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Report | March 31, 2021

Audit of Public Health Emergency Readiness at Military Installations (DODIG-2021-070)


Publicly Released: April 2, 2021



The objective of this audit was to determine whether military installation commanders implemented measures to prepare for public health emergencies, and respond to and recover from the coronavirus disease–2019 (COVID-19) pandemic, on DoD installations.



DoD guidance defines a public health emergency (PHE) as an occurrence or imminent threat of an illness or health condition that poses:

  • high probability of a significant number of deaths in the affected population, considering the severity and probability of the event;
  • widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people;
  • health care needs that exceed available resources; or
  • severe degradation of mission capabilities or normal operation.

PHEs can be caused by various events, including industrial accidents, the release of a biological toxin, and the spread of a novel infectious disease, such as COVID-19. COVID-19 is an infectious disease that can cause a wide spectrum of symptoms. On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic, and on March 13, 2020, the President declared the COVID-19 pandemic a national emergency.

Military installation commanders (commanders) must be prepared to make timely decisions to protect lives, property, and infrastructure and sustain mission-critical operations and essential services during a PHE, such as the COVID-19 pandemic.

DoD guidance provides commanders with policies and procedures for preparing for and responding to a PHE. According to the guidance, commanders must designate public health emergency officers to provide guidance and recommendations on preparing for, declaring, responding to, mitigating, and recovering from PHEs. Commanders are responsible for directing public health emergency officers to investigate PHEs on the installations and recommend mitigation or control measures.



Commanders at the eight installations we reviewed implemented measures to prepare for PHEs, and respond to and recover from the COVID-19 pandemic. Commanders:

  • prepared for PHEs to maintain readiness. For example, commanders designated public health emergency officers, ensured public health emergency officers were trained, created Emergency Management plans, and conducted annual PHE exercises such as the Disease Containment Tabletop Exercise for a novel virus.
  • took actions to control and prevent the spread of COVID-19. For example, commanders evaluated the COVID-19 health threat, and four of eight commanders at the installations we reviewed declared a PHE. PHE declarations outlined the situation and actions in response to the PHE. All eight commanders issued and communicated guidance, such as base access and social distancing guidelines to installation personnel and visitors through memorandums, website postings, and virtual town halls, to protect individuals and help prevent the spread of the disease.
  • planned to recover from the COVID-19 pandemic and return to full mission operations. For example, all eight commanders developed and implemented recovery guides or return-to-work plans, specific to COVID-19, identifying procedures to protect personnel, perform vital missions, and support the local community under a phased approach. Commanders also implemented the health protection condition framework on installations to inform individuals of specific recommended health protection actions.

As a result of the measures that commanders implemented to prepare for PHEs, and respond to and recover from the COVID-19 pandemic, installation personnel protected lives and sustained mission-critical operations.


This report is the result of Proj. No. D2020-D000RG-0146.000.

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