1
|
Ndiaye SM, Dembélé DS, Lo M, Fané A, Diagne FM, Dembélé KK, Fall K, Djiba MN, Ndiaye S, Diallo TS. Military affected by the first wave of COVID-19 in Senegal: stress and resilience factors during care. Pan Afr Med J 2024; 47:53. [PMID: 38646131 PMCID: PMC11032076 DOI: 10.11604/pamj.2024.47.53.36263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 02/04/2024] [Indexed: 04/23/2024] Open
Abstract
COVID-19 had a psychological impact on the population, particularly those affected. Our objective was to investigate stress and resilience factors in the Senegalese soldiers affected during the first wave of COVID-19. Our retrospective and qualitative study included military personnel listed as contacts, suspects, or positive cases and supported by the Armed Forces Psychological Support Program during the period of isolation. The stress factors were health-related, sociological, and occupational. The conditions and the experience of isolation, stigmatization, and suspension of their professional projects were concerns for the soldiers. They had relied on personal, familial, and professional resources to cultivate resilience during the quarantine. Isolation during the pandemic showed psychological consequences, the foundations of which have been found in our study.
Collapse
Affiliation(s)
- Serigne Modou Ndiaye
- Psychiatric Service, Army Training Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | - Diambéré Séga Dembélé
- Psychiatric Service, Army Training Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | - Moustapha Lo
- Psychiatric Service, Army Training Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | - Adama Fané
- Psychiatric Service, Army Training Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | | | | | - Khadim Fall
- Psychiatric Service, Army Training Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | | | | | - Tabara Sylla Diallo
- Psychiatric Service, Army Training Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| |
Collapse
|
2
|
Griffith RL, Dostal C, Moon NA, Fedele D. The COVID-19 pandemic and the military: Lessons learned for readiness and resilience. MILITARY PSYCHOLOGY 2023; 35:377-382. [PMID: 37615556 PMCID: PMC10464645 DOI: 10.1080/08995605.2023.2237392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
|
3
|
Akavian I, Nitzan I, Talmy T, Nitecki M, Gendler S, Besor O. SARS-CoV-2 Omicron Variant: Clinical Presentation and Occupational Implications in Young and Healthy IDF Soldiers. Mil Med 2023; 188:e1552-e1557. [PMID: 36056686 PMCID: PMC9494320 DOI: 10.1093/milmed/usac263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/29/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION To this date, there is little known about the symptoms, their duration, and occupational implications of Coronavirus disease (COVID-19) in the military population. Decisions regarding implementing precaution measures are based on data deriving from the general population. Moreover, the Omicron variant seems to cause a disease with lesser severity than previous variants. We aimed to describe the clinical presentation and estimate the loss of workdays due to mild COVID-19 during an Omicron predominant wave among a young, healthy, and mostly vaccinated military population. MATERIALS AND METHODS A cross-sectional, survey-based study among IDF soldiers who replied to an online questionnaire following recovery from COVID-19. Data included self-reported vaccination status, symptoms presentation and duration, and service-related sick days. Student's t-test and chi-square test of independence were used to compare differences in continuous and categorical variables, respectively. A binary logistic regression analysis was performed to estimate the odds ratio and 95% CIs for prolonged symptom duration (4 days and above) by participants' characteristics. The IDF medical corps institutional review board approved this study. RESULTS A total of 199 soldiers, with a mean age of 21.9 years, were included in the study. Upper respiratory tract symptoms, headache, and constitutional symptoms were found to be the most common among symptomatic soldiers. The median reported time for inability to continue the daily routine, including work, was 5 days [Interquartile range (IQR), 0-10]. Median duration of symptoms was 4 days (IQR, 0-10). In addition, women were found to have longer symptomatic disease (odds ratio = 2.34; 95% CI, 1.20-4.52). CONCLUSIONS Our findings demonstrate that even among a young and fully vaccinated population, COVID-19 caused by the Omicron variant may result in substantial medical leave from military service, compared to common cold or influenza virus infection. Our study sample was relatively small; however, the response rate was high and our results shed light on the yet-to-be fully characterized Omicron variant-related COVID-19. Despite the current common perception of COVID-19 as a self-limiting mild disease with low burden of symptoms, our findings show the potential occupational burden of infection with COVID-19 on military units and their readiness and could be considered when discussing public health restrictions and further steps taken to minimize outbreaks ramifications.
