[Federal Register Volume 86, Number 17 (Thursday, January 28, 2021)]
[Notices]
[Pages 7387-7391]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-01977]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Requirement for Negative Pre-Departure COVID-19 Test Result or
Documentation of Recovery From COVID-19 for all Airline or Other
Aircraft Passengers Arriving Into the United States From Any Foreign
Country
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice of Agency Order.
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SUMMARY: The Centers for Disease Control and Prevention (CDC), located
within the Department of Health and Human Services (HHS) announces an
Agency Order requiring negative pre-departure COVID-19 test results or
documentation of recovery from COVID-19 for all airline or other
aircraft passengers arriving into the United States from any foreign
country. This Order was signed by the CDC Director on January 25, 2021
and supersedes the previous Order signed by the CDC Director on January
12, 2021.
DATES: This Order was effective January 26, 2021.
FOR FURTHER INFORMATION CONTACT: Jennifer Buigut, Division of Global
Migration and Quarantine, Centers for Disease Control and Prevention,
1600 Clifton Road NE, MS H16-4, Atlanta, GA 30329. Email:
[email protected].
SUPPLEMENTARY INFORMATION: This Order prohibits the introduction into
the United States of any aircraft passenger departing from any foreign
country unless the passenger: (1) Has a negative pre-departure test
result for SARS-CoV-2, the virus that causes COVID-19 (Qualifying
Test); or (2) written or electronic documentation of recovery from
COVID-19 after previous SARS-CoV-2 infection in the form of a positive
viral test result and a letter from a licensed health care provider or
public health official stating that the passenger has been cleared for
travel (Documentation of Recovery).
This Order supersedes the previous Order signed by the CDC Director
on January 12, 2021. This Order further clarifies the exemption
categories for federal law enforcement and U.S. Department of Defense
(DOD) personnel observing DOD precautions to prevent the transmission
of COVID-19 during travel. This Order also replaces the previous
language concerning the ability of airlines and aircraft operators to
request specific waivers and replaces it with a limited humanitarian
exemption category allowing individuals and organizations to request an
exemption. To be eligible for this limited humanitarian exemption, the
individual or organization must demonstrate both: (1) Exigent
circumstances where emergency travel is required to preserve health and
safety (e.g., emergency
[[Page 7388]]
medical evacuations); and (2) that predeparture testing cannot be
accessed or completed before travel. No changes were made to the
Passenger Attestation.
This Order constitutes a controlled free pratique to any airline or
other aircraft operator with an aircraft arriving into the United
States. Pursuant to this controlled free pratique, the airline or other
aircraft operator must comply with the conditions outlined in the
Order.
A copy of the Order is provided below. A copy of the signed Order
and Passenger Attestation can be found at https://www.cdc.gov/quarantine/fr-proof-negative-test.html.
Centers for Disease Control and Prevention, Department of Health and
Human Services
Order Under Section 361 of the Public Health Service Act (42 U.S.C.
264) and 42 Code of Federal Regulations 71.20 & 71.31(b)
Requirement for Negative Pre-Departure COVID-19 Test Result or
Documentation of Recovery From COVID-19 for all Airline or Other
Aircraft Passengers Arriving Into the United States From any Foreign
Country 1
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\1\ This Order supersedes the previous order signed by the U.S.
Centers for Disease Control and Prevention (CDC) Director on January
12, 2021.
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Summary
Pursuant to 42 CFR 71.20 and as set forth in greater detail below,
this Notice and Order prohibit the introduction into the United States
of any aircraft passenger departing from any foreign country unless the
passenger: (1) Has a negative pre-departure test result for SARS-CoV-2,
the virus that causes COVID-19 (Qualifying Test); or (2) written or
electronic documentation of recovery from COVID-19 after previous SARS-
CoV-2 infection in the form of a positive viral test result and a
letter from a licensed health care provider or public health official
stating that the passenger has been cleared for travel (Documentation
of Recovery).
The negative pre-departure test must be a viral test that was
conducted on a specimen collected during the 3 days preceding the
flight's departure from a foreign country (Qualifying Test).
Alternatively, if the passenger has recovered from COVID-19, the
passenger may instead travel with written or electronic documentation
of a positive viral test result that confirms previous SARS-CoV-2
infection and a letter from a licensed health care provider or public
health official stating that the passenger has been cleared for travel
(Documentation of Recovery). A passenger must retain written or
electronic documentation reflecting the negative Qualifying Test result
or Documentation of Recovery presented to the airline or other aircraft
operator. A passenger must also produce such Qualifying Test result or
Documentation of Recovery upon request to any U.S. government official
or a cooperating state or local public health authority.
