Consular Affairs Medical Professionals Visa Announcement Adds to Chaos

 

Via March 27 DOS Briefing:

QUESTION: Thank you very much. Say, Ian, I wanted to ask you a question about this doctor visas thing that you have on your web page. Are you moving medical professionals who can work on COVID-19 treatments basically to the front of the line or speeding up their processing or give them – giving them some sort of preference? And what would you say to people who say you’re essentially trying to poach people and you’re encouraging a brain drain? Thank you.

MR BROWNLEE: We had – excuse – thank you, Carol, for that question. We had some – I’ve got to confess maybe what we put up on the web page is not as clear as it might have been. We’re ready to work with people who are already accepted into existing U.S. programs and had otherwise planned to travel to the United States. We are not going out looking for others. These are people who were ready to come in. What we’ve done is around the world we have suspended routine visa services, but we are – we have not shut down visa services. We’ve suspended routine visa services, and our posts overseas are ready to work with applicants who are – who were already identified as being eligible for these visas. Does that answer your question?
[…]
QUESTION: My question is that – can I actually just follow up on Carol’s question about the visas with regards to the medical professionals? Thank you for the clarification, and I appreciate you saying the initial tweet maybe wasn’t clear enough. Can you – based on what you just said, can we just say now that there is actually an exception to medical professionals who already have their jobs secured but they need their visa to be processed? So can we say that State Department is actually processing those visas, because at the moment all other visas are suspended? And can you elaborate a little bit more on the motivation to process those visas over others? Thank you.

MR WALTERS: [MED CROSSING TO CA LANE]
Well, let me clarify one point. All other visas are not suspended. They are not suspended. We have suspended routine visa services so that we can concentrate our efforts on assisting U.S. citizens. But all other visa services are by no means suspended. So for example, adoption visas. We are still processing visas for U.S. couples who are adopting children overseas. In some cases where there are immigrant visas where an applicant would be at risk of aging out under the law, we are still processing those visas. What we’ve done is substantially reduced our – the provision of visa services.

But let me just – for the sake of absolute clarity, I will read you the – what we are saying about these student – excuse me, about these doctors. The Department of State stands ready to work with doctors and other medical professionals who are already accepted into existing U.S. programs and otherwise expected to travel to the United States to work or study. Even though routine visa services are suspended, the Department and our post services are working to serve the most urgent visa applicants as resources and local government restrictions allow. We encourage medical professionals who already have an approved U.S. visa petition or certificate of eligibility in an approved exchange visitor program, particularly those working to treat or mitigate the effects of COVID-19, to consult with the relevant U.S. embassy or consulate to determine what services that post is currently able to provide. Over.

QUESTION: Hi there. I’m sorry, I’m still confused about this whole physician, medical professional visa thing. If in fact there’s no special treatment being given to them or you’re not specifically encouraging them, why did you put out this tweet or this statement that was also on the travel.state.gov? It wasn’t just a tweet. I don’t get it. It just seems to be – if there is no special treatment, it seems to be a bit tone deaf, considering this mad scramble that everyone else in the world is going through, and including in the U.S.

And then the other thing I’d just like to point out is for everyone else who got that fact sheet, which is great – thank you very much – but make sure you scroll down in the repatriation section, because you don’t see all of the countries at first, and I made that mistake just now. Anyway, thank you for doing this.

[…]
MR BROWNLEE: I’m sorry. Once again, I had mute pressed. Matt, I – what I said to myself here was I’m going to have to take the question as to how this all came to pass. But we are still processing visas around the world for certain cases. These are one, certain H-2As are another. But otherwise I’m happy to take that question. Thank you.

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US Embassy Turkmenistan Now on Ordered Departure For All USG Family Members Under 18

 

On March 27, 2020, the State Department issued a Level 3 Reconsider Travel Advisory for Turkmenistan. The advisory also announced the ordered, mandatory departure of  “all family members of U.S. government employees under the age of 18 in addition to the authorized departure of non-emergency personnel and family members of U.S. government employees due to stringent travel restrictions and quarantine procedures that affect commercial flights.”
See excerpt below:

Reconsider Travel to Turkmenistan due to the Global Health Advisory and Embassy Ashgabat’s limited capacity to provide support to U.S. citizens.

