LESSONS LEARNED: WHY THE UNITED STATES NEEDS A COUNTER-PANDEMIC BORDER STRATEGY
Photo by GummyBone/iStock / Getty Images
BY ROBERT BONNER AND GILLIAN HORTON
The following is an excerpt from Harvard’s Belfer Center Homeland Security Policy Paper Series. The full-length paper appeared on September 28, 2020, and may be found here.
Global pandemics are inevitable in our increasingly interconnected world, and are an urgent matter of border security—perhaps the most critical of our time. While no nation has created a truly comprehensive strategy for the use of border screening to counter pandemics, countries such as New Zealand, Japan, and Thailand that adopted strict border controls early on have seen remarkably low case numbers and mortality rates. These initial results are promising, and point to the importance of a decisive, strategic response to pandemics at the border.
In the United States, senior government officials became aware of the emerging threat of COVID-19 on January 3, 2020, and subsequently took a number of incremental steps to stem the tide, including a series of travel bans starting with China and targeting a growing list of “high risk” countries, increased interagency cooperation, and more screening and contact tracing. However, the first travelers with COVID-19 had already landed in the United States by January 2020. While we are not arguing for complete travel bans and lengthy quarantines for all arrivals during a pandemic, at least not as a first step, the border control measures taken by the United States were largely implemented on an ad hoc basis, were under-resourced, and unfortunately left most of U.S. Customs and Border Protection’s (CBP) extensive resources and authorities at the ports of entry untapped. Simply put, they were too little, too late.
It is critical that our policymakers learn quickly and act decisively—including through the development and deployment of mitigation measures at our border before the next pandemic hits. As a result, we propose a Counter-Pandemic Border Strategy (CPBS) that draws on successful strategies put in place at foreign and U.S. ports of entry in the wake of 9/11, the last time the U.S. government reacted to a truly devastating threat at its borders. Although no single measure can eliminate threats such as terrorism or a pandemic, there are many countermeasures that can be taken, and based on the behavior of COVID-19, a robust border strategy can play a key role in “flattening the curve”—reducing both lives lost and damage to the U.S. and global economy.
RECOMMENDATIONS
While the eight core elements of the CPBS described below are focused on the U.S. government and what it needs to put in place before the next pandemic, all nations can benefit from its core principles and these will ideally be adopted more broadly. The CPBS is not designed to reduce spread of novel viruses to zero, for that would be an impossible goal, but instead represents a layered approach across the entire travel continuum that can be scaled up or down to respond to a pandemic—including an entirely new virus with unknown or evolving characteristics. The following are core elements of the CPBS:
Recommendation 1: The U.S. Government must make countering pandemics at the border a priority. CBP is the single, unified agency that is responsible for the U.S. borders, including all the nation’s ports of entry or official entry points. In order to have an effective CPBS, CBP must be given and must embrace a new priority mission: When a pandemic is declared, CBP’s priority must be nothing less than preventing people infected with the virus from entering the United States and potentially infecting large numbers of the general population. CBP must act as the executive agent for the CDC at all ports of entry into the United States on arrival, as well as at foreign airports where CBP personnel are stationed and travelers are beginning their journey to the United States.
Recommendation 2: The U.S. Government must establish clear lines of effort as it relates to the CPBS. As policymakers review lessons learned from COVID-19, it is clear that the CPBS must be in place before it is needed so it can be flipped on as soon as a pandemic alert is declared by the CDC, rather than rolled out on the fly as a pandemic unfolds. In order to do this, agency roles and interactions must be clearly delineated, and the chain of command that kicks in when the CDC declares a pandemic must be determined in advance.
Recommendation 3: DHS must create a cadre of CBP Health (Counter-Pandemic) Specialists. Of the approximately 21,000 CBP officers (CBPOs) assigned to our nation’s ports of entry, 2,000-3,000 should receive special training and certification in basic health and communicable diseases, including counter-pandemic issues. This cadre of Health Specialists would perform the duties of a CBPO in ordinary times (border control, immigration and customs processing, counter-terrorism, etc.), but their principal duties would switch in the face of a pandemic.
