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The term "emergency declaration" triggers visions of people grabbing overflowing suitcases and rushing into streets teeming with traffic and trying to
leave town in Hollywood-style disaster movie fashion. However, that is not what is happening and the most Americans will probably hardly notice
the effect of the declaration as they go about their day to day lives today.
But for health authorities, hospitals, healthcare institutions, public and private health organizations, who even before swine flu broke out in the spring,
have been making plans for how to deal with pandemic flu should normal capacity become overwhelmed, the declaration now clears the way for those
plans to have a fast track route to implementation.
Former head of the US Centers for Disease Control and Prevention (CDC), Dr Richard Besser explained that in essence this measure gives hospitals
the freedom and flexibility to do whatever they need to treat the pandemic flu like an emergency.
""This declaration really changes the playing fields for hospitals; they've been doing planning for disasters. Now they can implement those plans," he
told ABC News.
Nicole Lurie, Department of Health and Human
Services (HHS) Assistant Secretary for Preparedness and Response said people should not panic about this. She told ABC News that:
"This is just another really proactive step that we are trying to take so that everybody is prepared as they can be."
The White House stressed that the national emergency declaration is not to signify that the flu situation is getting worse, but in order to prepare health
systems to deal with a potential worsening.
"This whole thing isn't about the fact that things are worse now," said Lurie. "It's really about hospitals being able to be prepared in case they get
worse."
In legal terms, under Section 1135 of the Social Security Act [42 USC §1320b-5] healthcare facilities may ask the HHS if they can waive the usual procedures, within the timescale and geographical limits set down in the already approved emergency plans,
in response to the pandemic.
Specifically the state of emergency, once declared, gives healthcare facilities the legal power to submit waivers to establish care sites, modified patient
triage protocols, transfer patients, and take outer measures to fast track and fully implement disaster operation plans.
For example, if a hospital becomes overwhelmed with pandemic flu cases it can submit a "1135 waiver" and ask for the local school to close and be
converted into a temporary "field hospital".
For such "1135 waivers" to be legal, two things must be in place: the Secretary for HHS must have declared a Public Health Emergency (this has been
in place since the spring), and the "President must have declared a national emergency either through a Stafford Act Declaration or National
Emergencies Act Declaration", as explained in a White House Blog entry posted on Sunday.
The requirements that may be waived also include those related to Medicare, Medicaid or the Children's Health Insurance Program (CHIP), the
Emergency Medical Treatment and Active Labor Act (EMTALA), and the Health Insurance Portability and Accountability Act (HIPAA).
This is not the first occasion in recent times where 1135 waivers were authorized, for example they were used to fast track emergency plans to deal
with Hurricanes Katrina in 2005, and Ike and Gustav in 2008, and even the 56th Presidential Inauguration earlier this year.
However, this is the first time that a US President has declared a national emergency explicitly because of an infectious disease since the presidential
power of emergency was created in 1976.
Since 2009 H1N1 swine flu first broke out in the US in spring this year, over 1,000 people have died and the virus is now active in 46 states.
Swine Flue Medications - Tamiflu
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