Environmental Science Discussion 4

The rapid spread of seasonal influenza during the 2012-13 season brought a series of public health challenges and corresponding response efforts. For decades, responses to annual flu have been undertaken routinely without extensive legal intervention. With the recent declaration of states of public health emergencies in Boston (January 9, 2013) and New York State (January 12, 2013), however, the legal baseline is changing. Propelled by a slate of state and local emergency declarations during the 2009-10 H1N1 pandemic, public officials are beginning to show cause for the issuance of formal emergency declarations in support of flu response efforts.

The confluence of the terrorist attacks on the United States and the anthrax mail attacks focused attention and fear on the use of pathogens as weapons of mass destruction. In response, the Centers for Disease Control and Prevention ("CDC"), in collaboration with the National Governors Association, the National Conference on State Legislatures, the Association of State and Territorial Health Officials and the National Association of County and City Health Officials commissioned the center for Law and the Public's Health at Georgetown and Johns Hopkins Universities ("the Center") to develop a model act (Model State Emergency Health Powers Act) for states to consider enacting in preparation for bioterrorism. However, the legal effects of these types of declarations are profound. Public and private actors are now given significant, expedited public health powers. Scarce resources like vaccines can be more efficiently allocated. Laws relating to licensure, scope of practice, and liability can be effectively waived. Though originally conceptualized and once reserved for catastrophic, long-term health-related or bioterrorismevents, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks.

February may be the month for the Super Bowl and Valentine’s Day, but the influenza season is also expected to peak and then tail off in March. During the 2009-2010 flu season, H1N1 influenza hospitalization rates were twice as high for Blacks, Hispanics, American Indians, and Alaska Natives than for Whites. H1N1 hospitalization rates then were 29.7 per 100,000 people for Blacks, 30.7 for Hispanics and 16.3 for Whites according to the  CDC report. When compared to Whites, H1N1 vaccination rates were almost 10 percent lower for Black adults, about 4 percent lower for Black children, and more than 11 percent lower for Hispanic children. Seasonal flu vaccinations rates were almost 22 percent lower among Hispanic adults when compared to Whites. A smilar report released by Trust for America’s Health in November 2010 also found both H1N1 and seasonal flu vaccination rates were much lower for Blacks and Hispanics than for Whites.

Question: Carefully explore and discuss the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public's health. In your discussions, also examine the questions of when and whether government may infringe upon individual liberties in order to protect public health.