本帖最後由 awepp 於 2020-4-8 15:38 編輯
 TR-COVID-19-Assistance-Request.pdf (122.75 KB)
克羅齊艦長的求救信
DEPARTMENT OF THE NAVY
uss THEODORE ROOSEVELT (CVN
UNIT Ioozso Box 1
FPO AP 96632
30 Mar 20
Subj: REQUEST FOR ASSISTANCE IN RESPONSE TO PANDEMIC
BLUF: If required the USS THEODORE ROOSEVELT would embark all assigned Sailors, set
sail, and be ready to fight and beat any adversary that dares challenge the US or our allies. The
virus would certainly have an impact, but in combat we are willing to take certain risks that are
not acceptable in peacetime. However, we are not at war, and therefore cannot allow a single
Sailor to perish as a result of this pandemic unnecessarily. Decisive action is required now in
order to comply with CDC and NAVADMIN 083/20 guidance and prevent tragic outcomes.
2020年3月30號
主旨:對於大流行病的請求援助
BLUF:如果需要，美國海軍 羅斯福號將揚帆啟航，並準備好戰鬥並擊敗，任何膽敢挑戰美國及盟友的敵人。病毒確實產生衝擊，與之對抗，我們願意承擔一定程度在和平時期無法接受的風險。然而，我們並不在戰爭中，因此無法允許我們任何一位水手因這疾病做非必要的殞命。現在必須採取果斷的行動，以遵從CDC及 NAVADMIN 083/20準則，來避免悲劇性的後果。
1. Problem Statement. With the crew embarked, TR is unable to comply with CDC protocols or
NAVADMIN 083/20 guidance. Based on CDC guidelines and TR observations, the only
effective method to preserve an individual's health is total isolation for 14+ days in accordance
with the NAVADMIN Individual hotel/barracks rooms with separate heads). Due to a
warship's inherent limitations of space, we are not doing this. The spread of the disease is
ongoing and accelerating.
1.問題陳述。在船員們上崗時，TR(例行訓練?)無法遵從CDC或者NAVADMIN 083/20準則。基於CDC準則及例行訓練的觀察，保持個人健康的唯一有效辦法是，在 NAVADMIN個人旅館或有 separate heads的野戰房間，進行完整的隔離14+天。因為軍艦的空間固有限制，我們沒這麼做。疾病的傳播是正在進行並且加速。
2. Inappropriate Focus on Testing. Testing has no direct infuence on the spread of the COVID-
l9 virus. It merely confirms the presence of the virus. Due to the close quarters required on a
warship and the current number of positive cases, every single Sailor, regardless of rank, on
board the TR must be considered "close contact" in accordance with the NAVADMIN. Testing
will only be useful as the ship returns to work after isolation or quarantine to confirm the
effectiveness of the quarantine period. Our focus now must be on quarantine and isolation in
strict compliance with CDC and NAVADMIN guidance.
2.對檢驗的失當關注。檢驗對於COVID-19病毒的傳播，並無直接的影響。這僅僅只能確認病毒的存在。因為軍艦上狹窄的居住空間，現行在甲板上例行訓練的水手、陽性反應者，每個水手無論風險高低都必須根據NAVADMIN以"緊密接觸"來考量。檢驗只在船員隔絕或隔離完，重返船上工作時，確認隔離期間的效用時有用。我們現在必須將焦點放在，嚴格遵守CDC及 NAVADMIN 準則下的隔離及隔絕。
The COVID-19 test cannot prove a Sailor does not have the virus; it can only prove that a Sailor
does. As an illustration, of the first 33 TR Sailors diagnosed with COVID-19, 21% (7 of those
33) infected Sailors were negative on a test, then subsequently presented with of COVID-19 infection within 1-3 days post-test.
COVID-19檢驗無法證明一個水手是否感染病毒;這只能證明他已經有。舉例來說，最初被診斷感染COVID-19的33名TR水手中，有21%(33位中的7位)在檢驗中成陰性，而在1-3天後的檢查呈現感染。
Based on data since first case, approximately 21% of the Sailors that tested negative and
are currently moving into group restricted movement ashore are currently infected, will develop symptoms
over the next several days, and will proceed to infect the remainder of their shorebased restricted group.
基於第一個例子的數據，大約21%檢驗呈陰性，並且送上岸上限制行動團體的水手，將會在接下來幾天後出現症狀，然後將會繼續感染剩下在岸上限制團體內的人。
3. Inappropriate Quarantine and Isolation. With the exceptions of a handful of senior officer
staterooms, none of the berthing onboard a warship is appropriate for quarantine or isolation.
Thousands of "close contact" Sailors require quarantine in accordance with guidance. TR has
begun to move personnel off ship into shore-based group restricted movement locations. Of the
off ship locations currently available, only one complies with the NAVADMIN guidance.
Infected Sailors reside in these off ship locations. Two Sailors have already tested positive in an
open bay gymnasium equipped with cots. Although marginally better than a warship, group quarantine sites are not a solution and are not in accordance with current guidance.
