Prioritizing interventions for preventing COVID-19 outbreaks in military basic training
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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.
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SciScore for 10.1101/2021.11.28.21266969: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:One limitation of our analysis is that we did not have detailed information on contact structure within training units. In the absence of this information, we made the simplifying assumption that everyone within a training unit had equal contact with everyone else. There are also details about sex segregation at certain stages of the basic training process that we did not consider and could affect contact patterns. Because contact heterogeneity …
SciScore for 10.1101/2021.11.28.21266969: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:One limitation of our analysis is that we did not have detailed information on contact structure within training units. In the absence of this information, we made the simplifying assumption that everyone within a training unit had equal contact with everyone else. There are also details about sex segregation at certain stages of the basic training process that we did not consider and could affect contact patterns. Because contact heterogeneity is thought to be a primary driver of individual heterogeneity in transmission (48), our model was not well-suited to addressing the potential role of superspreading in the basic training setting. In addition, there is also uncertainty regarding the extent and nature of contacts among trainees, trainers, and support staff. Because outbreak probability was strongly influenced by the probability of introductions by trainers and support staff, studies of the relative strength of trainee-trainee and trainer-trainee contacts could be important for refining understanding of outbreak risk in basic training settings. We also did not evaluate the potential impact of contact tracing in this setting. While contact tracing has proven effective in other settings (49), it may be difficult to implement effectively in this setting because the frequency and nature of contacts within a relatively large group make standard definitions of close contacts uninformative (50). There are uncertainties about some of our parameter values, such as mask effectivene...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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