COVID-19 outbreaks in military populations threaten force health and readiness, and basic training presents particular challenges. A new publication co-authored by WRAIR scientists and posted on the preprint server medRxiv outlines improved strategies for preventing outbreaks during basic training, emphasizing the need for customized approaches in unique settings.
Because new recruits are generally young and healthy adults, they may be more prone to mild or asymptomatic infection, and basic training requires them to live and train in proximity. A third challenge is that testing upon entry to basic training can miss infections acquired shortly before arrival.
Using a simulation model based on data from two real-life Army base COVID-19 outbreaks, researchers assessed the effectiveness of four hypothetical interventions in reducing the probability and size of outbreaks in this setting:
- reducing introductions by trainers and support staff
- increasing rounds of arrival testing of trainees
- increasing compliance with wearing face masks and practicing physical distancing
- increasing immunity among trainees through pre-arrival vaccination
Introductions to trainers and support staff were a significant point of vulnerability in the model. Whereas trainees enter the training post once and are tested upon arrival, trainers and staff come and go daily and have a much greater chance of becoming infected at some point during training. Trainees receiving a false positive test result upon arrival also posed a risk, resulting in healthy trainees being isolated among those with COVID infections.
Researchers concluded that, until vaccine uptake reaches high coverage among individuals involved with basic training, non-pharmaceutical interventions will be necessary to prevent outbreaks in military basic training. Customized strategies could prove effective in other specialized circumstances as well.