Pursuant to 42 CFR 71.31(b) and as set forth in greater detail
below, this Notice and Order constitute a controlled free pratique to
any airline or other aircraft operator with an aircraft arriving into
the United States. Pursuant to this controlled free pratique, the
airline or other aircraft operator must comply with the following
conditions to receive permission for the aircraft to enter and
disembark passengers in the United States:
Airline or other aircraft operator must verify that every
passenger--2 years of age or older--onboard the aircraft has attested
to receiving a negative Qualifying Test result or to having recovered
from COVID-19 after previous SARS-CoV-2 infection and being cleared to
travel by a licensed health care provider or public health official.
Airline or other aircraft operator must confirm that every
passenger onboard the aircraft has documentation of a negative
Qualifying Test result or Documentation of Recovery from COVID-19.
Statement of Intent
This Order shall be interpreted and implemented to achieve the
following paramount objectives:
Preservation of human life;
Preventing the further introduction, transmission, and
spread of the virus that causes COVID-19 into the United States,
including new virus variants;
Preserving the health and safety of crew members,
passengers, airport personnel, and communities; and
Preserving hospital, healthcare, and emergency response
resources within the United States.
Definitions
Aircraft shall have the same definition as under 42 U.S.C.
40102(a)(6). ``Aircraft'' includes, but is not limited to, commercial,
general aviation, and private aircraft destined for the United States
from a foreign country.
Aircraft Operator means an individual or organization causing or
authorizing the operation of an aircraft.
Airline shall have the same definition as under 42 CFR71.1(b).
Attest/Attestation means having completed the attestation in
Attachment A. Such attestation may be completed in written or
electronic form. The attestation is a statement, writing, entry, or
other representation under 18 U.S.C. 1001.\2\
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\2\ CDC encourages airline or aircraft operator to incorporate
the attestation into paperless check-in processes. Airline or
aircraft operator may use a third party (including a third-party
application) to collect attestations, including to provide
translations. But airline or aircraft operator has sole legal
responsibility to provide and collect attestations, to ensure the
accuracy of any translation, and to comply with all other
obligations under this Order. Airline or aircraft operator is
responsible for any failure of a third party to comply with this
Order. Airline or aircraft operator may not shift any legal
responsibility to a third party.
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Confirm that every passenger onboard the aircraft has documentation
reflecting a negative Qualifying Test result means confirmation that:
(1) The personal identifiers (e.g., name and date of birth) on
the negative Qualifying Test result match the personal identifiers
on the passenger's passport or other travel documents;
(2) if the passenger is arriving on a direct flight to the
United States, the specimen was collected within the 3 days
preceding the flight's departure;
(3) if the passenger is arriving via one or more connecting
flights the specimen was collected within the 3 days preceding the
departure of the initial flight;
(4) the test performed was a viral test (as defined below); and
(5) the test result states ``NEGATIVE,'' ``SARS-CoV-2 RNA NOT
DETECTED,'' ``SARS-CoV-2 ANTIGEN NOT DETECTED,'' or ``COVID-19 NOT
DETECTED.'' A test marked ``invalid'' is not acceptable.
Confirm that a passenger alternatively has written or electronic
documentation of recovery from COVID-19 means confirmation that:
(1) The passenger has presented documentation of a positive test
result and a signed letter on official letterhead that contains the
name, address, and phone number of a licensed healthcare provider or
public health official stating that the passenger has been cleared
for travel; \3\
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\3\ Health care providers and public health officials should
follow CDC guidance in clearing patients for travel to the United
States. Applicable guidance is available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html.
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(2) the positive test result occurred within the last three
months (90 days) preceding the passenger's flight to the United
States, or at such other intervals as specified in CDC guidance; \4\
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\4\ https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html.
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(3) the personal identifiers (e.g., name and date of birth) on
the positive test result and signed letter match the personal
identifiers on the passenger's passport or other travel documents;
(4) the test performed was a viral test (as defined below); and
[[Page 7389]]
(5) the test result states ``POSITIVE,'' ``SARS-CoV-2 RNA
DETECTED,'' ``SARS-CoV-2 ANTIGEN DETECTED,'' or ``COVID-19
DETECTED.'' A test marked ``invalid'' is not acceptable.
Foreign country means anywhere that is not a state, territory, or
possession of the United States.
Negative Pre-departure Test Result for COVID-19 or negative
Qualifying Test result means documentation of a negative COVID-19 test
taken within the 3 days preceding a flight's departure. Such
documentation may be in paper or electronic format as required by this
Order. Testing must be performed using a viral test. The documentation
must also include sufficient verification information--such as the name
and contact information for the laboratory or healthcare personnel who
performed the test.