Recommendation 4: CBP should screen passengers during the Pre-Board Phase. CBP currently has CBPOs stationed at foreign ports of embarkation as part of the Immigration Advisory Program (IAP), a key component of the agency’s “layered security strategy.” A significant percentage of the CBPOs assigned to overseas IAP teams should be certified Health Specialists who can be activated following a pandemic alert, and the United States should also make use of the data it receives to conduct targeted risk assessment. CBP receives a large amount of information through the IAP and data that is submitted to the airlines; this data is currently analyzed by CBP’s National targeting Center (NTC), which conducts risk assessment for both potential terrorist issues and eligibility to enter the United States, and can be used to establish a pre-board first line of defense.
Recommendation 5: The U.S. Government should use the In-Flight Phase to enlist air carriers in the screening and contact tracing process. Although they are generally commercial entities, air carriers spend more time in close proximity to passengers than any government official, and often play a role in reporting potential security concerns. In the case of a pandemic, international air carriers would be required to report passengers showing symptoms to CBP, provide written information to all passengers about symptoms and contact tracing, and notify passengers of the requirement to present themselves for primary counter-pandemic screening by CBP if they have symptoms associated with the pandemic virus.
Recommendation 6: CBP should screen all passengers for key indicators of illness upon arrival in the United States. This is an essential “front line” defense in the fight against a pandemic, and although it would require reallocation of existing resources as well as dedication of some new ones, it represents a singular opportunity to slow the spread of a pandemic virus. With this in mind, CBP should implement measures such as temperature checks, symptom lists, and roving officers throughout pre-primary. The United States should also consider securing quarantine facilities and co-locating testing labs at international airports, as other countries, including Thailand, have done, and CBP should be given explicit authority to require airlines to space out arrival times to alleviate overcrowding of Federal Inspection Areas.
Recommendation 7: Conduct prompt post-arrival contact tracing. Although the foregoing protocols will identify and screen out many contagious passengers, some passengers will be pre- or asymptomatic, so it is important to have a post-arrival contact tracing strategy in place to further reduce risk. This will require a robust federal, state, and local contact tracing program, led by the CDC, that acquires information on arrivals who become symptomatic or later test positive. CBP and its NTC should act as the repository for the seating charts for all flights arriving in the United States from abroad in order to provide a national coordinating function for contact tracing.
Recommendation 8: Expand CPBS Globally via a SAFE Framework for Pandemics. It is not enough for the U.S. alone to adopt the core elements of the CPBS. To be optimally effective, CPBS concepts should be adopted by many nations with reciprocal obligations to protect each other, and thereby the entire global community and economy. In the aftermath of 9/11, there was a collaborative multinational effort to use technology and smart border programs to facilitate the movement of legitimate travelers and trade, and international organizations, such as the World Customs Organization (WCO) and the International Civil Aviation Organization (ICAO), were instrumental in promoting a more unified multilateral approach that advanced “connected solutions” through data sharing and common standards and regulations. It is beyond question that both individual governments and international institutions were woefully unprepared for the current pandemic, and most have gone forward unilaterally. There is a better way, but it requires governments to act in a coordinated fashion and implement best “counter-pandemic” border practices, including the elements of the CPBS.
CONCLUSION
The United States is fully capable of implementing the above recommendations with a reasonable outlay of resources, though it will require political will, alignment of missions, and increased interagency coordination of a type not seen since the period after the 9/11 terrorist attacks, along with additional funding from Congress. However, the cost of implementing the CPBS pales in comparison to the enormous human and financial toll of a pandemic, and we cannot afford to do otherwise.
READ THE FULL PAPER HERE.
____________________
Q&A WITH THE AUTHORS
The CPBS is a fully articulated strategy, but will it work?
If the goal is to prevent a pandemic - that is, to prevent a novel virus from spreading - that is an impossible goal. But we believe that if the CPBS is in place and activated early on, it can be effective in “flattening the curve.” Or put differently, it can help prevent a spike in persons needing ICU hospitalizations as well as an overwhelming demand for critical medical equipment, such as ventilators. The CPBC can slow the spread of a pandemic, allow more time to develop a vaccine and be far less economically damaging than the measures we have taken, especially at the state government level.
There is no perfect solution for a pandemic. When you think about it, as economically harmful as the shutdown of all but essential businesses and stay-at-home orders have been, they have not been perfect solutions, either. People have to work at essential businesses to produce food and necessary supplies, and are working at clinics, grocery stores, pharmacies, and so on. And those subject to stay-at-home orders still need to go out and secure food, do banking, etc., so even with the shutdowns we have seen, many people have still been getting sick. It would be better in our view if policy makers had another tool in the tool kit, such as the CPBC, that could be used before resorting to these more draconian measures.
