COVID-19 Monitoring and Response Among U.S. Air Force Basic Military Trainees — Texas, March–April 2020: Morbidity and Mortality Weekly Report (MMWR)

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The Centers for Disease Control reported on June 2 in the MMWR a successful attempt to limit the spread of COVID-19 among trainees in the Air Force.  In an unusual setting, authorities were able to limit the number of symptomatic cases of COVID-19 to five out of 10579 trainees admitted to the training center at Joint Base San Antonio-Lackland in April and May.  All trainees were quarantined for two weeks; only symptomatic trainees were tested.  Of the five who were positive for SARS-COV-2, three were contacts of the first case.

The regimented nature of the Air Force base made it possible to enforce six foot physical distancing, the wearing of face masks, and quarantining of all new trainees as well as isolation of patients with symptoms.  As described in MMWR, “During that period, 345 (3%) trainees met criteria for testing and further investigation. Among these, 86 (25%) were tested during arrival quarantine, and five (1%) tested PCR-positive for SARS-CoV-2. Testing also identified five cases of rhinovirus or enterovirus, three cases of parainfluenza, two cases of metapneumovirus, and two cases of influenza B.”

Naturally, asymptomatic cases of COVID-19 were not evaluated.  However, by quarantining all new arrivals, it was possible to eliminate transmission even among those who had been asymptomatic– since anyone who arrived with the virus would not have been able to pass it on after two weeks in quarantine.

This unusual case demonstrates that it is possible to control transmission of this virus with strict isolation methods.  The precautions were taken in part because of prior epidemics of several viruses, including during the 1918 influenza pandemic.  In 1918, basic training camps were overwhelmed by numerous cases of influenza and many deaths.  The lessons learned from that pandemic and later epidemics, particularly associated with adenovirus, helped to inform authorities that strict isolation methods were needed.

Success in this setting should not be considered remarkable– failure would have been inexcusable.