25 September 2009

Compare to Navy pandemic influenza policy (not FOUO):

opnav-3500-41.zip     Navy Pandemic Influenza Policy                   September 21, 2009

A sends:

**************** UNCLASSIFIED// FOR OFFICIAL USE ONLY ****************

Subject: ALARACT 254/2009 - HQDA COMMAND DIRECTIVE FOR 2009-H1N1 INFLUENZA PANDEMIC
Originator: /C=US/O=U.S.
GOVERNMENT/OU=DOD/OU=ARMY/OU=ORGANIZATIONS/L=CONUS/L=WASHINGTON DC/OU=DA
PENTAGON TELECOMMUNICATIONS(UC)/OU=ALARACT RELEASE AUTHORITY(UC)
DTG: 170001Z Sep 09
Precedence: PRIORITY
DAC: General
To: /C=US/O=U.S. GOVERNMENT/OU=DOD/OU=AUTODIN PLAS/OU=AIG 6-AZ/OU=ALARACT
/C=US/O=U.S. GOVERNMENT/OU=DOD/OU=ARMY/OU=ORGANIZATIONS/OU=ADDRESS
LISTS/CN=AL ALARACT(UC)

--------------------------------------------------

UNCLASSIFIED//FOR OFFICIAL USE ONLY.

THIS MESSAGE HAS BEEN SENT BY THE PENTAGON TELECOMMUNICATIONS CENTER ON BEHALF OF DA WASHINGTON DC//CSA//

SUBJECT: HQDA COMMAND DIRECTIVE FOR 2009-H1N1 INFLUENZA PANDEMIC

REF/A/MEMORANDUM/HQDA (DAMO-SSW)/PANDEMIC INFLUENZA (PI) PLANNING/02JUL08//

REF/B/DOC/ARMY PANDEMIC INFLUENZA PLAN/05SEP09//

REF/C/DOC/DODI 6025.19/INDIVIDUAL MEDICAL READINESS (IMR)/03JAN06//

REF/D/DOC/AR 40-501/STANDARDS OF MEDICAL FITNESS, RAPID ACTION REVISION/10SEP08//

REF/E/MSG/ALARACT 117/2009 SWINE INFLUENZA A (H1N1) INFLUENZA/29APR09//

REF/F/MSG/ALARACT 126/2009 HQDA WARNORD H1N1 INFLUENZA OUTBREAK/02MAY09//

REF/G/MSG/ALARACT 131/2009 H1N1 INFLUENZA - PRE-DEPLOYMENT SCREENING AND ANTIVIRAL MEDICATION GUIDANCE/08MAY09//

REF/H/MSG/ALARACT 165/2009 H1N1 INFLUENZA - ADDITIONAL PRE-DEPLOYMENT SCREENING GUIDANCE FOR TRAVEL TO KUWAIT/02JUN09//

REF/I/MSG/MOD NINE PT TWO TO USCENTCOM INDIVIDUAL PROTECTION AND INDIVIDUAL UNIT DEPLOYMENT POLICY/02JUN09//

REF/J/DOC/DEFENSE INTELLIGENCE ASSESSMENT DIA-16-0908-020, FALL/WINTER (2009-2010) FORECAST: 2009-H1N1 INFLUENZA VIRUS POSES CONTINUING THREAT TO US FORCES (U), NATIONAL CENTER FOR MEDICAL INTELLIGENCE, DEFENSE INTELLIGENCE AGENCY/ 24AUG09//

REF/K/MSG/ALARACT 232/2009 MOD 1 TO ALARACT 165/2009 - HQDA INFLUENZA ADDITIONAL PRE-DEPLOYMENT SCREENING GUIDANCE FOR TRAVEL TO CENTCOM AOR/28AUG09//

REF A IS THE HQDA DAMO-SSW MEMORANDUM TASKING SENIOR COMMANDERS OF ARMY INSTALLATIONS WORLDWIDE TO COMPLETE INSTALLATION BIOLOGICAL PREPAREDNESS PLANS WITH PI ANNEXES BY 01DEC08.

REF B IS THE ARMY'S PANDEMIC INFLUENZA PLAN WHICH IS SYNCHRONIZED WITH NORTHCOM CONPLAN 3551-08.