On March 27, 2020, the Department of State ordered the departure of all family members of U.S. government employees under the age of 18 in addition to the authorized departure of non-emergency personnel and family members of U.S. government employees due to stringent travel restrictions and quarantine procedures that affect commercial flights.

The Government of Turkmenistan has implemented enhanced screening and quarantine measures to reduce the spread of COVID-19.  All incoming international flights are being redirected to Turkmenabat, approximately 291 miles from Ashgabat.  Passengers will be required to undergo medical screening and possibly involuntary quarantine at local medical facilities.

Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice. Visit the website of U.S. Embassy Ashgabat for additional information on these new measures.

Medical protocols in Turkmenistan are not consistent with U.S. standards and some travelers have been required to undergo medical testing unrelated to COVID-19.  Consider declining any medical testing unrelated to COVID-19.

Due to the possibility of quarantine of unknown length, carry additional supplies of necessary medication in carry-on luggage.  Contact the U.S. Embassy if you are subject to quarantine or prior to undergoing any invasive medical testing or procedures.

Read the full announcement here.

Map via state.gov

Related posts:
Is @StateDept Actively Discouraging US Embassies From Requesting Mandatory Evacuations For Staff? #CentralAsia? #Worldwide? March 23, 2020
US Embassy Turkmenistan Now on Voluntary Departure For Non-Emergency USG Staffers/Family Members (March 9, 2020)

 

@StateDept Orders Evacuation of Designated USG Employees From US Embassy Baghdad, USCG Erbil, and BDSC

 

On March 26, the State Department updated its Iraq Travel Advisory, a Level 4 Do Not Travel to Iraq “due to terrorism, kidnapping, armed conflict, the Global Health Advisory, and Mission Iraq’s limited capacity to provide support to U.S. citizens.”
The updated advisory announced the mandatory departure of designated U.S. government employees from the U.S. Embassy in Baghdad, the Baghdad Diplomatic Support Center (BDSC), and the U.S. Consulate General in Erbil on March 25 “due to security conditions and restricted travel options as a result of the COVID-19 pandemic.”
Excerpt below:

U.S. citizens in Iraq are at high risk for violence and kidnapping. Numerous terrorist and insurgent groups are active in Iraq and regularly attack both Iraqi security forces and civilians. Anti-U.S. sectarian militias threaten U.S. citizens and Western companies throughout Iraq. Attacks by improvised explosive devices (IEDs) occur in many areas of the country, including Baghdad.

On March 25, 2020, the Department of State ordered the departure of designated U.S. government employees from the U.S. Embassy in Baghdad, the Baghdad Diplomatic support Center, and the U.S. Consulate General in Erbil due to security conditions and restricted travel options as a result of the COVID-19 pandemic. On December 31, 2019, the Embassy suspended public consular services, until further notice, as a result of damage done by Iranian-backed terrorist attacks on the Embassy compound. U.S. Consulate General Erbil remains open and continues to provide consular services. On October 18, 2018, the Department of State ordered the suspension of operations at the U.S. Consulate General in Basrah. That institution has not reopened. Due to security concerns, U.S. Embassy personnel in Baghdad have been instructed not to use Baghdad International Airport.

U.S. citizens should not travel through Iraq to Syria to engage in armed conflict, where they would face extreme personal risks (kidnapping, injury, or death) and legal risks (arrest, fines, and expulsion). The Kurdistan Regional Government stated that it will impose prison sentences of up to ten years on individuals who illegally cross the border. Additionally, fighting on behalf of, or supporting designated terrorist organizations, is a crime that can result in penalties, including prison time and large fines in the United States.

Read in full here.

US Mission Indonesia Now on Ordered Departure For All Family Members Under 21

 

On March 26, the State Department issued a new Travel Advisory for Indonesia, a Level 4 Do Not Travel advisory “due to the Global Health Advisory and Embassy Jakarta’s limited capacity to provide support to U.S. citizens.
It also announced the mandatory evacuation of all family members under 21 for US Mission Indonesia, including the US mission to ASEAN:

On March 25, the Department of State allowed for the Ordered Departure of all eligible family members (EFMs) under age 21 from Embassy Jakarta, Consulates Medan and Surabaya, and the U.S. Mission to ASEAN.

