ABSTRACT
The U.S. economy is reopening after the Coronavirus Disease 2019 (COVID-19) public health emergency (PHE) resulted in Federal, State, and local mandated closures and restrictions across many sectors in the first half of 2020. A safe, secure, efficient, and resilient air transportation system that addresses the threat of COVID-19 is critical to reducing the public health risk and supporting the United States’ critical infrastructure needs. Government, aviation, and public health leaders must work together to meaningfully reduce the public health risk and restore passenger, aviation workforce, including crew, and public confidence in air travel. This document provides the U.S. Government’s guidance to airports and airlines for implementing measures to mitigate the public health risks associated with COVID-19, prepare for an increase in travel volume, and ensure that aviation safety and security are not compromised. It is intended to address public health concerns and support U.S. air carriers and airports as they make decisions and implement changes to reduce the spread of SARS-CoV-2, the virus that causes COVID-19. The U.S. Government views public health as a key component of a resilient aviation transportation system, much like safety and security. The aviation industry has maintained a safe and secure system, because stakeholders do not compete on safety and security;we expect the aviation industry to take the same approach to implementing guidance on public health risk mitigations. Contents include: air transportation stakeholder roles;COVID-19 outbreak mitigation planning;public health risk mitigation in the passenger air transportation system;future areas of research;and implementation challenges specific to international travel.
ABSTRACT
Página de los CDC con información dirigida a: profesionales sanitarios (guías provisionales para evaluar a los pacientes, diagramas de flujo, recomendaciones para tratar a pacientes con la infección confirmada o con sospecha, listas de comprobación para pacientes potenciales o confirmados, artículos de revistas y publicaciones), profesionales de salud pública (nº de casos en EE.UU. y a nivel mundial, medidas de prevención en hogares y comunidades, preguntas más frecuentes, recursos clave en la preparación para el control de la infección), laboratorios (guías para muestras clínicas, guías para laboratorios de bioseguridad, protocolos de identificación), ciudadanos, pacientes y cuidadores (información sobre la transmisión, síntomas y complicaciones, prevención y tratamiento, preguntas más frecuentes), viajeros (viajes a China, procedentes de China, tripulación), etc.
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From the Document: SDPHL [South Dakota Public Health Laboratory] performs the 2019-nCoV [2019 novel coronavirus] RT-PCR [reverse transcription polymerase chain reaction] test designed to detect the SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] virus from respiratory specimens such as nasopharyngeal (NP), oropharyngeal (OP), and sputum specimens. SDPHL performs nucleic acid extraction on three Roche LC2.0 extractors, three Qiagen EZ-1 Advanced, and one Kingfisher instruments. SDPHL performs real-time reverse transcriptase polymerase chain reaction (RTPCR) on three Thermo Fisher ABI 7500 Fast DX and two QuantStudio instruments. SDPHL will add one additional Kingfisher and one Thermo Fisher ABI 7500 Fast DX to the state COVID-19 testing infrastructure. The current RT-PCR infrastructure at SDPHL can perform over 300 specimens in a conventional workday. Proposed RT-PCR infrastructure expansion will increase that throughput to almost 500 specimens each day.COVID-19 (Disease);Health--Testing
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From the Document: It is important to note that the State of Maine has already met and exceeded the stated goal of testing a minimum of 2% of its population, or 26,000 monthly, by implementing several testing strategies. Maine's focus now is on expanding testing even further, focusing on the highest-risk populations, by continuing to implement a number of testing strategies. These include activating multiple testing venues, utilizing varied testing platforms/instruments and PCR [polymerase chain reaction] tests, granting new healthcare entities opportunities to conduct local testing, leasing/purchasing additional testing equipment, and partnering with various private entities to provide additional test kits and resources for expanded testing. As a result of these efforts, Maine CDC's [Centers for Disease Control and Prevention] Health & Environmental Testing Laboratory has removed all testing 'tiers' or prioritzations within the public health laboratory and has recommended testing for all congregate settings after a single confirmed COVID-19 [coronavirus disease 2019] case.COVID-19 (Disease);Health--Testing
ABSTRACT
From the Document: The COVID-19 [coronavirus disease 2019] pandemic continues to present an unprecedented and rapidly evolving challenge to the state of Minnesota. For a variety of reasons, Minnesota is currently prioritizing COVID-19 testing for those who are symptomatic or are in a high-risk setting or population (congregate settings, staff in high-risk settings, critical utility workers, etc). We are continuing to expand the availability of testing for high-priority groups through a strong public/private partnership between MDH [Minnesota Department of Health], the University of MN, the Mayo Clinic, and health systems and providers throughout the state, so that we can immediately respond to emerging hotspots and areas of concern, as part of our overall goal of ensuring testing is available with as few barriers as possible for anyone who needs it. Funding from the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Enhancing Detection effort in Minnesota (MN-ELC) will help increase overall testing for COVID-19 across the state and improve the public health infrastructure that supports an effective response to disease outbreaks.COVID-19 (Disease);Health--Testing
