.

With my continued respect and admiration,

SG

Bruce L. Gillingham, MD, CPE, FAOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

SG’s Message – Continuing to Deliver

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Esteemed Navy Medicine Colleagues,

It is hard to believe, but June marks six months since we first detected COVID-19 in the United States. During this time, our Navy and our Nation have changed in ways that would hardly seem recognizable at the end of 2019. One thing that has remained consistent is that Navy Medicine has stood on the front lines of this fight, bringing Medical Power to our Navy and Marine Corps team.

This is now the new normal and we must learn to sail, fight, and win in this environment. Throughout the early rounds of this battle, Navy Medicine’s kinetic responses were easily visible on every TV and made every headline. Whether it was the sight of two Hospital ships sailing into harm’s way to respond to our country’s needs, or the story of our Expeditionary Medical Facilities rapidly deploying to support our fellow citizens in need, Navy Medicine met the enemy head on. Now, we must shift from this initial response phase to one that builds the strength and resilience of our force so they can operate and succeed this new environment.

Using rapid cycle feedback and continuous learning, we are taking the lessons learned of this initial phase and leveraging them to shape our future strategy. A real life example of this is seen with our work with COVID Convalescent Plasma (CCP). Two weeks ago, the DOD announced the use of the FDA-approved CCP as an investigative treatment against COVID-19. CCP is collected from the blood of individuals whose immune systems have developed antibodies against COVID. Within hours of the newly established policy, we rapidly collected CCP from volunteers aboard the USS Theodore Roosevelt (CVN-71); and over the course of three days, the blood bank/donor center at USNH Guam had collected more than 200 life-saving plasma units. This was the first of many donations as crew from the USS Kidd (DDG-100) also contributed plasma. Navy Medicine will continue to be at the forefront of this effort to gather CCP from Sailors and Marines who have recovered from this disease, and we will use it to treat those who become seriously ill.

Over the last six weeks, TR has also been the focus of a public health outbreak investigation conducted by Navy Marine Corps Public Health Center in partnership with the Centers for Disease Control and Prevention (CDC). This investigation was conducted with volunteer crewmembers who were asked to complete a short survey and provide two specimens for laboratory testing (voluntary blood and nasal swab samples). This is the first CDC published report on this specific demographic of young adults and one of the key findings was that loss of taste or smell was the main symptom most associated with the COVID-19 infection. This joint investigation broadens our understanding of this disease and will inform future testing and mitigation strategies to ensure the readiness of our fleet and force. I recommend you take the opportunity to review the published findings at www.cdc.gov/mmwr.

As our knowledge about the coronavirus continues to expand, we remain steadfast in our commitment to protect the health of our force based on the best available scientific evidence. This is why we exist and it remains our solemn obligation to care for and support America’s Service members and their families. Despite the complexity of this adversary, because of your incredible dedication and unwavering support, we will continue to deliver …Medical Power in Support of Naval Superiority.

With my continued respect and admiration,

SG

Bruce L. Gillingham, MD, CPE, FAOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

SG’s Message – Stronger Together

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Navy Medicine Family,

This week the world witnessed the 8 minute and 46-second video which showed the tragic death of George Floyd, an African American man and father. As I watched this disturbing image, I was outraged and sadly reminded that countless people of color continue to experience and endure disparate treatment, injustice and racism today.

This is an emotionally raw and painful time for many and the countless global demonstrations against social injustice further highlight the fact that racism, prejudice and discrimination continue to exist. But unlike the coronavirus that we have been fighting over the past months, we can’t just stay at home and socially distance ourselves from racism. But we can do our part to lead with purpose, inspire others with our actions, break down racial and ethnic barriers. I encourage you to be a part of the solution and fight it, through collaborative and constructive efforts, and not divisive, destructive, and violent activities.

I am sensitive to the fact that the events that have taken place over the last couple of weeks have impacted each of us in different ways. This gives us good reason to reach out to our follow Sailors, Marines, and co-workers and have meaningful conversations. Now, more than ever, we must work on listening – truly listening – to each other. Active listening is what the best doctors, nurses, corpsmen, medical professionals, and leaders do. When we hear what people are saying, it increases our understanding and helps to bridge a divide. As medical professionals, we know that listening is the first step in healing.

As your Surgeon General, I want to emphasize that Our One Navy Medicine family is fully committed to the principles of diversity and equality and will not idly stand by. We will continue to discuss these issues and engage in further dialogue to make positive change that can help ensure we are demonstrating mutual respect, a foundational element of our core values. We will focus on our aspirations and how we’ll turn these in to actionable steps that we can take to ensure we are stronger, more cohesive and more effective as a team. Our unique histories and experiences make us better as a Navy and Marine Corps team and as a Nation. I thank each and every one of you for who you are and all that you do to demonstrate that we are stronger together.

SG Sends

Bruce L. Gillingham, MD, CPE, AOA
RADM, MC, USN
Surgeon General, U.S. Navy
Chief, Bureau of Medicine and Surgery

SG Message – One Team One Fight

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Esteemed Colleagues,

The stress and anxiety over COVID-19 remains significant throughout our country.  Aside from the unknowns surrounding this contagion, the pandemic has introduced limitations to daily social life, forced individuals into lengthy periods of isolation, and spurred concerns over financial matters.  For those who are beginning a ROM status, this state of stress can feel intensified.

As we continue to confront the challenges we face from COVID-19, we must all have the confidence that regardless of the setting, we never work alone, nor should we feel that we have to suffer in silence.  No one is alone in this fight – our One Navy Medicine team must remain vigilant and help those most in need.  This pandemic has touched each of us in one way or another.  Many of us know someone directly affected by this virus, and emotions are difficult to process when you are restricted from being with them.  Sadly, many have been laid to rest without their loved ones present –and this tragedy in itself is on a greater level for our Sailors and Marines.

