0405BioterrorismMatt hews

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Travel-Nature

Published on March 11, 2008

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PUBLIC HEALTH EMERGENCY LEGAL PREPAREDNESS:  PUBLIC HEALTH EMERGENCY LEGAL PREPAREDNESS Gene W. Matthews, J.D. Public Health Law 1126 Oxford Road, Atlanta,GA 30306 (404) 373-1276 MatthewsPHLaw@aol.com Concept Outline:  Concept Outline The Predicate: “Guns of August” Analogy: Global Communications Technology Has Leapfrogged Our Present Strategy and Doctrine. The Challenge: Q: “How do we find new Public Health Strategies & Doctrines?” One Path Is to Build New Bridges Use P.H. Law as a Tool to Accomplish: Outreach + Training + Coordinated Research I. The Predicate: “Guns Of August” Analogy:  I. The Predicate: “Guns Of August” Analogy “Great Tragedies Occur When Technology Leaps Ahead of Strategy and Doctrine.” Barbara Tuchman Our 21st Century Global Communication Technology Has Jumped Ahead of Our 20th Century Strategy and Doctrine. Westphalian Governance (International Relations: 1648 to 2003):  Westphalian Governance (International Relations: 1648 to 2003) (Horizontal Governance) -Sovereignty -Non-interference with internal affairs -Bilateral agreements and treaty (Adapted from: Adapted from Germs, Norms, and Power: Global Health’s Political Revolution By David P. Fidler, Indiana University School of Law) State A State B State C Post-Westphalian Governance In 21st Century Public Health Events:  Post-Westphalian Governance In 21st Century Public Health Events “The Tipping Point” Global access to communications technology State A State B State C Post-Westphalian Governance:  Post-Westphalian Governance “Vertical Communication” Global access to communications technology State A State B State C Post-Westphalian Governance:  Post-Westphalian Governance WHO Media Global access to communications technology State A State B State C Post-Westphalian Governance:  Post-Westphalian Governance WHO “surveillance” Media Global access to communications technology State A State B State C Post-Westphalian Governance:  Post-Westphalian Governance WHO “travel alerts” “surveillance” Media Global access to communications technology State A State B State C Post-Westphalian Governance:  Post-Westphalian Governance WHO “travel alerts” “surveillance” Media Multi-national “Interference” in China, Canada, etc Global access to communications technology State A State B State C The Toronto Paradox 27,000 “voluntary” quarantine 27 formal orders 1 appeal (withdrawn) DIVISIVENESS SOCIAL PANIC COHESION Media Impact on P.H. Emergency Parallels to WTC events of 9/11? + Madrid? Cultures are temporarily changed! How?...Why?” SOCIAL RESEARCH NEEDED ASAP!:  The Toronto Paradox 27,000 “voluntary” quarantine 27 formal orders 1 appeal (withdrawn) DIVISIVENESS SOCIAL PANIC COHESION Media Impact on P.H. Emergency Parallels to WTC events of 9/11? + Madrid? Cultures are temporarily changed! How?...Why?” SOCIAL RESEARCH NEEDED ASAP! Two Routes of the Challenge::  Two Routes of the Challenge: NATURE PUBLIC HEALTH “Guns of August”: The Global Access to Communications Technology HUMAN Natural Events Human Acts Natural Events (21st Century Emerging Infections):  Natural Events (21st Century Emerging Infections) Mad Cow Disease West Nile Virus SARS Monkey Pox Avian Flu Next emerging infections?? Cascade of Communications Challenges Human Events (21st Century Asymmetrical Terrorism):  Human Events (21st Century Asymmetrical Terrorism) Bioterrorism Events Anthrax Attacks of 2001 