3.不當的隔離及隔絕。除了少數高級軍官住艙外，一艘靠泊的軍艦上沒有一個適合的艙房適合用來隔離或隔絕。依據指南，有數以千計的"緊密接觸"水手需要隔離。TR開始將人員從船上移動到岸上的限制行動團體。現行非艦上的可用地點，唯一一條遵守 NAVADMIN 準則。受感染的水手居住在這些離艦地點。兩名水手在開敞式體育場的床上已經檢驗出陽性。雖然這僅僅比軍艦上好點，團體隔離的場地不是一個解決辦法並且也不根據現行的準則。
In order to stop the spread of the virus, the CDC and the Navy and Marine Corps Public Health
Center both recommend individual quarantine. They both recommend against group quarantine.
They recommend limited or no contact with other exposed individuals and no use of the same
facilities or items exposed individuals have touched. NAVADMIN 083/20 echoes this guidance.
為了阻止病毒的傳播，CDC及海軍和海軍陸戰隊公共衛生中心都建議個體隔離。他們都建議不要進行團體隔離。他們建議限制或者不要與其他暴露的個體接觸，並且不要使用他們所接觸的設備或物品。 NAVADMIN 083/20與此相呼應。
The environment most conducive to spread of the disease is the environment the crew of the TR
is in right now, both aboard ship and ashore:
最有利於傳播疾病的環境是，現在進行例行訓練的水手，靠岸的船及岸上都是:
a. Large amounts of Sailors in a confined space
b. Open, shared berthing
c. Shared restroom facilities
d. Confined, shared workspaces and computers
e. Shared messing for large numbers
f. Meals cooked food provided by exposed personnel
g. Mandatory watch/operational tasks demanding consistent close contact (food
preparation, service cleaning, TFCC watches, unavoidable meetings to plan
execute COVID response actions, etc.)
h. Movement about the ship requires consistent close contact with other exposed
individuals (confined passageways, previously touched ladder railings/hatch
levers/door knobs etc.)
a.大量水手在狹窄的空間裡
b.開放，共享的鋪位
c.共享廁所設備
d.密閉，共享的工作區及電腦
e.因多人數的共享混亂
f.由暴露個體所提供的膳食
g. 觀測/操作 任務 所無法避免的近距離接觸
(食物準備、設備清理、TFCC watches、開會執行COVID 的反應行動而造成的無法避免的會晤)
h.在船上移動所無法免與其他暴露個體的接觸
(狹窄的通道、先前摸過的欄杆/艙口桿/門把手等)
4. Ineffectiveness of Current Strategy: Based on current limitations (lack of appropriate
quarantine and isolation facilities, inability to effectively achieve social distancing), TR has
instituted limited measures to slow the spread of the disease. We have moved a small percentage
of the crew off ship, increased the frequency of thorough cleaning and attempted some social
distancing. The current strategy will only slow the Spread. The current plan in execution on TR
will not achieve virus eradication on any timeline.
4.當前策略的無效姓:基於當前各種限制(缺乏適當的隔離隔絕設施、無法有效實現社交距離)，
例行訓練TR限制了減緩疾病傳播的方法。我們已讓小百分比的水手下船，增加徹底清潔的頻率及嘗試保持社交距離。當前的策略將只能減緩傳播的速度。當前的計畫會因為執行例行訓練，而將無法完成對病毒的根除在任何時間軸。
5. Lessons Learned from the Diamond Princess: From an epidemiological research article on
the COVID-19 infection onboard Diamond Princess (the only comparable situation encountered
thus far) (Roklov et a1.) titled "COVID-19 outbreak on the Diamond Princess cruise ship:
estimating the epidemic potential and effectiveness of public health counterneasures:”
5.從鑽石公主號(郵輪)學到的教訓:來自一篇流行病學關於鑽石公主號感染的研究的文章(到目前為止，唯一遇到的類似情況)，標題為“在鑽石公主號上爆發的COVID-19:評估潛在的瘟疫及公共衛生對策的有效性
“Cruise ships carry a large number of people in confined spaces with relative homogeneous
mixing. On 3 February, 2020, an outbreak of COVID-19 on cruise ship Diamond Princess was
reported following an index case on board around 21-25 January. By 4 February, public health
measures such as removal and isolation of ill passengers and quarantine of non-ill passengers
were implemented. By 20 February, 619 of 3,700 passengers and crew were tested
positive. We estimated that without any interventions within the time period of 21 January to 19
February, 2920 out of the 3700 would have been infected. Isolation and quarantine
therefore prevented 2307 cases. We showed that an early evacuation of all passengers on 3
February would have been associated with 76 infected persons.” (As opposed to 619)
『郵輪在密閉空間裡載了大量的人員，且相對均勻的混合。2020年2月3號，報告指出在1月21至25號左右，COVID-19在鑽石公主號呈現指數型爆發。到了2月4號。公共衛生措施實施，像是移除及隔絕生病的乘客，並隔離沒發病的乘客。到了2月20號，總共3700名的乘客及船員檢驗中，619位呈現陽性。我們估計如果在1月21到2月19，如果沒任何作為，將有2920位被感染。因此隔絕及隔離阻止了2307名例子。我們顯示指出，在2月3號，早期疏散所有乘客，則是76名感染者』(作為619位的對比)
The final sentence of the abstract:
“Conclusions: The cruise ship conditions clearly amplified an already highly transmissible
disease. The public health measures prevented more than 2000 additional cases compared to no
interventions. However, evacuating all passengers and crew early on in the outbreak would have
prevented many more passengers and crew from infection.”
