Integration of Multiple Surveillance Systems to Track COVID-19 in the U.S. Army Population

ABSTRACT Introduction The coronavirus disease (COVID-19) pandemic presented unique challenges for surveillance of the military population, which include active component service members and their family members. Through integrating multiple Department of Defense surveillance systems, the Army Public Health Center can provide near real-time case counts to Army leadership on a daily basis. Materials and Methods The incidence of COVID-19 was tracked by incorporating data from the Disease Reporting System Internet, laboratory test results, Commanders’ Critical Incidence Reports, reports from the Centers for Disease Control and Prevention military liaison, and media reports. Cases were validated via a medical record review for all Army beneficiaries. Descriptive analyses were performed using Microsoft Excel and SAS 9.4 to measure demographic frequencies. Results In the first year of the pandemic from February 1, 2020 to February 28, 2021, a total of 96,315 COVID-19 cases were reported to the Disease Reporting System internet, the Army’s passive surveillance system, of which 95,429 (99%) were confirmed and 886 (1%) were probable. A total of 76 outbreak reports were submitted from 14 Army installations. The proportion of Army beneficiaries with severe illness was low: 2,271 (2.4%) individuals required hospitalization and 269 (0.3%) died. Installations in Texas reported the highest proportion of confirmed—not hospitalized cases (n = 19,246, 20.7%), confirmed—hospitalized cases (n = 1,037, 45.7%), and deaths (n = 137, 50.9%) as compared to other states with Army installations. Conclusions The pandemic has demonstrated the need for a robust public health enterprise with a focus on data collection, validation, and analysis, allowing leaders to make informed decisions that may impact the health of the Army.