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Health Workers in Uniform: Lessons Learned

By Cmdr. Michael Kaplan, MD
Director of Medical Services

Naval Hospital Jacksonville, Florida

While USS Kidd (DDG 100) was deployed to the U.S. Fourth Fleet Area of Responsibility, a Sailor began experiencing COVID-19 symptoms April 20, a month after the ship’s last port call.

SOUTH CHINA SEA: The Arleigh Burke-class guided-missile destroyer USS Kidd (DDG 100) conducts a replenishment-at-sea with the dry cargo and ammunition ship USNS Carl Brashear (T-AKE 7). (U.S. Navy photo by Mass Communication Specialist 2nd Class Jacob Milham/Released)

In the weeks preceding this first positive case onboard, the crew of USS Kidd was already applying the Navy’s COVID-19 lessons learned. In early April, Sailors began to make and wear cloth face masks. They conducted a quarantine and isolation drill to determine how to segregate sick and healthy crew members on a ship with limited space.

In addition, the surface Navy and operational commanders sent COVID-19 mitigation guidance to the fleet and built contingencies in the event another deployed ship experienced an outbreak.

200406-N-HI500-2014 PACIFIC OCEAN (April 6, 2020) Gunner’s Mate Seaman Recruit Beverly Jordan, from Los Angeles, and Ship’s Serviceman 2nd Class Naomi Dunkley, from Saint Elizabeth, Jamaica, cut paracord to create straps for cloth masks aboard the Arleigh Burke-class guided-missile destroyer USS Kidd (DDG 100). (U.S. Navy photo by Mass Communication Specialist 3rd Class Brandie Nuzzi/Released)
200325-N-HI500-1001 PACIFIC OCEAN (March 25, 2020) Hospital Corpsman 2nd Class Rhiley Bauer, from Ketchikan, Alaska examines Logistic Specialist 2nd Class Didier Dorsainville, from Orange, N.J., during a medical training drill aboard the Arleigh Burke-class guided-missile destroyer USS Kidd (DDG 100), March 25, 2020. Kidd is conducting routine operations in the eastern Pacific Ocean. (U.S. Navy photo by Mass Communication Specialist 3rd Class Brandie Nuzzi/Released)

This is the story of the seven-member medical team from Naval Hospital Jacksonville who jumped into action to provide medical care to the crew of USS Kidd.

Be Prepared to Respond Quickly to a Possible Outbreak

On the morning of April 23, my boss, Capt. Matthew Case, commanding officer of Naval Hospital Jacksonville, came over to my office. He asked if we could send a team to a ship in distress, to do testing, isolating, and quarantining of Sailors who may be sick with COVID-19, as well as provide medical support until they can get back to a safe place.

I said, “Sure, when would they need to go?”

He said three hours.

We balanced who would be most qualified and available on such short notice without leaving the hospital in a bad place, since every department had been stretched because of COVID-19.
 
We built a team of seven medical providers: Along with me, an allergy/immunology and internal medicine physician by trade, were Lt. Cmdr. Clifton Wilcox, MD, a preventative medicine physician; the lab technician, Hospitalman Joseph Kim; two preventative medicine technicians, Hospital Corpsman 2nd Class Derrick Hudson and Hospital Corpsman 1st Class Jason Turgeon; and finally, the two hospital corpsmen, Hospital Corpsman 3rd Class Brian Krawsczyn and Hospitalman Jason Moyer.
 
Within hours of the call, we were packed up with all the equipment and tests. We didn’t have much time to think about what we were getting into, which is probably a good thing. Not too many people would want to run into a burning building. When we left we knew very little about how many Sailors were currently sick. 
 
We took a P-8 Poseidon from Jacksonville, a couple of miles down the street from our hospital. It flew us to El Salvador, and from there we took an SH-60 Sea Hawk helicopter offshore.

