From the severe acute respiratory syndrome (SARS) epidemic in 2003 to the Ebola Outbreak just last year, past communicable diseases that can spread quickly via air travel have highlighted the grave threat communicable diseases pose to public health, as well as their detrimental impact on the global economy, according to a recent audit report by the Government Accountability Office (GAO).
The key federal departments charged with preparing for and responding to communicable disease include the Departments of Transportation (DOT), Health and Human Services (HHS), Homeland Security, State (DHS) and Labor and their relevant components, including the Federal Aviation Administration (FAA), HHS’s Centers for Disease Control and Prevention (CDC), DHS’s US Customs and Border Protection (CBP) and Labor’s Occupational Safety and Health Administration.
“Depending on location and threat, these agencies along with aviation stakeholders and their partners—including local public health authorities, first responders, contracted aviation-services firms, and others—may each have a role in preparing for or responding to a communicable disease incident,” GAO explained.
After reviewing 14 US international airports and 3 major airlines, GAO determined that the US aviation system needs a comprehensive national plan to contain the spread of communicable diseases through air travel.
“Air travel—more than any other mode of transportation—creates the potential for infected persons to move quickly from one part of the world to another while sharing confined quarters with other travelers,” GAO stated. “With the anticipated growth in international air travel, the recurring threat of communicable diseases from abroad, and the potential economic cost of disrupting air travel, it is imperative that the US aviation system is sufficiently prepared to help respond to any communicable disease threat.”
According to the, in 2014, almost 52-million international air travelers from every corner of the globe entered the United States. The FAA expects that number to continue to increase as the global economy continues to develop.
With the anticipated growth of air travel, which allows an infection to move quickly from one part of the world to another, it is imperative that US aviation and airports are sufficiently prepared to help respond to any communicable disease threat.
Although all of the airports and airlines GAO reviewed had plans in place for responding to communicable disease threats from abroad, no federal agency tracks which airports and airlines have them, making it difficult to determine the extent to which all US airports and airlines have such plans.
The plans in place for each airport and airline generally addressed the high-level components that GAO identified as common among applicable federal and international guidance. Furthermore, 11 of the airports GAO reviewed have CDC-developed communicable disease response plan (CDRPs), and CDC plans to expand development of CDRPs to select US airports.
However, CDC and DOT officials acknowledge that only certain “elements” of a national aviation-preparedness plan are in place. Such a plan is critical to maximizing an effective response to a public health threat.
GAO said, “A national aviation-preparedness plan that is generic to all communicable diseases and can be adapted for specific diseases would provide individual airports and airlines with an adaptable and scalable framework with which to integrate their individual plans and promote harmonization of individual plans across airports and airlines. As such, the plan could also serve as the basis for testing communication mechanisms among responders to help ensure those mechanisms are effective.”
In addition, a national aviation preparedness plan could help ensure that airport and airline staff have received appropriate training and access to properly maintained equipment during an outbreak to reduce the risk of exposure to communicable diseases.
“Most importantly,” GAO noted, “A national aviation-preparedness plan would provide airports and airlines with an adaptable and scalable framework with which to align their individual plans—to help ensure that individual airport and airline plans work in accordance with one another.”
Consequently, to help improve the US aviation sector’s preparedness for future communicable disease threats, GAO recommended that the Secretary of Transportation collaborate with relevant stakeholders to develop a national aviation-preparedness plan for communicable disease outbreaks.
DOT agreed with the recommendation to develop a plan, but suggested public health agencies lead the effort. DOT stated, “Responding to these threats within the transportationcontext, as well as in other respects, is primarily a matter of public health emergency preparedness. We are prepared to support those agencies that, unlike DOT, have both the legal authority and expertise to develop a national preparedness plan for communicable diseases and we stand ready to participate in their planning efforts.”
GAO stood by their recommendation. They agreed that public health expertise is needed in developing a national aviation-preparedness plan, but stated DOT has primary responsibility in overseeing the aviation sector.
