Status of Research Efforts and Action Still Needed to Develop Federal Preparedness Plan (GAO-20-655T)

Summary

GAO testimony, GAO-20-655T, before the Subcommittee on Space and Aeronautics of the House Committee on Science, Space, and Technology on June 23, 2020. It is the statement of Heather Krause, Director, Physical Infrastructure, on air travel and communicable diseases. GAO states that the United States still lacks a comprehensive plan for national aviation preparedness to limit the spread of communicable diseases through air travel. It recalls that in December 2015, during the Ebola epidemic, GAO recommended that the Department of Transportation work with relevant stakeholders to develop such a plan. It notes that U.S. passenger airline traffic fell by 96 percent in April.

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United States Government Accountability Office
Testimony
Before the Subcommittee on Space
and Aeronautics, Committee on
Science, Space, and Technology,
House of Representatives
AIR TRAVEL AND
For Release on Delivery
Expected at 11:30, a.m. ET
Tuesday, June 23, 2020

COMMUNICABLE
DISEASES
Status of Research Efforts
and Action Still Needed to
Develop Federal
Preparedness Plan
Statement of Heather Krause, Director,
Physical Infrastructure

GAO-20-655T
June 23, 2020

AIR TRAVEL AND COMMUNICABLE DISEASES
Status of Research Efforts and Action Still Needed to
Develop Federal Preparedness Plan
Highlights of GAO-20-655T, a testimony
before the Subcommittee on Space and
Aeronautics, Committee on Science, Space,
and Technology, House of Representatives

Why GAO Did This Study What GAO Found
The transmission of COVID-19 has The United States still lacks a comprehensive plan for national aviation
been greatly aided by air travel. In light preparedness to limit the spread of communicable diseases through air travel. In
of the pandemic and warnings about December 2015 during the Ebola epidemic, GAO recommended that the
the risks of air travel, U.S. passenger Department of Transportation (DOT) work with relevant stakeholders, such as
airline traffic fell by 96 percent in April the Department of Health and Human Services (HHS), to develop a national
2020 as compared to April 2019. aviation-preparedness plan for communicable disease outbreaks. GAO
COVID-19 is only the latest concluded that the absence of a national plan undermined the ability of the
communicable disease threat to raise public-health and aviation sectors to coordinate on a response or to provide
public health concerns regarding the
consistent guidance to airlines and airports. Moreover, Annex 9 to an
spread of contagion through air travel.
international aviation treaty to which the United States is a signatory contains a
Ensuring that the United States is
prepared to respond to disease threats
standard that obligates member states to develop such a plan. DOT is now
from air travel, as well as conducting confronting an even more widespread public health crisis—the Coronavirus
the necessary research to reduce the Disease (COVID-19) global pandemic—without having taken steps to implement
risks of contagion, are two vital this recommendation. Not only could such a plan provide a mechanism for the
responsibilities of the federal public-health and aviation sectors to coordinate to more effectively prevent and
government. control a communicable disease threat, it could also help minimize unnecessary
disruptions to the national aviation system, disruptions that to date have been
This statement provides information on significant. Some aviation stakeholders have publicly highlighted the resulting
(1) the U.S. aviation system’s piecemeal approach to adopting standards during the response to COVID-19,
preparedness to respond to
such as various airline and airport policies regarding facemasks, as
communicable disease threats and (2)
demonstrating the need for a more coordinated response. The existence of a
FAA’s management of its R&D
portfolio, including the extent to which national plan might have reduced some of the confusion among aviation
disease transmission on aircraft and at stakeholders and passengers. While DOT agrees that a national aviation
airports has been the focus of FAA preparedness plan is needed, the agency continues to suggest that HHS and the
research. This statement is based on Department of Homeland Security have responsibility for communicable disease
GAO-16-127 issued in December 2015 response and preparedness planning. GAO continues to believe that DOT is in
and GAO-17-372 issued in April 2017. the best position to lead this effort given its oversight responsibilities and ties with
GAO conducted updates to obtain relevant aviation stakeholders.
information on the actions agencies
The Federal Aviation Administration (FAA) has sponsored limited federal
have taken to address these reports’
recommendations.
research into disease transmission onboard aircraft and in airports. FAA’s
research goals focus on areas like improving airport operations and air space
What GAO Recommends management, and developing new technologies, which FAA has aligned to
DOT’s strategic goals related to safety, infrastructure, and innovation. Based on
GAO made several recommendations prior work and interviews with FAA officials, GAO found that FAA’s research in
in its prior work, including that DOT
cabin safety for crew and passengers does not focus on disease transmission.
develop a comprehensive national
For example, according to FAA officials, ongoing research that most closely
aviation-preparedness plan, and that
FAA identify long-term R&D priorities, relates to disease contamination is research related to monitoring the quality of
among other things. Progress has “bleed air,” which is outside air that is drawn through jet engines into an aircraft
been made in addressing some of the cabin. In 2017, GAO found that FAA could be more strategic in how it develops
recommendations. Continued attention its research and development (R&D) portfolio, chiefly in identifying long-term
is needed to ensure that the remainder research needs and explaining how FAA selects projects. Of the three
of these recommendations are recommendations GAO made in that report to improve FAA’s management of its
addressed. R&D portfolio, FAA fully addressed one, issuing guidance in 2018 on prioritizing
View GAO-20-655T For more information,
and selecting R&D projects. While FAA has made some progress addressing
contact Heather Krause, 202-512-2834, GAO’s recommendations on research portfolio development and reporting,
krauseh@gao.gov further attention to these recommendations could help ensure that FAA
strategically identifies research priorities across the agency.
United States Government Accountability Office
Letter Letter

