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Letter
Incidence of SARS-CoV-2/COVID-19 in military personnel of Bolivia
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  1. Juan Pablo Escalera-Antezana1,2,
  2. C A Mariaca-Cerball3,
  3. L E Alvarado-Arnez4,
  4. M A Balderrama-Saavedra4,
  5. D K Bonilla-Aldana5,6 and
  6. A J Rodriguez-Morales4,5,6,7
  1. 1 National Responsible for Telehealth Program, Ministry of Health, La Paz, La Paz, Bolivia
  2. 2 School of Medicine, Universidad Privada Franz Tamayo/UNIFRANZ, La Paz, La Paz, Bolivia
  3. 3 Navy Captain, Chief of Information and Enhancement of the SINAGER-SAT, Viceministry of Civil Defense, La Paz, Bolivia, Plurinational State of
  4. 4 School of Medicine, Universidad Privada Franz Tamayo, Cochabamba, Cochabamba, Bolivia, Plurinational State of
  5. 5 Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia
  6. 6 Public Health and infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
  7. 7 Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia
  1. Correspondence to Dr A J Rodriguez-Morales, Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira 660003, Risaralda, Colombia; arodriguezm{at}utp.edu.co

http://dx.doi.org/10.1136/bmjmilitary-2020-001705

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    The impact of COVID-19 has not been described so far in a military setting, especially in Latin America.1 Latin America has recently become the main epicentre of the pandemic due to the significant rise in the number of cases in Brazil and other countries in the region, accounting for more than 10.61 million cases just in South America (November 22, 2020).2 The healthcare population has been described as significantly affected in multiple states,3 but also other occupations, including military, are compromised due to COVID-19.

    There are 50 040 individuals registered in the military personnel of Bolivia, 91% from the army, 8% from the navy and 1% from the air force. During 2 months of surveillance in military personnel, 1261 cases were diagnosed (2.5% of the military population), ranging from 0 to 168 cases/day, with a median of 7 cases/day (IQR 0–27) (Figure 1). From the total, 92.2% corresponded to sergeants and commissioned officers and 7.8% corresponded to soldiers and seamen. Quarantine was ordered for 341 sergeants and commissioned officers and 220 soldiers and seamen. Twenty-four patients have died (1.9%), and 680 (53.9%) have recovered (Figure 1). From the total infected, 53.8% were located in the capital department, La Paz, followed by Cochabamba (28.8%), among other departments (Figure 2).

    Figure 1
    Figure 1

    (A) Daily number of confirmed cases of SARS-CoV-2/COVID-19 among all the military personnel, including sergeants and commissioned officers, and soldiers and seamen, in Bolivia. (B) Daily number of deaths and recoveries from SARS-CoV-2/COVID-19 among all the military personnel.

    Figure 2
    Figure 2

    Geographical distribution of the confirmed cases of SARS-CoV-2/COVID-19 among all the military personnel in Bolivia. The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

    The course of the pandemic due to COVID-19 is affecting different population groups and occupational activities in multiple countries, as has been especially highlighted recently for healthcare workers. In the case of military personnel, although some months in the time period of the pandemic have passed, there is limited information about them concerning COVID-19,1 especially in Latin America.

    Latin America is currently the main focus of the COVID-19 pandemic. In this region, there are many countries where there is a lack of information and research of such impact, such as Bolivia, and their different population groups, including the military, as here we report for the first time.

    Up to 22 November 2020, Bolivia has reported 143 922 cases with 8904 deaths (6.19%). The impact in the country has been significant in terms of the number of cases and deaths, now also showing the effect among military personnel. More than 1 in 10 members of the military personnel have been affected so far and increasing. However, fortunately, among those infected, the case fatality rate is significantly lower than that in the general population, which may be explained because most of them are young, healthy and free of risk factors, in comparison to the general Bolivian population.

    As expected, the capital department, La Paz, where most of the forces are concentrated, has the highest proportion of infected military personnel due to SARS-CoV-2. Nevertheless, there are troops with COVID-19 in all the departments of the country.

    The management of COVID-19 in military personnel is challenging as they also helped in the sanitary control of disease, especially in rural areas, but also because of the need for national safety and, in the case of Bolivia, this personnel is the main force controlling quarantine blocking points in land transportation across the country.

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      . COVID-19 in Latin America: the implications of the first confirmed case in Brazil. Travel Med Infect Dis 2020;35:101613. doi:10.1016/j.tmaid.2020.101613 pmid:http://www.ncbi.nlm.nih.gov/pubmed/32126292
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    Footnotes

    • Twitter @DrAJRodriguezM

    • Contributors JPE-A and AJR-M conceived the idea and the study design. CAM-C and JPE-A collected the data. LEA-A, MAB-S, DKB-A and AJR-M analysed the data. AJR-M wrote the first draft. All the authors read and approved the subsequent versions and the final submitted manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.