190711-N-BD308-0024 JACKSONVILLE, Fla. (July 11, 2019) Lt. j.g. Alex Orlando, from Gainesville, Fla., a pilot assigned to Patrol Squadron (VP) 30, prepares to board a P8-A Poseidon aircraft at Naval Air Station Jacksonville. (U.S. Navy photo by Mass Communication Specialist 2nd Class Levingston Lewis/Released)

Test Everyone, Even if They Don’t Show Symptoms

200529-N-SB299-1085 SAN DIEGO (May 29, 2020) A Sailor assigned to the guided-missile destroyer USS Kidd (DDG 100) has his temperature checked as he returns to the ship as part of the Navy’s aggressive response to the COVID-19 outbreak. In order to be cleared to return to the ship, Sailors must have received two separate negative test results. Kidd arrived in San Diego April 28 to receive medical care for its Sailors and clean and disinfect the ship following a COVID-19 outbreak while underway. (U.S. Navy photo by Mass Communication Specialist 2nd Class Alex Millar/Released)

That evening, we began testing the crew. Within 24 hours of arriving, we already had 25 percent of Kidd Sailors tested. Once we identified someone who was positive yet asymptomatic, we took the initiative to isolate them, so they couldn’t spread the infection. Our goal was to reduce further spread among potentially vulnerable Sailors who were not already infected.

Of all the Sailors who tested positive while still onboard, about 50 percent were asymptomatic.

Testing everyone took a lot time. One challenge was that our COVID-19 testing machine could only run one sample at a time. We could average about four to five tests per hour at best. Before the ship arrived in San Diego, we tested 100 percent of the crew, but this required that we run the tests 24 hours a day.

We still had days until we would arrive in San Diego and disembark the crew. Until then, we wanted to do everything we could to minimize the spread on the ship, to ensure Sailors could remain healthy and do their job.

I have to give kudos to Kidd’s independent duty corpsman, Chief Hospital Corpsman Clinton Barton, and his medical department. They did a great job identifying which Sailors were likely infected. Barton took it upon himself to isolate those not feeling well before we even got there.

Despite the limited space on a cramped destroyer, he did the right thing: isolating people he had concerns about. That allowed us to rapidly test those people first, make sure our equipment was working properly and try to mitigate the spread. As we continued to test other Sailors who did not have symptoms, we just increased the isolation ward he had created.

200511-N-VN584-1076 SAN DIEGO (May 11, 2020) Gas Turbine Systems Technician (Mechanical) 1st Class Jonathan Young, assigned to the future USS Daniel Inouye (DDG 118), left, and Navy Career Counselor 1st Class Daryl Bragg, assigned to the future USS Frank E. Petersen Jr. (DDG 121), deliver food and drinks to Sailors assigned the guided-missile destroyer USS Kidd (DDG 100). Kidd arrived in San Diego April 28 as part of the Navy’s aggressive response to the COVID-19 outbreak aboard the ship at sea. (U.S. Navy photo by Mass Communication Specialist 2nd Class Alex Corona/Released)

Minimize Exposure to Avoid Being Infected

We implemented a number of steps to try to mitigate the spread, such as administering N-95 masks to the entire crew, increasing the cleaning frequency for common areas and making sure Sailors wash their hands or use sanitizer before going into common areas such as the galley.

200428-N-VN584-1071 SAN DIEGO (April 28, 2020) Chief Hospital Corpsman Michael Wade, assigned to Commander, Naval Surface Force, U.S. Pacific Fleet Medical Readiness Division, organizes medical supplies while preparing for Sailors aboard the guided-missile destroyer USS Kidd (DDG 100) as part of the Navy’s aggressive response to the COVID-19 outbreak on board the ship. (U.S. Navy photo by Mass Communication Specialist 2nd Class Alex Corona/ Released)

The location of the ship from where we started was outside the typical range of a helicopter. USS Makin Island (LHD 8) provided an additional resource, should we run into trouble and need to move Sailors off USS Kidd. Makin Island is capable of taking on types of aircraft that Kidd can’t, allowing for longer medevacs.

200420-N-LR905-1564 PACIFIC OCEAN (April 20, 2020) The amphibious assault ship USS Makin Island (LHD 8) conducts routine operations in the eastern Pacific. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jacob D. Bergh/Released)

With an embarked fleet surgical team, Makin Island can also provide Role 2 level of care. Role 2 care includes basic resuscitation and stabilization and may include surgical capability, basic laboratory, limited x-ray, pharmacy, and temporary holding facilities.