REF C IS THE DOD INSTRUCTION FOR INDIVIDUAL MEDICAL READINESS.

REF D IS THE ARMY REGULATION FOR STANDARDS OF MEDICAL FITNESS.

REF E IS THE ARMY OFFICE OF THE SURGEON GENERAL (OTSG) INFLUENZA A (H1N1) INFORMATION MESSAGE.

REF F IS THE HQDA WARNING ORDER FOR THE 2009 H1N1 FLU OUTBREAK.

REF G IS THE OTSG ALARACT PROVIDING PRE-DEPLOYMENT SCREENING AND ANTIVIRAL MEDICATION GUIDANCE WITH ATTACHMENT 1, SRP ALGORITHM FOR ACUTE ILLNESS SCREENING.

REF H PROVIDES ADDITIONAL SCREENING GUIDANCE FOR TRAVEL TO KUWAIT.

REF I IS THE USCENTCOM MESSAGE DIRECTING PRE-SCREENING, TO INCLUDE TEMPERATURE SCREENING, OF ALL PERSONNEL DEPLOYING OR TRAVELING TO THE CENTCOM AOR.

REF J IS THE DIA INTELLIGENCE ASSESSMENT OF THE 2009 H1N1 INFLUENZA VIRUS.

REF K DIRECTS TEMPERATURE SCREENING OF ALL PERSONNEL ENTERING THE CENTCOM AOR IN RESPONSE TO REF I.

SUBJECT: HQDA COMMAND DIRECTIVE FOR 2009-H1N1 INFLUENZA PANDEMIC

1. (U/FOUO) SITUATION.

1.A. (U) GENERAL. THE 2009-H1N1 INFLUENZA VIRUS HAS ACHIEVED SUSTAINED HUMAN-TO-HUMAN TRANSMISSION, LARGE CLUSTERS AND BROAD GEOGRAPHIC SPREAD. THE WORLD HEALTH ORGANIZATION (WHO) DECLARED 2009-H1N1 HAS ACHIEVED "PANDEMIC"  STATUS, MEANING THE DISEASE IS PREVALENT WORLDWIDE. MOST CASES OF 2009-H1N1 INFLUENZA HAVE BEEN NO MORE SEVERE THAN THE SEASONAL FLU. THE PANDEMIC SEVERITY INDEX FOR 2009-H1N1 INFLUENZA IS LOW BECAUSE THE ILLNESS HAS BEEN RELATIVELY MILD AND DEATHS IN MOST POPULATION GROUPS HAVE BEEN UNCOMMON. PUBLIC HEALTH OFFICIALS CONTINUE TO MONITOR THE SITUATION IN THE EVENT SEVERITY INCREASES. THUS FAR, THERE HAVE BEEN 3,205 DEATHS WORLDWIDE, AND 593 DEATHS IN THE U.S. LEVELS OF INFLUENZA ACTIVITY REMAINED ABOVE NORMAL DURING THE SUMMER MONTHS BECAUSE OF THE PANDEMIC 2009-H1N1 INFLUENZA VIRUS.  2009-H1N1 INFLUENZA SPREADS IN THE SAME MANNER AS THE REGULAR SEASONAL FLU. INDIVIDUALS CAN HELP LIMIT THE SPREAD OF THE DISEASE USING GOOD HYGIENE PRACTICES.

1.B. (U/FOUO) THE WORLD HEALTH ORGANIZATION (WHO) IS CURRENTLY IN WHO PHASE 6 (PANDEMIC). USNORTHCOM AND USPACOM ARE AT DOD PHASE 1 (PREVENT). THE REMAINDER OF DOD IS CURRENTLY IN PHASE 0 (SHAPE). ARMY ACTIONS TO PREPARE FOR, PREVENT, MITIGATE, RESPOND TO, AND RECOVER FROM EFFECTS OF INFLUENZA WILL BE BASED ON DISEASE CONDITIONS AND OPERATIONAL REQUIREMENTS.