Chairwoman Horn, Ranking Member Babin, and Members of the
Subcommittee:

Thank you for the opportunity to discuss our body of work relating to
reducing the risk of communicable disease transmission in the aviation
sector and the status of the Department of Transportation’s (DOT)
aviation research and development on this topic. The outbreak of
Coronavirus Disease 2019 (COVID-19) is having profound effects around
the world. Its global transmission was greatly aided and accelerated by air
travel, which totaled more than 4.5 billion passengers in 2019, mostly
before the widespread outbreak. In light of the resulting pandemic and
warnings about the risks of air travel, U.S. passenger airline traffic fell by
96 percent in April 2020, as compared to April 2019. COVID-19 is only
the latest communicable disease to raise concerns about the spread of
contagion through air travel. Since 2002, there have been six major public
health epidemic threats with global ramifications, including the severe
acute respiratory syndrome (SARS) in 2003 and the Ebola virus disease
in 2014. More than any other mode of transportation, air travel creates the
potential for infection to move quickly from one part of the world to
another. In December 2015, we recommended that the Secretary of
Transportation should work with relevant federal stakeholders to develop
a national aviation-preparedness plan for communicable disease
outbreaks. 1

In order to identify technologies and solutions to improve the safety of the
civil aviation system, the federal government conducts research and
development (R&D) to advance U.S. technological leadership and foster
a dynamic aerospace industry. The Federal Aviation Administration (FAA)
within DOT, along with the National Aeronautics and Space
Administration (NASA), is responsible for the management of the federal
government’s civil aviation R&D. The Centers for Disease Control (CDC)
within the Department of Health and Human Services (HHS) also
sponsors health-related research involving air transportation.

My testimony today is based largely on reports we issued in 2015 on air
travel and communicable disease and in 2017 on FAA’s management of

1GAO, Air Travel and Communicable Diseases: Comprehensive Federal Plan Needed for
U.S. Aviation System’s Preparedness, GAO-16-127 (Washington, D.C.: Dec. 16, 2015).

Page 1 GAO-20-655T Air Travel and Communicable Diseases
commercial aviation R&D. 2 Specifically, this testimony describes: (1) the
U.S. aviation system’s preparedness to respond to communicable
disease threats from abroad and (2) FAA’s management of its R&D
portfolio, including the extent to which disease transmission on aircraft
and at airports has been the focus of FAA research.

To conduct our prior work, we reviewed available documents and
interviewed officials from the key federal departments with responsibilities
for conducting aviation research and for preparing for communicable
disease threats from abroad and responding to them. In addition, we
interviewed a range of stakeholders to discuss aviation preparedness and
research, and potential opportunities to improve those areas. More
detailed information on our objectives, scope, and methodology can be
found in each of the reports.

