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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Airport Roles in Reducing Transmission of Communicable Diseases. Washington, DC: The National Academies Press. doi: 10.17226/25367.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Airport Roles in Reducing Transmission of Communicable Diseases. Washington, DC: The National Academies Press. doi: 10.17226/25367.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Airport Roles in Reducing Transmission of Communicable Diseases. Washington, DC: The National Academies Press. doi: 10.17226/25367.
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TRANSPORTATION RESEARCH BOARD 2018 EXECUTIVE COMMITTEE* OFFICERS CHAIR: Katherine F. Turnbull, Executive Associate Director and Research Scientist, Texas A&M Transportation Institute, College Station VICE CHAIR: Victoria A. Arroyo, Executive Director, Georgetown Climate Center; Assistant Dean, Centers and Institutes; and Professor and Director, Environmental Law Program, Georgetown University Law Center, Washington, D.C. EXECUTIVE DIRECTOR: Neil J. Pedersen, Transportation Research Board MEMBERS Scott E. Bennett, Director, Arkansas Department of Transportation, Little Rock Carlos Braceras, Executive Director, Utah Department of Transportation, Salt Lake City Ginger Evans, President, Tower Consulting, LLC, Arlington, VA Nathaniel P. Ford Sr., Executive Director–CEO, Jacksonville Transportation Authority, Jacksonville, FL A. Stewart Fotheringham, Professor, School of Geographical Sciences and Urban Planning, Arizona State University, Tempe Susan Hanson, Distinguished University Professor Emerita, Graduate School of Geography, Clark University, Worcester, MA Steve Heminger, Executive Director, Metropolitan Transportation Commission, San Francisco, CA Chris T. Hendrickson, Hamerschlag University Professor of Engineering, Carnegie Mellon University, Pittsburgh, PA Jeffrey D. Holt, Managing Director, BMO Capital Markets, NY S. Jack Hu, Vice President for Research and J. Reid and Polly Anderson Professor of Manufacturing, University of Michigan, Ann Arbor Roger B. Huff, President, HGLC, LLC, Farmington Hills, MI Geraldine Knatz, Professor, Sol Price School of Public Policy, Viterbi School of Engineering, University of Southern California, Los Angeles Melinda McGrath, Executive Director, Mississippi Department of Transportation, Jackson Patrick K. McKenna, Director, Missouri Department of Transportation, Jefferson City Brian Ness, Director, Idaho Transportation Department, Boise James P. Redeker, Commissioner, Connecticut Department of Transportation, Newington Leslie Richards, Secretary, Pennsylvania Department of Transportation, Harrisburg Mark L. Rosenberg, Executive Director, The Task Force for Global Health, Inc., Decatur, GA Gary C. Thomas, President and Executive Director, Dallas Area Rapid Transit, Dallas, TX Pat Thomas, Senior Vice President of State Government Affairs, United Parcel Service, Washington, D.C. (Retired) James M. Tien, Distinguished Professor and Dean Emeritus, College of Engineering, University of Miami, Coral Gables, FL Dean H. Wise, Consultant, Dean Wise LLC, Winchester, MA Charles A. Zelle, Commissioner, Minnesota Department of Transportation, Saint Paul EX OFFICIO MEMBERS Ronald Batory, Administrator, Federal Railroad Administration, U.S. Department of Transportation Mary R. Brooks, Professor Emerita, Dalhousie University, Halifax, Nova Scotia, Canada, and Chair, TRB Marine Board Mark H. Buzby (Rear Admiral, U.S. Navy), Administrator, Maritime Administration, U.S. Department of Transportation Steven Chalk, Deputy Assistant for Secretary for Transportation, U.S. Department of Energy Steven Cliff, Deputy Executive Officer, California Air Resources Board, Sacramento Howard R. Elliott, Administrator, Pipeline and Hazardous Materials Safety Administration, U.S. Department of Transportation Daniel K. Elwell, Acting Administrator, Federal Aviation Administration, U.S. Department of Transportation Audrey Farley, Associate Administrator for Administration, Pipeline and Hazardous Materials Safety Administration, Washington, D.C. LeRoy Gishi, Chief, Division of Transportation, Bureau of Indian Affairs, U.S. Department of the Interior, Washington, D.C. John T. Gray II, Senior Vice President, Policy and Economics, Association of American Railroads, Washington, D.C. Brandye Hendrickson, Acting Administrator, Federal Highway Administration, U.S. Department of Transportation Nikola Ivanov, Director of Operations, Center for Advanced Transportation Technology Laboratory, University of Maryland, College Park, and Chair, TRB Young Members Council Donald Jackson (Major General, U.S. Army), Deputy Commanding General for Civil and Emergency Operations, U.S. Army Corps of Engineers, Washington, D.C. Heidi King, Deputy Administrator and Acting Administrator, National Highway Traffic Safety Administration, U.S. Department of Transportation Raymond Martinez, Administrator, Federal Motor Carrier Safety Administration, Washington, D.C. Keith Nelson, Senior Advisor to the Secretary, Office of the Assistant Secretary for Research and Technology, U.S. Department of Transportation Craig A. Rutland, U.S. Air Force Pavement Engineer, U.S. Air Force Civil Engineer Center, Tyndall Air Force Base, FL Karl Schultz (Admiral, U.S. Coast Guard), Commandant, U.S. Coast Guard Karl Simon, Director, Transportation and Climate Division, U.S. Environmental Protection Agency Paul Skoutelas, President and CEO, American Public Transportation Association, Washington, D.C. Daniel Sperling, Professor of Civil Engineering and Environmental Science and Policy; Director, Institute of Transportation Studies, University of California, Davis K. Jane Williams, Acting Administrator, Federal Transit Administration, U.S. Department of Transportation Frederick G. (Bud) Wright, Executive Director, American Association of State Highway and Transportation Officials, Washington, D.C. * Membership as of October 2018.