Commercial flight options may become limited, as well as decreased medical evacuation options from Indonesia. Indonesia’s health system has limited capacity to test for the virus causing COVID-19. Travelers should consider these factors and their health before traveling to Indonesia and follow the Centers for Disease Control’s guidelines for the prevention of coronavirus if they decide to travel.

Read the full advisory here.
Post’s March 20 Health Alert notes : “We understand that Indonesia’s health system has limited capacity to test for COVID-19 and to manage treatment of persons with COVID-19.[…] The government of Indonesia has implemented enhanced screening and quarantine measures to reduce the spread of COVID-19.  Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice. As of March 20, 2020, Indonesia has suspended entry for foreigners using visa exemption and visa on arrival.
Post’s March 17 Health Alert said, “The U.S. Embassy in Jakarta, Consulate General in Surabaya, and Consular Agency in Bali have implemented social distancing measures but remain open for Consular Services.” On March 20, it said, “The U.S. Mission in Indonesia has suspended routine consular services.”

COVID-19 Tracker: State Department and Foreign Service Posts (March 25 Update)

 

We originally created a tracker for COVID-19 cases for the State Department and our Foreign Service posts on March 21. We updated that post on March 22. (See Tracking COVID-19 Cases at State Department and Foreign Service Posts (Updated)).
Since Pompeo’s quip at a presser on March 17  that “We’ve had a couple of employees – count them on one hand – who have positive tests” we still don’t have official breakdown of numbers as to how many employees and family members have actually been infected, how many have recovered from the virus, or even how many were tested, or how many have been medically evacuated for COVID-19.
The last couple of days even with Senior State Department officials doing their “Special Briefing”, we still don’t have a good official count on numbers and places where there are positive, suspected, or quarantined staffers/family members due to COVID-19 cases.
On March 23, SSDO said:

“So the domestic numbers are easier to quantify just based on communications with posts abroad.  Obviously, this is a rapidly evolving situation, especially in the overseas environment. I can tell you we’re still at single digits here in the United States with cases – one each, two each, three each in Washington; Houston; Boston; New York; Quantico, Virginia; and Seattle.  So the numbers themselves are – overseas are still double-digit.  We’re looking at less than 30 scattered over 220 posts around the world, and it remains a challenge. Obviously, the – this type of outbreak, had we known earlier what the epidemiology was and had some of that data, perhaps we would have a better feel for how this was going to move across our overseas posts.  But we are keeping pace with it.  And again, the number at this point is less than 30.” 

In our updated COVID-19 tracker we are noting this info as “fuzzy math.”
On March 24, the SSDO was asked “out of the approximately 40 or so cases of COVID-positive people that you’ve got at State, how many are FSOs and how many are local staff?”.  SSDO responded:

“In terms of the cases that we’re following from the State Department’s perspective, I don’t have the precise breakdown in front of me of how many of our direct-hire employees versus local staff.  I certainly can get that information.  But again, it changes so rapidly that it’s – we just want to focus on the fact that we’re doing everything we can to take care of our people overseas, and for our local staff who are so important to our operations do what we can to facilitate their getting care in the local economy. ” 

On March 25, Dr. William Walters, Deputy Chief Medical Officer for Operations was one of the briefers and said:

So it’s important to remember that the State Department is about 75,000 – a 75,000-person workforce overseas. We’re tracking 58 current cases in our overseas workforce, spread across the – each – one to 11 cases – I’m sorry, 33 cases is the largest number in any particular regional bureau. But at 58 cases, that’s less than one in 1,000, and that’s a direct result of aggressive actions through the Bureau of Medical Services, through the chiefs of mission at post, and implementing social distancing and telework and all the things that the department has been working so hard at over the past several weeks. Domestically, we’re tracking 16 cases in five cities, the largest at just eight. So that’s 16 cases across thousands of employees. Again, the department has taken this very seriously, has implemented just the right non-pharmaceutical interventions to keep that workforce safe.