For this statement, we contacted DOT, Department of Homeland Security
(DHS), and HHS officials to determine the status of a national aviation-
preparedness plan for the aviation system as recommended in our 2015
report. In addition, we interviewed FAA officials to learn about actions
FAA has taken to address the recommendations we made in our 2017
report to improve the development, tracking, and reporting of the federal
government’s civil-aviation research and development portfolio. We also
reviewed aviation-related research on communicable disease from the
past 10 years, selected based on key word searches.

We conducted the work on which this testimony is based in accordance
with generally accepted government auditing standards. Those standards
require that we plan and perform the audit to obtain sufficient, appropriate
evidence to provide a reasonable basis for our findings and conclusions
based on audit objectives. We believe the evidence obtained provides a
reasonable basis for our findings and conclusions based on our audit
objectives.

In the United States, the roles and responsibilities related to preparing for,
Background assessing, and responding to communicable disease threats in the civil
aviation system require immense coordination among a number of federal
agencies and aviation stakeholders. Each federal agency has a different
mission, which affects its responsibilities for protecting against
communicable disease threats. The DHS and HHS are the lead agencies

2GAO-16-127and GAO, Aviation Research and Development: FAA Could Improve How It
Develops Its Portfolio and Reports Its Activities, GAO-17-372 (Washington, D.C.: Apr. 24,
2017).

Page 2 GAO-20-655T Air Travel and Communicable Diseases
for responding to a communicable disease threat. They focus on
protecting our borders at ports of entry, including airports, from threats
from abroad and protecting the nation from domestic and foreign health,
safety, and security threats, respectively. FAA is responsible for civil
aviation and commercial space transportation flight safety in the United
States and the safe and efficient movement of air traffic in the national
airspace system, as well as for the safety of U.S. airlines, other U.S.
operators, and FAA-certificated aircrews worldwide. As part of this
responsibility, FAA regulates and certificates airports, airlines, and airmen
and provides guidance. 3

In the case of a communicable disease threat, numerous federal, state,
and local entities may be called upon to respond, depending on their legal
authority and whether the threat is identified before, during, or after the
flight. For example, before boarding, HHS and DHS may identify travelers
who are not allowed travel, based on public health threats. 4 The CDC can
prohibit the introduction of nonresident foreign nationals into the United
States from designated countries or places, but only for such time as the
CDC deems necessary for public health. During a flight, CDC regulations
require pilots to immediately report to CDC any deaths or the occurrence
of any travelers with signs or symptoms that may indicate a
communicable disease infection during international flights coming to the
United States. And, once an aircraft with a suspected ill passenger
approaches an airport, federal or local public health officials, first
responders (e.g., fire or emergency medical technicians), airport
authorities, air traffic control personnel, or a combination of these
stakeholders may make decisions about and lead certain aspects of the
response based on the situation and available response protocols or
preparedness plans. In addition, some response-related roles and
responsibilities are established in law or by interagency agreements, and
others may be defined in FAA-required airport-emergency plans, although
those plans are not required to address communicable disease threats.

In addition, FAA supports and coordinates a range of R&D activities for
the civil aviation system. The inventory of FAA’s R&D activities is

3Within the Department of Labor (DOL), the Occupational Safety and Health
Administration (OSHA) aims to assure safe and healthful working conditions, including for
airline crews and the contract employees who clean aircraft.
4When HHS requests DHS assistance, HHS notifies DHS’s Transportation Security
Administration of individuals it has identified as public health threats who should be
designated “Do Not Board.”

Page 3 GAO-20-655T Air Travel and Communicable Diseases
expressed in the National Aviation Research Plan (NARP) and in FAA’s
Fiscal Year R&D Annual Review. 5 FAA is required to submit both of these
documents annually to Congress. 6 According to FAA’s most recent
NARP, FAA’s research budget from all accounts in FY 2017 was $422.3
million. 7 FAA’s research budget supports activities conducted by FAA as
well as a range of partners, including other government agencies,
universities, and private sector organizations.

FAA’s process for developing its commercial aviation research portfolio
spans the agency. To develop the NARP and its R&D portfolio, FAA’s
program planning teams, which focus on specific research program
areas, identify R&D projects to meet one of DOT’s three strategic goals
and FAA’s five R&D goals. 8 Further, an executive board in FAA provides
guidance and oversight over the agency’s portfolio development process,
and a statutorily created advisory committee—consisting of individuals
that represent corporations, universities, associations, and others—
conducts external reviews of FAA’s R&D programs for relevance, quality,
and performance. This advisory committee also makes recommendations
to FAA on the proposed R&D portfolios and budgets.