C O N F E R E N C E P R O C E E D I N G S 5 5 Airport Roles in Reducing Transmission of Communicable Diseases Summary of a Workshop of the Airport Cooperative Research Program’s 2018 Insight Event John Wilhelmi Rapporteur March 6–7, 2018 National Academy of Sciences Building Washington, D.C. Organized by the Airport Cooperative Research Program Transportation Research Board 2019

Transportation Research Board Conference Proceedings 55 ISSN 1073-1652 ISBN 978-0-309-48007-9 Subscriber Categories Aviation; security and emergencies; terminals and facilities Transportation Research Board (TRB) publications are available by ordering individual publications directly from the TRB Business Office, through the Internet at www.TRB.org or national-academies.org/trb, or by annual subscription through organizational or individual affiliation with TRB. Affiliates and library subscribers are eligible for substantial discounts. For further information, contact the Transportation Research Board Business Office, 500 Fifth Street, NW, Washington, DC 20001 (telephone 202-334-3213; fax 202-334-2519; or e-mail TRBsales@nas.edu). © 2019 National Academy of Sciences. All rights reserved. Printed in the United States of America. NOTICE: This report has been reviewed by a group other than the authors according to the procedures approved by a Report Review Committee consisting of members of the National Academies of Sciences, Engineering, and Medicine. The members of the committee responsible for the project were chosen for their special competencies and with regard for appropriate balance. This conference was supported by Eastern Research Group, Inc. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. Suggested citation: Transportation Research Board. Conference Proceedings 55: Airport Roles in Reducing Transmission of Communicable Diseases. Summary of a Workshop of the Airport Cooperative Research Program’s 2018 Insight Event. Washington, D.C.: National Academies of Sciences, Engineering, and Medicine, 2019.

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, non-governmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.national-academies.org. The Transportation Research Board is one of seven major programs of the National Academies of Sciences, Engineering, and Medicine. The mission of the Transportation Research Board is to increase the benefits that transportation contributes to society by providing leadership in transportation innovation and progress through research and information exchange, conducted within a setting that is objective, interdisciplinary, and multimodal. The Board’s varied committees, task forces, and panels annually engage about 7,000 engineers, scientists, and other transportation researchers and practitioners from the public and private sectors and academia, all of whom contribute their expertise in the public interest. The program is supported by state transportation departments, federal agencies including the component administrations of the U.S. Department of Transportation, and other organizations and individuals interested in the development of transportation. Learn more about the Transportation Research Board at www.TRB.org.

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence- based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, con- clusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/ whatwedo.

Planning Committee for the Insight Event: Airport Roles in Reducing Transmission of Communicable Diseases Jeral Ahtone, American Airlines Paulo Magalhaes Alves, MedAire, Inc. Clive Brown, Centers for Disease Control and Prevention Edward Bushman, Los Angeles World Airports James M. Crites, James M. Crites LLC Kristen Rosdahl Ehresmann, Minnesota Department of Health Augustus Hudson, Hartsfield–Jackson Atlanta International Airport Julie Morita, Chicago Department of Public Health Mary Wilson, University of California, San Francisco Eastern Research Group, Inc. Breanna Detweiler Ian Todreas Maxwell Unterhalter John Wilhelmi Transportation Research Board Staff Marci A. Greenberger, Senior Program Officer Brittany Summerlin-Azeez, Program Coordinator CRP Publications Staff for Conference Proceedings 55 Eileen P. Delany, Director of Publications Natalie Barnes, Associate Director of Publications Linda A. Dziobek, Senior Editor Cover design by Beth Schlenoff, Beth Schlenoff Design

