Shahbodaghi S David, Biehler Joseph L, Escamilla Bryan R, Kwon Paul O
Officer in charge (OIC) and Medical Director of the East Bliss Health and Dental Center, as well as the Hospital Continuing Medical Education (CME) Director at William Beaumont Army Medical Center (WBAMC) at Fort Bliss, TX.
Commanding General of the New York Army National Guard's 53rd Troop Command headquartered at Camp Smith Training Site, Peekskill, NY.
Med J (Ft Sam Houst Tex). 2022 Jul-Sep(Per 22-07/08/09):70-76.
The coronavirus (COVID-19) pandemic has changed the world; and the US military changed with it. Although this virus presents with a wide spectrum of disease progression (no symptoms to acute respiratory distress syndrome leading to death), its impact extends beyond health outcomes. At the time of this study, numerous research and development projects were underway to develop a COVID-19 vaccine or other treatment modalities; however, there were no Federal Drug Administration (FDA) approved vaccines or medical therapeutics that definitively provided a cure. Instead, public health officials relied on non-pharmaceutical interventions (NPI) as a main strategy to contain and mitigate the disease. The US military in partnership with host nation countries, such as the Kingdom of Saudi Arabia, exemplified unity of effort through a coordinated response: mass testing, prompt contact tracing, quarantine, and isolation. One main non-pharmaceutical intervention (NPI) strategy includes social distancing which has been shown to significantly impact pandemic influenza transmission translating to COVID-19 mitigation measures. In the military, strict adherence to quarantine, restriction of movement, and isolation orders can be a challenge since appropriate facilities and resources are limited in deployed and training environments. Further, asymptomatic carriage and transmission of COVID-19 disease (mean incubation time 6.2 days and range of 2-14 days) can complicate quarantine and testing methodologies. Moreover, deployment of the NPI mitigation strategies such as quarantine and isolation in an effective and timely manner is essential to prevent further spread. In essence, quarantine is the prevention, and isolation is the cure. This paper aims to describe how a deployed US Army Role I can effectively utilize NPI and containment strategies during a global pandemic in an austere environment.
冠状病毒（COVID-19）大流行改变了世界；美国军队也随之发生了变化。尽管这种病毒表现出广泛的疾病进展情况（从无症状到导致死亡的急性呼吸窘迫综合征），但其影响超出了健康结果范畴。在本研究开展之时，众多研发项目正在进行，以开发COVID-19疫苗或其他治疗方式；然而，当时尚无美国食品药品监督管理局（FDA）批准的能确切治愈该病的疫苗或药物疗法。相反，公共卫生官员依靠非药物干预措施（NPI）作为控制和缓解该疾病的主要策略。美国军队与沙特阿拉伯王国等东道国合作，通过协调应对展现了齐心协力：大规模检测、及时的接触者追踪、检疫和隔离。一项主要的非药物干预措施（NPI）策略包括保持社交距离，事实证明这对大流行性流感传播有显著影响，可转化为COVID-19缓解措施。在军队中，严格遵守检疫、行动限制和隔离命令可能是一项挑战，因为在部署和训练环境中，合适的设施和资源有限。此外，COVID-19疾病的无症状携带和传播（平均潜伏期6.2天，范围为2至14天）会使检疫和检测方法变得复杂。而且，及时有效地部署诸如检疫和隔离等NPI缓解策略对于防止进一步传播至关重要。从本质上讲，检疫是预防，隔离是治疗。本文旨在描述在严峻环境下，部署的美国陆军一级医疗单位如何在全球大流行期间有效利用NPI和控制策略。