Collapse
Affiliation(s)
- Inbal Akavian
- Medical Corps, Israel Defense Forces, Ramat Gan 02149, Israel
| | - Itay Nitzan
- Medical Corps, Israel Defense Forces, Ramat Gan 02149, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem 9574869, Israel
| | - Tomer Talmy
- Medical Corps, Israel Defense Forces, Ramat Gan 02149, Israel
| | - Maya Nitecki
- Medical Corps, Israel Defense Forces, Ramat Gan 02149, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem 9574869, Israel
| | - Sami Gendler
- Medical Corps, Israel Defense Forces, Ramat Gan 02149, Israel
| | - Omri Besor
- Medical Corps, Israel Defense Forces, Ramat Gan 02149, Israel
| |
Collapse
|
4
|
Šuljagić V, Đurić-Petković D, Lazić S, Mladenović J, Rakonjac B, Opačić D, Ljubenović N, Milojković B, Radojević K, Nenezić I, Rančić N. Epidemiological Predictors of Positive SARS-CoV-2 Polymerase Chain Reaction Test in Three Cohorts: Hospitalized Patients, Healthcare Workers, and Military Population, Serbia, 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3601. [PMID: 36834297 PMCID: PMC9967496 DOI: 10.3390/ijerph20043601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resulting coronavirus disease 2019 (COVID-19) has caused a fast-moving pandemic. Diagnostic testing, aimed to identify patients infected with SARS-CoV-2, plays a key role in controlling the COVID-19 pandemic in different populations. (2) Methods: This retrospective cohort study aimed to investigate predictors associated with positive polymerase chain reaction (PCR) SARS-CoV-2 test results in hospitalized patients, healthcare workers (HCWs), and military personnel (MP) during 2020, before the widespread availability of COVID-19 vaccines. Persons with a positive test result were compared with persons with a negative test result in three cohorts during the study period. (3) Results: A total of 6912 respondents were tested, and 1334 (19.3%) of them had positive PCR SARS-CoV-2 test results. Contact with a known COVID-19 case within 14 days (p < 0.001; OR: 1.48; 95% CI: 1.25-1.76), fever (p < 0.001; OR: 3.66; 95% CI: 3.04-4.41), cough (p < 0.001; OR: 1.91; 95% CI: 1.59-2.30), headache (p = 0.028; OR: 1.24; 95% CI: 1.02-1.50), and myalgia/arthralgia (p < 0.001; OR: 1.99; 95% CI: 1.65-2.42) were independently associated with positive PCR SARS-CoV-2 test results in the cohort of MP. Furthermore, fever (p < 0.001; OR: 2.75; 95% CI: 1.83-4.13), cough (p < 0.001; OR: 2.04; 95% CI: 1.32-3.13), headache (p = 0.008; OR: 1.76; 95% CI: 1.15-2.68), and myalgia/arthralgia (p = 0.039; OR: 1.58; 95% CI: 1.02-2.45) were independently associated with positive PCR SARS-CoV-2 test results in the cohort of HCWs. Moreover, independent predictors of positive PCR SARS-CoV-2 test results in hospitalized patients were contact with a known COVID-19 case within 14 days (p < 0.001; OR: 2.56; 95% CI: 1.71-3.83), fever (p < 0.001; OR: 1.89; 95% CI: 1.38-2.59), pneumonia (p = 0.041; OR: 1.45; 95% CI: 1.01-2.09), and neurological diseases (p = 0.009; OR: 0.375; 95% CI: 0.18-0.78). (4) Conclusions: According to data gathered from cohorts of hospitalized patients, HCWs, and MP, before the widespread availability of COVID-19 vaccines in Serbia, we can conclude that predictors of positive PCR SARS-CoV-2 test results in MP and HCWs were similar. Accurate estimates of COVID-19 in different population groups are important for health authorities.