Viral test means a viral detection test for current infection
(i.e., a nucleic acid amplification test or a viral antigen test)
approved or authorized by the relevant national authority for the
detection of SARS-CoV-2.
United States has the same meaning as ``State'' and ``U.S.
Territory'' in 42 CFR 71.1(b).
Exemptions
The following categories of individuals and organizations are
exempt from the requirements of this Order:
Crew members of airlines or other aircraft operators
provided that they follow industry standard protocols for the
prevention of COVID-19 as set forth in relevant Safety Alerts for
Operators (SAFOs) issued by the Federal Aviation Administration
(FAA).\5\
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\5\ https://www.faa.gov/other_visit/aviation_industry/airline_operators/airline_safety/safo/all_safos/media/2020/SAFO20009.pdf. Airlines, aircraft operators, and their crew members
may follow even stricter protocols for safety, including testing
protocols.
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Airlines or other aircraft operators transporting
passengers with COVID-19 pursuant to CDC authorization and in
accordance with CDC guidance.\6\
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\6\ Interim Guidance for Transporting or Arranging
Transportation by Air into, from, or within the United States of
People with COVID-19 or COVID-19 Exposure available at https://www.cdc.gov/quarantine/interim-guidance-transporting.html.
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Federal law enforcement personnel on official orders who
are traveling for the purpose of carrying out a law enforcement
function, provided they are covered under an occupational health and
safety program in accordance with CDC guidance. Those traveling for
training or other business purposes remain subject to the requirements
of this Order.
U.S. Department of Defense (DOD) personnel, including
military personnel and civilian employees, dependents, contractors
(including whole aircraft charter operators), and other U.S. government
employees when traveling on DOD assets, provided that such individuals
are under competent military or U.S. government travel orders and
observing DOD precautions to prevent the transmission of COVID-19 as
set forth in Force Protection Guidance Supplement 14--Department of
Defense Guidance for Personnel Traveling During the Coronavirus Disease
2019 Pandemic (December 29, 2020) including its testing guidance.
Individuals and organizations for which the issuance of a
humanitarian exemption is necessary based on both (1) exigent
circumstances where emergency travel is required to preserve health and
safety (e.g., emergency medical evacuations) and (2) where pre-
departure testing cannot be accessed or completed before travel.
Additional conditions may be placed on those granted such exemptions,
including but not limited to, observing precautions during travel,
providing consent to post-arrival testing, and/or self-quarantine after
arrival in the United States, as may be directed by federal, state,
territorial, tribal or local public health authorities to reduce the
risk of transmission or spread.
Background
The COVID-19 pandemic has spread throughout the world. Individuals
who travel may be at risk for exposure to SARS-CoV-2 before, during,
and after travel. This could result in U.S.-bound travelers further
spreading the virus to others during travel, upon arrival in the United
States, and at their destinations.
Over the last few weeks, the United Kingdom (UK) has faced a rapid
increase in COVID-19 cases in South East England, leading to enhanced
epidemiological and virological investigations. On December 14, 2020,
Public Health England announced that a new variant of SARS-CoV-2 had
been identified across the southeast of England.\7\ Preliminary
analysis in the UK suggests that this SARS-CoV-2 variant may be more
transmissible than previously circulating variants, with an estimated
potential to increase the reproductive number (R0) by 0.4-
0.7 or greater with an estimated increased transmissibility of up to 70
percent.\8\
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\7\ https://www.gov.uk/government/news/phe-investigating-a-novel-variant-of-covid-19.
\8\ https://www.ecdc.europa.eu/en/publications-data/threat-assessment-brief-rapid-increase-sars-cov-2-variant-united-kingdom.
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On December 19, 2020, in response to the emergence of the UK
variant, the countries comprising the UK announced stricter measures to
be applied from December 20 and over the coming weeks, with affected
areas entering a `Tier 4' level with movement restrictions within and
between more and less heavily affected areas. These measures have
included recommendations for residents of the most affected areas to
restrict movements and travel, including international travel, outside
of these areas. The government of Scotland announced a travel ban
between Scotland and the rest of the UK. In addition, the Netherlands
issued a travel ban from the UK effective through January 1, 2021, and
Belgium temporarily halted flight and train travel from the UK. Other
countries took similar measures to restrict travel from the UK.
A second new variant of SARS-CoV-2 was reported in the Republic of
South Africa (RSA) on December 18, 2020, that also appears to spread
more rapidly than earlier variants of the virus. The RSA variant is
distinct from the UK variant but shares a mutation in the spike protein
that appears to increase transmissibility. Since being identified, the
new variant has spread inland from coastal regions of RSA and has
become the predominant variant in some areas of the country.
