Airport Lessons Learned from the COVID-19 Pandemic (2023)

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2023 A I R P O R T C O O P E R A T I V E R E S E A R C H P R O G R A M ACRP RESEARCH REPORT 253 Research sponsored by the Federal Aviation Administration Subscriber Categories Aviation Airport Lessons Learned from the COVID-19 Pandemic John Wilhelmi Eastern Research Group, Inc. Palm Springs, CA Kaila Stein Eastern Research Group, Inc. Arlington, VA Matthew Mitchell Eastern Research Group, Inc. Concord, MA

AIRPORT COOPERATIVE RESEARCH PROGRAM Airports are vital national resources. They serve a key role in transpor- tation of people and goods and in regional, national, and international commerce. They are where the nation’s aviation system connects with other modes of transportation and where federal responsibility for man- aging and regulating air traffic operations intersects with the role of state and local governments that own and operate most airports. Research is necessary to solve common operating problems, to adapt appropriate new technologies from other industries, and to introduce innovations into the airport industry. The Airport Cooperative Research Program (ACRP) serves as one of the principal means by which the airport industry can develop innovative near-term solutions to meet demands placed on it. The need for ACRP was identified in TRB Special Report 272: Airport Research Needs: Cooperative Solutions in 2003, based on a study spon- sored by the Federal Aviation Administration (FAA). ACRP carries out applied research on problems that are shared by airport operating agen- cies and not being adequately addressed by existing federal research pro- grams. ACRP is modeled after the successful National Cooperative High- way Research Program (NCHRP) and Transit Cooperative Research Program (TCRP). ACRP undertakes research and other technical activi- ties in various airport subject areas, including design, construction, legal, maintenance, operations, safety, policy, planning, human resources, and administration. ACRP provides a forum where airport operators can cooperatively address common operational problems. ACRP was authorized in December 2003 as part of the Vision 100— Century of Aviation Reauthorization Act. The primary participants in the ACRP are (1) an independent governing board, the ACRP Oversight Committee (AOC), appointed by the Secretary of the U.S. Department of Transportation with representation from airport operating agencies, other stakeholders, and relevant industry organizations such as the Airports Council International-North America (ACI-NA), the American Associa- tion of Airport Executives (AAAE), the National Association of State Aviation Officials (NASAO), Airlines for America (A4A), and the Airport Consultants Council (ACC) as vital links to the airport community; (2) TRB as program manager and secretariat for the governing board; and (3) the FAA as program sponsor. In October 2005, the FAA executed a contract with the National Academy of Sciences formally initiating the program. ACRP benefits from the cooperation and participation of airport professionals, air carriers, shippers, state and local government officials, equipment and service suppliers, other airport users, and research organi- zations. Each of these participants has different interests and responsibili- ties, and each is an integral part of this cooperative research effort. Research problem statements for ACRP are solicited periodically but may be submitted to TRB by anyone at any time. It is the responsibility of the AOC to formulate the research program by identifying the highest priority projects and defining funding levels and expected products. Once selected, each ACRP project is assigned to an expert panel appointed by TRB. Panels include experienced practitioners and research specialists; heavy emphasis is placed on including airport professionals, the intended users of the research products. The panels prepare project statements (requests for proposals), select contractors, and provide technical guidance and counsel throughout the life of the project. The process for developing research problem statements and selecting research agencies has been used by TRB in managing coop- erative research programs since 1962. As in other TRB activities, ACRP project panels serve voluntarily without compensation. Primary emphasis is placed on disseminating ACRP results to the intended users of the research: airport operating agencies, service pro- viders, and academic institutions. ACRP produces a series of research reports for use by airport operators, local agencies, the FAA, and other interested parties; industry associations may arrange for workshops, training aids, field visits, webinars, and other activities to ensure that results are implemented by airport industry practitioners. ACRP RESEARCH REPORT 253 Project 03-49 ISSN 2572-3731 (Print) ISSN 2572-374X (Online) ISBN 978-0-309-69865-8 Library of Congress Control Number 2023937627 © 2023 by the National Academy of Sciences. National Academies of Sciences, Engineering, and Medicine and the graphical logo are trade- marks of the National Academy of Sciences. All rights reserved. COPYRIGHT INFORMATION Authors herein are responsible for the authenticity of their materials and for obtaining written permissions from publishers or persons who own the copyright to any previously published or copyrighted material used herein. Cooperative Research Programs (CRP) grants permission to reproduce material in this publication for classroom and not-for-profit purposes. Permission is given with the understanding that none of the material will be used to imply TRB, AASHTO, APTA, FAA, FHWA, FTA, GHSA, or NHTSA endorsement of a particular product, method, or practice. It is expected that those reproducing the material in this document for educational and not-for-profit uses will give appropriate acknowledgment of the source of any reprinted or reproduced material. For other uses of the material, request permission from CRP. NOTICE The research report was reviewed by the technical panel and accepted for publication according to procedures established and overseen by the Transportation Research Board and approved by the National Academies of Sciences, Engineering, and Medicine. The opinions and conclusions expressed or implied in this report are those of the researchers who performed the research and are not necessarily those of the Transporta- tion Research Board; the National Academies of Sciences, Engineering, and Medicine; or the program sponsors. The Transportation Research Board does not develop, issue, or publish standards or spec- ifications. The Transportation Research Board manages applied research projects which provide the scientific foundation that may be used by Transportation Research Board sponsors, industry associations, or other organizations as the basis for revised practices, procedures, or specifications. The Transportation Research Board; the National Academies of Sciences, Engineering, and Medicine; and the sponsors of the Airport Cooperative Research Program do not endorse products or manufacturers. Trade or manufacturers’ names or logos appear herein solely because they are considered essential to the object of the report. Published research reports of the AIRPORT COOPERATIVE RESEARCH PROGRAM are available from Transportation Research Board Business Office 500 Fifth Street, NW Washington, DC 20001 and can be ordered through the Internet by going to https://www.mytrb.org/MyTRB/Store/default.aspx Printed in the United States of America

e 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. e 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. John L. Anderson is president. e 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. e 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. e 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.nationalacademies.org. e Transportation Research Board is one of seven major programs of the National Academies of Sciences, Engineering, and Medicine. e mission of the Transportation Research Board is to provide leadership in transportation improvements and innovation through trusted, timely, impartial, and evidence-based information exchange, research, and advice regarding all modes of transportation. e Board’s varied activities annually engage about 8,000 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. e 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.