Collapse
Affiliation(s)
- Vesna Šuljagić
- Department of Healthcare-Related Infection Control, Military Medical Academy, 11000 Belgrade, Serbia
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
| | | | - Srđan Lazić
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Jovan Mladenović
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Bojan Rakonjac
- Institute of Microbiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Dolores Opačić
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Nenad Ljubenović
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Biljana Milojković
- Institute of Epidemiology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Katarina Radojević
- Torlak Institute of Virology, Vaccines, and Serums, 11000 Belgrade, Serbia
| | - Ivana Nenezić
- Department of Healthcare-Related Infection Control, Military Medical Academy, 11000 Belgrade, Serbia
| | - Nemanja Rančić
- Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
- Centre for Clinical Pharmacology, Military Medical Academy, 11000 Belgrade, Serbia
| |
Collapse
|
5
|
Segal D, Arzi YI, Bez M, Cohen M, Rotschield J, Fink N, Karp E. Promoting Compliance to COVID-19 Vaccination in Military Units. Mil Med 2022; 187:e1389-e1395. [PMID: 33959759 PMCID: PMC8135994 DOI: 10.1093/milmed/usab183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/10/2021] [Accepted: 04/27/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND On December 27th, 2020, the Israeli Defense Forces initiated a mass COVID-19 vaccination campaign aiming to vaccinate its personnel. This population upheld specific characteristics in terms of age and sex, lack of significant comorbidities, and a general scarcity of risk factors for sustaining a severe COVID-19 illness. We present the measures taken to increase vaccination compliance, and the vaccination rate that followed these actions. Our secondary goal was to compare between vaccination rates in frontline battalions and highly essential military units (group A) and rear administration and support military units (group B). METHODS This was a retrospective review that included 70 military units that were composed of 18,719 individuals of both sexes, mostly free of significant comorbidities. We divided the challenges of maximizing vaccination rates into two main categories: vaccine compliance (including communication and information) and logistical challenges. We compared the vaccination rates in groups A and B using a multivariable linear regression model. A P-value of .05 was considered significant. RESULTS The mean age in 70 military units was 22.77 ± 1.35 (range 18-50) years, 71.13% males. A total of 726 (3.88%) individuals have been found positive for SARS-CoV-2 between March 1st, 2020 and February 18th, 2021. On February 18th, 2021, 54 days after the vaccination campaign was launched, 15,871 (84.79%) of the study population have been vaccinated by the first dose of Pfizer COVID-19 vaccine, expressing an 88.21% compliance rate (excluding recovered COVID-19 cases who were not prioritized to be vaccinated at this stage). Vaccination compliance in military units from group A was found to be higher when compared to group B (P < .001), leading to a 90.02% of group A population being either previously SARS-CoV-2 positive or COVID-19 vaccinated. CONCLUSIONS A designated army campaign led by a multidisciplinary team could rapidly achieve a high COVID-19 vaccination rate. The information presented can serve organizations worldwide with similar characteristics that plan a mass COVID-19 vaccination campaign.
