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

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1   The COVID-19 pandemic significantly disrupted commercial air travel. As critical infra- structure, commercial service airports in the United States continued to operate throughout the pandemic, even when passenger counts dropped precipitously. Airports of all sizes and types faced difficult questions, including the following: • Which combination of health protocols will best protect workers and passengers from COVID-19? • What trusted information resources should airports access to learn about COVID-19 and how to reduce its transmission? • Should airports and their tenants screen or test workers for COVID-19? • How can airports accommodate social distancing in terminals that are already space- constrained? • Which new products and technologies are most effective at killing or controlling COVID-19? Since the pandemic emerged, commercial service airports and numerous stakeholders researched these and many other questions in order to help sustain air travel while also reducing disease transmission and assuring passengers of their safety. Commercial service air travel interests now have a great deal of experience responding to COVID-19. This report provides a compilation of the lessons they have learned and is intended as a resource not only for continued response to COVID-19 but also as preparation for future communicable disease outbreaks. The research focused on the lessons learned by commercial service airports from their responses to the COVID-19 pandemic—particularly the measures implemented in an effort to reduce disease transmission. In 2021, the research team completed 124 interviews with representatives from 127 commercial service airports of all sizes and from all geographic regions. The interviews sought information on how airports had responded to COVID-19 in calendar year 2020 (before vaccines were widely available and before the U.S. federal government issued its mask mandate). This report compiles and summarizes the interview responses. Its primary audience is commercial service airports; secondary audiences include public health authorities, gov- ernment officials, airport tenants, industry trade associations, and other air travel interests. The following pages present a high-level summary of lessons learned; the remainder of the report presents further detail. S U M M A R Y Airport Lessons Learned from the COVID-19 Pandemic

2 Airport Lessons Learned from the COVID-19 Pandemic Airports and Communicable Diseases Prior to 2020, commercial service airports in the United States had limited experience preparing for or responding to communicable disease outbreaks. Airports with this experi- ence were mostly large hubs with international arrivals, and these were mainly experienced in responding to ill passengers on isolated flights—not a pandemic of the magnitude and duration of COVID-19. Pandemic response was new territory for much of this industry. It is understood that commercial service airports are not health care settings and are not expected to do the work of public health departments during communicable disease outbreaks. That said, the COVID-19 pandemic response illustrated steps that commercial service airports can take to help prevent disease spread among workers and the traveling public—and to remain operational even as most non-critical infrastructure shuts down. Commercial Service Airports in the United States More than 500 commercial service airports operate in the United States, and their commu- nicable disease response resources vary widely. Large hub airports have their own public safety departments, typically with more than 100 employees who specialize in emergency manage- ment, law enforcement, firefighting, hazardous material response, and emergency medical services. Some large hub airports have the added benefit of a Centers for Disease Control and Prevention (CDC) quarantine station on the premises. At the other end of the spectrum, nonhub airports have limited internal emergency management resources, their workers fill many job functions, and they often rely on contracts and mutual aid agreements with outside parties to provide public safety services. Commercial service airports vary in other characteristics as well (e.g., location and owner- ship structure) that relate to communicable disease response. For example, some airports in certain remote or isolated places faced highly restrictive local government policies intended to prevent them from importing COVID-19; other jurisdictions had far less restrictive poli- cies. Airports in moderate climates could increase the use of outdoor space in order to over- come social distancing challenges; airports in colder climates could not easily do the same. Despite these and many other (sometimes considerable) differences experienced across the industry, all commercial service airports faced the same challenge: a highly contagious disease that was widely circulating in their communities and creating the constant potential for infected workers, passengers, or visitors to enter airport terminals. This report docu- ments the range of actions airports took to meet that common challenge. Lessons Learned from Responding to COVID-19 This report summarizes input from interviews with about one-fourth of the commercial service airports in the United States. Due to various airport- and location-specific nuances, it does not present prescriptive guidelines or recommendations for how all airports should have responded to COVID-19 or should respond to future outbreaks. This is because public health protocols found to be effective at certain airports may not be effective—or even feasible— at others. Although the differences between commercial service airports were noted in many inter- views, some basic principles of communicable disease response apply more broadly. These key topics are introduced in this section; the rest of this report—especially Chapter 3— documents the full range of interview input. Airports are encouraged to consider all input