Tracker is not embeddable right now, so the links do not work; however, we have links as reference and can post separately, as needed.  The newest addition in the update below includes the cases in Madrid, which we were originally informed were 6 positive cases, and now are at reportedly 16 positive cases. Also includes the fuzzy accounting from the March 24 briefing on domestic cases, and the presumptive positive case at SA-1 per internal email on the night of March 24. After we updated the tracker, we saw the March 25 briefing with MED”s Walters and CA’s Brownlee. Walter mentions “tracking 58 current cases” with 33 cases as the highest in one unnamed regional bureau, plus 16 cases in five unidentified cities domestically (3/23 briefing notes six cities).
We think that the fuzziness is intentional. It is very likely that MED (perhaps even Ops) has detailed trackers internal to those offices and could provide a straight-forward breakdown like DOD, if they want to. We’re hearing complaints of “no central info on cases department wide”. As of March 25, based on official briefers, domestic cases went from single digits on 3/23 to 16 domestically; and less than 30 on 3/23 to 58 overseas.

 

DGHR Notifies HR Employees of Measures to Manage COVID-19 in SA-1  

 

We learned from two sources that State Department DGHR Carol Perez sent out an email notice to HR Employees on “Measures to Manage COVID-19 in SA-1 ” on the evening of March 24.  SA-1 is a State Department annex office located on E Street in Columbia Plaza A & B that includes multiple agency tenants like the HR (now GTM) bureau and the Bureau of Administration.

“GTM was notified today of a presumptive positive case of COVID-19 in SA-1.  The person has been out of the office since the close of business Thursday, March 19.”

The email went on to describe the measures the State Department has undertaken including the A bureau cordoning off “space on the floor where the person works for disinfection.” The DGHR’s email notified HR employees that MED and the Bureau of Administration supervised a vendor conducting “a deliberate and professional disinfection of those spaces.”
“The disinfected spaces will be safe for re-occupation tomorrow, March 25,” the DGHR writes. Her email also told employees that “Areas contiguous to those spaces (hallways, elevators) continue to be safe for use” and that  GTM (HR) “remains operational, and the rest of SA-1 remains open as a worksite. ”
The notice ends with a reminder that employees should be aware of CDC guidelines to limit the spread of COVID-19 and says that “ Employees should stay home and not come to work if they feel sick or have symptoms of illness.” Employees are also reminded if they are at work to “wash their hands frequently and employ social distancing” and that “Directorates and Offices should not engage in group events of 10 or more individuals at this time.”
DGHR’s closing line said “The health and safety of our employees remains our top priority.  Please take care of yourselves and each other.”
One source told us that the DGHR message was apparently sent only to those in the HR (GTM) bureau. Sender A asks:

“If someone working in HR was exposed, then, ostensibly, does that not mean that anyone else working in that same building (SA-1) might also have been exposed irrespective of whether or not they work for HR? Or that customers of that HR officer who visited SA-1 might’ve been? I mean, really? Are we REALLY stove piping info like this?!”

A second source told us that this was the approach the Consular Affairs bureau took in communicating about the positive case of COVID-19 in SA-17
We don’t know if the presumptive positive case is with HR or the A bureau, but if it’s the latter, it would be weird for HR employees to be notified but not the A bureau, hey?
The top official who says “The health and safety of our employees remains our top priority” can do better communicating information about COVID-19 cases within the State Department. We were informed that there is still “no central info on cases department-wide or measures individual embassies are taking to share best practices or information on gravity of situation.” Note that MED said it is tracking cases. See COVID-19 Tracker: State Department and Foreign Service Posts (March 25 Update).
We’re having a hard time understanding that. This is an agency that takes notes about everything but is unable to track this virus in domestic offices and overseas posts?
These are scary times, no doubt but remember the human. I often do yard work these days to keep my anxiety down or I won’t get anything done.  Different folks deal with anxieties, uncertainties and fears differently, except that it gets more difficult to do absent relevant needed information. Do folks really want to see rumors flying around the annexes? As often said, rumors express and gratify the emotional needs of the community. It occupies the space where that need is not meet, and particularly when there is deficient communication.
Valued employees deserve more.

 

US Embassy Lima Works on Repatriating Thousands of Americans #StuckInPeru

Updated: March 28, 9:45 am PDT

A Health Alert from US Embassy Lima in Peru notes that post is continuing its operations and is “coordinating with the Peruvian Government to arrange repatriation flights over the next few days for U.S. citizens to return to the United States.”
Post’s Alert issued on Tuesday said that “As of March 24, approximately 700 Americans have departed Peru on repatriation flights. It also announced the departure from post of Ambassador Urs, and the travel to Peru of Principal Deputy Assistant Secretary of State for Western Hemisphere Affairs Julie Chung  “to support our aggressive repatriation efforts.”