While underway, 15 Sailors from Kidd were transported to Makin Island, where they received radiographic imaging and laboratory diagnostic services, as well as general medical services.

Test Everyone Again

Although we’d tested 100 percent of the crew already, we retested everyone in San Diego on arrival. Knowing who is positive is imperative, and the only way to know is through testing.

200518-N-VN584-1060 SAN DIEGO (May 18, 2020) Chief Cryptologic Technician (Collection) Marisol Swenney, assigned to the future USS Daniel Inouye (DDG 118), center, and Senior Chief Fire Controlman Michael Miller of the future USS Carl M. Levin (DDG 120), confirm muster sheets during crew swap, the next phase of recovery for the guided-missile destroyer USS Kidd (DDG 100). The Navy re-tested the crew for COVID-19 and transferred nearly 90 confirmed healthy Sailors from quarantine to the ship to replace the caretaker crew that went aboard after the ship arrived in San Diego April 28. (U.S. Navy photo by Mass Communication Specialist 2nd Class Alex Corona/Released)

Learn From the Experiences of Others

We took advantage of some of the lessons from the outbreak aboard USS Theodore Roosevelt (CVN 71). I think the combination of hard work, some good planningeven though we had extraordinarily little timeand just making sure we did everything we possibly could allowed it to work out.

200603-N-VY375-1101 NAVAL BASE GUAM (June 3, 2020) The aircraft carrier USS Theodore Roosevelt (CVN 71) flies a replica of Capt. Oliver Hazard Perry’s “Don’t Give Up the Ship” flag as it arrives at Apra Harbor, June 3, 2020. Following an extended visit to Guam in the midst of the COVID-19 global pandemic, Theodore Roosevelt completed carrier qualifications June 2 and is in Guam for resupply during a deployment to the Indo-Pacific. (U.S. Navy photo by Mass Communication Specialist 2nd Class Pyoung K. Yi/Released)

Having multiple courses of action is always a good idea, because you never know if something is not going to work the way you expect. Fortunately, we had enough redundancy built into the system.

Also, bring the right equipment, and think outside the box. Then you just put it together.

Clearly, this mission demonstrates having a robust and well-rounded medical force ready is integral to ensuring our Navy is capable of meeting whatever challenges arise.

200428-N-SB299-1397 SAN DIEGO (April 28, 2020) The guided-missile destroyer USS Kidd (DDG 100) arrives in San Diego April 28 as part of the Navy’s aggressive response to the COVID-19 outbreak on board the ship. (U.S. Navy photo by Mass Communication Specialist 2nd Class Alex Millar/ Released)

NOTE: On returning to Jacksonville, Kaplan and his team retested negative, were quarantined for 14 days, and retested negative a third time before returning to work.

https://navylive.dodlive.mil/2020/06/10/health-workers-in-uniform-lessons-learned/ U.S. Navy

U.S. Navy COVID-19 Updates

This blog is the official site for information and updates on Coronavirus Disease 19 (COVID-19). Visit frequently to learn about the latest policies, leadership messages and guidance on how to protect yourself, your family and your Shipmates.

Below you’ll find, in chronological order, video messages and statements from Navy leaders, Navy news articles, links to NAVADMINs and ALNAVs, and other resources.

March 15, 2020: Navy.mil article: Navy Sets Coronavirus Transfer and Travel Rules: What You Need to Know (March 15, 2020)

March 14, 2020: NAVADMIN 65/20: Navy Mitigation Measures in Response to Coronavirus Outbreak: Update 1

March, 14, 2020: Video Message From Chief of Naval Operations ADM Mike Gilday and Master Chief Petty Officer of the Navy Russell Smith:

March 14, 2020: Stop the Spread of Germs Video

March 14, 2020: ALNAV 26/20: Official and Personal Domestic Travel Force Health Protection Guidance for Department of the Navy (CONUS Travel Guidance)

March 13, 2020: Acting Secretary of the Navy Thomas B. Modly’s Vector 15 message on the March 12 All Navy Message (ALNAV 25/20) on COVID-19.