5FAA uses the NARP to present budget requirements for its R&D programs to Congress.
The NARP identifies FAA’s R&D goals and research programs that the agency has
prioritized. The FAA’s Fiscal Year R&D Annual Review provides summaries of R&D
accomplishments.
649 U.S.C. § 44501(c).

7Three appropriation accounts contribute to FAA’s overall research budget, including
Research, Engineering and Development (RE&D), Facilities & Equipment (F&E), and
Grants-In-Aid for Airports (AIP).
8DOT’s three strategic goals focus on safety, infrastructure, and innovation. FAA’s R&D
goals focus on, among other things, airport and air space management, infrastructure
durability, new technologies, system-wide analysis, and improving the human component
of the system.

Page 4 GAO-20-655T Air Travel and Communicable Diseases
In 2015, we found that the United States lacked a comprehensive national
In the Continued aviation-preparedness plan to limit the spread of communicable diseases
Absence of a through air travel, though some individual airport and airline preparedness
plans did exist.9 Accordingly, we recommended that DOT work with
Comprehensive relevant stakeholders, such as HHS, to develop a national aviation-
National Plan, the preparedness plan for communicable disease outbreaks. We emphasized
that a comprehensive national plan would provide a coordination
U.S. Aviation System mechanism for the public-health and aviation sectors to more effectively
Remains Insufficiently prevent and control a communicable disease threat while also minimizing
unnecessary disruptions to the national aviation system. Additionally, U.S.
Prepared to Respond airports and airlines are not required to have individual preparedness
to Communicable plans for communicable disease threats and no federal agency tracks
which airports and airlines have them. As such, the extent to which U.S.
Disease Threats airports and airlines have such plans is unknown. However, all 14 airports
and 3 airlines we reviewed in 2015 had independently developed
preparedness plans for responding to communicable disease threats from
abroad. These plans generally addressed the high-level components that
we identified as common among applicable federal and international
guidance for emergency preparedness, such as establishment of an
incident command center and activation triggers for a response. While the
14 airports and 3 airlines had plans that address communicable diseases,
representatives from these airports and airlines reported facing multiple
challenges in responding to threats. Identified challenges that included
obtaining guidance; communication and coordination among responders;
and assuring employees have appropriate training, equipment, and
sanitary workplaces. As we stated in our 2015 report, a national aviation
preparedness plan to respond to communicable disease outbreaks could
help address these challenges.

As of June 2020, DOT, DHS, and HHS stated that the federal government
still has not developed a national aviation-preparedness plan to respond
to communicable disease outbreaks. In making our recommendation in
2015, we pointed to Annex 9 to the Chicago Convention—an international
aviation treaty to which the United States is a signatory—which contains a
standard that obligates International Civil Aviation Organization (ICAO)
member states to develop a national aviation-preparedness plan for

9GAO-16-127.

Page 5 GAO-20-655T Air Travel and Communicable Diseases
communicable disease outbreaks. 10 DOT and CDC officials in 2015
stated that some elements of a national aviation-preparedness plan
already exist, including plans at individual airports. However, as we
discussed in our 2015 report, individual airport plans are often contained
in multiple documents, and FAA reported that the plans are intended to
handle communicable disease threats posed by passengers on one or
two flights, rather than an epidemic—which may require involvement from
multiple airports on a national level. Most importantly, a national aviation-
preparedness plan would provide airports and airlines with an adaptable
and scalable framework with which to align their individual plans, to help
ensure that individual airport and airline plans work in concert with one
another.

DOT and CDC officials agreed in 2015 and continue to agree today that a
national aviation-preparedness plan could add value. DOT, however,
maintains that those agencies that have both legal authority and expertise
for emergency response and public health—namely DHS and HHS—are
best positioned to take the lead role in developing such a plan within the
existing interagency framework for national-level all-hazards emergency
preparedness planning. We continue to believe that DOT would be in the
best position to lead the effort because FAA and DOT have stronger and
deeper ties to, as well as oversight responsibility for, the relevant
stakeholders that would be most involved in such a broad effort, namely
airlines, airports, and other aviation stakeholders. In addition, DOT’s
Office of the Secretary is the liaison to ICAO for Annex 9 to the Chicago
Convention, in which the relevant ICAO standard is contained.