1.C. (U/FOUO) ONGOING ARMY ACTIONS. SINCE THE ONSET OF THE 2009-H1N1 VIRUS IN LATE APRIL, THE ARMY HAS TAKEN SEVERAL ACTIONS TO PROTECT THE FORCE, CONTINUE MISSION AND PREPARE FOR THE FUTURE. CURRENTLY, THE ARMY IS DOING THE FOLLOWING:

1.C.1. (U) EDUCATING THE ARMY COMMUNITY ON 2009-H1N1 AND SEASONAL INFLUENZA THROUGH ONLINE POSTINGS, GENERAL OFFICER COMMAND INFORMATION VIDEOS, TABLETOP EXERCISES, PUBLISHING PUBLIC AFFAIRS/AWARENESS ARTICLES, CONDUCTING TOWNHALL MEETINGS AND DISTRIBUTING FORCE HEALTH PROTECTION (FHP) FLYERS AND TRI-FOLDS ABOUT PANDEMIC INFLUENZA.

1.C.2. (U) PROVIDING IMMEDIATE MEDICAL CARE TO ALL MILITARY AND CIVILIAN PERSONNEL, CONTRACTORS, AND BENEFICIARIES WITH CONFIRMED 2009-H1N1. THE DOD AND THE ARMY HAVE SECURED ANTIVIRALS TO TREAT SERVICE MEMBERS AND OTHER MILITARY HEALTH SYSTEM BENEFICIARIES WHO MAY REQUIRE THEM.

1.C.3. (U/FOUO) ALL MILITARY AND CIVILIAN PERSONNEL, AND CONTRACTORS TRAVELING TO THE CENTCOM AREA OF RESPONSIBILITY ARE BEING SCREENED IN ACCORDANCE WITH (IAW) CENTERS FOR DISEASE CONTROL AND PREVENTION GUIDELINES, TO INCLUDE TEMPERATURE-TAKING, IN ORDER TO IDENTIFY SYMPTOMATIC PERSONNEL, PREVENT THEIR TRAVEL, AND TREAT APPROPRIATELY. ADDITIONALLY, PERSONNEL ARRIVING IN KUWAIT ARE BEING SCREENED TO FURTHER IDENTIFY SYMPTOMATIC PERSONNEL AND TREAT PRIOR TO ONWARD TRAVEL IN THEATER.

1.C.4. (U) PLANNING AN AGGRESSIVE AND MANDATORY 2009-H1N1 VACCINATION CAMPAIGN. THE ARMY WILL INITIALLY RECEIVE 1 MILLION DOSES AND EXPECTS TO BEGIN VACCINATION NLT 15 NOVEMBER. PRIORITY OF VACCINATION WILL BE TO DEPLOYED FORCES, DEPLOYING FORCES, NEW ACCESSIONS, AND ACTIVE DUTY HEALTHCARE PERSONNEL.

1.D. (U/FOUO) CONTINUING PANDEMIC INFLUENZA PLANNING REQUIREMENTS. THE FOLLOWING PI PLANNING REQUIREMENTS, TASKED AND FULLY ARTICULATED IN REFS A AND B REMAIN IN EFFECT:

1.D.1. (U/FOUO) SENIOR COMMANDERS OF ARMY INSTALLATIONS ARE REQUIRED TO:

1.D.1.A. (U/FOUO) PREPARE FULLY SYNCHRONIZED INSTALLATION BIOLOGICAL PREPAREDNESS PLANS (IBPP) WITH PI ANNEXES IAW PARA 3C(1)(Q)4 AND APPENDIX 32 TO ANNEX C OF REF A AND PARA 4A(1) OF REF B.

1.D.1.B. (U/FOUO) ENSURE THAT PI PLANNING OF ALL ACTIVITIES TENANT ON OR SUPPORTED BY THEIR INSTALLATIONS IS FULLY SYNCHRONIZED WITH THE IBPP.

1.D.2. (U/FOUO) COMMANDERS OF ARMY COMMANDS (ACOMS), ARMY SERVICE COMPONENT COMMANDS (ASCCS), AND DIRECT REPORTING UNITS (DRUS) ARE REQUIRED TO:

1.D.2.A. (U/FOUO) INFORM INSTALLATION SENIOR COMMANDERS OF SPECIFIC MISSION REQUIREMENTS FOR THEIR PARTICULAR COMMAND.

1.D.2.B. (U/FOUO) ENSURE THAT PI PLANNING OF THEIR ACTIVITIES TENANT ON OR SUPPORTED BY ARMY INSTALLATIONS IS FULLY SYNCHRONIZED WITH THE IBPP DEVELOPED BY THE SENIOR COMMANDER OF THE COGNIZANT HOST INSTALLATION.