“For medical reasons, Ambassador Krishna Urs departed Peru on March 20.  He continues to engage from Washington with senior Peruvian officials as well as to support the Department’s efforts on behalf of the United States.”

As of 5:00PM on March 25, post said it has  repatriated over 1000 Americans from Peru.
In video below released by Embassy Lima, the Chargé d’Affaires Denison K. Offutt says that there are currently over 5,000 Americans in Peru. We don’t know if all of them are asking to return to the United States, but if so, this would be one of the largest evacuations of U.S. citizens from overseas at this time. This is not as huge as the nearly 15,000 evacuation from Lebanon in 2006 but the  logistics of moving a large number of people to the United States with border closures and limited air traffic during a pandemic will be extraordinarily challenging.
According to Embassy Lima, the Peruvian government declared a national state of emergency on March 15, 2020, at 8:00 PM Peru local time.  Under the state of emergency, Peru enacted 15 days of mandatory quarantine, starting at 00:00 on March 16, 2020.  At 23:59 PM on March 16, 2020, the Peruvian Government closed all international borders (land, air, and maritime) and suspended all interprovincial travel within Peru (land, air, and river).
Update from post indicates unusual difficulties with host country in obtaining permission for these repatriation flights . First, the Government of Peru told Ambassador Urs on March 23 that it had authorized repatriation flights, only for the contracted airline to notify the embassy at night that the flights are not approved. The following day, the Ministry of Foreign Affairs confirmed to US Embassy Lima that no U.S. flights had been approved. Ambassador Urs then spoke to the Peruvian Foreign Minister at 6:45 a.m., during which time, he was reportedly assured that the permissions would be granted in time. The Peruvian government ultimately declined to provide the proper clearances for a LATAM flight to pick up Americans stranded in Cusco.  A charter flight operated by American Airlines departed Miami with a scheduled arrival at 12:30 p.m.  Embassy Lima said that the Peruvian government also declined to approve permits for the charter flight, so the pilot returned the airplane to Miami.
Something’s going on there, hey?
During the March 25 Special Briefing, CA PDAS Ian Brownlee called the logjam “a capacity issue on the part of the Peruvian Government” and that the “information didn’t efficiently trickle down to the people in the regulatory agencies that had to issue the permits, the landing permits for the planes.”
Embassy Lima’s update on March 25 said  that there were two flights scheduled today, but these are “booked with humanitarian priority individuals, including older adults, people with underlying health conditions, minors traveling without a parent or legal guardian, and other adults in need of medical assistance.” Also that “the U.S. Embassy is scheduling additional flights for this week pending Peruvian government authorization.” As of March 25, Embassy Lima was able to get its first flight from Cusco to Miami (via Lima) and is reportedly scheduling a flight from Iquitos to Miami. So that’s good news.
Meanwhile, Foreign Affairs Minister François-Philippe Champagne confirmed that Canada received the go-ahead for 3 Air Canada flights to bring stranded Canadians home from Peru this week.
On March 21, Politico reported that a U.S. official familiar with the situation said the Peruvian government is not allowing Americans stuck in Peru to leave until the White House ensures thousands of Peruvians are given safe passage home.[…] “The government of Peru is basically holding these Americans hostage,” the U.S. official said. “They want the U.S. to fill planes with Peruvians before they’ll let the planes land to pick up Americans. But they’re not ready or organized in the United States to gather their people up, and they don’t want to pay for the flight.“
Could Peru wait this out or slow this down as Americans stuck in Peru fumes louder, and clogs congressional offices with complaints? Already Senator Rubio (R-Texas FL) has publicly scolded the State Department for Americans stuck in Peru “due to lack or (sic) urgency by some in mid-level of .”
Except that Peru apparently wants something from the White House not the State Department.
March 25 DOS Special Briefing with CA PDAS Ian Brownlee called the logjam in Peru a “capacity issue:”

The logjam there was a capacity issue on the part of the Peruvian Government. To reduce this to simplicity, we had commitment from the senior-most levels of the government – from the foreign minister, et cetera, the ministerial level – that yes, the flight yesterday Monday would be able to go forward – flights yesterday Monday would be able to go forward. That information didn’t efficiently trickle down to the people in the regulatory agencies that had to issue the permits, the landing permits for the planes, and so the American Airlines flight that was going into Lima literally turned around as it was preparing to enter Peruvian airspace because it didn’t have the permit necessary.

