Throughout history, the U.S. military has played a vital role in combating the spread of infectious diseases both on American soil and abroad. In January, South Korea announced its first cases of COVID-19. Within mere weeks, the infection rate skyrocketed, turning South Korea into the second epicenter of the global pandemic.On Feb. 20, the Korean Center for Disease Control reported 104 confirmed cases of the illness, with 57 in the city of Daegu. Due to the cluster of four Army installations in and around Daegu, the virus was at our doorsteps. Overnight, the military community in Daegu became the bellwether for the Army's response to the virus. As South Korea's number of confirmed cases continued to increase, the 11,000 troops, dependents, and civilians in Daegu became the first large U.S population to confront COVID-19. As a precaution, military leadership initiated a mass data analysis to identify service members and their families who had either traveled to or through mainland China.The U.S. Forces Korea (USFK) and Eighth Army COVID-19 community-of-interest is divided into six distinct areas, approximately one-third of the size of Texas. 19th Expeditionary Sustainment Command's (ESC) area of responsibility is Area IV, which includes the majority of the southern portion of South Korea.As the regional one-star headquarters, Eighth Army directed 19th ESC to retain command authority for organic units and tactical control for all other Eighth Army subordinate units in Area IV. The implementation of this command authority adjustment enabled the synchronization of movement, messaging, and streamlined communication for nonorganic brigades, battalions, and companies whose higher headquarters resided outside of Area IV. As an operational framework, 19th ESC developed a counter-COVID-19 campaign plan with three lines of effort: protect the force, respond to threats, and sustain readiness. The mission was to prevent the spread of COVID-19 and remain postured to conduct sustainment operations.Protect the ForceThroughout the COVID-19 response, 19th ESC was laser-focused on protecting the force and community by implementing enhanced prevention and hygiene measures. The command was able to rapidly implement stringent health protection measures to seize control and prevent the spread of the virus in the following areas:Task Organization: With the Eighth Army command authority directive, having command authority of other Eighth Army units in Area IV was a challenge. However, to maintain control of Area IV's overall health protection posture and track positive COVID-19 cases, this authority was vital. It allowed for the quick dissemination of information and area-wide compliance with the health protection condition (HPCON) guidance. Additionally, the authority gave the command a foothold across the southern portion of the Korean peninsula permitting the issuance of guidance that assisted in suppressing the spread of the virus.Command and Control: To effectively command and control subordinate units, on Feb.19, less than 24 hours after the declaration of HPCON Bravo, 19th ESC transformed their secure tactical command post into an environment more conducive to providing support to the local community. It was clear that the driving force for effective operations was the free-flowing exchange of information between U.S forces and the local Republic of Korea (ROK) government. The reorganized command post enhanced the command’s ability to openly communicate with local government officials and conduct secure classified informal updates, as necessary.Surgeon Fusion Cell and Health Protection Council: On Feb. 19, 19th ESC expanded its existing surgeon cell to include public health, medical operations, patient tracking, and Korean Augmentation to the U.S. Army. Previously, the surgeon cell consisted only of the surgeon, medical noncommissioned officer-in-charge, and a medical operations officer. The expanded fusion cell enabled a preventive medicine and public health capability for patient tracking, and operation structures for medical and health protection products and dissemination. Additionally, it established a reporting structure from all 19th ESC tactical control units for patients under investigation, commander's critical information requirements, and tracking of quarantined individuals. Furthermore, 19th ESC established a health protection council to increase the overall readiness and resiliency of the team through the identification of threats and the application of resources to promote the health, safety, and wellness of all the Soldiers. The council was built on previously established readiness and resiliency working groups.Respond to ThreatsTo combat the spread of COVID-19, 19th ESC implemented emerging capability and aggressive information-sharing between the Department of Defense (DoD), U.S military, and the ROK military and community.HPCON Measures: The initial implementation of HPCON measures across the peninsula exposed a lack of understanding. HPCON public health guidance from USFK was initially issued in a table format where restrictions and changes were highlighted to show applicability. The change to the infographic slides for each HPCON made it easier to articulate the standards for each area. With the declaration of HPCON Bravo peninsula-wide and the implementation of HPCON Charlie in U.S. Army Garrison Daegu on Feb. 20, Eighth Army issued an operation order that required the approval of the first general officer in the chain of command to travel to and from Daegu.Public Health Emergency Directives: The protection of the force remains our number one priority. We continually monitor and assess the conditions of COVID-19 in South Korea and its presence near USFK installations. On March 25, a public health emergency was declared by the USFK commander. “To ensure I possess the necessary authorities needed to enforce compliance and protect the force, I have declared a public health emergency for all U.S. commands and military installations in the Republic of Korea." This directive required mandatory quarantine and access requirements for USFK