SARS-CoV-2 Transmission in the Military during the Early Phase of the Pandemic—A Systematic Analysis

Sylvia Xiao Wei Gwee, Pearleen Ee Yong Chua and Junxiong Pang
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Sylvia Xiao Wei Gwee: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore
Pearleen Ee Yong Chua: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore
Junxiong Pang: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore

IJERPH, 2022, vol. 19, issue 12, 1-27

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.

Keywords: COVID-19; military; transmission; exposure; clinical characteristics (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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