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How the military stays ready during disease outbreaks

Headshot of Dr. Sanchez Dr. Toti Sanchez is a senior scientist and deputy chief at Armed Forces Health Surveillance Branch

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Armed Forces Health Surveillance Branch | Coronavirus

A Q & A with Dr. Jose L. (Toti) Sanchez, Senior Scientist & Deputy Chief, AFHSB


What is your focus area?

A major component of my work is to ensure that major health surveillance program plans and initiatives are current and reflect alignment with the Defense Health Agency’s Strategic Plan. Under the guidance of AFHSB’s Chief, I also help to build strong scientific and collaborative relationships within the Public Health Directorate.

How do you monitor disease outbreaks?

I spend a significant amount of time monitoring the many peer-reviewed, governmental and international association reports. I also analyze the disease outbreak reports and coordinate data gathering and report generation from AFHSB’s Global Emerging Infections Surveillance, Epidemiology and Analysis), and Integrated Biosurveillance  sections.

In my role as Senior Scientist at AFHSB, I serve on the Infectious Disease Clinical Research Program Operational Steering Committee, a “think-tank” committee of experts who provide guidance on military-relevant research efforts in support of the U.S. military’s force health protection needs. I also work as an instructor at the Uniformed Services University of the Health Sciences. I ensure students and residents in public health learn the basic skills of outbreak investigation, associated surveillance, and research initiatives.

How do you support AFHSB's response to COVID-19?

The COVID-19 pandemic has placed an immense workload on our AFHSB staff to produce analyses and reports for DHA leadership, senior DoD officials, the Secretary of Defense, and respond to questions from Congressional officials. In my role as Deputy Chief, AFHSB, I ensure that reports, documents and COVID-19 related policy reviews are accurate and produced in a timely fashion from AFHSB’s three sections. Since February 2020, I’ve reviewed and provided input to nearly 70 executive summaries , several information and position papers, and at least 20 weekly surveillance summaries addressing COVID-19 issues.

Where have you traveled in this role?

My travel is mainly limited to the National Capital Region. I’ve participated in tabletop drills such as an interagency simulation for Crimson Contagion, a response to a severe influenza pandemic. I’ve also served as a representative to the Defense Health Board to evaluate health surveillance matters such as COVID-19 and respiratory infections in support of DHA’s Combat Support Agency mission.

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DHA-PI 6205.01: Medical Logistics Guidance for the DoD Coronavirus Disease 2019 (COVID-19) Vaccination Program

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This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (n), establishes the Defense Health Agency's (DHA's) procedures for ordering, receiving, and managing COVID-19 Vaccines inventory and ancillary kits.

DHA-IPM 20-004: Department of Defense (DoD) Coronavirus Disease 2019 (COVID-19) Vaccination Program Implementation

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This Defense Health Agency (DHA) Interim Procedures Memorandum (IPM), based on the authority of References (a) through (d), and in accordance with the guidance cited in References (e) through (aa), establishes the DHA’s procedures to implement instructions, assign responsibilities, and prescribe procedures for the COVID-19 Vaccination Program. This DHA-IPM applies to DHA, DHA Components (activities under the authority direction, and control of the DHA), Military Departments (MILDEP), and the United States Coast Guard (CG). This DHA-IPM cancels and replaces DHA-IPM 20-004, “Department of Defense (DoD) Coronavirus Disease 2019 (COVID-19) Vaccination Program Implementation,” December 13, 2020.

Supplemental Guidance for Providing DoD Coronavirus Disease 2019 Vaccines to DoD Contractor Employees and Select Foreign Nationals

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This memorandum provides supplemental guidance on the provision of coronavirus disease 2019 (COVID-19) vaccines, in accordance with reference (a). The Defense Health Agency (DHA) is the lead coordinating DoD Component for executing this guidance, in coordination with the Military Departments and other DoD Components as appropriate.

HA Guidance for Coronavirus Disease 2019 (COVID-19) Laboratory Pre-Testing Questionnaire

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This memorandum provides guidance for a COVID-19 laboratory pre-testing questionnaire that will be mandatory for all Active Duty Service members and encouraged for all other DoD beneficiaries treated at military medical treatment facilities.

Executive Order on Ensuring Access to United States Government COVID-19 Vaccines

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This EO outlines who should receive priority access to COVID-19 vaccines developed in the United States or procured by the United States Government (“United States Government COVID-19 Vaccines”).

Coronavirus Disease 2019 Vaccine Guidance

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This memorandum provides guidance on the provision of coronavirus disease 2019 (COVID-19) vaccines. The Defense Health Agency (DHA) is the lead coordinating DoD Component for executing this guidance, in coordination with the Military Departments and other DoD Components.

DHA-AI 3020-01: Return to the Workplace Staffing Plan in the Coronavirus Disease 2019 Environment

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This Defense Health Agency-Administrative Instruction (DHA-AI), based on the authority of References (a) through (b) and in accordance with the guidance of References (c) through (z3), establishes the Defense Health Agency's (DHA) plan to return to full operations and support the whole-of-government response, during the Coronavirus Disease 2019 (COVID-19) pandemic. This DHA-AI also provides a preventive plan to monitor and assess for the appearance of new cases and implement those processes that will prevent them from impacting the workforce. The processes describe herein are intended to offer an actionable plan for the workforce to re-enter DHA Administrative Offices. See Appendix 1 for a summary of the DHA Administrative Office Reopening Plan. The plan uses the Force Health Protection Guidance and Health Protection Conditions (HPCON), in accordance with Reference (d), to ensure protection for the workforce, including the most vulnerable-to-serious complications from the virus while enabling DHA Administrative Offices to continue its mission. See Appendix 2 for the conceptual HPCON framework.

  • Identification #: 3020-01
  • Date: 11/3/2020
  • Type: Administrative Instructions
  • Topics: Coronavirus

DHA AI 3020.01: Return to the Workplace Staffing Plan in the Coronavirus Disease 2019 (COVID-19) Environment

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This Defense Health Agency-Administrative Instruction (DHA-AI), establishes the Defense Health Agency’s (DHA) plan to return to full operations and support the whole-of-government response, during the Coronavirus Disease 2019 (COVID-19) pandemic and in preparation for regression or resurgence in COVID-19 cases that could impact the workforce.

  • Identification #: DHA AI 3020.01
  • Date: 6/12/2020
  • Type: Administrative Instructions
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Armed Forces Reportable Medical Events Guidelines and Case Definitions Memo

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The Armed Forces Reportable Medical Events Guidelines and Case Definitions (RME Guidelines) standardize reporting and tracking of disease and other conditions of public health and military importance. Timely reporting permits earlier recognition of public health events and interventions to protect the health of the force.

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