Collapse
Affiliation(s)
- David Segal
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
- The Department of Orthopedic Surgery, Meir Medical Center, Affiliated with the School of Medicine, Tel Aviv University, Kfar Saba 4435757, Israel
| | - Yonatan Ilibman Arzi
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
| | - Maxim Bez
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
| | - Matan Cohen
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
| | - Jacob Rotschield
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
| | - Noam Fink
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
| | - Erez Karp
- Israeli Defense Forces Medical Corps, Affiliated with the Hebrew University of Jerusalem, Tel Hashomer 526000, Israel
| |
Collapse
|
6
|
Cho UJ, Wang S, Yi S, Choi YH, Kim EY, Kim JA, Bae S, Yu J, Choi J, Park YJ. Characteristics of COVID-19 outbreaks and risk factors for transmission at an army training center in South Korea from June to August 2021. Osong Public Health Res Perspect 2022; 13:263-272. [PMID: 36097748 PMCID: PMC9468682 DOI: 10.24171/j.phrp.2022.0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022] Open
|
7
|
SARS-CoV-2 Transmission in the Military during the Early Phase of the Pandemic-A Systematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127418. [PMID: 35742662 PMCID: PMC9224230 DOI: 10.3390/ijerph19127418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
Militaries worldwide have been affected by COVID-19 pandemic. However, the impact and epidemiological characteristics of transmission during the early phase of the pandemic is not well-studied. This study aims to systematically estimate the baseline incidence of COVID-19 in the military worldwide and identify the potential risk factors of transmission and clinical characteristics of the cases. English and Chinese literature reporting COVID-19 cases in military worldwide published on four electronic databases (PubMed, Scopus, EMBASE, and CKNI) through 28 May 2021 were systematically screened and synthesized qualitatively. Forty-six studies involving at least 711,408 military personnel in 17 countries were synthesized. Low incidence of cases was observed in the military with pooled COVID-19 incidence of 0.19% (95%CI: 0.00–9.18%). We observed a higher incidence among those (1) with overseas exposure (39.85%; 95%CI: 0.00–95.87%) rather than local exposure (3.03%; 95%CI: 0.00–12.53%), (2) who were on either local/overseas military deployment (26.78%; 95%CI: 0.00–71.51%) as compared to those not deployed (4.37%; 95%CI: 0.00–17.93%), and (3) on overseas military deployment (39.84%; 95%CI: 0.00–95.87%) as compared to local military deployment (3.03%; 95%CI: 2.37–3.74%). The majority of the cases were symptomatic (77.90% (95%CI: 43.91–100.00%)); hospitalization and mortality rates were low at 4.43% (95%CI: 0.00–25.34%) and 0.25% (95%CI: 0.00–0.85%), respectively; and headache, anosmia, ageusia, myalgia, nasal congestion, and cough were the most commonly observed symptoms. Overseas and local deployment were observed to have higher risk of SARS-CoV-2 transmission. Sustainable, active SARS-CoV-2 surveillance strategies are crucial to detect and contain transmission early during military deployments.
Collapse
|
8
|
Duque MC, Correa-Cárdenas CA, Londoño-Méndez S, Oliveros C, Pérez J, Daza CD, Albarracin L, Márquez EK, Alvarado MT, Ortíz FDLS, Romero Y, Gutierrez-Riveros S, Méndez C. Epidemiological Indicators of SARS-CoV-2 (COVID-19) and Vaccination Effectiveness on the Report of Positive Cases in the Colombian Army. Front Med (Lausanne) 2021; 8:791761. [PMID: 34957159 PMCID: PMC8695765 DOI: 10.3389/fmed.2021.791761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
The description of the epidemiological indicators of SARS-CoV-2 (COVID-19), such as the mortality rate (MR), the case fatality rate (CFR), and the attack rate (AR), as well as the geographical distribution and daily case reports, are used to evaluate the impact that this virus has had within the Colombian Army and its health system. As military forces around the world represent the force that defends sovereignty, independence, the integrity of the national territory, and the constitutional order, while maintaining migration controls in blocked border areas during this critical pandemic times, they must carry out strict epidemiological surveillance to control the situation among the servicemen. Up to date, the Colombian Army has faced a very high attack rate (AR = 8.55%) due, among others, to living conditions where active military personnel share bedrooms, bathrooms, and dining facilities, which facilitate the spread of the virus. However, being a mainly young and healthy population, the MR was 1.82 deaths/1,000 ha, while the CFR = 2.13% indexes consistently low if compared with those values reported for the national population. In addition, the effectiveness of vaccination is shown in daily cases of COVID-19, where, for the third peak, the active military population presented a decrease of positive patients compared to the dynamics of national transmission and the total population of the military forces (active, retired, and beneficiaries).