1.D.2.C. (U/FOUO) AS SPECIFIED BY COMMANDERS OR COMPARABLE EXECUTIVE AUTHORITIES OF OTHER US MILITARY SERVICES OR FEDERAL AGENCIES, ENSURE THAT PI PLANNING OF THEIR ACTIVITIES TENANT ON OR SUPPORTED BY INSTALLATIONS OF THOSE OTHER SERVICES OR AGENCIES IS FULLY SYNCHRONIZED WITH THE PI PLANNING CONDUCTED BY THE COGNIZANT COMMANDERS OR COMPARABLE EXECUTIVE AUTHORITIES.

1.D.2.D. (U/FOUO) PURSUANT TO REFERENCE A, PREPARE NECESSARY PLANS TO ENSURE CONTINUITY OF TITLE 10 RESPONSIBILITIES, WITH EMPHASIS ON PROVISION OF COMBAT READY LAND POWER TO COMBATANT COMMANDERS, UNDER AN OPERATING ENVIRONMENT OF PANDEMIC INFLUENZA LASTING 18-24 MONTHS.

2. (U/FOUO) MISSION. THE U.S. ARMY PREPARES FOR, RESPONDS TO, AND RECOVERS FROM PANDEMIC INFLUENZA (PI) IN ORDER TO ENSURE CONTINUITY OF TITLE 10 U.S. CODE RESPONSIBILITIES, AND PROVIDE COMBAT READY LAND POWER TO COMBATANT COMMANDERS. WHEN DIRECTED, THE U.S. ARMY SUPPORTS U.S. GOVERNMENT (USG) PI RESPONSE EFFORTS.

3. EXECUTION.

3.A. (U/FOUO) ARMY CHIEF OF STAFF'S INTENT.

3.A.1. (U/FOUO) PURPOSE. MINIMIZE THE IMPACT OF PI ON THE UNITED STATES ARMY WHILE SIMULTANEOUSLY SUPPORTING, WITHIN CAPABILITIES, THE USG DOMESTIC AND INTERNATIONAL PI MITIGATION EFFORTS. THE U.S. ARMY CONDUCTS OPERATIONS IN A MANNER THAT ENGENDERS DOMESTIC AND INTERNATIONAL TRUST AND CONFIDENCE IN THE USG AND U.S. ARMY.

3.A.2. (U/FOUO) KEY TASKS (TASKS THAT CONTRIBUTE TO BOTH ENSURING CONTINUITY OF TITLE 10 FUNCTIONS AND SUPPORTING U.S. GOVERNMENT PI RESPONSE EFFORTS

3.A.2.A (U/FOUO) MEDICAL SURVEILLANCE, ANALYSIS & REPORTING/DISSEMINATION

3.A.3.B. (U/FOUO) FORCE HEALTH PROTECTION

3.A.2.C. (U/FOUO) ASSURE CAPABILITY TO PROJECT & SUSTAIN COMBAT POWER

3.A.2.D. (U/FOUO) SUPPORT THE USG PI RESPONSE

3.A.2.E. (U/FOUO) COORDINATE AND SYNCHRONIZE

3.A.3. (U/FOUO) ESSENTIAL TASKS (A SUBSET OF KEY TASKS THAT REPRESENT THE MINIMUM THAT THE ARMY MUST DO IN ORDER TO SUSTAIN CONTINUITY OF TITLE 10 FUNCTIONS)

3.A.3.A. (U/FOUO) FORCE HEALTH PROTECTION

3.A.3.B. (U/FOUO) ASSURE CAPABILITY TO PROJECT & SUSTAIN COMBAT POWER

3.A.3.C. (U/FOUO) COORDINATE AND SYNCHRONIZE

3.A.4. (U/FOUO) END STATE. THE PANDEMIC HAS CONCLUDED. COMBATANT COMMANDERS AND CIVIL AUTHORITIES NO LONGER REQUIRE U.S. ARMY SUPPORT. THE U.S. ARMY IS POSTURED TO EXECUTE TITLE 10 U.S.C. RESPONSIBILITIES.