Why not simply ban all travel to the United States for the duration of a pandemic?
The total travel bans we saw in the United States were not particularly effective, as they were rolled out incrementally and after much of the damage had already been done, and while they banned travel by foreigners, we still needed to allow U.S. citizens and LPRs who had been in hot spots to return. In addition, these measures have crippled the airline and tourism industries and caused the loss of countless jobs along the lines of what we saw in the immediate aftermath of 9/11.
Our proposal only modestly restricts travel and would not mandate a travel ban. Indeed, global travel could continue, with modest disruption for those travelers showing symptoms or a pre-board certificate of good health for those who had traveled to a pandemic hot spot. The CPBS would not force the collapse of the airline and tourism industry, which has been the result of current measures. As such, it would provide a way to flatten the curve and limit loss of life up front without dealing a body blow to the global economy.
You cite New Zealand and a couple of other countries that successfully implemented strict border measures. Why not just adopt, say, the New Zealand strategy?
Our view is that New Zealand’s success countering the pandemic is to be applauded, but if they had had the CPBS in place, they might not have needed to adopt a ban on all foreign travelers to New Zealand or the extensive quarantine measures. These measures included quarantining (rather than testing and briefly detaining) arrivals for a lengthy 14-day period, and even included returning citizens who had no symptoms and had not traveled to hot spots. The New Zealand border control strategy may have gone further than necessary, as the country adopted “elimination” rather than mitigation—meaning its goal has been to prevent the virus from infecting anyone within its borders, rather than slow down the virus and flatten the curve. Preventing the virus entirely would not be a realistic objective for the United States in our view, and many other countries would likely balk at these strict measures or be unable to legally implement them. Moreover, if the New Zealand approach was taken broadly, it would shut down global travel, which the CPBS is designed to avoid. While it is possible that we could find ourselves facing a virus so deadly that it warrants a complete shutdown of all borders worldwide, we don’t believe this is a realistic first resort, and that a good strategy should be able to be scaled up or down.
As we speak, we are still in the midst of the COVID-19 pandemic. Can CPBS be implemented now and would it help?
It is too late to implement the CPBS for the COVID-19 pandemic. Based on our experience in government, and with implementing counter-terrorism border security programs in the immediate aftermath of 9/11, it will take our government a good two years to have the CPBS in place, and that’s from the time it is approved and funded. Part of the reason for this is once CBP has a clearly defined role in CPBS, it will need to train 2,000-3,000 CBPOs as Health Specialists who can be activated when the next pandemic is identified and declared. To better risk assess passengers traveling to the United States, CBP also needs to acquire authority to secure electronic API, airline manifest data, for the preceding leg of travel when there is a connector flight. Re-formulating CBP’s IAP teams to oversee pre-boarding pandemic screening will also require time to set up protocols and assure host nation cooperation, and implementing a multinational SAFE Framework, in our experience, will take even longer. These things take time. That said, it is vital that we have CPBS in place before the next pandemic, which is why we urge policymakers to begin now.
However, there are some pieces of the CPBS that could be adopted even as we are in the midst of the COVID-19 pandemic. For example, test labs could be co-located at our major international airport, such as, JFK, LAX, SFO, and Atlanta, so that persons with symptoms can be tested before being allowed to enter the United States. We should also be ensuring that travelers who test positive are quarantining, and doing contact tracing for passengers in proximity to a traveler who tests positive. These measures are only a fragment of what we are recommending in the CPBS, but they can be done now. Even though there is already community spread throughout much of the United States, we need to be doing whatever we can to stem the spread of the virus and stop additional clusters—and second or even third waves—from occurring. We are far from out of the woods.
____________________
Robert Bonner is a former United States District Judge, former Administrator of the Drug Enforcement Administration, and former Commissioner of Customs and Border Protection (CBP), where he served from 2001 to 2005.
Gillian Horton is a Senior Manager at E3/Sentinel who advises government decisionmakers in the homeland security space.
The views and opinions expressed here are those of the authors and do not necessarily reflect the official policy or position of the Pacific Council.