摘要的最後一句話:
『結論:郵輪的狀況明顯放大了一個本身就高度傳播的疾病。相較於不介入，公共衛生措施阻止超過2000名額外的感染者。然而，在疾病爆發前早點疏散所有乘客及船員，可以阻止更多人感染。』
The Diamond Princess was able to more effectively isolate people onboard than TR, due to a
much higher percentage of individualized and compartmentalized accommodations onboard for
paying customers. Their measures still allowed hundreds of people to become infected. TR's
best-case results, given the current environment, are likely to be much worse.
鑽石公主號相比TR，可以能夠更有效地隔絕船上的人員，因為它也更高百分比的獨立性及劃分更多的住艙給付錢的客人。他們的措施仍然造成上百名人員感染。給予在現在這環境，TR的最好防疫結果，可能會糟糕許多。
6. Pronosed New Strategy: There are two end states TR could achieve:
a. Maximize warfighting readiness and capacity as quickly as possible. No timeline
necessary. We go to war with the force we have and fight sick. We never achieve a COVID-
free TR. There will be losses to the virus.
b. Achieve a TR. Requires strict adherence to CDC guidelines and a
methodical approach to achieve a clean ship. This requires immediate and decisive action. It
will take time and money.
6.建議的新策略:TR可達到的兩個最終狀態
a.盡可能將作戰準備及能力最大化越快越好。無須時間表。我們用我們自己的力量去戰爭並且對抗疾病。我們從沒完成戰勝 COVID的TR。這將敗給病毒。
b.完成一個TR。需要嚴格信奉CDC準則，及有條不紊的方法來實現一艘乾淨的船。這需要立刻及果斷的行動。這將花費時間與金錢。
As war is not imminent, we recommend pursuing the peace time end state.
TR has two primary goals in order to achieve that end state:
a. Prevent unnecessary deaths, reduce the number of Sailors that contract COVID-19 and
eliminate fulture virus spread.
b. Regain and maximize warfighting readiness and capacity as quickly as possible.
戰爭並不緊迫，我們建議尋求一個平靜的時間終止狀態。
為了達成這終止狀態，TR有兩個主要目標:
a.阻止不必要的死亡，降低水手感染COVID-19，及消除未來病毒的傳播。
b.盡快增加及最大化戰鬥準備及能力。
In order to achieve these goals, a clean ship is required. Every Sailor onboard must be
guaranteed virus-free and the ship environment must be disinfected. One infected Sailor
introduced to the ship will spread the virus. Off ship lodging in compliance with CDC and
NAVADMIN guidance is required for over 4,000 Sailors to achieve a clean ship and crew.
為了完成這些目標，一艘乾淨的船是需要的。每位上船的水手必須保證是無病毒的，船上環境必須是消毒過的。一個受感染的水手到船上來將會散播病毒。需要一個可容納超過4000名水手，並遵守CDC準則的離艦住所，以完成人員及船艦的清潔。
7. Conclusion. Decisive action is required. Removing the majority of personnel from a
deployed US. nuclear aircraft carrier and isolating them for two weeks may seem like an
extraordinary measure. A portion of the crew (approximately 10%) would have to stay aboard to run the reactor plant, sanitize the ship, ensure security, and provide for contingency response to
emergencies. This is a necessary risk. It will enable the carrier and air wing to get back
underway as quickly as possible while ensuring the health and safety of our Sailors. Keeping
over 4,000 young men and women on board the TR is an unnecessary risk and breaks faith with
those Sailors entrusted to our care.
7.結論。必須採取果斷的行動。從美國核動力航空母艦撤離大部分人員，並且隔離兩周，似乎是一個非比尋常的措施。一部分的船員(約10%)將不得不留在艦上運作反應爐、消毒船隻、確保安全，以及提供萬一緊急狀況時的反應。這是必要的風險。當確保我們水手健康及安全後，這將能讓航母及戰機盡快重新回來。持續讓超過4000名年輕男女值勤TR是個不必要的風險，也破壞了那些水手們交付給我們照料的信任。
There are challenges associated with securing individualized lodging for our crew. This will
require a political solution but it is the right thing to do. We are not at war. Sailors do not need
to die. If we do not act now, we are failing to properly take care of our most trusted asset our
Sailors.
Request all available resources to find NAVADMIN and CDC compliant quarantine rooms for
my entire crew as soon as possible.
提供我們水手的個人化住所將會是個挑戰。這將需要一個政治解決方案，但，是正確該做的事。我們並不在戰爭，水手不需要去死。如果我們不現在行動，我們將無法照顧我們最珍貴的資產-我們的水手。
請求所有可用的資源，以找到符合 NAVADMIN及CDC準則的隔離房越快越好。
B. E. CROZIER
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CR扩增发现，艾滋病患者几乎全部携带HHV-6A病毒。
