In a new report, the Government Accountability Office (GAO) says that coordination and safety problems among Department of Health and Human Services (HHS) staff during repatriation efforts early in the COVID-19 pandemic put themselves, the recalled US citizens, and surrounding communities at risk of infection.
According to the report, released yesterday, HHS agencies didn’t perform in the roles identified for the emergency return of US citizens during a pandemic when bringing the roughly 1,100 US citizens home, where they were quarantined.
Staff told to remove PPE
The government watchdog also noted that the agencies that make up HHS, including the Administration for Children and Families, the Office of the Assistant Secretary for Preparedness and Response, and the Centers for Disease Control and Prevention, disagreed about which agency was in charge of the efforts and whether they constituted a repatriation.
That disagreement, the report said, led to issues at the March Air Reserve Base quarantine facility in California, which received the first flight of citizens from Wuhan, China, in January 2020. Specifically, the lack of understanding about which agency was in charge caused confusion, and the lack of coordination resulted in the agencies operating independently of each other, leading to frustration and complications.
Also, the GAO detailed how HHS’s delay in issuing a federal quarantine order led to a repatriate attempting to leave the quarantine facility, HHS personnel used personal protective equipment (PPE) inconsistently amid a disagreement on who was responsible for infection prevention and mitigation, and an HHS official told staff to take off their PPE because it was creating “bad optics.”
Further, the report said, HHS didn’t include repatriation in its pandemic planning exercises, denying constituent agencies the opportunity to test deployment of repatriation plans together.
Advice to revise plans, conduct simulations
The National Response Framework, which contains guidelines for managing disasters and emergencies, tells agencies that, going forward, they need to understand their different roles and which plans apply and to create appropriate recommendations for responses.
“GAO is making two recommendations to the Secretary of Health and Human Services: (1) revise or develop new emergency repatriation response plans to clarify agency roles and responsibilities during a pandemic; and (2) plan and conduct repatriation exercises with relevant stakeholders—including federal partners and state, local, and territorial governments—to test repatriation plans in response to a pandemic,” the report said, adding that HHS agreed with the recommendations.
HHS provides temporary help to US citizens that the Department of State recalls from a foreign country because of destitution, illness, threat of war, or other crises. In February 2020, the department also repatriated citizens quarantined on the Diamond Princess cruise ship from Yokohama, Japan.
Jan 31, 2020, CIDRAP News story “CDC quarantines 195 passengers; US declares nCoV public health emergency“