Summary 3 presented in this report before changing any approaches to preparing for communicable disease outbreaks. Airports should always ensure that their disease response efforts meet applicable local, state, tribal, and federal mandates. Key topics raised during interviews with commercial service airports include the following: • Widely varying government-mandated COVID-19 protocols. This report does not include guidelines and recommendations that apply industry-wide because state and local elected officials and public health authorities issued a range of COVID-19 requirements that applied to commercial service airports. In 2020, some states had COVID-19 occupa- tional health and safety standards, mandatory entry screening of arriving passengers, and statewide mask mandates; other states had limited or no requirements that applied to commercial service airports. • Importance of early awareness of COVID-19. Some airports were aware of and began responding to the COVID-19 pandemic well before others. Airports with early aware- ness could secure pandemic-related personal protective equipment (PPE), hand sanitizer, cleaning solutions, and other supplies before demand and prices increased. Factors con- tributing to early awareness included (1) being designated as a funneling airport—one at which arriving international passengers were screened for COVID-19; (2) being in a region that had early COVID-19 surges; and (3) being notified by local public health authorities of the emerging pandemic. • Leadership by example. Some airports cited effective leadership as essential to implement- ing airport-wide COVID-19 protocols. From executive management to department heads, managers who emphasized the need to protect workers, supported COVID-19 health protocols, and visibly adhered to those protocols contributed to a workplace culture that valued disease prevention and hygiene. • An engaged workforce. The COVID-19 pandemic affected workers at all levels of an air- port’s organization, including public safety, maintenance, human relations, legal, and information technology, among others. Some airports said that giving workers or their representatives a seat at the table when identifying pandemic-related workplace hazards and hazard mitigation policies helped to ensure that workers were invested in and com- pliant with COVID-19 health protocols. • Meeting or surpassing public health mandates. Some commercial service airports chose to meet all applicable public health mandates but not to surpass them. Different rea- sons were given for this approach, including (1) deferring public health policy to those who specialized in it; (2) fearing the legal implications of implementing an ineffective policy that conflicted with local guidelines; and (3) being located in a state that prohib- ited local jurisdictions from developing COVID-19 protocols that were stricter than state mandates. However, some commercial service airports chose to implement COVID-19 requirements that surpassed the minimum requirements of their jurisdictions. For exam- ple, some of these airports implemented their own mask mandates before local and state government agencies did so. • Identifying trusted sources of information. Nearly every commercial service airport inter- viewed for this project sought information from outside parties on COVID-19 and how to mitigate its associated risks. These outside parties included public health departments, trade associations, other commercial service airports, and local medical professionals. Having a community of professional contacts may be of help in future outbreaks; some outside parties may be too involved in their own disease response duties to respond to inquiries from unknown contacts. • Developing and maintaining communicable disease response plans (CDRPs). Many com- mercial service airports use CDRPs to prepare for and respond to communicable disease outbreaks. These plans (which are currently not required by federal regulation) will not

