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The CDC's wrong-way approach to contact tracing

 The CDC's wrong-way approach to contact tracing
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As part of the long-term effort to stem the spread of COVID-19, U.S. public health officials plan to rely on contact tracing. Identifying individuals who may have come in contact with another infected person — such as workers or travelers on an airplane — is a vitally important approach in containing the disease. Unfortunately, a misguided mandate proposed by the Centers for Disease Control (CDC) has delayed collection of vital data and spurred a debate over who is in charge of gathering travelers' contact information.

When followed by treatment or isolation, contact tracing is a proven and effective strategy to prevent the spread of infectious diseases. It entails communicating with individuals who may potentially have come in contact with an infected person. Once reached, that person is given instructions on how to mitigate the problem, such as self-isolation or further testing. It has been used for decades to combat communicable diseases including tuberculosis, polio, measles and rubella. Airlines work with CDC to provide aircraft manifest data when requested. 

In the United States, contract tracing is done on the local level, is not standardized among jurisdictions and is not routinely shared among public health officials. The nature of COVID-19 means getting highly accurate and rapid information about individuals so they can be contacted about possible exposure. A holistic national response is clearly needed.

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In February of this year, the CDC issued an interim final rule that would require airlines to collect, verify, maintain and report international travelers' personal information within 24 hours of the flight to the CDC. The data includes passengers' full name, U.S. address, email and primary and secondary phone numbers. But there are a host of reasons why the task of collecting and maintaining critical data on passengers with the explicit goal of stopping the spread of this specific disease should be assigned to the federal government, not to the airlines.

For one, air travelers are hardly the primary source of international arrivals. In 2017, foreign and domestic airlines carried 102.5 million passengers to the United States. But more than 240 million arrived by car, train and bus. Five million more passengers arrived by cruise ship. Transportation itself is a vehicle for spread and a contact tracing database needs to account for the different ways international travelers arrive in the United States.

Then there are the twin issues of validation and verification. Certain information like name and a permanent address for international travelers is relatively easy to verify through an identification or passport check. But what about an email address, or the street address and phone number of a hotel? What if a passenger does not have a secondary phone number? For homeland security purposes, federal law already requires airlines to provide passenger name record (PNR) data but experts at a recent Senate hearing noted that only 75 percent of PNRs have flyers’ telephone numbers and just 56 percent contain emails. The incompleteness undermines its usefulness. Garbage in, garbage out.

What's more is that most airlines do not collect the five data points called for by the CDC. Only about half of the passenger data today is collected by the airlines themselves. The rest are collected by online travel agencies (OTAs), agents and other third parties which, beyond passenger names, are not always transmitted to airlines.

To be effective, time is of the essence. In the Federal Register notice, the CDC notes that although the development of an airline-led passenger information system would be challenging, the agency would work "with airlines on an individual basis" to ensure they are able to meet the requirements of the new rule. However, with more than 200 carriers flying international passengers to the United States, creating a coordinated system among those airlines will take time.

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Washington needs to work with its state and local partners — as well as the airlines and other travel providers — to build a comprehensive, government-led system of information. It should include information for international as well as domestic passengers and cover all modes of travel, not just airlines. Such a database needs to be collected, verified and maintained by a single, governmental entity. 

This public health crisis has upended the country. With deaths due to the disease still claiming lives, we cannot afford to waste time on an incomplete, unverified and siloed approach to an immediate problem. 

Robert Puentes is president and CEO of the Eno Center for Transportation, an independent think tank. Paul Lewis is vice president of Policy and Finance at Eno.