During December 21-26, 2020, several countries implemented
restrictions on travel from South Africa, including China, El Salvador,
Germany, Guatemala, Israel, Panama, Sudan, Switzerland, Turkey, and the
UK. The Netherlands imposed a ban on travel from RSA on December 21 but
lifted the ban for both the UK and RSA on December 23, stating that
travelers will instead need to present a negative COVID-19 test result
obtained within 72 hours of their scheduled arrival in the Netherlands,
followed by 10 days of self-quarantine. On December 28, Japan imposed a
ban on entry of all foreign nationals through the end of January 2021.
On December 28, the Government of South Africa announced new
restrictions on businesses and public movement. As of January 7, 2021,
Canada requires air passengers 5 years of age or older to test negative
for COVID-19 before arrival. On January 8, the United Kingdom announced
a pre-departure testing requirement for all inbound international
travelers with limited exceptions; a 10-day post-arrival quarantine
will still be required.
On December 25, 2020, CDC issued an Order requiring proof of a
negative Qualifying Test result for all airline
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passengers arriving from the UK to the United States. Since then, cases
of the UK and RSA variants have been discovered in four Canadian
provinces, including in individuals with no travel history indicating
spread in Canada. The UK variant has also been found in at least 50
countries and the RSA variant has also been detected in at least 15
countries. The first case of the UK variant in the United States was
found in Colorado on December 29, in an individual with no known travel
history. On December 30, a second case was reported in California.
Since then, the UK variant strain has accounted for 144 cases in 20
U.S. states. Another new variant strain of concern initially detected
in South America in March 2020 has been detected in at least 19
countries on 5 continents through late December and has mutations in
the spike protein that raise concerns of increased infectivity.
While it is known and expected that viruses constantly change
through mutation leading to the emergence of new variants, these new
variants have emerged at a time when numbers of new cases in the United
States have continued to increase at alarming rates. Additional new
virus variants are also likely to emerge as the virus continues to
evolve and mutate. Accordingly, further action is needed to help
mitigate the spread of these and other new virus variants into the
United States.
Based on increased transmissibility and spread of these new
variants of SARS-CoV-2, and to reduce introduction and spread of these
and future SARS-CoV-2 variants into the United States, expanding
current UK pre-departure testing requirements to all foreign countries
and U.S.-bound passengers is warranted. This approach to testing-based
risk assessment has been addressed in CDC guidance and the Runway to
Recovery guidance jointly issued by the Departments of Transportation,
Homeland Security, and Health and Human Services.\9\ Testing for SARS-
CoV-2 infection is a proactive approach and not dependent on the
infecting strain. Approximately 120 countries now use testing in some
form to monitor risk and control introduction and spread. With case
counts and deaths due to COVID-19 continuing to increase around the
globe and the high proportion of infected people with asymptomatic or
pre-symptomatic infections, the United States must take a dual approach
to combatting the virus. This means concurrently mitigating and slowing
the introduction and spread of SARS-CoV-2 and controlling transmission
within U.S. communities that are currently being overwhelmed by a surge
in infections, hospitalizations, and deaths.
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\9\ Runway to Recovery 1.1, December 21, 2020, available at
https://www.transportation.gov/briefing-room/runway-recovery-11.
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Pre-departure testing may detect travelers infected with SARS-CoV-2
before they initiate their travel. CDC recommends viral testing and
receipt of results 1-3 days \10\ before departure for international
travelers, particularly those traveling long distances or passing
through transportation hubs such as airports where social distancing
may be challenging. CDC modeling indicates that pre-departure testing
is most effective when combined with self-monitoring.\11\ Testing
before departure results in the greatest reduction of transmission risk
during travel when the specimen is collected close to the time of
departure. Earlier testing (i.e., more than 3 days before travel)
provides little benefit beyond what self-monitoring alone can provide.
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\10\ https://www.cdc.gov/coronavirus/2019-ncov/travelers/testing-air-travel.html.
\11\ Johansson MA, Wolford H, Paul P, et al. Reducing travel-
related SARS-CoV-2 transmission with layered mitigation measures:
Symptom monitoring, quarantine, and testing, available at https://www.medrxiv.org/content/10.1101/2020.11.23.20237412v1.
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For persons previously diagnosed with COVID-19 who remain
asymptomatic after recovery, CDC does not recommended retesting within
3 months after the date of symptom onset (or the date of first positive
viral diagnostic test if their infection was asymptomatic) for the
initial SARS-CoV-2 infection.\12\ Persons who develop any symptoms of
COVID-19 during this time period should not travel and seek care for
testing and evaluation. This guidance may be updated as additional
information about people who have recovered from COVID-19 becomes
available.
