2009 H1N1 (Swine Flu) Legal Preparedness and Response
In response to emerging legal issues concerning cases of H1N1 (swine flu) internationally, Centers
personnel worked in real-time to track various legal updates related to declarations of emergency or public health emergency at the international, national, and regional levels, as well as provide information on key legal issues. Please see below various information, including memoranda, articles,
checklists, and other documents that can accessed online or in PDF format [subject to continued availability of online links].
Disclaimer - Please note that information provided on this website does not represent the official legal positions of any federal, state, or local government agency or entity that provides funding to the Centers, nor is it meant to provide specific legal guidance or advice. Public health practitioners, responders, and others should contact their legal advisors for specific legal guidance.
U.S. Federal, State, and Territorial Declarations of Emergency or Public Health Emergency
For an illustrative map documenting emergency declarations across the United States, please link here.
- State of Iowa Declaration of Public Health Disaster ~ Iowa Governor Chet Culver declared a state of public health disaster, recognizing the potential for spread of H1N1 and the state’s first confirmed case. The declaration enables the State to purchase and distribute additional antivirals and personal protective equipment, and enhance communications with local public health officials, health care providers, state and federal agencies, and private partners. Date: May 2, 2009 through May 31, 2009
- State of Maryland Declaration of States of Emergency and Catastrophic Health Emergency ~ Maryland Governor Martin O'Malley signed an executive order declaring a state of emergency and catastrophic health emergency for the State to prepare for the spread of H1N1 swine flu in Maryland. Date: May 1, 2009
- State of Florida Declaration of Public Health Emergency ~ Florida's Surgeon General, Dr. Ana M. Viamonte Ros in consultation with Governor Charlie Crist has declared a public health emergency that has “the potential to result in substantial injury or harm to the public health.” The declaration allows the state “to suspend pharmaceutical pedigree requirements as applicable to the wholesale distribution of the prescription drugs Tamiflu and Relenza needed to cope with this emergency.” The declaration also allows the Surgeon General to take any additional action necessary to protect the public health. Date: May 1, 2009
- American Samoa Declaration of Public Health Emergency ~ American Samoa Governor Togiola T.A. Tulafono declared a state of public health emergency pursuant to the Revised Constitution of American Samoa and the Emergency Public Health Powers
Act. Date: May 1, 2009
- State of Nebraska Declaration of Emergency ~ Nebraska Governor Dave Heineman declared a state of emergency which recognizes the spread of A/H1N1 as a "public health incident of international significance" and allows for state agencies and departments to implement plans for the allocation of antiviral medicines from stockpiles to distribute throughout the state. Date: April 30, 2009
- State of Wisconsin Declaration of Public Health Emergency ~ Wisconsin Governor Jim Doyle declared a state of public health emergency. The declaration designates the Wisconsin Department of Health Services as the lead agency to respond to the public health emergency and to take all necessary and appropriate measures to prevent and respond to incidences of A/H1N1 Influenza in the state. Date: April 30, 2009
- State of Maine Declaration of Civil Emergency ~ Maine Governor John Baldacci declared a state of civil emergency to mobilize response efforts in the State. Date: April 29, 2009
- State of Texas Disaster Declaration ~ Texas Governor Rick Perry issued a state-wide disaster declaration to coordinate emergency response efforts and seek federal reimbursement. Date: April 29, 2009 through May 29, 2009
- State of Ohio Declaration of Emergency ~ Ohio Governor Ted Strickland declared a state of emergency to mobilize response efforts in the State. Date: April 28, 2009 through June 12
- State of California Declaration of Emergency ~ California Governor Arnold Schwarzenegger declared a state of emergency. The declaration was employed to (1) order all state agencies and departments to utilize and employ state personnel, equipment and facilities to assist the Department of Public Health (DPH) and the State Emergency Plan as coordinated by the California Emergency Management Agency; (2) order DPH and the Emergency Medical Services Authority to execute contracts for providing services, materials, personnel and equipment to supplement extraordinary preventive measures being taken across the state; (3) suspending non-competitive bid contracts for services, material, personnel and equipment needed to respond to this outbreak; and (4) waiving select certification requirements for public health laboratories to help in the state’s expansion of our testing capabilities. Date: April 28, 2009