The difficulty arises there from the fact that there was some infections in the civil aviation authority and in the civilian side of the airport, and they just shut down that entire entity and they’re trying to run it on a bit of a shoestring from the military side of the airport. We’re helping them address this shortfall by – we’ve taken the INL, the International Narcotics and Law Enforcement hangar on the military side of the airport, taken everything out of it. We’re arranging chairs in there at socially distant appropriate spacing and we’re preparing to use that as a working space, a processing space to move people through. We’re also preparing to send down a flyaway team of consular officers and we have a senior officer from the Bureau of Western Hemisphere Affairs going down to assist as well. So we’re doing what we can to help the Peruvians fill that sort of capacity gap, and we hope – we hope – that this will keep things moving more fluidly in the future. Out.

#
Related post:
US Embassy Lima: Avianca Airlines May Have Outbound Flights For #StuckinPeru Americans

Evacuation Tracker: U.S. Foreign Service Posts (Updated March 24, 2020)

SSDO Special Briefing, March 24, 2020

“In an unprecedented move, the department has authorized departure from post for all employees abroad who are considered to be especially medically vulnerable to the consequences of COVID-19.  To date, we’ve also granted ordered departure and authorized voluntary departure to 17 posts and will continue to assess the need to grant more as time progresses. “

QUESTION:  [… ] And then secondly, I’m sure you’ve seen these reports that there are numerous embassies, or at least several embassies, where people are basically clamoring for order departure status, and that they are being discouraged from that.  Can you address that?

SENIOR STATE DEPARTMENT OFFICIAL:  Oh, no.  All help is appreciated.  On the second part of your question, Matt, so our embassies overseas have their emergency teams meet regularly to discuss the situation at post, and they have a process and procedure in place where they can really evaluate the transportation system, the healthcare system, and not just the status of COVID in the country.  And when they reach a certain point where they feel like, okay, maybe time to request authorized ordered departure, they submit a request to the undersecretary of management, and those are coming in regularly, and the undersecretary reviews them and then makes decisions on what to approve.  At this point, I think one of the biggest issues is the travel restrictions that countries are instituting around the world.

MODERATOR ONE:  If I could just add on to that, those decisions are made against a robust set of criteria and decisions made based to – based on a consistent set of principles, all which are geared towards maximizing the safety for our employees.

Senior State Department Official Special Briefing, March 23, 2020

QUESTION:  And do you have numbers on authorized departures and ordered departures?  How many people have taken you up on it so far?

SENIOR STATE DEPARTMENT OFFICIAL ONE:  We’ll have to take that question and get back to you.  I don’t have those numbers at my fingertips.  I apologize.

Related post:
March 23, 2020: U.S. Foreign Service Posts: Tracking Voluntary Departures and Mandatory Evacuations

@StateDept Official Touts “Robust Health Care System”, Talks BioFire FilmArray For COVID19 Testing at FS Posts

 

Via SSDO Special Briefing, March 24, 2020

QUESTION:  Hi, guys.  Following up a little bit about what Matt was talking about, when it comes to these embassies overseas, I want to clarify something we talked about yesterday.  It sounds to me like, for the moment, these staff members are completely reliant on local healthcare infrastructure for testing and treatment should they get ill.  Is that correct?  And are you planning to stand up any kind of medical capacity at these embassies or is the plan to just try to bring them home and treat them here if we need to?  Thank you.

SENIOR STATE DEPARTMENT OFFICIAL:  Okay.  Well, working overseas for the State Department or for any government agency in a country that may have poor medical resources has been challenging all along.  We have a process in place that generally we try and make sure that people with underlying medical conditions would only go to places where they have local resources that could take care of them.  Obviously COVID presents new challenges.

We do have, like I said earlier, a robust health care system, a medical program.  We have doctors, nurse practitioners, physician assistants, and nurses deployed at almost every mission around the world.  We rely also heavily on local staff that we employ in our health units.  And they’re the frontline.  I mean, they’ll see the patients first, whether it’s COVID, whether it’s anything else, and either provide care directly or to find the best local care available.