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From the Document: Expanded testing capacity is one of the four pillars of Governor Hogan's Maryland Strong: Roadmap to Recovery. Maryland is pursuing a four-pronged approach for increasing its state-wide laboratory testing capacity towards the short-term goal of sustaining more than 10,000 reverse transcription polymerase chain reaction ()-based COVID-19 [coronavirus disease 2019] tests a day, and expanding to 20,000 tests a day: 1. Expanding internal state public health lab (SPHL) capacity;2. Creating partnerships with commercial and academic labs to enhance use of their capacity;3. Pursuing other strategic opportunities through work with manufacturers of point-of-care testing systems to clarify how to best deploy safe and accurate diagnostic systems, coordination with private hospital laboratories, and pursuing a White House offer to make use of Maryland-based federal laboratories;and 4. Laying the foundation for a statewide serological-test-based survey to estimate the prevalence of prior COVID-19 infection in the state. Maryland's SPHL has a daily capacity of 970 tests. Work is currently in progress to acquire, adapt and/or outfit the following analytical platforms to significantly increase current SPHL capacity.COVID-19 (Disease);Health--Testing
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From the Document: The Louisiana Department of Health (the Department) includes the state Office of Public Health and one state lab servicing all nine public health regions. Initial testing for SARS-COV-2 [severe acute respiratory syndrome coronavirus 2] began in Louisiana's state lab on February 29, 2020. Louisiana has gone from a very limited amount of testing that was only available in our state lab to now having commercial labs across the state to complete and report as many tests as possible. Since then, more than 38,500 cases and 2,600 deaths associated with COVID-19 [coronavirus disease 2019] have been identified in Louisiana. As of May 27, 2020, overall positivity in the State is 11.1% since the first case, reflecting 347,647 test results.COVID-19 (Disease);Health--Testing
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From the Document: Michigan is on pace to conduct 465,000 total tests, or over 2 percent of its population, in May 2020 and has plans to expand testing substantially from here. The state has set a near-term goal of reaching 15,000 diagnostic tests per day and a medium-term goal of reaching 30,000 diagnostic tests per day (approximately 900,000 individuals per month or about 9 percent of the state's population). In mid-May 2020, Michigan averaged about 17,000 total tests completed per day and about 14,400 diagnostic tests per day. a) Michigan is maximizing use of testing platforms by partnering with a wide range of laboratories to conduct testing. Over 70 entities in the state have some testing capability, whether as a CLIA [Clinical Laboratory Improvement Amendments] high-complexity laboratory conducting PCR [polymerase chain reaction] tests or as a CLIA waived entity conducting point-of-care tests. Together, these entities report capacity to test 25,000 per day if corresponding supplies were available;however, supply shortages continue to significantly restrict Michigan's testing capability.COVID-19 (Disease);Health--Testing
ABSTRACT
From the Document: To date, the health care system in Massachusetts has tested more than 500,000 people for COVID-19 [coronavirus disease 2019]. On average, ~10,000 individuals are tested for COVID-19 in Massachusetts each day, comprising 4.4% of Massachusetts' population each month. The Commonwealth continues to work aggressively to expand access to testing to ensure: [1] All symptomatic residents (including those with mild symptoms) have timely access to a diagnostic test;[2] All close contacts (including those that are asymptomatic) have timely access to a diagnostic test;[3] Access to testing for vulnerable and high-risk populations;[4] Capacity to support frequent testing of nursing facility staff, as recommended by CDC [Centers for Disease Control and Prevention] and CMS [Centers for Medicare & Medicaid Services];[5] Massachusetts can reach its target of a 5% positive test rate by July;[6] Capacity to conduct intensive epidemiologic testing to establish the population rate (and change in rate) of incidence of COVID-19 infection and the prevalence of current and past COVID-19 infections[.]COVID-19 (Disease);Health--Testing
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From the Document: FSM [Federated States of Micronesia] is fortunate to not have any cases of COVID-19 [coronavirus disease 2019]. Robust travel restrictions have been in place since the FSM President declared a state of Emergency in January 31, 2020. Points of entry screening have been in place since February 2020. FSM is planning to repatriate stranded residents in early June 2020. The current testing strategy is to test all persons under investigation (PUI) according to current defintions [sic].Health--Testing;COVID-19 (Disease)
