Multi-disciplinary Leadership to Mitigate COVID-19 in an Austere West African Military Environment

Stephanie L Mitchell; Thomas A Mitchell; Nathaniel Horwitz-Willis; Timur N Alptunaer; Jeffrey A Gipson; Stacy A Shackelford

doi:10.1093/milmed/usac045

Multi-disciplinary Leadership to Mitigate COVID-19 in an Austere West African Military Environment

Mil Med. 2022 Mar 9:usac045. doi: 10.1093/milmed/usac045. Online ahead of print.

Authors

Stephanie L Mitchell^{1

2}, Thomas A Mitchell^{1

3}, Nathaniel Horwitz-Willis^{4

5

6}, Timur N Alptunaer⁷, Jeffrey A Gipson⁶, Stacy A Shackelford⁸

Affiliations

¹ SLM and TAM contributed equally to this paper.
² School of Public Health, University of California, Berkeley, CA 94704, USA.
³ US Army Institute of Surgical Research, Fort Sam Houston, TX 78234, USA.
⁴ 102d Intelligence Wing Medical Group, Massachusetts Air National Guard, Joint Base Cape Cod, Otis ANGB, MA 02115, USA.
⁵ Department of Public Health, Massachusetts College of Pharmacy and Health Sciences, Boston, MA 02115, USA.
⁶ 724th Expeditionary Air Base Squadron, US Air Force, Ramstein-Miesenbach 66877, Germany.
⁷ 946th Forward Resuscitative Surgical Team, US Army, Mobile, AL 36605, USA.
⁸ Joint Trauma System, Defense Health Agency, Fort Sam Houston, TX 78234, USA.

PMID: 35262696
DOI: 10.1093/milmed/usac045

Abstract

Introduction: The COVID-19 pandemic created challenges for forward-deployed military units to Western Africa. Austere military environments afford multiple avenues to transmit COVID-19 amongst service members.

Materials and methods: A COVID-19 outbreak on a military base in Western Africa spanning over 100 days is statistically analyzed using a Pearson's correlation coefficient. Furthermore, a COVID-19 reproductive number (R0) is evaluated to examine the relationship between specific command-directed policies to mitigate COVID-19 transmission.

Results: The multidisciplinary partnership of military command, medical, and public health leadership implemented evidence-based and epidemiologically informed COVID-19 preventive base-wide policies, including appropriate isolation/quarantine policies. The R0 for the outbreak was 0.03 and remained <1 for the outbreak duration. This base remained COVID-19 free for multiple weeks after policy implementation.

Conclusions: The implementation of practical mitigating base-wide policies through seamless communication between military command/medical/public health leadership resolved the COVID-19 outbreak while maintaining mission readiness. Weekly COVID-19 testing epidemiological data may be utilized by commanders to direct further decision-making on tightening/loosening base-wide policy restrictions for continued mission-essential operations, e.g., security, food service, or airfield operations.

Grants and funding

No Funding/No Funding