Collapse
Affiliation(s)
- Maria Clara Duque
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Camilo A Correa-Cárdenas
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Sebastián Londoño-Méndez
- Semillero Observatorio para la contención del COVID-19 en América Latina, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Oliveros
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Julie Pérez
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Carlos D Daza
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Lorena Albarracin
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia.,Trainee Field Epidemiology Training Program (FETP), Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), Bogotá, Colombia
| | - Elizabeth K Márquez
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Maria T Alvarado
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Frank De Los Santos Ortíz
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Yanira Romero
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Sergio Gutierrez-Riveros
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| | - Claudia Méndez
- Laboratorio de Referencia e Investigación, Grupo de Investigación en Enfermedades Tropicales del Ejército (GINETEJ), Dirección de Sanidad Ejército, Bogotá, Colombia
| |
Collapse
|
9
|
Higginson JD, Tumin D, Kuehhas TC, DeLozier-Hooks SE, Powell CA, Ramirez DD, Dabelić A, Basso MR. COVID-19 Vaccine Hesitancy Among Deployed Personnel in a Joint Environment. Mil Med 2021; 188:e32-e36. [PMID: 34897473 PMCID: PMC9383089 DOI: 10.1093/milmed/usab518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/12/2021] [Accepted: 12/01/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION In the United States, vaccine hesitancy has been identified as a major barrier to vaccination against COVID-19, but attitudes toward COVID-19 vaccination among military personnel are not well understood. We evaluated the prevalence and correlates of COVID-19 vaccine consent or refusal among deployed personnel in a joint environment. MATERIALS AND METHODS Deidentified data were retrospectively extracted from the electronic medical record of the Military Health System in May 2021. All personnel currently assigned to the deployment area of operations were included in the analysis if their choice to receive the vaccine was known. Personnel characteristics were compared by vaccine acceptance status using chi-square tests, Fisher's exact tests, or correlation coefficients. This analysis was exempted from Institutional Review Board review. RESULTS The sample included 1,809 individuals, primarily members of the Army (72%) and members of Reserve (53%) or National Guard (27%) units. In the overall sample, 61% accepted the vaccine, with vaccine acceptance rates being lowest among Black or African American personnel (54%; P = .03 for comparison across racial groups) and members of Reserve or National Guard units (59%; P < .001 for comparison by component). No differences in vaccine acceptance were found according to sex or health status (including prior COVID-19 infection). CONCLUSIONS Overall vaccine acceptance was greater among deployed military personnel than that reported in the U.S. population as a whole. However, lower vaccine acceptance among personnel from marginalized populations suggests a need to ensure that all service members have sufficient opportunities to have a frank and ongoing discussion with health care providers to address concerns related to vaccination. Additionally, lower vaccine acceptance among Reserve and National Guard personnel indicates a need for innovative educational approaches to counter vaccine hesitancy in the premobilization phase of deployment.
Collapse
Affiliation(s)
- Jason D Higginson
- Office of the Dean Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA
| | - Dmitry Tumin
- Office of the Dean Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA
| | | | | | | | | | | | - Michael R Basso
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55902, USA
| |
Collapse
|
10
|
Oh TH, Baeck JH, Lee SR, Park DS, Yu YD. The Prevalence of Sexually Transmitted Infections and Sociosexual Behaviors in the South Korean Military Before and During the COVID-19 Pandemic. Mil Med 2021; 188:e1285-e1292. [PMID: 34791363 PMCID: PMC8690001 DOI: 10.1093/milmed/usab479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/01/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction This study evaluated the epidemiological factors of sexually transmitted infections (STIs) among South Korean troops including the prevalence, therapeutic methods, and sexual risk behaviors. Material and Methods The medical records of the STIs diagnosed troops at the Armed Forces Capital Hospital (AFCH) for 36 months (between January 2018 and December 2020) were retrospectively reviewed. The data collection for the study began after obtaining research approvals from the institutional ethics committee of AFCH. The patients were classified into two subgroups, pre-coronavirus disease 2019 (COVID-19) and COVID-19 groups. The clinical parameters of the patients including STI-related symptoms and underlying diseases were analyzed. The sociosexual conduct of the two study groups was evaluated and compared by using a survey questionnaire. Results Overall, 138 STI patients with mean age of 21.2 years were included (pre-COVID-19: 106 patients/COVID-19: 32 patients). 