Change Request for
“2019 Novel Coronavirus Airport Entry Questionnaires”
(OMB Control No. 0920-1287)
Expiration Date: 09/30/2020
Program Contact
Amber Stolp
Office of Policy and Regulatory Affairs
Division of Global Migration and Quarantine
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention
1600 Clifton Road, N.E., MS C12
Atlanta, Georgia 30333
Phone: 770.488.7018
Email: [email protected]
Submission Date: May 26, 2020
Circumstances of Change Request for OMB 0920-1287
The Centers for Disease Control and Prevention (CDC), Division of Global Migration and Quarantine (DGMQ) requests a nonmaterial/non-substantive of the currently approved Information Collection Request: “2019 Novel Coronavirus Airport Entry Questionnaires”.
The Traveler Health Declaration form is an information collection tool used by CDC to facilitate public health follow-up of travelers who may have been exposed to or infected with a communicable disease. Currently, CDC has Office of Management and Budget, Office of Information and Regulatory Affairs approval for a web-based, fillable-PDF, and paper-based Traveler Health Declaration form.
In response to the outbreak of coronavirus disease 2019 (COVID-19), CDC has been tasked with conducting public health assessments at U.S. airports of travelers coming from areas experiencing an outbreak of a novel (new) coronavirus (named “COVID-2019”). The purpose is to detect ill individuals or individuals at risk of being ill with COVID-2019. Currently, CDC is conducting these assessments for travelers from Iran, Ireland, People’s Republic of China (excluding the Special Administrative Regions of Hong Kong and Macau), the Schengen Area of Europe (Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, Netherlands, Norway, Poland, Portugal, San Marino, Slovakia, Slovenia, Spain, Sweden, Switzerland, Monaco, and Vatican City) and the United Kingdom.
CDC has now been tasked with expanding the assessment for travelers from Brazil and may expand to new outbreak areas as the response continues to evolve.
As such, CDC is requesting the following changes to include Brazil, and to incorporate feedback on ways to better improve processes and incorporate the changing nature of the COVID-2019 response:
Update the United States Traveler Health Declaration Form to include the following:
Update name of disease to “coronavirus disease 2019 (COVID-19)” pandemic at top of form
Remove question about Hubei Province since this is no longer needed to ask specifically and falls within People’s Republic of China in the footnote. (“In the past 14 days, have you been to Hubei Province, China?”)
Add Brazil to the list of countries that will be screened on the bottom of the form.
Re-order countries in footnote to be in alphabetical order and identify what the United Kingdom includes.
Operationally:
Travelers coming from Brazil will also be screened
The paper version of the United States Traveler Health Declaration Form will now be shared with TSA so airlines can provide the form to passengers coming to the United States on flights from Brazil.
Increase in Annualized Total Burden Hours:
The previous burden calculated for this data collection consisted of 2,349,475 hours. As a result of the changes proposed in this change request, and an update of estimates of travelers from other countries as part of the airport entry questionnaire, the new burden will consist of 244,702 hours. Travel from the current countries has reduced significantly, allowing for the total burden to decrease even with the addition of another country. An updated burden table is included below (changes are highlighted).
Attachments
Attachment E1 – COVID-2019 Paper Format – U.S. Traveler Health Declaration_5.26.2020ChangeRequest-Tracked Changes
Attachment E2 – COVID-2019 Paper Format – U.S. Traveler Health Declaration_5.26.2020ChangeRequest-Clean
Respondent |
Form |
Number of Respondents
|
Number of Responses per Respondent |
Average Burden per Response (in minutes) |
Total Burden Hours |
|
Traveler |
United States Travel Health Declaration (Web, Fillable PDF, or Paper) |
640,000 |
1 |
15/60 |
160,000 |
|
Preboarding Health Screen |
20,000 |
1 |
5/60 |
|||
United States Travel Health Declaration for Repatriation |
10,000 |
1 |
15/60 |
2,500 |
||
United States Travel Health Declaration for Repatriation from Ship |
10,000 |
1 |
15/60 |
2,500 |
||
COVID-2019 Referral Slip |
640,000 |
1 |
5/60 |
53,333 |
||
Supplemental COVID-2019 Questionnaire |
5,333 |
1 |
10/60 |
889 |
||
COVID-2019 Air Travel Illness and Death Investigation Form |
1,920 |
1 |
15/60 |
|||
COVID-2019 Daily Symptom Check |
10,000 |
28 |
5/60 |
23,333 |
||
Total |
|
244,702 |
||||
Decreased burden associated with the United States Travel Health Declaration (English, Mandarin Chinese, Farci, Spanish, Italian)
Respondents: 6,155,000
Hours: 1,538,750
Decreased burden associated with the 2019-nCoV Supplementary Questionnaire
Respondents: 198,517
Hours: 33,086
Decreased burden associated with the 2019-nCoV Air Travel Illness and Death Investigation Form
Respondents: 80,080
Hours: 20,020
Decreased burden associated with the 2019-nCoV Referral Slip
Respondents: 6,155,000
Hours: 512,917
Total decreased burden: 2,104,773
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | JReichard |
| File Modified | 0000-00-00 |
| File Created | 2021-01-14 |