installations. It also granted the 19th ESC commander additional authorities to establish protection measures for the entire workforce, including civilian personnel in Area IV.Enhanced Sanitation Protocols: 19th ESC implemented an enhanced sanitation policy to mitigate risks of COVID-19 transmission from contaminated surfaces and aerosolized particles (large droplets and microdroplets). The use of masks or cloth face coverings in all confined workspaces was made mandatory. Hand sanitizer and handwashing stations were placed at all major entrances to facilities with signs emphasizing their use. Commonly used surfaces were sprayed with disinfectant and logged for tracking purposes, doors were propped open to avoid the use of doorknobs at latrines, and posters showing washing of hands with soap and water for at least 20 seconds were prominently displayed throughout buildings. Disposable gloves were made available at gas stations and other areas where multiple individuals would touch various objects. All work areas were properly ventilated every hour to clear out droplets and microdroplets. Preventive Medicine (PM) teams reviewed air filtration systems and vacuum cleaners to ensure the presence of HVAC filters. Chairs and workspaces were reconfigured to ensure proper social distancing and use of non absorbent materials, such as vinyl rather than cloth, were implemented.PM teams from 154th PM detachment were mobilized to assess the above protocols and provide feedback on improvement measures. These steps were taken in addition to the health protection council working group and executive review committee established to ensure the implementation of force health protection protocols.Sustaining ReadinessTo maintain the command’s “Fight Tonight” posture, 19 ESC’s focus remained on unit readiness. The employment of the materiel readiness common operating picture, movement planning board, and messaging was vital to keep the force moving forward.Readiness Common Operating Picture. To gain situational awareness and synchronize resources, 19th ESC developed a readiness common operating picture that was used to identify commodity shortfalls with classes of supply, such as Class I (rations) and Class VIII (medical). The readiness common operating picture became part of Eighth Army Distribution Working Group, displaying a 72-hour snapshot.Movement Planning. 19th ESC also set up a board to manage all movements in and out of Daegu. The application of the movement board enhanced the overall management of personnel movements, thereby limiting any unnecessary exposure during the COVID-19 pandemic.Class VIII Procurement. Early on, 19th ESC worked with Eighth Army and U.S. Army Medical Materiel Center–Korea (USAMMC-K) to determine the Class VIII requirement and set a priority of support. USAMMC-K continued to use long standing processes and procedures in the execution of ground common user land transportation contracts for the movement of Class VIII materiel.The transportation methods were soon expanded to include coordination of weekly aerial resupply sustainment missions and tactical unit enhancement when needed. USAMMC-K also developed an online in-transit visibility portal displaying details on the quantities and nomenclature of critical medical materiel, providing visibility of operational resupply movements to the end user. The consistency of transportation availability through the increased operational requirements and lapse of a special measures agreement directly contributed to the timely and effective delivery of the majority of Class VIII materiel.Training. Lost training opportunities due to COVID-19 hinder the unit's ability to execute collective training tasks. Now, several months in, units must operate in a restrictive training environment that is limited to only squad-level training events. Moreover, COVID-19 forced the postponement of the scheduled Combined Command Post Training (CCPT) 20-1. This caused a rapid reevaluation of the planned training objectives. The objectives for CCPT 20-1 were retooled to extract training value from running 24-hour command post operations. By aligning the retooled training objectives to COVID-19 response execution, 19th ESC salvaged the lost training value from the training events postponement.Through the first 90 days of COVID-19 operations, 19th ESC significantly reduced the spread of COVID-19 to military personnel and their families despite the thousands of cases spreading throughout the country. As of May 19, the total cases in South Korea reached 11,078 with 13 new confirmed cases within the 24 hours prior to writing this article. Amidst the 6,871 confirmed cases in Daegu, the virus only infected 8 USFK personnel, including one service member. The response of 19th ESC set conditions to prevent the spread of COVID-19 and to protect the members of the DoD community. The lessons learned during this operation may provide a framework for epidemic response doctrine.--------------------Brig. Gen. Mark T. Simerly is commanding general of 19th Expeditionary Sustainment Command. He holds a Bachelor of Arts degree and is a Distinguished Military Graduate from University of Richmond. Simerly holds a Master of Science in National Resource Strategy from National Defense University and a Master of Military Arts and Sciences degree from U.S. Army Command and General Staff College.Maj. Antwon Person is distribution management center planner at 19th Expeditionary Sustainment Command. He holds a bachelor's degree from Virginia State University and a master’s degree in logistics management from Florida Institute of Technology. His military education includes Quartermaster Basic Officer Course, Combined Logistics Captains Career Course, Theater Logistics Studies Program, Command and General Staff College, and Joint Forces Staff College.--------------------This article was published in the October-December 2020 issue of Army Sustainment.RELATED LINKSArmy Sustainment homepageThe Current issue of Army Sustainment in pdf formatCurrent Army Sustainment Online ArticlesConnect with Army Sustainment on LinkedInConnect with Army Sustainment on Facebook