Smallpox Vaccinations of 2003 Ricin Events in 2003-2004 “Conventional” Weapon Events Airliner Hijackings of 9/11/2001 Madrid Subway Attacks of 2004 Chemical & Nuclear Threats Chemical Weapon Concerns “Suitcase Bomb” & “Dirty Bomb” Senarios Communications Cascade Elements of Terrorism?:  Elements of Terrorism? EVENT Elements of Terrorism?:  Elements of Terrorism? EVENT Audience Human Events (Asymmetrical Terrorism) :  Human Events (Asymmetrical Terrorism) COMMUNICATION EVENT Audience I. The 21st Century World: New Triangulation on Public Health:  I. The 21st Century World: New Triangulation on Public Health NATURE’s Challenges PUBLIC HEALTH “Guns of August” Leap: The Global Access to Communications Technology HUMAN’s Challenges Communication Technology Natural Events Human Events The New Challenge to Public Health::  The New Challenge to Public Health: “How do we find new strategies and doctrines for public health in the 21st century”? II. The Challenge to Public Health:  II. The Challenge to Public Health An Answer: “Law is the Bridge Between Science and the Humanities” Dr. William F. Foege II. The Challenge to Public Health:  II. The Challenge to Public Health Challenges Challenges of of Science the Humanities Rx: Build New Bridges (The Law Can Assist In Building Bridges) Slide22:  III. OPPORTUNITIES FOR “NEW BRIDGES” Slide23:  Public Health Law Enforcement Emergency Management Medical Services Courts Federal, State, and Local “Legal Preparedness” The Silos Slide25:  Quarantine A collective action for the common good Public good Individual liberties Paramount to meet needs of individuals infected and exposed Slide26:  HISTORICAL CONTEXT 1954: Two Ships Passed in the Night! Salk Polio Vaccine – 1954 (END IN U.S. OF COMMUNITY-WIDE PUBLIC HEALTH CONTROL MEASURES—300 years!) Brown v. Board of Education 1954 (BEGINNING OF MODERN EVOLUTION OF PROCEDURAL PROTECTIONS OF INDIVIDUAL LIBERTIES AGAINST GOVERNMENT ACTION) New 2003 SARS Lessons-Toronto:  New 2003 SARS Lessons-Toronto LEVELS OF QUARANTINE HAVE EVOLVED --USE OF MASKS, GLOVES, ETC. --“SNOW DAY” and “SHELTER-IN-PLACE” --VOLUNTARY ISOLATION / QUARANTINE --TELEPHONE MONITORING IN THE HOME --GOV’T ORDERED ISOLATION / QUARANTINE --INVENTED CONCEPT OF “WORK QUARANTINE” --ACTIVE USE OF LAW ENFORCEMENT OFFICERS TO SERVE PROCESS AND MONITOR 2003 SARS Lessons:  2003 SARS Lessons “Public Health Must Be Prepared to Act BOLDLY AND SWIFTLY And To Treat Individuals With DIGNITY AND FAIRNESS.” Dr. Julie L. Gerberding INTERPLAY OF FEDERAL AND STATE/LOCAL LAWS:  INTERPLAY OF FEDERAL AND STATE/LOCAL LAWS State & local have primary responsibility for Quarantine and Isolation. Federal has authority to prevent interstate spread + international importation of disease. HHS may accept state & local assistance in enforcement of federal Q regulations HHS may assist state & local officials in their control of communicable diseases. INTERPLAY OF FEDERAL AND STATE/LOCAL LAWS:  INTERPLAY OF FEDERAL AND STATE/LOCAL LAWS FEDERAL CONTROL & SARS Due to the potential for a case of SARS to spread interstate, it is clear that the Federal quarantine authority could be applied to a single SARS case inside a state or local jurisdiction, if necessary. --CDC would not have to wait for an interstate SARS spread to actually take place before acting. --BUT any such CDC action on SARS would be carefully coordinated with the appropriate state or local officials. Slide31:  Public Health Law Enforcement Emergency Management Medical Services Courts Federal, State, and Local “Legal Preparedness” The