Future directions of infection control and risk management on military vessels: a narrative review

Background and Objective: Infectious disease outbreaks on military vessels have been a consistent challenge and can result in severe implications for readiness and national security. Crew member duties and the shipboard environment create conditions that may exacerbate disease spread, such as close and frequent contact, enclosed areas, and limited space for isolation. Prior to the coronavirus disease 2019 (COVID-19) pandemic, militaries had established infection control and risk management plans. COVID-19 outbreaks onboard military vessels, however, revealed potential discrepancies between these protocols and responses. The objective of this review is to assess infection control and risk management protocols during COVID-19 outbreaks on military vessels, identify potential gaps in responses, and propose future directions for controlling infection and mitigating risk onboard vessels that align with the principles of infectious disease epidemiology, infection control and prevention (ICP), and industrial hygiene (IH).