3.B. (U/FOUO) ACOMS, ASCCS, DRUS, AND ARMY INSTALLATION SENIOR COMMANDERS WORLDWIDE BE PREPARED TO IMPLEMENT PI RESPONSE PLANS TO INCLUDE, FOR INSTALLATIONS, INSTALLATION BIOLOGICAL PREPAREDNESS PLANS (IBPP); CONTINUE SURVEILLANCE FOR FLU-LIKE SYMPTOMS AND INFECTION CONTROL PROCESSES IN ORDER TO ENSURE CONTINUITY OF TITLE 10 U.S. CODE RESPONSIBILITIES AND PROVIDE COMBAT READY LAND POWER TO COMBATANT COMMANDERS.

3.C. (U/FOUO) VACCINATIONS

3.C.1. (U/FOUO) VACCINATIONS FOR BOTH SEASONAL INFLUENZA AND 2009-H1N1 ARE MANDATORY FOR ACTIVE DUTY MILITARY PERSONNEL, INCLUDING MOBILIZED RESERVE COMPONENT SOLDIERS. MILITARY PERSONNEL WILL RECEIVE THE 2009-H1N1 INFLUENZA VACCINE WHEN DIRECTED BY THE CHAIN OF COMMAND.

3.C.1.A. (U/FOUO) SEASONAL FLU VACCINE IS AVAILABLE AND BEING ADMINISTERED NOW IN MANY MILITARY MEDICAL TREATMENT FACILITIES (MTF). THE SEASONAL INFLUENZA VACCINE DOES NOT PROTECT AGAINST THE NOVEL 2009-H1N1 VIRUS; HOWEVER, IT IS STILL THE BEST DEFENSE TO PROTECT YOURSELF FROM THE REGULARLY OCCURRING FLU VIRUS, WHICH WILL BECOME MORE PREVALENT DURING THE WINTER MONTHS.

3.C.1.B. (U/FOUO) 2009-H1N1 VACCINE IS EXPECTED TO BE AVAILABLE IN OCTOBER. THE ARMY WILL INITIALLY RECEIVE 1 MILLION DOSES AND EXPECTS TO BEGIN VACCINATION NLT 15 NOVEMBER. PRIORITY OF DOD 2009-H1N1 VACCINE ALLOCATIONS WILL BE TO DEPLOYED FORCES, DEPLOYING FORCES, NEW ACCESSIONS, AND ACTIVE DUTY HEALTH CARE PERSONNEL.

3.C.2. (U/FOUO) IT IS HIGHLY RECOMMENDED THAT EVERYONE BE VACCINATED. CONUS ARMY FAMILY MEMBERS, RETIREES, ARMY CIVILIANS AND CONTRACTORS WILL OBTAIN THE 2009-H1N1 VACCINE WHERE THEY NORMALLY RECEIVE THEIR SEASONAL INFLUENZA VACCINE. THESE POPULATIONS ARE ENCOURAGED TO GET VACCINATED AS SOON AS POSSIBLE. OCONUS FAMILY MEMBERS WILL RECEIVE THE 2009-H1N1 VACCINE THROUGH THEIR LOCAL MILITARY TREATMENT FACILITY (MTF).

3.C.3. (U/FOUO) RESERVE COMPONENT SOLDIERS.

3.C.3.A. (U/FOUO) DUE TO THE EXPECTATION THERE WILL BE LIMITED INITIAL SUPPLIES OF 2009-H1N1 VACCINE, ALL ACTIVE ARMY NATIONAL GUARD SOLDIERS AND ACTIVE ARMY RESERVE SOLDIERS (E.G., ACTIVE GUARD RESERVE (AGR), CIVIL SUPPORT TEAM MEMBERS, ETC.) WILL BE IMMUNIZED THROUGH DOD 2009-H1N1 VACCINE ALLOCATIONS BY PRIORITY BASED ON OPERATIONAL NEEDS AND/OR HEALTH RISKS ACCORDING TO DOD GUIDANCE.

