Prioritizing interventions for preventing COVID-19 outbreaks in military basic training

PLoS Comput Biol. 2022 Oct 7;18(10):e1010489. doi: 10.1371/journal.pcbi.1010489. eCollection 2022 Oct.

Abstract

Like other congregate living settings, military basic training has been subject to outbreaks of COVID-19. We sought to identify improved strategies for preventing outbreaks in this setting using an agent-based model of a hypothetical cohort of trainees on a U.S. Army post. Our analysis revealed unique aspects of basic training that require customized approaches to outbreak prevention, which draws attention to the possibility that customized approaches may be necessary in other settings, too. In particular, we showed that introductions by trainers and support staff may be a major vulnerability, given that those individuals remain at risk of community exposure throughout the training period. We also found that increased testing of trainees upon arrival could actually increase the risk of outbreaks, given the potential for false-positive test results to lead to susceptible individuals becoming infected in group isolation and seeding outbreaks in training units upon release. Until an effective transmission-blocking vaccine is adopted at high coverage by individuals involved with basic training, need will persist for non-pharmaceutical interventions to prevent outbreaks in military basic training. Ongoing uncertainties about virus variants and breakthrough infections necessitate continued vigilance in this setting, even as vaccination coverage increases.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Cohort Studies
  • Disease Outbreaks / prevention & control
  • Humans
  • Military Personnel*

Grants and funding

This work was supported by the U.S. Department of Defense (DoD) Defense Health Program (DHP) Research, Development, Test, and Evaluation (RDT&E) funds appropriated to the Walter Reed Army Institute of Research (WRAIR) and was executed through a contract (No. W81XWH20C0072) between the U.S. Army Medical Research and Development Command and the University of Notre Dame (TAP). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.