C O O P E R A T I V E R E S E A R C H P R O G R A M S AUTHOR ACKNOWLEDGMENTS This project was a success due to airport officials and the public health officials participating in inter- views and sharing their COVID-19 response experiences. Most interviews were conducted in 2021, when airport officials and public health officials were extremely busy with their ongoing pandemic response activities. Nonetheless, they took the time to describe their successes and areas of improvement for the benefit of the entire airport community. The authors thank these individuals for selflessly sharing their experiences and insights during an otherwise difficult time. We hope this compilation of COVID-19 lessons learned provides a valuable resource to the commercial service airport industry and to other air travel interests. CRP STAFF FOR ACRP RESEARCH REPORT 253 Christopher J. Hedges, Director, Cooperative Research Programs Waseem Dekelbab, Deputy Director, Cooperative Research Programs Marci A. Greenberger, Manager, Airport Cooperative Research Program Brittany Summerlin-Azeez, Program Coordinator Natalie Barnes, Director of Publications Heather DiAngelis, Associate Director of Publications ACRP PROJECT 03-49 PANEL Field of Policy and Planning Julie Morita, Robert Wood Johnson Foundation, Princeton, NJ (Chair) Paulo Magalhães Alves, MedAire, Inc., Scottsdale, AZ Clive M. Brown, Centers for Disease Control and Prevention, Atlanta, GA Matt Cornelius, Airports Council International–North America Liaison Kristen Rosdahl Ehresmann, Minnesota Department of Health (retired), Apple Valley, MN Augustus L. Hudson, Hartsfield–Jackson Atlanta International Airport, Atlanta, GA Frank R. Miller, Burbank–Glendale–Pasadena Airport Authority, Burbank, CA Mary Elizabeth Wilson, University of California San Francisco, San Francisco, CA

Before 2020, airports’ paradigm for communicable disease preparedness focused on responding to an aircraft with one or more ill passengers. Today, it is imperative that airport employees know how to respond to many disease outbreak scenarios—not just a single pas- senger or a plane with multiple passengers and crew members who may have a communi- cable disease or have been exposed to it. ACRP Research Report 253: Airport Lessons Learned from the COVID-19 Pandemic summarizes commercial service airports’ lessons learned in their responses to the COVID-19 pandemic. The worldwide COVID-19 pandemic emerged and spread rapidly and, for more than a year, changed the way people interacted with others, both personally and professionally. The ACRP had already been advancing the body of knowledge available to airports on public health emergencies and other public health events. For example, an Insight Event, Airport Roles in Reducing Transmission of Communicable Diseases, was held in March 2018. A follow-on project, ACRP Project 03-49, “Effective Collaboration to Plan and Respond to Communicable Disease Threats,” was selected from that event. In February 2020, just when the country was beginning to shut down due to COVID-19, that project’s research team was about to convene workshops with airport operators to identify best practices for airports and their public health partners to prevent, respond to, and mitigate the transmis- sion of communicable diseases. The unfolding events of the COVID-19 pandemic made completing that work impossible; airport operators and public health officials were focused on responding to the pandemic, and convening in-person meetings was not advised. Recognizing the importance of this topic, the project panel opted to pause the follow-on project and change its objectives to instead gather airport lessons learned from responding to the pandemic. The researchers from Eastern Research Group, Inc., were able to pivot and submit a revised research approach to meet the new objective. They interviewed represen- tatives from 127 commercial service airports as well as public health officials who engaged with some of those airports. Airport operators of various sizes and across different depart- ments will find the information in this report useful as they prepare for and respond to future communicable disease outbreaks. F O R E W O R D By Marci A. Greenberger Staff Officer Transportation Research Board

Note: Photographs, figures, and tables in this report may have been converted from color to grayscale for printing. The electronic version of the report (posted on the web at nap.nationalacademies.org) retains the color versions. 1 Summary 6 Chapter 1 Background 6 1.1 Airports and Communicable Diseases 8 1.2 About This Project: Lessons Learned from COVID-19 9 1.3 About This Report 10 Chapter 2 Research Methods 10 2.1 Semi-structured Interviews with Airport Officials 14 2.2 Interviews with Public Health Officials 15 2.3 Search of the Peer-reviewed Literature 16 Chapter 3 Summary of Interviews with Airport Officials 16 3.1 Profile of Airports Contacted and Interviewed 18 3.2 Communicable Disease Response Plans 23 3.3 Communication and Coordination with Public Health Authorities and Other Parties 28 3.4 Social Distancing at Airports 34 3.5 Face Coverings and Masks 42 3.6 Cleaning and Hygiene Protocols 53 3.7 Screening and Testing for COVID-19 at Airports 65 3.8 Infrastructure Considerations for Reducing COVID-19 Transmission 69 3.9 Other Issues 75 3.10 Concluding Questions and Lessons Learned 85 Chapter 4 Summary of Interviews with Public Health Officials 89 References 91 List of Acronyms A-1 Appendix A Interview Questions for Airport Participants B-1 Appendix B Review of Communicable Disease Response Plans C O N T E N T S