In COVID obviously, as health infrastructure overseas breaks down, it’s more of a challenge.  In terms of testing, we have up to now relied on local sources, local – maintain facilities for testing.  I’m not sure if we’ve actually sent back samples to the CDC in Atlanta, but that’s an option as well.  But I heard news today that there’s been approval for a use of a device called BioFire FilmArray, which is an apparatus that we actually have in a number of embassies overseas, so lab testing machines doesn’t require – it requires expertise, but it doesn’t require a special license to use.  And BioFire company just had their approval given for use of – for creation of a cartridge to test for COVID.  So going forward, we anticipate we’ll be able to do a lot more of our own monitoring and testing.  Thank you.

During the briefing, the SSDO said, “ COVID obviously, as health infrastructure overseas breaks down, it’s more of a challenge.”  True, but he did not really answer  the “is the plan to just try to bring them home and treat them here if we need to?” part of the question, did he? 
Also the maker of the BioFire® COVID-19 Test said on its website that it is yet to be submitted for Emergency Use Authorization in the second quarter of 2020, while the BioFire® Respiratory 2.1 Panel us expected to be submitted to the FDA for EUA in the third quarter of 2020:
BioFire® COVID-19 Test

In collaboration with the U.S. Department of Defense, BioFire Defense is developing a fully-automated, sample-to-result assay for the specific detection of SARS-CoV-2, the causative agent of COVID-19. This assay is designed to run on both the BioFire® FilmArray® 2.0 and BioFire® FilmArray® Torch Systems and will deliver results in about an hour. The BioFire COVID-19 Test is being developed on an accelerated timeline, with submission for Emergency Use Authorization (EUA) anticipated in Q2 of 2020.

BioFire® Respiratory 2.1 Panel

In parallel, BioFire Diagnostics is developing new SARS-CoV-2-specific assays for addition to the BioFire® FilmArray® Respiratory 2 (RP2) Panel. This new panel will be named the BioFire® Respiratory 2.1 (RP2.1) Panel and is being developed for both the BioFire® FilmArray 2.0 and BioFire® FilmArray Torch Systems. In addition to the detection of SARS-CoV-2, the BioFire RP2.1 Panel will detect 21 additional respiratory pathogens to help clinicians quickly rule in and rule out other common causes of respiratory illness in about 45 minutes. Development of the BioFire RP2.1 Panel is also occurring on an accelerated timeline, and submission to the FDA for EUA and 510(k) clearance is anticipated in Q3 of 2020.

In the meantime, SSDO also said, “In terms of testing, we have up to now relied on local sources, local – maintain facilities for testing.”
What happens in places where there is no local testing?

Is @StateDept Actively Discouraging US Embassies From Requesting Mandatory Evacuations For Staff? #CentralAsia? #Worldwide?

Updated: March 24, 12:54 am PDT

Updated: March 24, 2020 10:47 pm PDT

Updated March 26, 12:07 am PDT

SSDO Special Briefing, March 24, 2020

QUESTION:  [… ] And then secondly, I’m sure you’ve seen these reports that there are numerous embassies, or at least several embassies, where people are basically clamoring for order departure status, and that they are being discouraged from that.  Can you address that?

SENIOR STATE DEPARTMENT OFFICIAL:  Oh, no.  All help is appreciated.  On the second part of your question, Matt, so our embassies overseas have their emergency teams meet regularly to discuss the situation at post, and they have a process and procedure in place where they can really evaluate the transportation system, the healthcare system, and not just the status of COVID in the country.  And when they reach a certain point where they feel like, okay, maybe time to request authorized ordered departure, they submit a request to the undersecretary of management, and those are coming in regularly, and the undersecretary reviews them and then makes decisions on what to approve.  At this point, I think one of the biggest issues is the travel restrictions that countries are instituting around the world.

MODERATOR ONE:  If I could just add on to that, those decisions are made against a robust set of criteria and decisions made based to – based on a consistent set of principles, all which are geared towards maximizing the safety for our employees.

On March 19, we received an email from a post in Central Asia with the subject line: “Abandoned in Central Asia.” We learned that “after weeks of internal debate with Main State” authorized (voluntary) departure was finally approved for their Embassy on March 17. Apparently, last week, the Embassy’s Emergency Action Committee (EAC) also agreed that it was time to go OD”, that is, go on ordered departure, a mandatory evacuation from post except for emergency staffers. Note that the OD was not for suspension of operations.