32.6% of the patients received college education before the military service. Regarding previous history of STIs, 24 patients (17.4%) had previous experience of STIs, which occurred before participation in the current study. Initial urine analysis results showed that 95 (68.8%) and 79 patients (57.2%) showed pyuria and bacteriuria, respectively. Neisseria gonorrhoeae (29.7%) was the most commonly identified pathogen. Each pathogen was treated with the therapies recommended by the current treatment guidelines, and no patient showed any recurrence of the disease during follow-up. Both pre-COVID-19 (91.5%) and COVID-19 (93.8%) groups showed high rates of binge drinking during off-duty. The pre-COVID-19 group had a greater number of patients (21.7%) having multiple sex partners (during the past 12 months) than the COVID-19 group (15.6%). The COVID-19 group had 18.8% of the troops involved in sexual activity even after the onset of STI-related clinical symptoms, whereas the rate was significantly higher than 2.8% of the pre-COVID-19 group (P = .001). The COVID-19 groups showed a significantly higher number of patients (four patients, 12.5%) experiencing suicidal ideation than the pre-COVID-19 group (two patients, 1.9%) (P = .010). Both groups showed <40% of condom use rates at the last sexual intercourse. Conclusion The soldiers with STIs showed high rates of binge alcohol consumption, while the rates of engaging in safe sex by using condoms are markedly low. Although the COVID-19 group was under influence of social distancing and military base lockdown, the soldiers’ sociosexual conduct was not significantly different in the pre-COVID-19 group. The importance of education on alcohol misuse and safe sexual relationships should be taken more seriously within the military.
Collapse
Affiliation(s)
- Tae Hoon Oh
- Department of Urology, College of Medicine, CHA University, Bundang CHA Hospital, Seongnam, Korea.,Department of Urology, Armed Forces Medical Command, Armed Forces Capital Hospital, Seongnam, Korea
| | - Jong Hyun Baeck
- Department of Urology, College of Medicine, CHA University, Bundang CHA Hospital, Seongnam, Korea
| | - Seung Ryeol Lee
- Department of Urology, College of Medicine, CHA University, Bundang CHA Hospital, Seongnam, Korea
| | - Dong Soo Park
- Department of Urology, College of Medicine, CHA University, Bundang CHA Hospital, Seongnam, Korea
| | - Young Dong Yu
- Department of Urology, College of Medicine, CHA University, Bundang CHA Hospital, Seongnam, Korea
| |
Collapse
|
11
|
Kim C, Kim YM, Heo N, Park E, Choi S, Jang S, Kim N, Kwon D, Park YJ, Choi B, Ha B, Jung K, Park C, Park S, Lee H. COVID-19 Outbreak in a Military Unit in Korea. Epidemiol Health 2021; 43:e2021065. [PMID: 34525497 PMCID: PMC8689117 DOI: 10.4178/epih.e2021065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/08/2021] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES This study presents the response of a military unit to the COVID-19 outbreak in Gyeonggi Province. As soon as two soldiers were identified as index cases, the infectious disease investigators of the Gyeonggi Provincial Government, Korea Disease Control and Prevention Agency and the Armed Forces Epidemiologic Investigation Center, discussed the investigation and response plan for an imminent massive outbreak. METHODS The joint immediate response team (IRT) conducted interviews with confirmed patients with COVID-19, reviewed medical records, performed contact tracing using global positioning system (GPS), and undertook a field investigation. For risk assessment, the joint IRT visited all eight sites of the military units and the army chaplain's church to evaluate the transmission risk of each site. The evaluation items included the size of the site, the use of air conditioning, whether windows were opened, and whether masks were worn. A pooled testing was used for a low-risk population to quickly detect the spread of COVID-19 in the military base. RESULTS A day before the symptom onset of the index case, the lecturer and >50% of the attendees were infected with COVID-19 while attending a lecture that lasted 2 h and 30 min. Attendees were not wearing masks and were in a poorly ventilated room. CONCLUSION Since the disease can be spread before symptom onset, contact tracing must be performed to investigate potential exposures prior to symptom onset and manage any exposed persons.
