Letizia Andrew G, Goforth Carl W, Ge Yongchao, Termini Michael S, Schilling Megan A, Sugiharto Victor A, Chen Hua Wei, Ramos Irene, Sealfon Stuart C
Naval Medical Research Center, Navy Medicine, Silver Spring, Maryland.
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
AJPM Focus. 2022 Sep;1(1):100003. doi: 10.1016/j.focus.2022.100003. Epub 2022 Jun 5.
Quarantining is commonly used to mitigate the spread of SARS-CoV-2. However, questions remain regarding what specific interventions are most effective.
After a 2-week home quarantine, U.S. Marine Corps recruits underwent a supervised 2-week quarantine at a hotel from August 11 to September 21, 2020. All recruits were assessed for symptoms through oral questioning and had their temperatures checked daily. Study participants answered a written clinical questionnaire and were tested for SARS-CoV-2 by polymerase chain reaction shortly after arrival in quarantine and on Days 7 and 14. The results were compared with those of a previously reported Marine-supervised quarantine at a college campus from May until July 2020 utilizing the same study, laboratory, and statistical procedures.
A total of 1,401 of 1,514 eligible recruits (92.5%) enrolled in the study, 93.1% of whom were male. At the time of enrollment, 12 of 1,401 (0.9%) participants were polymerase chain reaction positive for SARS-CoV-2, 9 of 1,376 (0.7%) were positive on Day 7, and 1 of 1,358 (0.1%) was positive on Day 14. Only 12 of 22 (54.5%) participants endorsed any symptoms on a study questionnaire, and none of the participants had an elevated temperature or endorsed symptoms during daily screening for SARS-CoV-2. Participation rate (92%) was much greater than the approximately 58.8% (1,848 of 3,143) rate observed in the previous Marine-supervised college campus quarantine, suggesting the changing attitudes of recruits during the pandemic (<0.001). Approximately 1% of participants were quantitative polymerase chain reaction positive after self-quarantine in both studies.
Key findings include the shifting attitudes of young adults during the pandemic, the limitations of self-quarantine, and the ineffectiveness of daily temperature and symptom screening to identify SARS-CoV-2‒positive recruits.
隔离是减轻严重急性呼吸综合征冠状病毒2(SARS-CoV-2)传播的常用方法。然而,关于哪些具体干预措施最为有效仍存在疑问。
2020年8月11日至9月21日,美国海军陆战队新兵在进行了为期2周的居家隔离后,在一家酒店接受了为期2周的监督隔离。通过口头询问对所有新兵进行症状评估,并每天测量体温。研究参与者填写了一份书面临床问卷,并在抵达隔离点后不久以及第7天和第14天通过聚合酶链反应进行SARS-CoV-2检测。利用相同的研究、实验室和统计程序,将结果与2020年5月至7月在大学校园进行的先前报告的海军陆战队监督隔离的结果进行比较。
1514名符合条件的新兵中有1401名(92.5%)参加了该研究,其中93.1%为男性。在入组时,1401名参与者中有12名(0.9%)的SARS-CoV-2聚合酶链反应呈阳性,1376名中有9名(0.7%)在第7天呈阳性,1358名中有1名(0.1%)在第14天呈阳性。在研究问卷上,只有22名参与者中的12名(54.5%)认可有任何症状,并且在每日SARS-CoV-2筛查期间,没有参与者体温升高或认可有症状。参与率(92%)远高于先前海军陆战队监督的大学校园隔离中观察到的约58.8%(3143名中的1848名),这表明疫情期间新兵态度的转变(<0.001)。在两项研究中,约1%的参与者在自我隔离后定量聚合酶链反应呈阳性。
主要发现包括疫情期间年轻人态度的转变、自我隔离的局限性以及每日体温和症状筛查在识别SARS-CoV-2阳性新兵方面的无效性。