- Commonwealth of Virginia Department of Public Health Declaration of Public Health Emergency ~ Virginia's Health Commissioner declared a public health emergency to better coordinate swine flu response efforts, including access to Virginia's database of licensed health care providers so that information can be more effectively and widely communicated. Virginia is also extending and enhancing its seasonal flu tracking program to ensure that any confirmed cases are promptly reported and tracked. Date: April 27, 2009
- FDA Emergency Use Authorization for Medicines and Diagnostic Tests for Swine Flu in Humans ~ the U.S. Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUAs) to expand access to diagnostic and therapeutic tools to identify and respond to the A/H1N1 flu virus, specifically use of Relenza and Tamiflu antiviral products and the rRT-PCR Swine Flu Panel diagnostic test. The EUA allows FDA, based on the evaluation of available data, to authorize the use of unapproved or uncleared medical products or unapproved or uncleared uses of approved or cleared medical products under certain criteria. The EUA ends when the declaration of emergency is terminated or the authorization revoked by the agency. For more information about EUAs from CDC, please link here. Date: April 27, 2009
- DHHS Declaration of a Public Health Emergency ~ Acting United States Department of Health and Human Services Secretary Charles Johnson declared a Public Health Emergency in response to the swine flu outbreak. The formal declaration of a Public Health Emergency (PHE) is a tool that facilitates DHHS’ preparation and mobilization for disasters and emergencies. The declaration of April 26, 2009, pursuant to section 319 of the Public Health Service Act, will help HHS prepare for prevention and mitigation activities by enabling Food and Drug Administration (FDA) emergency use authorizations of drugs, devices, or medical tests under certain circumstances. Specifically, the declaration of Public Health Emergency will enable the FDA to review and issue emergency use authorizations (EUAs) for the use of certain laboratory tests to help detect the newly discovered strain of influenza and for the emergency use of certain antivirals. Date: April 26, 2009
U.S. Local Government Declarations of Emergency or Public Health Emergency
- Ventura County (CA) Declaration of Emergency ~ Ventura County’s Board of Supervisors and Ventura county’s director of public health, Dr. Robert Levin, declared a local emergency as two cases of H1N1 have been confirmed and three probable cases are being tested. The declaration allows the county will be reimbursed by the state and federal government for costs associated with its response to 2009 H1N1 flu. Date: May 5, 2009
- Alameda County (CA) Declaration of Emergency ~ Alameda County supervisors declared a local emergency in response to the spread of H1N1 (swine flue) in the county. The declaration allows the county to receive financial assistance for personnel costs incurred tracking H1N1. Date: May 5, 2009
- Sonoma County (CA) Declaration of Emergency ~ Sonoma County Administrator Bob Deis and County Public Health Officer Dr. Mary Maddux-Gonzalez declared a local emergency to ensure the County’s access to local, state, and federal resources for detection and response to H1N1 (swine flu). Date: May 4, 2009
- San Mateo County (CA) Local Emergency Declaration ~ San Mateo County Manager David Boesch declared a local emergency to give the county access to state and federal funding to aid responses to H1N1 (swine flu). Date: May 1, 2009
- San Bernardino County (CA) Local Emergency Declaration ~ San Bernardino Chairman of the Board of Supervisors Gary C. Ovitt proclaimed a local emergency in response to H1N1 (swine flue). Date: April 30, 2009
- Los Angeles County Declaration of Emergency ~ According to the Los Angeles Times, LA County declared a local health emergency. Among other functions, the declaration authorizes the County to acquire additional antivirals from federal stockpiles. Date: April 28, 2009
International or Regional Declarations of Emergency or Public Health Emergency
- Guatemala Declaration of Disaster ~ Guatemala’s President, Άlvaro Colom, declared a national state of disaster for a period of 30 days beginning May 7, 2009 in response to Guatemala’s first confirmed case of 2009 H1N1. The declaration will allow the Guatemalan government “to take immediate actions that the situation warrants, to ensure the health of the population and prevent a possible spread of the virus.” Departmental governors and mayors have been asked to suspend unnecessary activities involving large clusters of people. Date: May 7, 2009