Collapse
Affiliation(s)
- Chanhee Kim
- Infectious Disease Control Center, Gyeonggi Provincial Government, Suwon, Korea
| | - Young-Man Kim
- Central Disease Control Headquarters, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Namwoo Heo
- Infectious Disease Control Center, Gyeonggi Provincial Government, Suwon, Korea
| | - Eunjung Park
- Infectious Disease Control Center, Gyeonggi Provincial Government, Suwon, Korea
| | - Sojin Choi
- Infectious Disease Control Center, Gyeonggi Provincial Government, Suwon, Korea
| | - Sehyuk Jang
- Central Disease Control Headquarters, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Nayoung Kim
- Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul, Korea
| | - Donghyok Kwon
- Central Disease Control Headquarters, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young-Joon Park
- Central Disease Control Headquarters, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Byeongseop Choi
- Republic of Korea Armed Forces Medical Command, Korea Army, Seongnam, Korea
| | - Beomman Ha
- Republic of Korea Army Headquarters, Korea Army, Gyerong, Korea
| | - Kyounghwa Jung
- Republic of Korea Army Headquarters, Korea Army, Gyerong, Korea
| | - Changbo Park
- Republic of Korea Armed Forces Epidemiologic Investigation Center, Korea Army, Seongnam, Korea
| | - Sejin Park
- Republic of Korea Armed Forces Medical Command, Korea Army, Seongnam, Korea
| | - Heeyoung Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
12
|
Pirnay JP, Selhorst P, Hong SL, Cochez C, Potter B, Maes P, Petrillo M, Dudas G, Claes V, Van der Beken Y, Verbeken G, Degueldre J, Dellicour S, Cuypers L, T’Sas F, Van den Eede G, Verhasselt B, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, André E, Neirinckx P, Soentjens P, Baele G. Variant Analysis of SARS-CoV-2 Genomes from Belgian Military Personnel Engaged in Overseas Missions and Operations. Viruses 2021; 13:1359. [PMID: 34372565 PMCID: PMC8310367 DOI: 10.3390/v13071359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023] Open
Abstract
More than a year after the first identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of the 2019 coronavirus disease (COVID-19) in China, the emergence and spread of genomic variants of this virus through travel raise concerns regarding the introduction of lineages in previously unaffected regions, requiring adequate containment strategies. Concomitantly, such introductions fuel worries about a possible increase in transmissibility and disease severity, as well as a possible decrease in vaccine efficacy. Military personnel are frequently deployed on missions around the world. As part of a COVID-19 risk mitigation strategy, Belgian Armed Forces that engaged in missions and operations abroad were screened (7683 RT-qPCR tests), pre- and post-mission, for the presence of SARS-CoV-2, including the identification of viral lineages. Nine distinct viral genotypes were identified in soldiers returning from operations in Niger, the Democratic Republic of the Congo, Afghanistan, and Mali. The SARS-CoV-2 variants belonged to major clades 19B, 20A, and 20B (Nextstrain nomenclature), and included "variant of interest" B.1.525, "variant under monitoring" A.27, as well as lineages B.1.214, B.1, B.1.1.254, and A (pangolin nomenclature), some of which are internationally monitored due to the specific mutations they harbor. Through contact tracing and phylogenetic analysis, we show that isolation and testing policies implemented by the Belgian military command appear to have been successful in containing the influx and transmission of these distinct SARS-CoV-2 variants into military and civilian populations.
Collapse
Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Philippe Selhorst
- Unit of Virology and Outbreak Research Team, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Barney Potter
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 21027 Ispra, Italy;
| | - Gytis Dudas
- Gothenburg Global Biodiversity Centre, 413 19 Gothenburg, Sweden;
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08410 Vilnius, Lithuania
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium;
| | - Bruno Verhasselt
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium;
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Emmanuel André
- Department of Laboratory Medicine, UZ Leuven Hospital, 3000 Leuven, Belgium; (L.C.); (E.A.)
