Community incidence patterns drive the risk of SARS-CoV-2 outbreaks and alter intervention impacts in a high-risk institutional setting
Sean M. Moore,
Guido España,
T. Alex Perkins,
Robert M. Guido,
Joaquin B. Jucaban,
Tara L. Hall,
Mark E. Huhtanen,
Sheila A. Peel,
Kayvon Modjarrad,
Shilpa Hakre,
Paul T. Scott
Affiliations
Sean M. Moore
Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, USA; Corresponding author.
Guido España
Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, USA
T. Alex Perkins
Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, USA
Robert M. Guido
Moncrief Army Health Clinic, Fort Jackson, SC 29207, USA
Joaquin B. Jucaban
Moncrief Army Health Clinic, Fort Jackson, SC 29207, USA
Tara L. Hall
Moncrief Army Health Clinic, Fort Jackson, SC 29207, USA
Mark E. Huhtanen
United States Army Training Center, Fort Jackson, SC 29207, USA
Sheila A. Peel
Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
Kayvon Modjarrad
Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
Shilpa Hakre
Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
Paul T. Scott
Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
Optimization of control measures for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in high-risk institutional settings (e.g., prisons, nursing homes, or military bases) depends on how transmission dynamics in the broader community influence outbreak risk locally. We calibrated an individual-based transmission model of a military training camp to the number of RT-PCR positive trainees throughout 2020 and 2021. The predicted number of infected new arrivals closely followed adjusted national incidence and increased early outbreak risk after accounting for vaccination coverage, masking compliance, and virus variants. Outbreak size was strongly correlated with the predicted number of off-base infections among staff during training camp. In addition, off-base infections reduced the impact of arrival screening and masking, while the number of infectious trainees upon arrival reduced the impact of vaccination and staff testing. Our results highlight the importance of outside incidence patterns for modulating risk and the optimal mixture of control measures in institutional settings.