3.C.3.B. (U/FOUO) DEPLOYING ARMY NATIONAL GUARD (ARNG) UNITS AND ARMY RESERVE UNITS NOT YET AT A MOBILIZATION STATION AND OTHER SPECIALIZED UNITS (E.G., CBRNE ENHANCED RESPONSE FORCE PACKAGE (CERFP) AND CBRNE CONSEQUENCE MANAGEMENT RESPONSE FORCE (CCMRF)) WILL BE IMMUNIZED THROUGH THE DOD 2009-H1N1 VACCINE ALLOCATIONS BY PRIORITY BASED ON OPERATIONAL NEEDS AND/OR HEALTH RISKS.  SPECIFIC NATIONAL GUARD BUREAU (NGB) AND ARMY RESERVE GUIDANCE IS PENDING.

3.C.3.C. (U/FOUO) ALL OTHER ARNG SOLDIERS, CIVILIAN EMPLOYEES, AND BENEFICIARIES WILL BE IMMUNIZED THROUGH THE STATE/TERRITORY 2009-H1N1 VACCINE ALLOCATIONS AS DETERMINED BY EACH STATE/TERRITORY ACCORDING TO PRIORITIZATION BASED ON OPERATIONAL NEEDS AND/OR HEALTH RISKS (E.G., TARGET GROUPS AS DEFINED BY THE HEALTH AND HUMAN SERVICES). ALL OTHER ARMY RESERVE SOLDIERS AND MISSION ESSENTIAL CIVILIAN EMPLOYEES WILL BE IMMUNIZED BASED ON PRIORITIZATION, OPERATIONAL NEEDS, AND/OR HEALTH RISKS. ADDITIONAL GUIDANCE IS PENDING.

3.C.3.D. (U/FOUO) THE ARNG CHIEF SURGEON'S OFFICE AT THE NATIONAL GUARD BUREAU WILL PROVIDE FURTHER GUIDANCE AND ASSISTANCE TO THE SEVERAL STATES AND TERRITORIES AS WARRANTED. THE ARMY RESERVE SURGEON AT OCAR WILL PROVIDE FURTHER GUIDANCE AS WARRANTED.

3.C.3.E. (U/FOUO) THE DIRECTOR OF THE ARMY NATIONAL GUARD (DARNG) WILL ASSIST THE ADJUTANTS GENERAL (TAGS) OF THE SEVERAL STATES TO UNDERSTAND THE FEDERAL GOVERNMENT 2009-H1N1 FLU VACCINE DISTRIBUTION/ALLOCATION PLAN, AND WILL ENCOURAGE TAGS TO HAVE THEIR STAFFS WORK CLOSELY WITH THEIR STATE OR TERRITORY PUBLIC HEALTH DEPARTMENTS TO ENSURE THEIR ARNG SOLDIERS ARE INCLUDED AND APPROPRIATELY PRIORITIZED IN THEIR 2009 H1N1 FLU VACCINE ALLOCATIONS AND PLANS. THE CHIEF OF ARMY RESERVES (OCAR) WILL WORK CLOSELY WITH NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS TO ENSURE ARMY RESERVE SOLDIERS ARE INCLUDED AND APPROPRIATELY PRIORITIZED IN THE LOCAL/STATE 2009-H1N1 VACCINE ALLOCATIONS AND PLANS.

3.C.4. (U/FOUO) VACCINE PRODUCTION IS PROJECTED TO RESULT IN AN ADEQUATE SUPPLY FOR THE ENTIRE FORCE, ITS FAMILY MEMBERS, AND BENEFICIARIES, AS INCREMENTAL VACCINE SHIPMENTS WILL CONTINUE THROUGHOUT THE INFLUENZA SEASON.

3.D. (U/FOUO) ALTHOUGH THE WORLD HEALTH ORGANIZATION DECLARED THE 2009-H1N1 ACHIEVED A PANDEMIC STATUS, THE (SEC)RETARY OF THE ARMY AND THE CSA HAVE NOT DIRECTED EXECUTION OF THE ARMY PI PLAN (REF B). THE ARMY IS CAREFULLY MONITORING THE COMMANDER'S CRITICAL INFORMATION REQUIREMENTS AND DECISION SUPPORT TEMPLATE IN APPENDIX 28 TO ANNEX C TO REF B TO ENSURE TIMELY DECISIONS ARE MADE TO MEET CONTINUITY OF TITLE 10 U.S. CODE RESPONSIBILITIES, PROVIDE COMBAT READY LAND POWER TO COMBATANT COMMANDERS, AND SUPPORT U.S. GOVERNMENT (USG) PI RESPONSE EFFORTS, WHEN DIRECTED. THE ARMY HAS DEVELOPED PI PLAN PHASES IAW OVERARCHING HEALTH AFFAIRS GUIDANCE. PER APPENDIX 28 TO ANNEX C TO REF B, THE FOLLOWING ARE TEN POTENTIAL SECARMY/CSA DECISIONS:

3.D.1. (U/FOUO) PHASE 0 (SHAPE) - PHASE 5 (RECOVER): DECISION 1 - RE-ALIGN INVENTORIES OF ESSENTIAL SUPPLIES

3.D.2. (U/FOUO) PHASE 1 (PREVENT) - PHASE 3 (INTERDICT): DECISION 2 - DEPLOY CAPABILITIES REQUIRED FOR CONTAINMENT

3.D.3. (U/FOUO) PHASE 1 (PREVENT) - PHASE 5 (RECOVER): DECISION 3 - MAP PRIORITIZATION OF UNITS FOR ANTI-VIRALS/VACCINATIONS

3.D.4. (U/FOUO) PHASE 2 (CONTAIN) - PHASE 5 (RECOVER): DECISION 4 - MOBILIZE TARGETED ARMY RESERVE CAPABILITIES

3.D.5. (U/FOUO) PHASE 2 (CONTAIN) - PHASE 5 (RECOVER): DECISION 5 - QUARANTINE, PROTECTIVE SEQUESTRATION OR ISOLATE UNITS

3.D.6. (U/FOUO) PHASE 2 (CONTAIN) - PHASE 5 (RECOVER): DECISION 6 - ADJUST COMMAND AND CONTROL

3.D.7. (U/FOUO) PHASE 2 (CONTAIN) - PHASE 5 (RECOVER): DECISION 7 - CLOSE OR ALTER USMA OPERATIONS AND/OR ACCESSIONSAND TRAINING OF SOLDIERS

3.D.8. (U/FOUO) PHASE 3 (INTERDICT) - PHASE 5 (RECOVER): DECISION 8 - ALTER OR HALT FORCE ROTATIONS

3.D.9. (U/FOUO) PHASE 3 (INTERDICT) - PHASE 5 (RECOVER): DECISION 9 - IMPLEMENT STOP LOSS

3.D.10. (U/FOUO) PHASE 3 (INTERDICT) - PHASE 5 (RECOVER): DECISION 10 - IMPLEMENT STOP MOVEMENT

3.E. (U) OTHER CSA DIRECTED PROTECTIVE MEASURES. IN ADDITION TO VACCINATION, EVERY ARMY SOLDIER (ACTIVE COMPONENT, ARMY RESERVE AND ARMY NATIONAL GUARD), CIVILIAN, FAMILY MEMBER AND CONTRACTOR CAN HELP PREVENT SPREAD OF EITHER STRAIN OF FLU BY:

3.E.1. (U) COVERING THE NOSE AND MOUTH WITH A TISSUE WHEN COUGHING OR SNEEZING, THEN THROWING THE TISSUE IN THE TRASH. VARIANT: COUGHING OR SNEEZING INTO THE SHIRT SLEEVE AT THE CROOK OF EITHER ELBOW.

3.E.2. (U) WASHING HANDS OFTEN WITH SOAP AND WARM WATER, ESPECIALLY AFTER COUGHING OR SNEEZING. ALCOHOL-BASED HAND SANITIZERS ALSO ARE EFFECTIVE.

3.E.3. (U) AVOIDING TOUCHING THE EYES, NOSE OR MOUTH; GERMS CAN SPREAD THIS WAY.

3.E.4. (U) AVOIDING CLOSE CONTACT WITH PEOPLE WHO HAVE FLU-LIKE SYMPTOMS.

3.E.5. (U) STAYING HOME IF THEY BECOME SICK, UNTIL 24 HOURS AFTER THE FEVER IS GONE. THIS WILL AVOID INFECTING OTHERS.