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (S.L.H.); (B.P.); (P.M.); (S.D.); (G.B.)
| |
Collapse
|
13
|
Albert C, Baez A, Rutland J. Human security as biosecurity Reconceptualizing national security threats in the time of COVID-19. Politics Life Sci 2021; 40:83-105. [PMID: 33949836 PMCID: PMC7902155 DOI: 10.1017/pls.2021.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Research within security studies has struggled to determine whether infectious disease (ID) represents an existential threat to national and international security. With the emergence of SARS-CoV-2 (COVID-19), it is imperative to reexamine the relationship between ID and global security. This article addresses the specific threat to security from COVID-19, asking, "Is COVID-19 a threat to national and international security?" To investigate this question, this article uses two theoretical approaches: human security and biosecurity. It argues that COVID-19 is a threat to global security by the ontological crisis posed to individuals through human security theory and through high politics, as evidenced by biosecurity. By viewing security threats through the lens of the individual and the state, it becomes clear that ID should be considered an international security threat. This article examines the relevant literature and applies the theoretical framework to a case study analysis focused on the United States.
Collapse
|
14
|
Pirnay JP, Selhorst P, Cochez C, Petrillo M, Claes V, Van der Beken Y, Verbeken G, Degueldre J, T’Sas F, Van den Eede G, Weuts W, Smets C, Mertens J, Geeraerts P, Ariën KK, Neirinckx P, Soentjens P. Study of a SARS-CoV-2 Outbreak in a Belgian Military Education and Training Center in Maradi, Niger. Viruses 2020; 12:v12090949. [PMID: 32867108 PMCID: PMC7552053 DOI: 10.3390/v12090949] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 01/14/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compromises the ability of military forces to fulfill missions. At the beginning of May 2020, 22 out of 70 Belgian soldiers deployed to a military education and training center in Maradi, Niger, developed mild COVID-19 compatible symptoms. Immediately upon their return to Belgium, and two weeks later, all seventy soldiers were tested for SARS-CoV-2 RNA (RT-qPCR) and antibodies (two immunoassays). Nine soldiers had at least one positive COVID-19 diagnostic test result. Five of them exhibited COVID-19 symptoms (mainly anosmia, ageusia, and fever), while four were asymptomatic. In four soldiers, SARS-CoV-2 viral load was detected and the genomes were sequenced. Conventional and genomic epidemiological data suggest that these genomes have an African most recent common ancestor and that the Belgian military service men were infected through contact with locals. The medical military command implemented testing of all Belgian soldiers for SARS-CoV-2 viral load and antibodies, two to three days before their departure on a mission abroad or on the high seas, and for specific missions immediately upon their return in Belgium. Some military operational settings (e.g., training camps in austere environments and ships) were also equipped with mobile infectious disease (COVID-19) testing capacity.
Collapse
Affiliation(s)
- Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
- Correspondence: ; Tel.: +32-244-32172
| | - Philippe Selhorst
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Christel Cochez
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Mauro Petrillo
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium; (M.P.); (G.V.d.E.)
| | - Vincent Claes
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Yolien Van der Beken
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Gilbert Verbeken
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (C.C.); (G.V.)
| | - Julie Degueldre
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - France T’Sas
- Clinical Laboratory, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (V.C.); (Y.V.d.B.); (J.D.); (F.T.)
| | - Guy Van den Eede
- European Commission, Directorate-General Joint Research Centre (JRC), 1050 Brussels, Belgium; (M.P.); (G.V.d.E.)
| | - Wouter Weuts
- Queen Astrid Military Hospital, 1120 Brussels, Belgium;
| | | | - Jan Mertens
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Philippe Geeraerts
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Kevin K. Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Pierre Neirinckx
- Medical Component, Ministry of Defense, 1140 Brussels, Belgium; (J.M.); (P.G.); (P.N.)
| | - Patrick Soentjens
- Center for Infectious Diseases, Queen Astrid Military Hospital, 1120 Brussels, Belgium;
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
| |
Collapse
|