In response to the current COVID-19 pandemic and in the absence of a
national aviation-preparedness plan, DOT officials pointed to ongoing
efforts to engage with interagency partners at DHS and HHS, as well as
industry stakeholders, to better collaborate on the aviation sector’s
communicable disease response and preparedness. For example, DOT
told us that it has facilitated conference calls between federal and private
sector stakeholders and has collaborated with CDC to update interim

10Chicago Convention on International Civil Aviation, Section F of Annex 9, subparagraph
8.16. ICAO is a United Nations specialized agency created in 1944 by the Convention on
International Civil Aviation (Chicago Convention), under which ICAO Member States
agreed, among other things, “to take effective measures to prevent the spread by means
of air navigation of cholera, typhus (epidemic), smallpox, yellow fever, plague and such
other communicable diseases as the [ICAO Member] States shall from time to time decide
to designate.” Chicago Convention on International Civil Aviation art. 14, Apr. 4, 1944, 61
Stat 1180, T.I.A.S. No. 1,591.

Page 6 GAO-20-655T Air Travel and Communicable Diseases
guidance for airline crews related to communicable diseases, specifically
COVID-19. 11 While these actions are helpful, some aviation stakeholders
have publicly highlighted piecemeal response efforts that may have led to
some of the confusion among stakeholders and chaos at certain airports
that occurred earlier this year following the COVID-19 travel bans and
increased screening efforts. For example, stakeholders described actions
taken by individual airlines in the absence of FAA guidance, such as to
cease operations to certain countries, and a piecemeal approach to
establishing standards for safely continuing or expanding service, such as
various airline and airport policies regarding facemasks. This piecemeal
approach points to the continued need for DOT to implement our 2015
recommendation to develop a coordinated effort to plan for and respond
to communicable disease threats. We have included this open
recommendation as one of 16 high priority recommendations to DOT. 12

11CDC, Updated Interim Guidance for Airlines and Airline Crew: Coronavirus Disease
2019 (COVID-19) (Updated Mar. 11, 2020).
12GAO, Priority Open Recommendations: U.S. Department of Transportation
GAO-20-513PR (Washington, D.C.: April 23, 2020).

Page 7 GAO-20-655T Air Travel and Communicable Diseases
FAA Has Taken Steps
to Improve Its R&D
Portfolio
Management, but
Has Conducted
Limited Research on
Disease Transmission
in Aircraft and Airports
FAA is Taking Steps to While a national aviation-preparedness plan can help better manage the
Improve the Formulation response to the next aviation pandemic, other efforts such as research
and development are also key. In 2017, we found that FAA’s actions
and Management of its
related to the management of its R&D portfolio were not fully consistent
R&D Portfolio Based on with statutory requirements, agency guidance, and leading practices.13 As
GAO Recommendations part of that work, we assessed FAA’s actions to manage its R&D portfolio
in three key areas: (1) developing its portfolio of R&D projects, (2)
tracking and evaluating those projects, and (3) reporting on its portfolio.
We found that FAA could be more strategic in how it develops its R&D
portfolio, chiefly in identifying long-term research needs and in improving
disclosure of how projects are selected. As a result of these deficiencies,
we found that FAA management could not be assured that the highest
priority R&D was being conducted. We also found that while FAA tracks
and evaluates its research projects consistent with leading practices, it
did not fully address all statutory reporting requirements, such as
identifying long-term research resources in the National Aviation
Research Plan (NARP) or preparing the R&D Annual Review in
accordance with government performance-reporting requirements. These
reporting deficiencies can limit the usefulness of the reports to internal
and outside stakeholders. Accordingly, in 2017, we recommended that
DOT direct FAA to (1) take a more strategic approach to identifying long-
term R&D research priorities across the agency, (2) disclose how
research projects are prioritized and selected, and (3) ensure that the
NARP and R&D Annual Reviews meet statutory requirements for content.
DOT agreed with all three recommendations.