3.E.6. (U) USING ANTI-BACTERIAL WIPES TO CLEAN, SEVERAL TIMES EACH DAY, SURFACE FREQUENTLY TOUCHED BY OR IN CLOSE PROXIMITY TO HUMAN BEINGS IN THE NORMAL COURSE OF DAILY LIFE AND WORK. EXAMPLES INCLUDE BUT ARE NOT LIMITED TO: DOOR KNOBS, CARD SWIPE ACCESS CONTROL DEVICES, TELEPHONE HANDSETS, COMPUTER KEYBOARDS, REFRIGERATOR/MICROWAVE DOOR HANDLES, AND DESK OR WORKBENCH SURFACES.

3.E.7. (U) IMPLEMENTING HEAD-TO-TOE BUNKING ARRANGEMENTS IN BARRACKS, MULTIPLE OCCUPANT BEDROOMS, AND OTHER CONFINED ENVIRONMENTS, TO INCLUDE OPERATIONAL COMBAT LOCATIONS.

3.F. (U/FOUO) COORDINATING INSTRUCTIONS 3.F.1. (U/FOUO) THE ARMY PANDEMIC INFLUENZA PLAN IS FOUND AT THE FOLLOWING AKO-S PATH: AKO-S HOME - ARMY ORGANIZATIONS - OPERATIONS - ARMY PANDEMIC INFLUENZA - ARMY PANDEMIC INFLUENZA HOME.

3.F.2. (U/FOUO) LEADERS WILL INCLUDE FLU CONSIDERATIONS IN ALL RISK ASSESSMENT AND MITIGATION PLANS FOR EVERY OPERATION, TRAINING EVENT, AND TASK TO INCLUDE COMBAT OPERATIONS.

4. (U/FOUO) ADMINISTRATION AND LOGISTICS. N/A.

5. (U) COMMAND AND SIGNAL.

5.A. (U) COMMAND AND CONTROL. DIRLAUTH ALCON. KEEP HQDA INFORMED.

5.B. (U) SIGNAL.

5.B.1. (U) HQDA, DAMO-ODO POCS: COL ADOLFO AQUINO, COMM: (703) 695-2224, ADOLFO.AQUINO@US.ARMY.MIL; LTC KIRK VINCENT, COMM: (703) 695-5030, KIRK.VINCENT@US.ARMY.MIL; OR LTC ANGELA WANNAMAKER, COMM. 703-695-5460, ANGELA.M.WANNAMAKER@CONUS.ARMY.MIL.

5.B.2. (U) HQDA, PI PLAN POC: MR. WILLIAM DUESBURY, DAMO-SSW, COMM:  (703)692-9673, WILLIAM.DUESBURY@HQDA-S.ARMY.SMIL.MIL.

5.B.3. (U) OFFICE OF THE SURGEON GENERAL POCS: COL SCOTT STANEK, COM:  703-681-3130, DSN: 761-3130, SCOTT.STANEK@US.ARMY.MIL; MAJ MATTHEW AIKEN, COM: 703-681-8053, DSN: 761-8053, MATTHEW.AIKEN@US.ARMY.MIL

5.B.4. (U) ARNG OFFICE OF THE CHIEF SURGEON POCS: LTC JOE ORTIZ, COMM: 703-607-1056, DSN 327-1056, JOSE.MARI.ORTIZ@US.ARMY.MIL OR MAJ PAT MOORE, COMM: 703-607-9164, DSN 327-9164, PATRICK.MOORE1@US.ARMY.MIL.

5.B.5. (U) AR OFFICE OF THE CHIEF SURGEON POCS: MAJ TODD TRAVER, COMM: 404-464-9569, DSN 367-9569, TODD.TRAVER@USAR.ARMY.MIL OR COL ETTA JOHNSON, COMM: 404-464-8470, DSN 367-8470, ETTA.JOHNSON@USAR.ARMY.MIL.

5.B.6. (U) MILITARY VACCINE AGENCY POC: COL MICHAEL KRUKAR, COM: 703-681-5101, DSN: 761-5101, MICHAEL.KRUKAR@US.ARMY.MIL.

5.B.7. (U) ACKNOWLEDGE RECEIPT BY E-MAIL TO POCS IN PARA 5.B.1.

EXPIRATION DATE CANNOT BE DETERMINED.

Classification: UNCLASSIFIED
Caveats: FOUO

Classification: UNCLASSIFIED
Caveats: FOUO