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\12\ https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html.
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Pre-departure testing does not eliminate all risk. However, when
pre-departure testing is combined with other measures such as self-
monitoring for symptoms of COVID-19, wearing masks, social distancing,
and hand hygiene, it can make travel safer by reducing spread on
conveyances, in transportation hubs, and at destinations. For
international air travelers and others with higher risk of exposure,
CDC additionally recommends a post-arrival test 3-5 days after arrival
at destination, combined with self-monitoring and a 7-day period of
staying home (or in a comparable location such as a hotel room) to
further reduce the risk of translocating the virus into destination
communities.\13\
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\13\ https://www.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html.
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As cases of COVID-19 continue to rise across the globe and travel
volume increases, routine pre-departure testing of all U.S.-bound
aircraft passengers is needed not only to reduce introduction of the
two known SARS-CoV-2 variants from UK and RSA, but also future variants
that might be more transmissible and cause more severe illness.
Action
For these reasons, I hereby determine that passengers covered by
this Order are at risk of transmitting the new SARS-CoV-2 virus
variants or other potential variants and that requiring such passengers
to demonstrate either negative COVID-19 test results or recovery from
COVID-19 after previous SARS-CoV-2 infection is needed as a public
health measure to protect the health of fellow travelers and U.S.
communities.
1. Requirements for Airlines & Other Aircraft Operators
Any airline or other aircraft operator with passengers arriving
into the United States from a foreign country, for each passenger
onboard the aircraft arriving into the United States, shall--
a. Verify that each passenger has attested to having received
either a negative Qualifying Test result or to recovery from COVID-19
after previous SARS-CoV-2 infection and clearance to travel. Airlines
or other aircraft operators must retain a copy of each passenger
attestation for 2 years. The attestation is attached to this order as
Attachment A.
b. Confirm that each passenger aged 2 years or older has
documentation of a negative Qualifying Test result or Documentation of
Recovery from COVID-19.
c. Not board any passenger without verifying the attestation and
confirming the documentation as set forth in 1.a-b.
Any airline or other aircraft operator that fails to comply with
section 1, ``Requirement for Airlines & Other Aircraft Operators,'' may
be subject to criminal penalties under, inter alia, 42 U.S.C. 271 and
42 CFR 71.2, in conjunction with 18 U.S.C. 3559 and 3571.
2. Requirements for Aircraft Passengers
Any aircraft passenger departing from any foreign country with a
destination in the United States shall--
(a) Provide an attestation to the CDC, through the airline or other
aircraft
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operator, of having received a negative Qualifying Test result or of
recovery from COVID-19 after previous SARS-CoV-2 infection and
clearance to travel. The attestation is attached to this order as
Attachment A. Unless otherwise permitted by law, a parent or other
authorized individual should attest on behalf of a passenger aged 2 to
17 years. An authorized individual may attest on behalf to any
passenger who is unable to attest on his or her own behalf (e.g., by
reason of physical or mental impairment).
(b) Retain a copy of the negative Qualifying Test result or
Documentation of Recovery from COVID-19 in his/her possession and
present it for inspection to the airline and upon request by an agent
of the U.S. government or a cooperating state or local public health
authority.
Any passenger who fails to comply with the requirements of section
2, ``Requirements for Aircraft Passengers,'' may be subject to criminal
penalties under, inter alia, 42 U.S.C. 271 and 42 CFR71.2, in
conjunction with 18 U.S.C. 3559 and 3571. Willfully giving false or
misleading information to the government may result in criminal
penalties under, inter alia, 18 U.S.C. 1001.
CDC may modify this Order by an updated publication in the Federal
Register or by posting an advisory to follow at www.cdc.gov.
This Order shall be enforceable through the provisions of 18 U.S.C.
3559, 3571; 42 U.S.C. 243, 268, 271; and 42 CFR71.2.
Effective Date
This Order shall enter into effect on January 26, 2021 and shall
remain in effect until the earliest of (1) the expiration of the
Secretary of Health and Human Services' declaration that COVID-19
constitutes a public health emergency; (2) the CDC Director rescinds or
modifies the order based on specific public health or other
considerations; or (3) December 31, 2021.
Authority
The authority for these orders is Sections 361 and 365 of the
Public Health Service Act (42 U.S.C. 264) and 42 CFR 71.20 & 71.31(b).
Dated: January 26, 2021.
Sherri Berger,
Acting Chief of Staff, Centers for Disease Control and Prevention.
[FR Doc. 2021-01977 Filed 1-26-21; 4:15 pm]
BILLING CODE 4163-18-P