The aim of this study was to develop and evaluate a pre-deployment sequestration (PDS) protocol to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases on board the USS Ronald Reagan (CVN-76).

The USS Ronald Reagan includes a crew of approximately 3000 Sailors and an embarked Air Wing of 2000 personnel. The PDS was conducted in 3 waves of 14-day strict quarantines during the months of April and May 2020. Sailors were cleared to board the ship with 2 negative reverse transcriptase polymerase chain reaction (rtPCR) tests at days 14 and 16. The ship was sanitized before Wave 1 boarding.

From March 1, 2020, through May 31, 2020, a total of 51 SARS-CoV-2 positive cases were detected. During the 3 waves of PDS, 28 Sailors were found to be positive on exit testing (14, 11, and 3, respectively); no cases were found among the Air Wing. During the first 90 days at sea, no SARS-CoV-2 cases were detected among any of the embarked personnel.

Although resource-intensive, the PDS protocol implemented for USS Ronald Reagan resulted in a coronavirus disease 2019 (COVID-19)-free ship during a global pandemic with unprecedented scope. Elements of this pandemic PDS protocol may be useful in other highly risk-averse environments with no tolerance for COVID-19 infections.

This study aimed to explore how deployed healthcare workers (HCWs) perceived personal preparedness for response, and their main avenues for coping to maintain resilience during the prolonged COVID-19 (SARS-CoV-2) pandemic.

Semi-structured interviews were conducted with 25 HCWs deployed to the frontline for an extended period to provide acute COVID-19 related care. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically.

HCWs demonstrated heightened self-confidence and readiness to deal with public health emergencies owing to the ramped-up efforts in infrastructure for outbreak management and pre-emptive infectious disease training. Despite overall confidence, deployed HCWs had to adopt various coping mechanisms to sustain resilience during the prolonged pandemic. Main themes on coping centred around the value of team leaders and support from family members as an effective buffer for work-induced stress while institution-based counseling services and welfare were viewed as important for fostering the internal locus of control and wellbeing.

Our findings suggest that strategies such as on-the-job training, continuous education and improved communication would be essential to maintain resilience of deployed HCWs. Considerations should be also given to the swift implementation of blended wellness support comprising digital and in-person counseling to sustain wellbeing and prepare for endemic COVID-19.

Military personnel deployed to combat and peacekeeping missions are exposed to high rates of traumatic events. Accumulating evidence suggests an important association between deployment and the development of other mental health symptoms beyond post-traumatic stress disorder.

This study examined the prevalence of agoraphobia, anxiety, depression, and hostility symptoms in a cohort of Dutch ISAF veterans (N = 978) from pre-deployment up to 10 years after homecoming. The interaction of potential moderating factors with the change in mental health symptoms relative to pre-deployment was investigated at each time point.

The probable prevalence of agoraphobia, anxiety, depression, and hostility symptoms significantly increased over time to respectively 6.5, 2.7, 3.5, and 6.2% at 10 years after deployment. Except for hostility symptoms, the probable prevalence at 10 years after deployment was the highest compared to all previous follow-up assessments. Importantly, less perceived social support after returning from deployment was found as a risk factor for all different mental health symptoms. Unit support was not associated with the development of mental health problems.

This study suggests a probable broad and long-term impact of deployment on the mental health of military service members. Due to the lack of a non-deployed control group, causal effects of deployment could not be demonstrated. Continued effort should nevertheless be made in the diagnosis and treatment of a wide range of mental health symptoms, even a decade after deployment. The findings also underscore the importance of social support after homecoming and its potential for the prevention of long-term mental health problems.

When New York City became an epicenter of the COVID-19 pandemic, healthcare workers from an array of specialties were deployed to work on general medicine units with limited time for clinical retraining.

This study assesses the subjective experience and perceived preparedness of a cohort of non-internal medicine clinicians who were deployed to assist with inpatient management of patients with COVID-19 in the Spring of 2020.

An online survey was distributed to clinicians (residents, fellows, attendings, nurse practitioners, and physician assistants) who cared for patients in roles outside their usual specialties during the pandemic at the Montefiore Health System in the Bronx, NY.