March 13, 2020: Department of Defense Statement on Enhanced Protection Measures

March 12, 2020: ALNAV 25/20: Force Protection Guidance for the Department of the Navy

March 12, 2020: NAVADMIN 64/20: ​NAVY MITIGATION MEASURES IN RESPONSE TO CORONAVIRUS OUTBREAK

Feb. 26, 2020: Navy Surgeon General Video Message:

Additional Resources

Department of Defense Coronavirus Update Site
Centers for Disease Control and Prevention COVID-19 Website

https://navylive.dodlive.mil/2020/03/15/u-s-navy-covid-19-updates/ U.S. Navy

2019 Personnel and Policy Changes

Whether you’re looking for your next billet, upcoming exam requirements or you’re curious if you can apply pay grades or just wondering about policy concerning family needs, this blog is for you.

We’re compiling personnel and policy announcements made during 2019 to help Sailors and their families find important career information.

Go to All Hands Magazine online for information on the Navy’s culture and heritage, and feature information for Sailors.

For your mobile phone and tablet, check out the latest editions of the Navy App Locker where you can find information on uniform regulations, education, fitness and more.

Click the categories below for announcements presented in reverse chronological order.

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CAREER

CIVILIANS

EDUCATION

EXAMS

HEALTH

PERFORMANCE

RELOCATION

RESERVES

SPOUSES/FAMILY

TECH TOOLS

UNIFORMS

 

Follow this page for updates.

CAREER

Navy Announces FY20 Senior Enlisted Advancement-to-Position Selection Board

MILLINGTON, Tenn. (NNS) — Active duty senior enlisted Sailors looking for their next billet in a higher paygrade will soon have the opportunity to get a jump on the process thanks to the Advancement-to-Position (A2P) selection board, the Navy announced July 17. Read more on Navy.mil

Navy Accepts Continuous Applications for Enlisted Women in Submarines

WASHINGTON (NNS) — The Navy is now continuously accepting applications for female enlisted Sailors in pay grades E1-E8 to convert to Submarine Force non-nuclear trained ratings, as announced in NAVADMIN 159/19, July 15. Read more on Navy.mil

Do You Want to be a Career Recruiter?

MILLINGTON, Tenn. (NNS) — The Navy announced the convening of the Career Recruiter Force (CRF) selection board to allow select enlisted Sailors to serve as Navy recruiters in NAVADMIN 139/19, June 25. Read more on Navy.mil

Navy Launches Advancement-to-Position Program

WASHINGTON (NNS) — Navy announced the creation of a program with an advancement incentive to fill priority recruiter and recruit division commander (RDC) billets June 3, in NAVADMIN 122/19. Read more on Navy.mil

Meritorious Advancement Program Gains a Season, Quotas Increase

WASHINGTON (NNS) — The Navy released the calendar year (CY) 2019 Meritorious Advancement Program (MAP) plan, Feb. 8, in NAVADMIN 031/19, announcing the transition from one to two MAP seasons and increasing quotas in a continuing effort to empower command triads to recognize their most highly-talented Sailors through immediate advancement. Read more on Navy.mil

FY19-20 Tours with Industry Applicants Sought

MILLINGTON, Tenn. (NNS) — Navy announced Feb. 7 that select Sailors can apply to participate in the Secretary of the Navy Tours with Industry (SNTWI) program. Read more on Navy.mil

No Ordinary Day, Flag Writers Get the Job Done

There are speeches to write, naval correspondence on your desk to be edited and travel plans to be scheduled. Days are a balancing act between meticulously scheduled events and last-minute changes, but no day is ever the same as the one before. It’s a fast-paced environment at times, but you have what it takes. Why? Because you are a Navy flag writer. Read more on Navy.mil

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CIVILIANS

U.S. Fleet Forces Command Kicks Off Navy Civilian Acculturation Program

NORFOLK (NNS) — The Chief of Navy Operations (CNO) announced the rollout of the Navy Civilian Acculturation Program (NCAP) in NAVADMIN 158/19 July 15, providing details of a new orientation program that is now available for newly hired civilians with no prior experience or background in the Navy. NCAP is designed to provide the Navy’s newest employees exposure and familiarization to naval culture to enable them to better integrate into the organization. Read more on Navy.mil

