Emergency Request Memo

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service
Centers for Disease Control
and Prevention (CDC)
Atlanta GA 30333
April 5, 2020

Dominic Mancini
Acting Deputy Director
Office of Information and Regulatory Affairs
Office of Management and Budget
Washington, D.C.
Subject: Request for Emergency Clearance
Dear Mr. Mancini:
Pursuant to the Office of Management and Budget (OMB) procedures established at 5
CFR 1320, Controlling Paperwork Burdens on the Public, I request that the following
collection of information, Airline and Vessel and Traveler Information Collection
(42 CFR Part 71.4(d)), be processed in accordance with section 1320.13 Emergency
Processing.
I have determined that this information must be collected prior to the expiration of time
periods established under Part 1320, and that this information is essential to the CDC’s
ability to effectively address the public health emergency from COVID-19 that began in
Wuhan City, Hubei Province, China, and which continues to expand globally and within
the United States. CDC has found that cruise ship travel markedly increases the risk and
impact of the COVID-19 disease outbreak within the United States. If unrestricted cruise
ship passenger operations were permitted to resume, infected and exposed cruise ship
cases would place healthcare workers at substantial increased risk. Specifically, these
cases would divert medical resources away from persons with other medical problems
and other COVID-19 cases, consuming precious diagnostics, therapeutics, and protective
equipment. Ongoing concerns with cruise ship transmission would further draw valuable
resources away from the immense Federal, state, and local effort to contain and mitigate
the spread of COVID-19. Further, the current ongoing non-passenger operation of cruise
ships has not sufficiently abated the public health concern, as ship crew become sick and
require medical care drawing on otherwise engaged Federal, state, and local resources.
As operators of non-U.S. flagged vessels sailing in international waters, it is imperative
that the cruise ship industry and cruise lines themselves take responsibility for the care of
their crew and do not further tax limited U.S. resources during a public health emergency.
Therefore, as part of an extended No Sail Order, CDC is requiring that cruise ship
operators have constructed appropriate, actionable, and robust plans to prevent, mitigate,
and respond to the spread of COVID-19 on board cruise ships if they intend to operate
within the jurisdiction of the United States. These plans must meet the following criteria:
• adequately prevents, mitigates, and responds to the spread of COVID-19 on board
cruise ships
• ensures that any disembarkation of passengers or crew is conducted in such a way
as to not result in further spread of COVID-19.

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response measures shall not significantly burden U.S. government operations or
the operations of any state or local government, including the U.S. healthcare
system.
remains consistent with CDC recommendations and guidance for any public
health actions related to COVID-19.

CDC cannot reasonably comply with the normal clearance procedures due to the public
harm that could result if routine processing of this request is required. CDC requests
emergency clearance to require cruise ship operators to develop these COVID-19
response and mitigation plans for review by CDC, as requested.
As of March 31, COVID-19 has caused more than 160,000 illnesses and nearly 3,000
deaths in the United States. The public health response is immensely resource intensive
and the additional burden of preventable cases from cruise ship should be addressed by
the cruise ship operators. Implementing this information collection from the cruise ship
operators can ensure that they have sufficient plans to address COVID-19 outbreaks
onboard, and prevent further cases in the United States. Absent this emergency approval
CDC will not be able to implement this program in a timely manner.
Please provide an approval/disapproval determination of this request to collect
information under an emergency clearance by close of business on Monday, April 6,
2020.

Respectfully,
Digitally signed by

Rima F.
Rima F. Khabbaz -S
2020.04.05
Khabbaz -S Date:
08:56:36 -04'00'
Rima Khabbaz, MD
Director, National Center for Emerging and Zoonotic
Infectious Diseases (NCEZID), Centers for Disease
Control and Prevention (CDC)