4 Airport Lessons Learned from the COVID-19 Pandemic prevent disease outbreaks from occurring, but they can help airports to prepare for and minimize the consequences of outbreaks. Nearly every CDRP reviewed for this project focused on responding to an incoming flight with one or more ill passengers and did not consider the many unique challenges posed by a prolonged pandemic. Many air- ports with CDRPs said they intended to update them to reflect lessons learned from the COVID-19 pandemic. Airports that intended to develop CDRPs for the first time said that this process would benefit from guidelines, model plans, and CDRP templates tailored to differing airport sizes. • Establishing relationships with key stakeholders. Key stakeholders should never be con- tacted for the first time during a crisis, when they are least likely to have the capacity to respond. Airport and public health officials interviewed for this project said that having established relationships with stakeholders prior to disease outbreaks can help airports to avoid roadblocks and improve decision-making during emergencies. Relationship build- ing is particularly important both to help with continuity when there is staff turnover and to provide resources for commercial service airports that operate independently from the city or county agencies that lead public health emergency responses (e.g., airport authorities). • Coordinating effectively with tenants. Multiemployer worksites are known to present occupational health and safety challenges. This is especially true for communicable dis- eases because people working in proximity at a multiemployer worksite may be following different disease prevention guidelines. Commercial service airports are classic exam- ples of multiemployer worksites. The airports interviewed for this project had varying philosophies on coordinating their COVID-19 responses with tenants. Some airports had hands-off approaches that assumed their tenants would follow their own corporate COVID-19 health protocols. Other airports had hands-on approaches (e.g., reviewing tenant preparedness plans or monitoring tenant compliance with mandates) to ensure that tenants were following basic COVID-19 guidelines. This latter philosophy recognized that any tenant employer with lax COVID-19 policies could increase disease transmis- sion risks for all airport workers. • Keeping workers healthy, safe, and well. Nearly every airport that participated in inter- views emphasized the need to protect its workers—especially its essential workers—from COVID-19. Several small hub airports and nonhub airports acknowledged that there were times when they came close to temporarily ceasing operations because so many essential workers were either out sick or could not report to work because they were under quarantine after a potential COVID-19 exposure. Some of these airports explored staffing contingency options (e.g., cross-training workers on multiple job functions) as a remedy. Further, nearly every airport interviewed for this project placed essential workers into non-overlapping cohorts or “bubbles” to avoid widespread illness. Other strategies to ensure workers’ health and wellness included staggering shifts, closing break rooms, offering generous sick leave policies, fostering employee morale, and addressing pandemic-related mental health concerns. • Implementing core non-pharmaceutical interventions. Throughout the pandemic, public health officials emphasized three non-pharmaceutical interventions to reduce the spread of COVID-19, specifically (1) mask use, (2) social distancing, and (3) improved hygiene. These interventions relied on passengers’ and workers’ personal willingness to comply. This report describes a broad range of strategies that commercial service airports imple- mented (and the obstacles they encountered) when promoting these interventions and when cleaning and disinfecting their terminals. • Adopting technologies to reduce spread of COVID-19. A common experience at com- mercial service airports was that of having multiple vendors promote a range of new products and technologies purported to help reduce the spread of COVID-19. Although

Summary 5 airport officials were not averse to adopting emerging technologies, many had difficulty finding independent verification of vendors’ effectiveness claims—or they decided to conduct effectiveness tests on their own. A few airport officials reported having adopted new technologies to reduce COVID-19 spread, only to later learn of the technologies’ limited effectiveness. The airport community would benefit from having a trusted third party available to perform rapid, independent technology evaluations in future outbreak scenarios. • Changing airport infrastructure to address COVID-19. The built environment at airports can increase or mitigate occupants’ risk of exposure to airborne pathogens—including COVID-19. During interviews, airport officials described changes they had made (or con- templated making) to heating, ventilation, and air conditioning (HVAC) systems. They also described how they had reconfigured their spaces to promote social distancing or to accommodate COVID-19 screening and testing. Interview responses suggested that airports about to undergo major renovations or expansion were less inclined to upgrade existing infrastructure in response to COVID-19. • Implementing or accommodating COVID-19 screening programs. Half of the airports interviewed screened their workers for COVID-19 at some point in 2020; screening was more common at large hub and medium hub airports than it was at small hub and nonhub airports. Some airports that screened workers used smartphone applications or screening kiosks to facilitate this process. Many airports that did not screen their workers for COVID-19 instead educated them about symptoms of concern and encouraged them to self-monitor and stay home if they developed symptoms or had potential exposures. COVID-19 screening of passengers was less common and in nearly every case was imple- mented by public health authorities, although the airports had to make space available for the screening and otherwise accommodate these programs. • Launching COVID-19 test sites. In 2020, COVID-19 test sites were most prevalent at large hub airports, with fewer sites available as airport size decreased. These sites offered a range of COVID-19 tests [e.g., polymerase chain reaction (PCR) versus antigen or rapid versus 24-hour turnaround]. At the airports interviewed for this project, the test sites differed in many ways, including (1) who did the testing, (2) where the testing was done, (3) whether public health authorities were involved in launching the test sites, and (4) what happened when passengers received positive test results. In a few jurisdictions, passengers on arriv- ing flights had to produce evidence of a negative COVID-19 test or agree to quarantine for a certain period. The remainder of this report, particularly Chapter 3, describes these issues in far greater detail. It also raises many other issues that commercial service airports faced, such as under- standing privacy laws, implementing contact tracing, transitioning to telework for non- essential employees, and researching COVID-19 transmission incidents that were known or suspected to have occurred at airports.