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EDUCATION

Post-9/11 GI Bill Education Benefits Transfer Deadline Extended for Members with 16 Years of Service

WASHINGTON (NNS) — The deadline for Sailors who have over 16 years of service to transfer their Post-9/11 GI Bill education benefits to dependents has been extended to Jan. 12, 2020 based on recently revised guidance issued by the Department of Defense (DoD). Read more on Navy.mil

Navy Implements Change to Education Program Announcements

WASHINGTON (NNS) — The Navy announced that education program information, application processes and deadlines will be announced through personalized notifications to eligible Sailors in NAVADMIN 106/19, May 10. Read more on Navy.mil

Department of the Navy Announces New Education Initiatives

WASHINGTON (NNS) — The Department of the Navy (DoN) released its Education for Seapower report Feb. 12, along with the Secretary of the Navy’s action memorandum providing the way forward for the new education initiatives for the department. Read more on Navy.mil

DoD Announces Post-9/11 GI Bill Education Benefits Transfer Exception

WASHINGTON (NNS) — The Department of Defense (DoD) has granted a temporary exception to policy to allow select service members to transfer their Post-9/11 GI Bill education benefits to dependents until July 12, 2019. Read more on Navy.mil

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EXAMS

More Ways to Complete Professional Military Knowledge Eligibility Exam

PENSACOLA, Fla. (NNS) — Sailors eligible for advancement to paygrades E-4/5/6/7 can now complete their Professional Military Knowledge Eligibility Exam (PMK-EE) requirements anytime, anywhere in the world, through a self-service app announced in NAVADMIN 140/19, June 26. Read more on Navy.mil

Mobile App Lets Sailors Prepare for and Take Advancement Exams

WASHINGTON (NNS) — The Navy’s Professional Military Knowledge Eligibility Exam (PMK-EE) mobile application conveniently allows Sailors to prepare for and complete these exams, which they must pass to advance through the E4/5/6/7 paygrades. Read more on Navy.mil

Going Digital: MyNavy Portal Introduces Advancement Dashboard for Enlisted Sailors

WASHINGTON (NNS) — It just got a lot easier for Sailors preparing for the Navy-wide Advancement Exam (NWAE) with the roll-out of the Advancement Dashboard on MyNavy Portal (MNP), March 8. Read more on Navy.mil

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HEALTH

Navy Announces Expansion of Urinalysis Testing Program

WASHINGTON (NNS) — Navy announced that the Department of Defense has expanded its ability to conduct random drug testing for manufactured opiate drugs June 3, in NAVADMIN 125/19. Read more on Navy.mil

Navy Announces Universal Training Precautions for Physical Exercise

WASHINGTON (NNS) — Navy released NAVADMIN 108/19, May 10, alerting Sailors and command leadership of the importance of universal training precautions (UTP) to reduce the risk of exercise-related collapse and death during physical exercise, to include the Physical Readiness Test (PRT) and command physical training. Read more on Navy.mil

Navy Updates Medical Waiver Process

FALLS CHURCH, Va. (NNS) — U.S. Navy surgeon general Vice Adm. Forrest Faison, on behalf of the Department of the Navy (DoN), instituted a new policy regarding the medical waiver process. The changes were officially signed Feb. 15, and impacts all applicants, with greater emphasis on enlisted to officer commissioning programs. Read more on Navy.mil

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PERFORMANCE

June 2019 SRB and Pay for Performance Pilot Update Announced

WASHINGTON (NNS) — The Navy updated the Selective Reenlistment Bonus (SRB) award plan for Active Component and Full Time Support Sailors and announced the continuation of an incentivized performance program in NAVADMIN 129/19, released June 11. Read more on Navy.mil

Enlisted Supervisor Retention Pay Update Announced

WASHINGTON (NNS) — The Navy updated Enlisted Supervisor Retention Pay (ESRP) award levels for senior active-duty nuclear-trained Sailors in NAVADMIN 085/19, released April 8. Read more on Navy.mil