We are all leaders no matter where we sit in the organization, and I expect each of you to reach out to your colleagues and shipmates to see how they are doing.  In addition to our formal mechanisms of PDHA and PDHRA, I ask that we continue to engage and stay close to these individuals and provide them all the time and support needed as they transition back to their regular duties.

Throughout this fight against COVID-19, our mental health providers have taken on the onus of responsibility, and although their roles are often unsung, the work they do each day has been commendable.  Whether at the MTF setting or with embedded mental health teams, our psychiatrists, psychologists, psychiatric mental health nurse practitioners, licensed clinical social workers, behavioral health technicians, and Navy Chaplains continue to leverage principles of high velocity learning to be resourceful and innovative while enhancing mission readiness.  Below are a few examples I would like to share with you:

  • Special Psychiatric Readiness Intervention Team (SPRINT).  In early April, we mobilized a SPRINT to Guam to provide needed assistance to the TR Sailors in quarantine at the time.  In collaboration with the 3rd Medical Battalion, Naval Hospital Guam and the Guam Chaplain Corps, this SPRINT used innovative methods to deliver remote Psychological First Aid.  These very methods continue to be impactful and have been used at other commands since.
  • Virtual Peer Support.  Through its Caregiver Occupational Stress Control program, Naval Hospital Jacksonville pioneered a website enabling virtual peer support for those dealing with stress at the hospital.  In addition, providers with Naval Medical Center San Diego developed a web tool to help personnel manage everyday stress.
  • Telehealth.  Throughout this fight, many of our providers have also begun to embrace telehealth and this has been especially true for mental health specialists.  Telehealth continues to serve as a significant tool allowing for that provider-patient connection when there are movement restrictions.  This capability is destined to grow more robust in this new normal.

In closing, please remember that there are many avenues to getting healthcare and counseling and there is NO WRONG WAY to access it!  I can assure you that regardless of where you serve or what you do, NO ONE IS ALONE IN THIS FIGHT – you will always have the full force of Navy Medicine’s power with you.  Together, our talent, knowledge, toughness, creativity, and teamwork will get us through all the challenges we face from COVID-19 and will emerge a stronger and even more capable organization.

In a time when the Fleet and Marine Corps have never needed us more, you are making a positive difference for them every day.  Thank you!

With my continued respect and admiration,

SG Sends

V/R,

Bruce L. Gillingham, MD, CPE, AOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery

SG’s Message – The Flame That Cannot Be Extinguished

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Dear Esteemed Navy Medicine Colleagues,

More than a hundred years ago, Florence Nightingale offered us the following words of wisdom: “Nursing is an art, and if it is to be made an art, it requires an exclusive devotion, as hard a preparation, as any painter’s or sculptor’s work.”  The devotion to the “art of nursing” is on full display for the world to see as Navy nurses continue to answer our Nation’s call and serve on the frontlines in the fight against the COVID-19 pandemic.

As we recognize National Nurses Week and the Nurse Corps Birthday on 13 May, we celebrate the care and evidence-based practice and innovation these medical professionals bring every day to help our Sailors, Marines, and fellow Americans get well and stay healthy.

A critical component to improve the wellness and readiness of our force as we battle COVID-19 is to increase our arsenal of knowledge about the virus.  In previous weeks, I discussed the dynamic efforts of the Navy Medical Research and Development (NMR&D) Enterprise in adapting to the challenges caused by this pandemic. In addition to operating within sea, air, land, space, cyberspace, and logistical frameworks, we must now fight against emerging pathogens and infectious diseases to protect America and our national security interests.  To this end, our teams of scientists and researchers have been spearheading innovative countermeasures that will successfully supply us with vital data needed to operate in what Adm. James Foggo calls the “seventh domain” of warfighting – the biosphere.

Recognizing the importance of collecting medical data to help our country defend against COVID-19, Naval Medical Research Center (NMRC) recently initiated the first-ever comprehensive research study to examine the serologic, clinical, and epidemiological aspects of the virus among young, healthy populations.  The aim is to support the Marine Corps Recruit Depot Parris Island’s medical mission to achieve maximum recruit health and meet graduation requirements and standards during the pandemic.

On May 4, NMRC commenced the COVID-19 Health Action Response for Marines (CHARM) study at Parris Island and the Citadel.  All study findings will be provided in real-time, in an effort to inform operational leaders with actionable information to help protect our Force and preserve war-fighting capabilities and readiness.  This study will help inform future decisions regarding isolation and quarantine, identify personnel infected with mild or no symptoms, and help determine when recruits can safely return to training.  Additionally, we hope to grasp a better understanding of how our bodies fight the virus by obtaining blood, saliva, and nasal samples that we can use to develop or improve tests, vaccines, drugs, and other countermeasures.

The road ahead will not be without challenges, but with the expertise of our NMR&D scientists, our public health teams, and Navy medical professionals on duty around the world, we will come out of this stronger and more mission ready.  Every day our scientists, nurses, corpsmen, doctors, and medical support staff actively continue to leverage the principles of rapid-cycle feedback to share lessons learned and inform future decision which help Navy and Marine Corps leaders mitigate the long-term impact of COVID-19.  Through it all, the spirit and light of Florence Nightingale’s raised “little lamp” is kept alive and burning brightly because of the skill and dedication our One Navy Medicine Team brings to the fight every day.

With my continued respect and admiration, SG

V/R,

Bruce L. Gillingham, MD, CPE, AOA

RADM, MC, USN

Surgeon General, U.S. Navy

Chief, Bureau of Medicine and Surgery