Silos III. Building New Bridges:  III. Building New Bridges Need for Some Practical Steps --Outreach --Training --Coordinated Research III. One Path to Building Bridges Need for Practical Steps:  III. One Path to Building Bridges Need for Practical Steps Outreach 1. Build Network of Asian Public Health Law Experts Immediately 2. Initiate a U.S. Community Legal Preparedness Initiative to Business Leaders Through Various Attorney Organizations (ABA, BENS, AHLA, etc) III. Building Bridges COMMUNITY-BASED LEGAL PREPAREDNESS DISCUSSIONS:  III. Building Bridges COMMUNITY-BASED LEGAL PREPAREDNESS DISCUSSIONS Reach out through State and City Lawyers’ Associations + P.H. Officers “Has your bar association set up a legal preparedness working group…yet?” Natural Participants: Hospital Attorneys, Civil Liberties, Law Schools, Transportation, Media, Drug Cos., Professional Associations, Attny Gens., etc. Community Legal Preparedness:  Community Legal Preparedness CDC Pilots Underway NC, TX, OK ABA Conference in Atlanta-August 2004 Contacts: Montrece Ransom = OZR@cdc.gov Darrell Reid = DReid@cdc.gov III. One Path to Building Bridges Need for Practical Steps:  III. One Path to Building Bridges Need for Practical Steps Training 3. Develop New Skills Course to P.H. Officers for Handling Emergencies Examples: (A) How Does a Community Change in an Emergency? (B) What are the Communications Imperatives? (C) Teach Bridge Building Skills to Connect to Other Silos that Overlap P.H. in Emergency Situations. (D) Teach The “Three Curves” of Public Health Politics: Increase CasesMedia AttentionPolitical Action etc. III. One Path to Building Bridges Need for Practical Steps:  III. One Path to Building Bridges Need for Practical Steps Coordinated Research 4. Interdisciplinary Research on the Impact of Communications Technology on Public Health Emergency Responses --Schools of Communication --Schools of Law --Schools of Public Health --Poli. Sci, Engineering, Sociology, etc. Concept Outline:  Concept Outline The Predicate: “Guns of August” Analogy: Global Communications Technology Has Leapfrogged Our Present Strategy and Doctrine. The Challenge: Q: “How do we find new Public Health Strategies & Doctrines?” One Path Is to Build New Bridges Use P.H. Law as a Tool to Accomplish: Outreach + Training + Coordinated Research FUTURE EXPECTATIONS :  FUTURE EXPECTATIONS “A RENAISSANCE IS NOW TAKING PLACE IN PUBLIC HEALH LAW” FUTURE EXPECTATIONS “CONNECT THE DOTS”:  FUTURE EXPECTATIONS “CONNECT THE DOTS” Health Officers Academicians Legislators Non-Profits Attorneys FUTURE EXPECTATIONS “ADDING NEW DOTS!!!!”:  FUTURE EXPECTATIONS “ADDING NEW DOTS!!!!” Health AGRI. Officers LAW ENFORCE. Academicians Legislators EMA’s JUDICIAL Non-Profits ? Attorneys CDC Public Health Law Activities:  CDC Public Health Law Activities Public Health Law Conferences in Atlanta were well attended: --June 2002 --June 2003 Next: June 14-16, 2004 in Atlanta Sheraton Colony Square Hotel CDC Public Health Law Activities:  CDC Public Health Law Activities The CDC Public Health Law News Published weekly by CDC hhtp://www.cdc.gov/subscribe.htlm More Information on CDC’s PHLP http://phppo.cdc.gov.od/phlp Slide45:  Cases Time Intensity “Three Curves” of Public Health Politics Slide46:  Cases Time Intensity Media “Three Curves” of Public Health Politics Slide47:  Cases Policy Actions Time Intensity Media “Three Curves of Public Health Politics” Slide48:  CDC Public Health Law Program Website www.phppo.cdc.gov/od/phlp

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