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RELOCATION

Navy Modernizing PCS Move Process

MILLINGTON, Tenn. (NNS) — Continuing efforts to improve the Permanent Change of Station (PCS) experience for Sailors and their families, the Navy is launching the MyPCS Mobile app July 17. Read more on Navy.mil

Navy Announces Spouse Licensure and Certification Reimbursement Policy

WASHINGTON (NNS) — As part of ongoing Navy Family Framework efforts to expand and improve the experience for spouses, Navy announced Sailors may be reimbursed up to 500 dollars for state licensure and certification costs of a spouse arising from relocation to another state due to a permanent change of station (PCS) move in NAVADMIN 134/19, June 24. Read more on Navy.mil

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RESERVES

Navy Updates Mobilization Deferment Policy for Selected Reserve Affiliation

WASHINGTON (NNS) — The Navy announced updates to the mobilization deferment policy for Sailors and veterans of other military services who choose to affiliate with the Selected Reserve (SELRES) in NAVADMIN 145/19, July 1. Read more on Navy.mil

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SPOUSES/FAMILY

Navy Announces Spouse Licensure and Certification Reimbursement Policy

WASHINGTON (NNS) — As part of ongoing Navy Family Framework efforts to expand and improve the experience for spouses, Navy announced Sailors may be reimbursed up to 500 dollars for state licensure and certification costs of a spouse arising from relocation to another state due to a permanent change of station (PCS) move in NAVADMIN 134/19, June 24. Read more on Navy.mil

Service Secretaries Tackle Employment Challenges for Overseas Spouses

WASHINGTON (NNS) — All three military service secretaries signed a memorandum today to jointly explore how military spouses can find employment and sustain careers at overseas bases. Read more on Navy.mil

MyNavy Family App Focuses on Stronger Families and Fleet

WASHINGTON (NNS) — Navy families navigating military life can now find support by downloading the MyNavy Family application which was released in the days leading up to Military Spouse Appreciation Day, May 10. The free app can be found in the Navy App Locker, https://applocker.navy.mil. Read more on Navy.mil

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TECH TOOLS

New Uniform Mobile App Has New Name, Guidance

ARLINGTON, Va. (NNS) — One of the more popular mobile applications the Navy has is the OPNAV Uniform Regulations app released in October 2017. Just like your worn out uniforms, the app needed updated. With a new name and more information, the OPNAV Uniform Regulations is now MyNavy UNIFORMS which hit app stores, July 18. Read more on Navy.mil

MyNavy Family App Offers One-Stop Shop for Various Needs

WASHINGTON (NNS) — From military installation searches to special family needs, relocation and retirement, the MyNavy Family mobile application is a one-stop shop for Navy spouses and Sailors’ families, combining official information from more than 22 websites. Read more on Navy.mil

Navy Announces Officer Photo Electronic Submission Capability

MILLINGTON, Tenn. (NNS) — Officers now have another way to submit their official photographs to their Official Military Personnel File (OMPF), Navy leaders said May 13. Read more on Navy.mil

CONUS Sailors Have New Leave Scheduling Tool

WASHINGTON (NNS) — The Navy launched an “eLeave” self-service tool capability within MyNavy Portal (MNP) Jan. 17, which allows CONUS-based Sailors to manage their ordinary leave using MNP. Read more on Navy.mil

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UNIFORMS

New Uniform Mobile App Has New Name, New Guidance

ARLINGTON, Va. (NNS) — One of the more popular mobile applications the Navy has is the OPNAV Uniform Regulations app released in October 2017. Just like your worn out uniforms, the app needed updated. With a new name and more information, the OPNAV Uniform Regulations is now MyNavy UNIFORMS which hit app stores, July 18. Read more on Navy.mil

Navy Uniform Policy Update Announced

WASHINGTON (NNS) — The Navy announced updates to uniform policy, grooming standards, uniform item availability and mandatory possession dates for new uniform items in NAVADMIN 075/19, released March 25. Read more on Navy.mil

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Follow this page for updates.

https://navylive.dodlive.mil/2019/07/25/2019-personnel-and-policy-changes/ poyrazdogany