Ordered Departures: Talking Ambassadors “out of it”

Sender A said that the Embassy’s EAC recommended “OD on Wednesday (March 18)” and then something happened. The South Central Asia (SCA) top bureau official reportedly “talked the AMB out of it.”  As to the rationale for this development, we were told that embassy employees were not informed. 
“We just know that on Sunday [March 15] EACs at two posts said they wanted OD” and by Monday, March 16, the respective chiefs of mission “had refused based on input” from the top bureau official, according to Sender A. 
So curious minds would like to know if these OD requests have actually been refused or if ambassadors were under pressure not to formally request it so the bureau will not have to refuse it in writing? Anyone know?
The frustrated employee writes: U.S. diplomats are now stuck in countries where U.S. citizens are specifically advised not to use local medical facilities and the Embassies only have small medical units for minor issues. Even if they’re needed, there are zero local hospital beds available. Best case, it sounds like multiple OIG complaints waiting to happen. But when did the administration’s image at home become more important than people’s lives? How much Swagger will SecState have when his people start dying?”

A Snapshot on Medical Facilities

We thought we’d checked the information on medical facilities for several countries in the region. For example, Turkmenistan is a Level 3 Reconsider Travel country. The State Department’s Travel Advisory says:
Medical protocols in Turkmenistan are not consistent with U.S. standards and some travelers have been required to undergo medical testing unrelated to COVID-19 including but not limited to HIV testing.  Consider declining any medical procedures including testing unrelated to COVID-19. Due to the possibility of quarantine of unknown length, carry additional supplies of necessary medication in carry-on luggage.”
According to Diplomatic Security’s 2020 Crime and Safety Report on Uzbekistan:
The country’s “health care system is not adequate to meet the needs of many serious emergencies. There is a lack of basic supplies and limited modern equipment. Emergency medicine is very basic. Some medication sold in local pharmacies may be counterfeit. Elderly travelers and those with pre-existing health problems may be at particular risk due to inadequate medical facilities. Most resident U.S. citizens travel to North America or Western Europe for their medical needs.”
Tajikistan’s “inadequate public healthcare infrastructure has given rise to private medical facilities offering varying degrees of quality care in some specialties. Also:
“Medical first responders (ambulance crews) do not meet Western standards, and are not widely available, likely poorly equipped, and often poorly trained.”
On Kyrgyzstan: Medical care is often inadequate in the country.
 “There is a shortage of basic medical supplies. Health care resources are limited and often below U.S. standards. Doctors and medical industry staff rarely speak English, and prices for treatment are not fixed. Use a translator or Russian/Kyrgyz speaking friend or family member to assist with medical treatment. U.S. citizens often travel outside of Kyrgyzstan for medical treatment, including most routine procedures.”
In Kazakhstan, medical care options are limited and well below U.S. standards.
“U.S. citizens often depart Kazakhstan for medical treatment, including many routine procedures. Serious long-term care is not a viable option in Nur-Sultan.”

An Ambassador’s Town Hall Meeting

Last Friday, a U.S. Ambassador at a post in South Central Asia held a town hall for embassy employees; held outdoors on the steps of the Embassy, we were told. 
The U.S. Ambassador, citing what he was told by the top SCA bureau official, informed embassy employees the following (provided to us in direct quotes by Sender A):
  • “Ambassador, you need to understand the United States is the red zone, it is not the safe haven that you think it is.”
  • “The U.S. has the highest number of COVID-19 cases per capita in the world.”
  • “It has not peaked in the United States, incidents are rising rapidly, it is out of control.”
  • “The ability to get a test for COVID-19 even with symptoms or comorbidities is extremely difficult.”
  • “The healthcare infrastructure of the United States is not capable of helping.”
This ambassador reportedly further told embassy employees that “500,000 Americans are overseas seeking assistance for getting home.” And that “We are taking down the American economy to fight this enemy.”

(March 25 Special Briefing with CA PDAS Ian Brownlee: “Our posts around the world have received requests for assistance with getting back to the United States from over 50,000 U.S. citizens and we’re committed to bring home as many Americans as we possibly can.”  Wowow!

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