Throughout 2020, the Armed Forces Health Surveillance Division and its Global Emerging Infections Surveillance branch continued to work with partners across the globe in their efforts to combat COVID-19 and protect military readiness. That work goes on even as vaccines for the disease have begun to be administered.

“We continue to fund worldwide respiratory pathogen surveillance studies and COVID-19-specific projects to understand the burden of disease and collect strains from infected cases across the globe,” said Navy Capt. Guillermo Pimentel, Global Emerging Infections Surveillance (GEIS) branch chief. These studies “allow the DOD to conduct advanced characterization of this novel coronavirus and support public health authorities of partner host nations.”

These efforts have allowed the Department of Defense to collect “critical information” for force health protection, and have allowed GEIS surveillance projects to reach approximately 80 countries, with its “principal strength being these partnerships with allies and demonstration of a field presence in key geographic locations of military relevance,” Pimentel added.

The data collected from surveillance studies are being used to “initiate, as well as to further adjust or modify, regional infectious disease protection guidance to maintain our forces ready to carry out their mission in each respective combatant command’s area of responsibility,” the GEIS chief said.

GEIS is also funding respiratory pathogen surveillance projects that provide data related to the burden of respiratory diseases to U.S and host nation militaries.

GEIS continues to fund COVID-19 genomic sequencing efforts from DOD service members and foreign nationals, Pimentel said. These sequencing efforts are at DOD labs in Cambodia, Thailand, Peru, and Kenya. By going outside the continental U.S., GEIS is better able to track the spread and impact in support of the combatant commands.

GEIS partners have sequenced more than 350 novel coronavirus isolates and have provided sequencing support to “multiple outbreaks in the Navy and Army,” he noted.

The Armed Forces Health Surveillance Division and its branches also continue to monitor influenza and other major health events and outbreaks that are of military relevance. In connection with academic partners and the Defense Threat Reduction Agency, the Integrated Biosurveillance Branch has a near real-time mapping application called the Health Surveillance Explorer that can be used to better respond to seasonal or pandemic influenza viruses, “estimate their impact on the readiness of the force, plan personnel requirements and implement interventions,” said IBB Chief Juan Ubiera.

GEIS’s military partners in its sequencing and tracking efforts are the Army (Walter Reed Army Institute of Research, U.S. Army Medical Research Institute of Infectious Diseases), Navy (Navy Medical Research Center, Naval Health Research Center) and Air Force (U.S. Air Force School of Aerospace Medicine).

One partner from USAFSAM, Dr. Anthony Fries, a bioinformaticist from the Air Force Research Laboratory’s 711th Human Performance Wing at Wright-Patterson, Ohio, said the AFRL continues to increase the sequencing of SARS-CoV-2 viruses “to assess what viral diversity is circulating in our service members.” Fries noted his lab has sequenced more than 800 patients with COVID-19.

“While the impact and optimism surrounding vaccines cannot be overstated…we are positioning our sequencing activities to see how this virus responds to a population that will soon have robust protection to it from these new vaccines,” Fries said. “From an evolutionary perspective, we’re hoping that this virus’s limited ability to diversify itself could restrict its ability to avoid our efforts to stop it with the new vaccines.”

Air Force Maj. (Dr.) Jameson Voss, chief, Air Force Medical Service Precision Medicine, Air Force Medical Readiness Agency, added: “We need to understand the genetic changes in the virus to ensure diagnostic, vaccine, and other countermeasures are still working.”