Contents Acronyms ................................................................................................................................................ ix Preface .................................................................................................................................................... xi CHAPTER 1: CHALLENGE: AIRPORTS AND COMMUNICABLE DISEASE TRANSMISSION .......... 1 CHAPTER 2: DISCUSSIONS: WHAT WE LEARNED ........................................................................... 3 Risk Management ................................................................................................................................ 3 Stakeholders ......................................................................................................................................... 7 Communications .................................................................................................................................. 9 Infrastructure ..................................................................................................................................... 11 Resources ........................................................................................................................................... 12 CHAPTER 3: LOOKING FORWARD .................................................................................................. 13 APPENDICES A. PROGRAM ....................................................................................................................................... 14 B. INVITED SPEAKERS AND ATTENDEES ....................................................................................... 15 C. RESOURCES IDENTIFIED DURING PRESENTATIONS ............................................................... 19 v i i

ACRP Airport Cooperative Research Program AOC ACRP Oversight Committee CDC Centers for Disease Control and Prevention CDRP Communicable Disease Response Plan DFW Dallas–Fort Worth International Airport DGMQ Division of Global Migration and Quarantine EMS emergency medical services ERG Eastern Research Group, Inc. FEMA Federal Emergency Management Agency ICAO International Civil Aviation Organization MERS Middle East respiratory syndrome OSHA Occupational Safety and Health Administration PDX Portland (Oregon) International Airport PHX Phoenix Sky Harbor International Airport PIO public information officer PPE personal protective equipment SARS severe acute respiratory syndrome TSA Transportation Security Administration WHO World Health Organization Acronyms i x

x i transmission of communicable diseases” is a highly com- plex topic that spans a wide range of issues, including different diseases and transmission modes, many pre- paredness and response actions, legal issues, and public relations approaches to addressing public perception of risk. Faced with this challenge, the planning committee planned the Insight Event to address the primary topic broadly rather than focus on a few specific matters, expe- riences, or issues. The planning committee identified four general subtopics for the Insight Event to address. They were risk management, stakeholders, communications, and infrastructure. Chapter 2 presents definitions of these subtopics and discussions of the subtopics during the 2-day Insight Event. ACRP and its Insight Event contractor, Eastern Research Group, Inc. (ERG), then developed a pro- gram based on the concepts outlined by the planning committee. Specifically, ACRP and ERG identified can- didate speakers, developed the Insight Event program and agenda, and promoted the Insight Event to airports, public health agencies, and other stakeholders. The 2-day Insight Event occurred on March 6 and 7, 2018, in Washington, D.C. Close to 100 individuals attended. The 2-day Insight Event included • Presentations from 13 invited speakers (listed in Appen- dix A), including a keynote address from Capt. Martin Cetron, M.D., Director of the Centers for Disease Con- trol and Prevention’s (CDC’s) Division of Global Migra- tion and Quarantine. The other speakers represented domestic and foreign airports, local public health agen- cies, an international aviation organization, and aca- demia. Appendix B lists invited speakers and attendees. The Airport Cooperative Research Program (ACRP) within the Transportation Research Board (TRB) of the National Academies of Sciences, Engineer- ing, and Medicine carries out applied research on prob- lems and issues that are of interest to airports and that are not being addressed by other federal research pro- grams. As the primary governing body of the program, the ACRP Oversight Committee (AOC) sets the agenda for the program’s annual research activities. In 2015, AOC decided to hold a series of Insight Events on topics of significance to airports. Insight Events are forums that foster dialogue among profes- sionals across sectors, institutions, and industries. Insight Events convene airport industry leaders and subject matter experts in various fields to encourage discussion and promote broader and deeper insight on topics of sig- nificance to airport operators. These in-depth, face-to- face gatherings are designed to promote communication and collaboration, foster innovation, and help identify areas of future interest and research, especially for topics of emerging importance. The decision to hold this event occurred toward the end of the 2014–2016 Ebola virus disease outbreak in West Africa. Concern about this outbreak’s implications for air travel, among other possible outbreaks, led AOC to have its first Insight Event focus on airport roles in reducing transmission of communicable diseases. Building on AOC’s idea, ACRP convened a planning committee of nine airport and public health officials to design and plan the Insight Event. This committee met in June 2017 to advise ACRP on how to proceed. The principal challenge before the planning committee was the breadth of the topic. “Airport roles in reducing Preface

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TRB's Conference Proceedings 55: Airport Roles in Reducing Transmission of Communicable Diseases summarizes a 2-day Insight Event convened by the Airport Cooperative Research Program and its Insight contractor, Eastern Research Group, Inc., March 6 and 7, 2018, in Washington, D.C. The event addressed four subtopics: risk management, stakeholders, communications, and infrastructure. Discussions centered on the roles of airports in reducing transmission of communicable diseases. Speakers represented the federal government, domestic and foreign airports, local public health agencies, an international aviation organization, and academia. The conference proceedings focused largely on strategies, best practices, and suggestions that pertain specifically to airports and transmission of communicable diseases, as identified by the invited speakers.

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