2019 Novel Coronavirus Airport Entry Questionnaires
Request for OMB approval of a New Information Collection
Supporting Statement B
Contact:
Nancy Khalil, J.D.
Centers for Disease Control and Prevention
1600 Clifton Road NE, MS H16-5
Atlanta, Georgia 30329-4027
Phone: (770) 488-2070
Email: kuj2@cdc.gov
B. Collections of Information Employing Statistical Methods 2
1. Respondent Universe and Sampling Methods 2
2. Procedures for the Collection of Information 2
3. Methods to Maximize Response Rates and Deal with No Response 3
4. Tests of Procedures or Methods to be Undertaken 4
5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data 5
No statistical methods are used in this data collection.
No sampling is involved in the entry risk assessment program. Currently, the U.S. Traveler Health Declaration form that comes in three different formats (Attachments C, D, or E), Supplemental COVID-2019 Questionnaire (Attachment J), COVID-2019 Air Illness or Death Investigation form (Attachment K) will be administered to travelers arriving at a U.S. airport from certain areas experiencing an outbreak of a novel (new) coronavirus (named “COVID-2019”). The Referral Slip (Attachment I), may be used if CDC is able to receive contact information through alternative mechanisms. The purpose of this information collection is to detect ill individuals or individuals at risk of being ill with COVID-2019, which was first detected in Wuhan City, Hubei Province, China. If an individual from an outbreak country undergoing screening (e.g. China or Iran) is identified as being at higher risk because of the area they came from; because they have signs or symptoms; or because they were exposed to a known case of COVID-2019; they will be required to undergo a further public health evaluation. Individuals will be either released and given a booklet of recommendations about self-monitoring, referred to a healthcare facility, or required to undergo quarantine or public health monitoring for a 14-day period following their arrival, to see if they develop any symptoms
As part of the entry risk assessment program, CDC is also assisting the Department of State in the repatriation of individuals from areas at high risk for COVID-2019. These individuals may be assessed for their risk of illness and exposure to COVID-2019 using the Preboarding Health Screen (Attachment F), the U.S. Traveler Health Declaration for Repatriation form (Attachment G), or the U.S. Traveler Health Declaration for Repatriation from Ship (Attachment H). These individuals will be quarantined for a period of no longer than two weeks following their arrival to see if they develop any symptoms and require further public health follow-up or medical care.
The primary signs/symptoms of concern for COVID-2019 are fever, cough, and difficulty breathing. COVID-2019 infection has been associated with severe respiratory illness in some patients and, to date, has been focused in specific geographic areas and travelers from those areas. The potential incubation period of concern is 2 weeks; this is based on the upper range incubation period seen with coronavirus infections.
The U.S. Traveler Health Declaration form, (Web, PDF, or Paper format) will be used at U.S. ports of entry to screen travelers coming to the United States from China and Iran, and potentially expand to other areas affected by the outbreak of COVID-2019. The format being used of the U.S. Traveler Health Declaration form (Paper, Fillable PDF, or Web form) will depend on network capabilities and location. If a traveler answers in the affirmative to experiencing any of the specified criteria, the threshold for a further public health evaluation is met. The Supplemental COVID-2019 Questionnaire may be used to better understand exposure risk. CDC will use the COVID-2019 Air Illness or Death Investigation form for anybody with symptoms to conduct an enhanced public health assessment to determine if referral to a healthcare facility is necessary. Mandarin and Farsi translation guides will be available to assist travelers who need them.
Travelers being repatriated to the United States due to the outbreak of COVID-2019 may have a brief symptom check using the Pre-Boarding Health Screen form prior to boarding. They will be monitored during the flight, and will be asked to complete a U.S. Traveler Health Declaration for Repatriation or a U.S. Traveler Health Declaration for Repatriation from Ships prior to or at arrival in the United States. After arrival, they may be put under travel restrictions for the incubation period of 14 days to see if they develop illness. This monitoring will involve basic temperature taking and symptom check, potentially up to twice a day.
Upon approval of this information collection request, answers to CDC’s information collections involving airport entry questionnaires, and temperature checks will be required by regulation. During the response to Ebola in 2014-2016, CDC worked with states to achieve a 99% response rate for those individuals who received follow-up after arrival. CDC is similarly emphasizing the importance of this follow-up with our state and local public health partners.
Most of the procedures being undertaken during these programs was successful during the response to Ebola in 2014-2016. CDC intends to leverage that experience to maintain a high rate of response to its information collections.
No statistical methods are used in this data collection. Therefore, no individuals were consulted.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | ije7 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-14 |