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| Severe Acute
Respiratory Syndrome (SARS) |
A.
Legal authority for restricting movement
In advance of the possible reappearance of SARS-CoV, public health officials
should:
- Work
closely with their legal counterparts to ensure that the legal authority
for movement restrictions at the local, state, and federal levels is
known and understood and to establish boundaries of authority and processes
to address multi-jurisdictional issues (See Supplement
A).
- Develop
plans for making decisions on movement restrictions, such as: 1)
requirements for pre-departure screening, 2) requirements for arrival
screening and/or quarantine, 3) travel prohibitions on cases and
contacts, 4) restrictions related to use of mass transit systems,
and 5) cancellation of non-essential travel.
- Work
closely with local, state, and federal law enforcement to develop
plans for enforcement of these restrictions.
B. Engagement of key partners
In advance of the possible reappearance of SARS-CoV, public health officials
should:
- Begin
preparedness planning by identifying key partners representing:
1) law enforcement (local, state, federal), 2) legal community, 3) emergency
medical services (for evaluation of ill arriving passengers and transportation
to the hospital), 4) hospital personnel, 5) transportation industry
personnel, and 6) other emergency management personnel. The partners
should be involved in the planning process.
- Develop
plans for the training, mobilization, and deployment of pertinent
public health and other staff.
- Conduct
training programs and drills.
- Provide
respirator fit-testing and training in use of PPE for persons
at risk for exposure to possible SARS cases.
- Plan
for the diversion of conveyances carrying supplies for maintenance
of critical infrastructure around key transportation hubs that may
be affected by SARS-CoV.
C. Protocols for management of ill arriving passengers
Public health officials and CDC quarantine staff, in collaboration with
legal and law enforcement authorities, should develop protocols for the
management of ill arriving passengers at ports of entry, including provisions
for:
- Meeting
flights with a reported ill passenger
- Establishing
notification procedures and communications links
- Separating
the ill passenger during assessment
- Assessing
the ill passenger and referring for evaluation and care
- Transporting
the ill passenger to a designated healthcare facility (see Supplement
D.)
- Collecting
locating information on other passengers and crew
- Collecting
the flight manifest, customs declarations, and other information
for contact tracing
- Identifying
any other ill passengers and separating them from well passengers
- Quarantining
contacts if necessary, including transportation to a quarantine facility
- Providing
enforcement for uncooperative ill passengers or contacts
See Supplement
A.
D. Memoranda of agreement (MOA) with healthcare facilities, transport services, emergency medical systems, and physicians
- State
and local public health officials should work with federal quarantine
staff to develop MOAs with hospitals near ports of entry; these
facilities must be equipped to isolate, evaluate, and manage possible
SARS patients (see Supplement C).
- Agreements
should include arrangements with a designated emergency medical
service for on-site assessment of ill passengers and transportation
to a hospital for evaluation.
See Supplement
A.
E. Designation of quarantine facility
State and local public health officials should identify a facility for
travelers who are designated as contacts and who require quarantine but
cannot be quarantined at home.
F. Roles and responsibilities
Roles and responsibilities should be outlined for the various partners
and the various levels of jurisdiction (local, state, and federal) for
each component of the response.
For additional
information and material on prevention of SARS travel-related risks, see CDC's SARS Travel webpage.
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