As of June 2020, FAA has fully addressed one of our recommendations
and taken partial action on two other recommendations. Specifically, FAA

13GAO-17-372.

Page 8 GAO-20-655T Air Travel and Communicable Diseases
fully responded to our recommendation that FAA disclose the process it
uses for prioritizing and selecting research projects by updating in 2018
its internal guidance documents to allow better transparency over project
selection. In partially responding to our recommendation to take a more
strategic approach to identifying research priorities across the agency, in
June 2019, FAA issued a redesigned National Aviation Research Plan
(NARP) for 2017-2018. The redesigned plan is a good first step. Also as
part of an effort to be more strategic, FAA is beginning to take actions to
understand emerging aviation issues requiring FAA’s research attention.
This recommendation has not been fully addressed as, according to FAA
officials, the agency is still developing guidance to ensure that future
NARPs take a strategic approach and incorporate emerging issues into
future plans. FAA officials told us they plan to finalize the guidance by the
end of 2020. Similarly, with respect to our recommendation aimed at
achieving compliance with statutory reporting requirements, the
redesigned 2017-2018 NARP included a list of agreements with federal
and nonfederal entities on research activities, resource allocation
decisions, and a description of technology transfer to government,
industry, and academia, among other items. Officials told us that they are
finalizing the 2019 R&D Annual Review, which has been redesigned to
address other statutory reporting requirements, and will develop guidance
to ensure that future documents meet those requirements.

Disease Transmission FAA has sponsored limited federal research into disease transmission
Research Has Received onboard aircraft and in airports. FAA’s research goals focus on areas like
improving airport operations and air space management, and developing
Limited FAA Focus in
new technologies, which FAA has aligned to DOT’s strategic goals
Recent Years related to safety, infrastructure, and innovation. Based on our prior work
and interviews with FAA officials, we found that FAA’s research in cabin
safety for crew and passengers does not focus on disease transmission.
For example, according to FAA officials, as of June 2020, ongoing
research that most closely relates to disease contamination is research
related to monitoring the quality of “bleed air,” which is outside air that is

Page 9 GAO-20-655T Air Travel and Communicable Diseases
drawn through jet engines into an aircraft cabin. 14 FAA officials said that
its Civil Aerospace Medical Institute is participating in this research.

Even so, FAA has funded some programs that are relevant to mitigating
communicable disease transmission at airports and on aircraft. For
example, in 2015 the Transportation Research Board’s Airports
Cooperative Research Program (ACRP), which is funded by FAA’s
Airport Improvement Program (AIP), decided to hold a series of
workshops on topics that are of significance to airports and that are not
being addressed by other federal research programs. 15 The decision to
hold the first ACRP workshop on communicable disease occurred toward
the end of the Ebola virus outbreak. ACRP has also issued reports on
reducing communicable disease transmission at airports and aircraft. 16
These reports have provided information and guidance to airports and
airlines on infectious disease mitigation onboard aircraft and ways to
respond to a communicable disease in airports. For example, a 2013
ACRP report recommends reducing the amount of time aircraft ventilation
systems are shutdown at the gate, so that an aircraft’s high efficiency
particulate air (HEPA) systems, which can capture more than 99 percent
of the airborne microbes, continue to operate. ACRP also has a research
project currently under way for publication early next year on effective
collaboration to prevent, respond to, and mitigate disease threats. 17

Prior to 2014, FAA also funded some research on disease transmission
on aircraft through its Centers of Excellence research consortium.
Specifically, in 2004, FAA established the Airliner Cabin Environment
Research (ACER) Center of Excellence, which conducts research on,
14Air supplied to a pressurized aircraft cabin occurs via an environmental control system.
Fresh air from outside the aircraft enters the environmental control system in most large
commercial airplanes via the aircraft engines. The compressed air is then “bled” through
ports and is cooled before being mixed with recirculated air, ultimately becoming
distributed throughout the cabin. See FAA, Civil Aerospace Medical Institute, Aircraft
Cabin Bleed Air Contaminants: A Review (Oklahoma City, OK: November 2015).
15Transportation Research Board, Airport Roles in Reducing Transmission of
Communicable Diseases: Summary of a Workshop of the Airport Cooperative Research
Program’s 2018 Insight Event (Washington, D.C.: 2019).
16Transportation Research Board, Infectious Disease Mitigation in Airports and on Aircraft,
(Washington, D.C.: 2013); Transportation Research Board, Preparing Airports for
Communicable Diseases on Arriving Flights: A Synthesis of Airport Practice (Washington,
D.C.:2017).
17Transportation Research Board, Effective Collaboration to Plan and Respond to
Communicable Disease Threats (03-49). Expected publication January 2021.

