COVID-19 Contact Tracing in an Overseas US Military Population

The purpose of this study was to describe the early epidemiology and contact tracing challenges for Covid-19 infection in an overseas military and DoD population. From February 28, 2020 to April 27, 2020, patients who were diagnosed with Covid-19 infection completed a Centers for Disease Control Persons Under Investigation (PUI) form during their encounter with a medical provider. Positive results were forwarded to the Public Health Department. The results of the contact tracing and PUI form were entered into a database and analyzed. Eight Covid-19 cases were diagnosed in this overseas population. Based on beneficiary population, the cumulative incidence was similar to 80/100,000 persons. The age distribution ranged from 25 to 60 years, median 36 years. Most patients were male (75%). More infection occurred in those living off base in the community (87.5%). With the capability of on-site testing at the hospital, the median duration from symptom onset to diagnosis improved from 5 days to 1 day. Disease contact tracing for DoD populations presents unique considerations in an overseas location. Public Health guidelines for the USA may have varying relevance in an overseas location. Rapid case identification with on-site testing is critical to disrupt disease transmission. Preventive measures for Covid-19 infection have decreased incidence of influenza-like illness.