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4 The challenges of managing a COVID outbreak during a long-range desert patrol
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  1. Lt Col Natasha Chatham-Zvelebil
  1. Consultant Emergency Medicine Roto 3B; Emergency Medicine Consultant Joint Hospital Group (South) and University Hospital Southampton

Abstract

The challenges of managing an infectious disease outbreak in a deployed military setting are well documented. During Op NEWCOMBE the outbreak of COVID in camp was predicted with Force Health Protection strategies and a medical response plan in place. Roto 3, December 2021 – June 2022, had a triple vaccinated task group, and models suggested any outbreak would be clinically and operationally insignificant.

These models did not consider the specific challenges of an outbreak during a long range environmentally challenging desert patrol. The consequences of this COVID outbreak were clinically and operationally significant. The clinical effects were disproportionately severe, with features of heat illness a likely contributor. The management of patients was challenged by heat and lack of climate controlled and isolation facilities. The medical group itself suffered with cases of COVID, resulting in the requirement of the Ground Manoeuvre Surgical Group to assume the deployed Role 1 clinical role, provide a partially climate-controlled environment and manage the logistics of maintaining the testing capability and PPE equipment. The outbreak resulted in 3 cancelled patrols, 8 aeromedical evacuations, 9 strategic evacuations and a total of 106 cases, of which 42 were confirmed or suspected whilst on patrol.

The clinical and operational impact of this COVID outbreak should have been predicted. The challenging environment combined with a physically degraded population towards the end of a 6-month deployment, demonstrated that using disease modelling based upon healthy UK-based populations is ineffective. Future deployments must take this into consideration.

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