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From the Document: Los Angeles County (LAC) will meet the goal of testing 2% of the County population, or ~200,000 individuals each month. LAC is currently performing over 350,000 test/month through our clinical providers, public health departments, and community testing sites. Initial efforts during the emergency focused on outbreak investigations and community testing access through drive-through and walk-through sites often located in non-clinical settings (e.g. event venues and malls). In the coming months, we are working with providers countywide to move the majority of community testing into health care settings, while ramping up public health-led surveillance, contact and outbreak operations. This clinically integrated approach will improve the value of testing performed while ensuring close follow-up and family- and community- centered counseling and management post-testing. We are working closely with countywide testing partners to enhance their access to testing capacity and supplies, personnel, personal protective equipment, and training and technical assistance.COVID-19 (Disease);Health--Testing;California--Los Angeles
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From the Document: Kansas currently has an initial statewide strategy for COVID-19 [coronavirus disease 2019] specimen collection and testing. The goal of this strategy is to facilitate a rapid increase in statewide testing using all testing sites and platforms available. KDHE [Kansas Department of Health and Environment] will work with vendors, laboratories, and local sampling sites to help ensure that testing supplies and platforms are in place or easily mobilized to support communities, Kansas local health departments, and to support the early detection of outbreaks in congregate settings.COVID-19 (Disease);Health--Testing
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From the Document: In 1978, the CNMI [Commonwealth of the Northern Mariana Islands] Department of Public Health was formed under the executive branch of government. Over the next thirty years it came to operate the sole hospital and emergency department, provide 90% of outpatient care to the residents, maintain one of two dialysis centers on island and provide all behavioral, environmental, population health services. Our unique organizational structure allows us to focus on both public health and clinical care for the same target population. a) In response to the Governor's COVID-19 [coronavirus disease 2019] Task Force, the CNMI COVID-19 testing strategy is multiprong. We utilize high throughput machines, DialPlexQ Solgent and ABI 7500 Fast Dx, to support large scale testing in the community at locations such as our drive-thru airport testing. In addition, we utilize GeneXpert for rapid testing of smaller groups as part of our port of entry screening protocol, which is also implemented as a directive from the Governor. Lastly, we utilize the Abbott ID NOW as point of care in the hospital and outpatient settings.Health--Testing;COVID-19 (Disease)
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From the Document: The goals of New Jersey's testing program revolve around saving lives, ensuring safety, continuing vigilance, and maintaining commitment to readiness as part of The Road Back to re-opening society and the economy. To accomplish these goals, the DOH [Department of Health] is dedicated to creating a robust foundation that supports testing, contact tracing, and safe places for isolation and quarantine.COVID-19 (Disease);Health--Testing
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From the Document: Nevada is currently testing at or above 2% of our population. As of May 29th, Nevada has completed 155,449 PCR [polymerase chain reaction] tests. There have been 8,350 confirmed cases and 410 deaths statewide. Each local jurisdiction is required to maintain at least 2% of population testing for their service areas and increase as needed over time. Nevada's public health laboratories use both a mid-throughput testing and the Hologic Panther high throughput. This testing technology is not only capable of rapid testing at a lab site, but also uses collection kits and is best suited for use with outbreak analyses and testing of large facilities where several tests need to be performed at once such as prisons and skilled nursing facilities. Nevada is currently using our public health laboratories, hospital laboratories and commercial laboratories to perform SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] testing. Plans have been developed to rapidly scale testing to meet increased demand including point-of-care and rapid result testing.COVID-19 (Disease);Health--Testing
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From the Document: The State of Missouri has a comprehensive testing strategy with multiple lines of effort, which prioritizes vulnerable populations and acknowledges private demand for diagnostic testing. The state is currently developing a plan for serological testing, but as its utility for individual citizens is still unknown, serological testing will be used for research purposes, until more information is available about potential immunity and timelines. Missouri's statewide testing strategy includes: [1] Messaging to the public, providers, laboratories, and test collection locations;[2] Prioritized testing for healthcare workers and first responders;[3] Box-in Outbreaks at State Facilities (such as those run by the Departments of Mental Health and Corrections);[4] Box-in Outbreaks at Non-State, Public Facilities (such as county jails and shelters);[5] Box-in Outbreaks at Long Term Care Facilities (LTCFs);[6] Box-in Outbreaks at Prioritized Employers (such as meatpacking plants and factories);[7] Community Testing and Prevalence Studies;[8] Sentinel Testing of Vulnerable Populations (such as LTCFs and other congregate care settings);[9] Baseline Operations of the State Public Health Laboratory;[10] Sector Security (including education and employers);[and 11] Individual Diagnostic Testing (including anticipated increased demand during cold and flu season)[.]COVID-19 (Disease);Health--Testing