Controlling COVID-19 Spread in a Confined, High-Risk Population | Infectious Diseases | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Controlling COVID-19 Spread in a Confined, High-Risk Population

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Marcus et al1 report on an encouraging coronavirus disease 2019 (COVID-19) control success story that public health officials serving similar high-risk populations may wish to emulate. From May 11 to August 24, 2020, 263 consecutive cohorts (30-50 persons each) of healthy young adults arrived at US Air Force Joint Base San Antonio–Lackland for recruit training. The trainees were screened twice during a 14-day quarantine period and closely monitored for COVID-19 infections. The multifaceted control plan was associated with a reduction in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among the 10 613 trainees, and the authors used the complex surveillance data to identify some unique findings that might have been missed in studying smaller populations. The authors found that patients with more symptoms and lower SARS-CoV-2–positive cycle threshold assay values were associated with more viral transmission among their peers. The authors found that the multiple COVID-19 interventions at Joint Base San Antonio–Lackland worked well, and there was sparse evidence of asymptomatic superspreaders. This successful control program, which took place in such a historically high-risk setting (ie, a military training camp), may be a useful guide for public health officials working to halt transmission in confined settings.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Published: February 25, 2021. doi:10.1001/jamanetworkopen.2021.0234

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Gray GC. JAMA Network Open.

Corresponding Author: Gregory C. Gray, MD, MPH, Duke University School of Medicine, DUMC Box 102359, Durham, NC 27710 (gregory.gray@duke.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Marcus  JE , Frankel  DN , Pawlak  MT ,  et al.  Risk factors associated with COVID-19 transmission among US Air Force trainees in a congregant setting.   JAMA Netw Open. 2021;4(2):e210202. doi:10.1001/jamanetworkopen.2021.0202Google Scholar
2.
Sanchez  JL , Cooper  MJ , Myers  CA ,  et al.  Respiratory infections in the US military: recent experience and control.   Clin Microbiol Rev. 2015;28(3):743-800. doi:10.1128/CMR.00039-14PubMedGoogle ScholarCrossref
3.
Gunzenhauser  JD , Brundage  JF , McNeil  JG , Miller  RN .  Broad and persistent effects of benzathine penicillin G in the prevention of febrile, acute respiratory disease.   J Infect Dis. 1992;166(2):365-373. doi:10.1093/infdis/166.2.365PubMedGoogle ScholarCrossref
4.
Gray  GC , McPhate  DC , Leinonen  M ,  et al.  Weekly oral azithromycin as prophylaxis for agents causing acute respiratory disease.   Clin Infect Dis. 1998;26(1):103-110. doi:10.1086/516275PubMedGoogle ScholarCrossref
5.
Russell  KL , Broderick  MP , Franklin  SE ,  et al.  Transmission dynamics and prospective environmental sampling of adenovirus in a military recruit setting.   J Infect Dis. 2006;194(7):877-885. doi:10.1086/507426PubMedGoogle ScholarCrossref
6.
Marcus  JE , Frankel  DN , Pawlak  MT ,  et al.  COVID-19 monitoring and response among US Air Force basic military trainees: Texas, March-April 2020.   Morb Mortal Wkly Rep. 2020;69(22):685-688. doi:10.15585/mmwr.mm6922e2PubMedGoogle ScholarCrossref
7.
Payne  DC , Smith-Jeffcoat  SE , Nowak  G ,  et al; CDC COVID-19 Surge Laboratory Group.  SARS-CoV-2 infections and serologic responses from a sample of US Navy service members: USS Theodore Roosevelt, April 2020.   Morb Mortal Wkly Rep. 2020;69(23):714-721. doi:10.15585/mmwr.mm6923e4PubMedGoogle ScholarCrossref
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close