Content provided in partnership with

Legal aspects of feared flu pandemic are pondered

Oakland Tribune, May 1, 2006 by Suzanne Bohan, STAFF WRITER

MILLBRAE -- On Day 5 of a deadly flu outbreak, there's no margin for error.

If missteps are made within those first several days, it could make the difference between containing a flu outbreak or helplessly watching it fan into the much-feared influenza pandemic.

That was the conclusion of about 200 health and legal experts assembled at the Clarion Hotel one day last week for a now- commonplace gathering: a flu pandemic planning session by those in charge of controlling an outbreak should it arise.

"The fragile hope is we can pounce on this early and contain it," said Dr. Anthony Iton, public health officer for Alameda County, who served on a panel at the event. "If we miss that opportunity, all bets are off."

Most Popular Articles in News: The Ten Best Laptop bags; Tata plans cheapest-ever car for Indian market; GLOBALIZATION AND THE DEVELOPMENT OF UNDERDEVELOPMENT OF THE THIRD WORLD; Corn is good for you; Corn is not only a tasty treat, but also a cereal that ...; THE 50 BEST STYLISH HANDBAGS TO CARRY; More »

By the fifth day of a hypothetical outbreak of a pandemic- caliber flu virus -- one that spreads easily and is far deadlier than usual -- public health departments might declare a state of emergency, Iton said. The leading candidate for causing such an outbreak is a now-famous flu virus called H5N1, which is carried primarily by certain bird populations.

Companies with affected employees would temporarily shut down, schools might close their doors, and federal health officials would jet into town to help control the outbreak and screen foreign travelers. Hospitals could face a run on their services and supplies, and public health workers would be working themselves to exhaustion. Patients would be kept in isolation, and all those potentially exposed kept under quarantine.

All this by Day 5.

The scene-setting session at the all-day conference gave a flavor of the extraordinary social, health, economic and political upheaval a full-blown pandemic would cause. Laced throughout the talk was consideration of the legal rights of health officials in containing outbreaks, and those of citizens faced with privacy violations.

The eight panelists pondered the case of a sales manager who became sick after returning from a trip to Asia, during which he was exposed to coughing and sneezing travelers.

Most of the infected bird populations are in Asia, as were the more than 200 human cases of avian influenza reported since 1997. Health officials believe most human avian flu infections arose from direct contact with infected poultry.

In this hypothetical scenario, by the third day, the sales manager is hospitalized in critical condition, and the World Health Organization announces that casual human-to-human transmission of H5N1 -- the most feared scenario -- has occurred in Asia.

By the fifth day, eight other employees working at the hypothetical firm, called Manufacturer, Inc., develop respiratory illnesses. Between the fifth and the sixth day, four of the sick employees are hospitalized. Two employees die that day, as does a janitor at the company hospitalized with a severe respiratory ailment.

A laboratory confirms four of the fictional cases are H5N1. Local health departments and Manufacturer Inc. begin receiving calls from the media worldwide, and it temporarily closes its doors. Word spreads of the disease, and workers at other companies start staying home to avoid the virus. An employee at the stricken firm also starts a blog, chronicling the illnesses.

To confine the outbreak to just these unfortunate few, health officials would have to move swiftly, invoking laws rarely used since polio and smallpox outbreaks in the first half of the 20th century.

"These legal tools haven't been dusted off in 50, 60 years," said Iton, who also has a law degree.

"We're also in an era of civil liberties," Iton added. "The balance of power has shifted much, much further away from government power and much more toward individual liberties, which is not a bad thing."

What it does mean, he emphasized, is that citizens need to understand why public health officers, in the event of a deadly flu outbreak, may act in ways that seem draconian.

"When there's a legitimate need for the use of government power, we have to reacquaint our communities with why" the power is being exercised, Iton said.

One of the first rights to be compromised might be that of medical privacy, as health officials seek details about infected patients. To serve a public health interest, a public health officer such as Iton is authorized to override certain provisions of federal and state medical privacy laws, said Brenda Carlson, deputy counsel for San Mateo County.

While public health officials can require treatment and examination of those suspected of carrying an infection threatening to public health, no one can force someone to get an inoculation without a court order. And if someone refuses an examination or treatment, it also cannot be forced without a court order.

If an outbreak is confirmed in another country, the U.S. State Department can demand screening of all U.S.-bound passengers boarding planes in that country. If the country refuses, travel restrictions can be imposed, said Ellen Miyasato, a lawyer with the U.S. Department of Health and Human Services.

Legal aspects of feared flu pandemic are pondered

Oakland Tribune, May 1, 2006 by Suzanne Bohan, STAFF WRITER

Find Research Guides for:

Find Featured Titles for: Reference

Most Popular Articles in News

Most Popular Publications in News