Improving the CDC Quarantine Station Network's Response to Emerging Threats (2022) / Chapter Skim
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5 Improving Coordination and Collaboration
5 Improving Coordination and Collaboration
Pages 149-170
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accomplishes its duties through a mixture of regulatory authorities as well as operating partnerships. Because of the nature of the quarantine function, these partnerships are with both domestic and international partners in government and the private sector -- other nation's quarantine and disease control organizations; U.S.
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º Transportation Security Administration (TSA)
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. DHS interagency coordination during the COVID-19 pandemic led to a number of international travel orders, including a mask mandate, vaccine order, global testing order, and contact data collection.
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While the 20 CDC quarantine stations cover all of the POEs, CBP officers serve as "eyes, ears, and hands for CDC and HHS." The DGMQ trains CBP officers to identify overt signs of quarantinable and other communicable diseases, which allows CBP officers to make an initial determination that a traveler may be ill. The CDC also provides job aids (RING cards)
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for certain infectious travelers who are noncompliant with local public health advice not to travel, and by issuing Security Directives and Emergency Amendments to impel commercial air carriers to implement measures consistent with CDC directives like a mask mandate. For individuals to be placed on the Do Not Board list, they have to be actively infectious, demonstrate they are noncompliant with public health isolation orders, and have an intent to board a commercial aircraft.
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The division also collaborates with the OGA on preparedness and response to pandemics and emerging threats and in addressing travel policies as part of the Global Health Security Initiative including the activities to strengthen U.S.–Mexico land border preparedness. The DGMQ also meets with Canadian counterparts monthly or more frequently (as has been the case during the COVID-19 pandemic)
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Local and state jurisdictional health departments contribute to preventing and responding to infectious disease outbreaks in a range of invaluable ways, from surveillance activities to the deployment of immunizations to the delivery of screening, care, and treatment. The HHS ASPR coordinates the overall public health response to a disease outbreak.
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2018–2023 strategic plan, which includes the strategy to "improve international collaboration and capacities for emerging infectious disease prevention, surveillance, control and research" (NCEZID, 2018, pg.
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The U.S. government designated CDC quarantine stations as the competent authority to support the implementation of the IHR at U.S.
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The Division's Quarantine Travel Epidemiology Team works with staff at the quarantine stations to respond to reports of illness or exposure to disease related to air or maritime travel when contact investigations are indicated. Its aviation activity works with STLT health departments, as well as with international partners, to facilitate aircraft contact investigations (Brown et al., 2021)
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The DGMQ has an important role to play in the development of a better international approach to maritime and aviation systems infectious disease control. Collaboration with Academic Partners Lessons from past pandemic response efforts provide key insights for evaluating the effectiveness of measures and outcomes.
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BEST PRACTICES FOR IMPROVING COORDINATION AND COLLABORATION Coordination between Federal and STLT Systems Developing and implementing best practices for improving coordination between federal and STLT systems can help to bolster infectious disease response efforts. For instance, through collaboration with federal and STLT stakeholders, the CSTE has identified multiple opportunities to strengthen communication and coordination between the DGMQ, the Quarantine and Border Health Services Branch (QBHSB)
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Develop shorter, on-demand webinar training for various outbreak response topics including awareness of HD local CDC realities. Develop clear protocols, requirements, and data collection tools for jurisdictional health departments in the Do Not Board CDC process.
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. ELEMENTS OF EFFECTIVE COORDINATION AND COLLABORATION Robust coordination and collaboration at the national, regional, and local levels provide the foundation for timely and effective public health response to an emerging or ongoing outbreak of infectious disease.
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For example, in conjunction with CDC and DGMQ experts, the CSTE developed and updated a Notification Protocol and Data Collection Guidance to support health departments in notifying infectious persons with recent travel to the CDC's quarantine stations.14 This process of seeking input from stakeholders at all levels should be continual throughout the cycle of response to an outbreak, beginning in the preparation phase before an outbreak occurs, then extending throughout the acute response and recovery stages. Existing mechanisms can be leveraged to facilitate this engagement.
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Key components of these best practices include predecisional collaboration and regular communication among international, federal, and STLT partners to ensure smooth operations on the ground at the jurisdictional level. Predecisional Collaboration Predecisional collaboration is foundational to infectious disease prevention and control efforts.
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Conclusion 5-4: International collaboration is an important component of the DGMQ's activities. The main framework for international col laboration regarding disease control and prevention are the Interna tional Health Regulations (IHR)
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Improve collaboration with international partners through regu larly scheduled forums: 1. Actively engage in the International Health Regulations (IHR)
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Recommendation 5-2: The Division of Global Migration and Quaran tine (DGMQ) should modernize health communication efforts with and for travelers to improve public understanding of disease control efforts as well as compliance.
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There's more to border health than interventions at our borders: CDC. Presentation to the National Academies of Sciences, Engineering, and Medicine Committee on Analysis to Enhance the Effectiveness of the Federal Quarantine Station Network.
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2021. Evaluation of jurisdictional & federal public health responses to past & cur rent outbreaks & implementation of CSTE protocol for health department notification to CDC quarantine stations of infectious persons with recent travel.
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2018. National Center for Emerging and Zoonotic Infectious Diseases Strategic Plan: 2018–2023.
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