85/169 (50.3%) clinicians responded. 16.5% reported strong feelings of preparedness prior to deployment (≥7/10 Likert scale). ‘Access to appropriate and efficient review materials prior to deployment’ was ranked as 6/10, overall level of stress as 8/10 and concern for contracting COVID-19 while deployed as 8/10. Responses regarding ‘general feelings of preparedness’ had a weak negative association with ‘feelings of frustration about one’s circumstance’ (r= -0.39, p<0.001). Weak negative associations were found between feelings of ‘access to adequate review materials’ and ‘overall stress levels’ (r= -0.31, p<0.001). A moderate positive association was found between ‘feelings of access to adequate review materials’ and ‘feeling on top of one’s work responsibilities’ (r= 0.40, p< 0.001).

The majority of respondents did not feel adequately prepared to care for patients with COVID-19 prior to deployment and had both high stress levels and fear of contracting COVID-19 in the first wave of the pandemic.

No significant relationships.

The purpose of this study is to identify key risk factors that could negatively affect public health emergency responders’ health and wellbeing. We seek to use this information to provide recommendations and strategies to mitigate such risks.

A narrative review of the peer-reviewed literature on wellbeing of military personnel and other responders was conducted. Data was grouped and categorized according to overarching domains.

Factors associated with wellbeing were categorized into 5 domains: (1) demographics; (2) mental health concerns; (3) social networks; (4) work environment; and (5) postdeployment life. The strategies identified to promote wellbeing included mental health assessments, preparedness trainings, debriefs in the field, postdeployment debriefs, resources in the field, and further postdeployment decompression strategies.

This study provides a unique understanding of the risk factors associated with poor health and wellbeing outcomes in public health emergency response work by extending the body of knowledge that focuses on other types of emergency and military response.

Symptoms of post-traumatic stress disorder (PTSD) can manifest several years after trauma exposure, and may impact everyday life even longer. Military deployment can put soldiers at increased risk for developing PTSD symptoms. Longitudinal evaluations of PTSD symptoms in deployed military personnel are essential for mapping the long-term psychological burden of recent operations on our service members, and may improve current practice in veterans’ mental health care.

The current study examined PTSD symptoms and associated risk factors in a cohort of Dutch Afghanistan veterans 10 years after homecoming. Participants (N = 963) were assessed seven times from predeployment up to 10 years after deployment. Growth mixture modeling was used to identify distinct trajectories of PTSD symptom development.

The probable PTSD prevalence at 10 years after deployment was 8%. Previously identified risk factors like younger age, lower rank, more deployment stressors, and less social support were still relevant 10 years after deployment. Four trajectories of PTSD symptom development were identified: resilient (85%), improved (6%), severely elevated-recovering (2%), and delayed onset (7%). Only the delayed onset group reported increasing symptom levels between 5 and 10 years postdeployment, even though 77% reported seeking help.

This study provides insights into the long-term burden of deployment on the psychological health of military service members. It identifies a group of veterans with further increasing PTSD symptoms that does not seem to improve from currently available mental health support, and underlines the urgent need for developing and implementing alternative treatment opportunities for this group.

This observational study examined return to duty (RTD) rates following receipt of early mental health interventions delivered by deployed mental health practitioners.

In-depth clinical interviews were conducted among 975 UK military personnel referred for mental health assessment whilst deployed in Afghanistan. Socio-demographic, military, operational, clinical and therapy outcomes were recorded in an electronic health record database. Rates and predictors of EVAC were the main outcomes examined using adjusted binary logistic regression analyses.

Overall 74.8% (n = 729) of personnel RTD on completion of care. Of those that underwent evacuation home (n = 246), 69.1% (n = 170) returned by aeromedical evacuation; the remainder returned home using routine air transport. Predictors of evacuation included; inability to adjust to the operational environment, family psychiatric history, previously experiencing trauma and thinking about or carrying out acts of deliberate self-harm.

Deployed mental health practitioners helped to facilitate RTD for three quarters of mental health casualties who consulted with them during deployment; psychological rather than combat-related factors predicted evacuation home.