Page 10 GAO-20-655T Air Travel and Communicable Diseases
among other things, the safety and health of passengers and crew inside
the cabin. In 2010 and 2012, ACER published research on air quality in
airline cabins and disease transmission in aircraft. 18 A researcher we
interviewed who is affiliated with ACER said that the Center established a
laboratory in 2006, called ACERL, which is currently conducting research
on the dispersion of airborne particles (including viruses) in the aircraft
cabin for CDC’s National Institute of Occupational Safety and Health. As
of 2014, ACER began operating independently as a consortium
academia, government, and others and is no longer being funded solely
by FAA.

FAA and DOT principally look to HHS and the CDC for guidance on
passenger health issues. HHS has statutory responsibility for preventing
the introduction, transmission, and spread of communicable diseases into
the United States and among the states. 19 Within HHS, CDC has defined
its mission as protecting America from health, safety and security threats,
both foreign and domestic. CDC alerts travelers about disease outbreaks
and steps they can take to protect themselves. CDC also has the
authority to quarantine passengers traveling from foreign countries, if
necessary, to prevent the introduction, transmission, or spread of
communicable disease. CDC’s National Institute for Occupational Safety
and Health has conducted research and issued guidance in the past on
disease transmission in aircraft and cabin crew health and, as previously
noted, is funding current research through the ACER Center. CDC has
also issued COVID-19 guidance for cabin crew safety.

18National Air Transportation Center of Excellence for Research in the Intermodal
Transport Environment (RITE), Airliner Cabin Environment Research (ACER) Program,
Report to the FAA on the Airliner Cabin Environment (Report No. RITE-ACER-CoE-2010-
1) (Aug. 16, 2010); National Air Transportation Center of Excellence for Research in the
Intermodal Transport Environment (RITE), Airliner Cabin Environment Research (ACER)
Program, Infectious Disease Transmission in Airliner Cabins (Report No. RITE-ACER-
CoE-2012-01) (Feb. 22, 2012).
19Under section 361 of the Public Health Service Act (codified at 42 U.S.C. § 264), HHS is
authorized to make and enforce regulations to prevent the entry and spread of
communicable diseases from foreign countries into the United States and among states.
The authority for carrying out these functions on a daily basis has been delegated to CDC,
an agency in HHS.

Page 11 GAO-20-655T Air Travel and Communicable Diseases
Some Technologies Could There are a variety of technologies that could help address infectious
Be Useful to Reduce the disease transmission associated with air travel, but these technologies
are at various stages of maturity. For example, the initial screening of
Risks of Communicable
passengers for fevers is typically done with handheld infrared
Disease in Air Travel thermometers and has been reportedly discussed for use by
Transportation Security Agents. Reports also state that the mass
screening of crowds using thermal cameras has been used in some
airports in Asia, but such scanners are still being tested for standalone
use in the United States, with some concerns reported about the
accuracy of the results. Aircraft disinfection has traditionally been done by
cleaning crews, but a number of methods are being developed using
heat, chemicals, and UV light, and are under examination by researchers.

Chairwoman Horn, Ranking Member Babin, and Members of the
Subcommittee, this completes my prepared remarks. I would be pleased
to respond to any questions that you or other Members of the
Subcommittee may have at this time.

If you or your staff have any questions about this statement, please
GAO Contact and contact me at (202) 512-2834 or krauseh@gao.gov. Contact points for
Staff our Offices of Congressional Relations and Public Affairs may be found
on the last page of this statement.
Acknowledgments
GAO staff who made key contributions to this testimony are Jonathan
Carver, Assistant Director; Paul Aussendorf; Roshni Davé; Hayden
Huang; Delwen Jones; Molly Laster; Cheryl Peterson; Gretchen Snoey;
and Elizabeth Wood.

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Page 12 GAO-20-655T Air Travel and Communicable Diseases
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