Improving the CDC Quarantine Station Network's Response to Emerging Threats (2022) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-30
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. A cornerstone of the DGMQ's efforts to prevent the importation of infectious diseases among this high volume of incoming international travelers is its network of quarantine stations.
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This undertaking follows a 2006 IOM report, Quarantine Stations at Ports of Entry: Protecting the Public's Health, that had also been requested by CDC. The emergence of the COVID-19 global pandemic again prompted CDC to request that the National Academies of Sciences, Engineering, and Medicine convene a committee to conduct an external assessment of the role of DGMQ and the federal quarantine station network in mitigating the risk of onward communicable disease transmission in light of changes in the global environment, including large increases in international travel, threats posed by emerging infections, and the movement of animals and cargo.
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and the federal quarantine stations' strategies, policies, infrastructure, and resources dedicated to mitigating the risk of onward communicable disease transmission in the con text of ongoing changes in the global environment, including large increases in international travel, threats posed by emerging infections, and the movement of animals and cargo. The committee will provide recommendations for the DGMQ to better respond to infectious disease outbreaks and pandemics.
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The committee reviewed needed changes in the CDC's infrastructure and regulatory authorities pertaining to • how the DGMQ may leverage innovative approaches to data sys tems and/or analytical methods to mitigate scale limitations for current processes; • potential changes to regulations to implement recommended measures; • the scope of responsibilities and types of partners needed at quar antine stations; • how best to support health departments and other partners in mitigating disease transmission; and • optimal types of staff and scheduling at CDC quarantine stations and headquarters. Study Methods In developing this report and its recommendations, the committee deliberated for approximately 5 months, from November 2021 through March 2022.
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.3,4 Expansion of the Quarantine Station Network Almost a century after the first quarantine station was built at Philadelphia's port in 1799 after a yellow fever outbreak, the passage of the National Quarantine Act (1878) shifted some quarantine powers from the state to the federal level.5 In 1944, the federal government's quarantine 2 CBP's use of "port of entry" refers to an administrative center whose jurisdiction may include more than one entry facility in a certain geographic area (e.g., the Philadelphia Port of Entry services Philadelphia International Airport, Philadelphia's seaport, Trenton Mercer Airport, Atlantic City International Airport, and ports in Lehigh Valley, PA)
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22 FIGURE 1-1 CDC quarantine stations and their jurisdictions.
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renewed concerns about bioterrorism and infectious disease threats and catalyzed the expansion of the federal quarantine station network. In fiscal year 2003, Congress began allocating funds for an expansion to a total of 25 quarantine stations at ports of entry including airports, seaports, and land-border crossings (Institute of Medicine, 2006)
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. The federal government has legal authorities6 to implement isolation and quarantine measures to help prevent the public's exposure to an individual who has or may have specific infectious diseases of great public health risk (CDC, 2021b)
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During the outset of the COVID-19 pandemic, however, the CDC implemented isolation and quarantine for individuals entering the United States from Hubei Province, China, and two cruise ships with identified outbreaks (CDC, 2020) .8 2006 IOM REPORT AND SUBSEQUENT DEVELOPMENTS The 2006 IOM consensus study report Quarantine Stations at Ports of Entry: Protecting the Public's Health provided a set of recommendations about how the DGMQ's quarantine station network could strengthen its capacities to mitigate disease importation and its response to infectious threats at the nation's borders (Institute of Medicine, 2006)
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The DGMQ also developed a series of tools and practices including a data system to catalogue all events occurring at quarantine stations and support follow up activities for ill travelers, such as documenting diagnostic test results. However, post-arrival public health follow-up has been limited due to failure to implement an electronic traveler contact data collection system.9 In addition to expanding the number of quarantine stations in the network, the stations have been revamped in response to the recommendations made in the 2006 report.
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The global impact of the COVID-19 pandemic revealed the broad range of partners with which the DGMQ must engage to effectively execute its roles and responsibilities in mitigating transmissible disease threats, including federal interagency partners; state, tribal, local, and territorial agencies; international partners; and private-sector entities. This study highlights the critical importance of fostering trust and strengthening the DGMQ's functional working relationships across agencies and sectors to effectively counter future infectious disease threats.
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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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INTRODUCTION 29 Wang, H., K
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