- Ecuador Declaration of Emergency ~ Ecuador declared a national state of emergency. According to a decree signed by President Rafael Correa, the state of emergency, which lasts 60 days, requires governmental entities to take necessary measures to contain the spread of swine flu. Date: April 29, 2009
- Costa Rica Declaration of Health Emergency ~ The Costa Rican government issued a "health emergency" declaration after confirming 2 cases of H1N1 flu. The declaration allows government to focus on prevention and control efforts. The declaration was signed by Costa Rican president, Oscar Arias and the Minister of Health, María Luisa Ávila. Please link here for a copy of the declaration (in Spanish). Date: April 28, 2009
- Columbia Declaration of Emergency ~ Colombia declared a national state of emergency to combat the threat of swine flu. The measure, announced on April 27, 2009 by Social Welfare Minister Diego Palacio, allows the government to contain and mitigate the impact of the emergency in the country. Date: April 27, 2009
- WHO Declaration of Public Health Emergency of International Concern (PHEIC) ~ Concerning public health measures, in line with the Regulations the Director-General declared a PHEIC, recommending that all countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia. Given the widespread presence of the virus, the Director-General considered that containment of the outbreak is not feasible. The current focus should be on mitigation measures. The Director-General recommended not to close borders and not to restrict international travel. People who are symptomatic should delay international travel. People developing symptoms following international travel should seek medical attention. Production of seasonal influenza vaccine should continue at this time, subject to re-evaluation as the situation evolves. Date: April 25, 2009
- Mexican Emergency Decree in Response to Swine Flu (in Spanish). Date: April 25, 2009
In addition, the Centers
lists below several resources to provide additional
information and resources that may assist in the assessment of
legal issues related to swine flu preparedness and response.
Links Related to Legal Preparedness and Response to H1N1 (Swine Flu)
- The Centers' Model State Emergency Health Powers Act.
- 2009 H1N1 (Swine) Flu and Legal Triage - PowerPoint presentation by James G. Hodge, Jr.
- The Swine Flu Outbreak and International Law - David P. Fidler, Indiana University Maurer School of Law, Centers' Senior Director, published in the American Society of International Law Insights.
- The Legal Landscape for School Closures in Response to Pandemic Flu or Other Public Health Threats - James G. Hodge, Jr., published in Biosecurity and Bioterrorism 2009; 7(1):45-50.
- Principles and Practice of Legal Triage During Public Health Emergencies - James G. Hodge, Jr. and Evan D. Anderson, published in the NYU Annual Survey of American Law
2008; 64(2): 249-291.
- Quarantine Decision Will Be Left to the Locals - Linda Carroll, MSNBC, April 29, 2009 (quoting James G. Hodge, Jr.).
- Center's Emergency System for the Advance Registration of Volunteer Health Professionals (ESAR-VHP) Legal and Regulatory Issues Project.
- Legal and Regulatory Issues Affecting Volunteer Health Practitioners in Emergencies - PowerPoint presentation by James G. Hodge, Jr. and Evan D. Anderson.
- Volunteer Health Professionals and Emergencies: Assessing and Transforming the Legal Environment, James G. Hodge, Jr., Lance A, Gable, and Stephanie H. Cálves, published in Biosecurity and Bioterrorism 2005; 3:3 216-223.
- The HIPAA Privacy Rule and Bioterrorism Prevention, Planning, and Response, James G. Hodge, Jr., Erin Fuse Brown, and Jessica O'Connell, published in Biosecurity and Bioterrorism 2004; 2:2: 73-80.
- The Swine Flu Outbreak and Public Health Response: Emergency Public Health Powers - Video (Real Player) PowerPoint presentation by Michelle M. Mello, Professor of Law and Public Health, Harvard School of Public Health, April 29, 2009
- Massachusetts Considering Public Health Emergency Legislation - On April 29, 2009, Massachusetts Senate unanimously passed a pandemic flu preparation bill that was introduced before the recent H1N1 flu outbreak. The Senate Bill would allow the public health commissioner — in a public health emergency — to close or evacuate buildings, enter private property for investigations, and quarantine individuals. The measure also requires a registry for volunteers that would be activated in an emergency. The measure repeals the current law that requires the Department of Public Health (DPH) commissioner to get approval from the governor and public health council before taking action after the Governor declares an emergency.
- Will Swine Flu Merit Quarantines? If so, New Law Gives States Authority - Deborah Cassens Weiss, ABA Journal Online, April 27, 2009 (quoting James G. Hodge, Jr.)
- Fighting the Flu with One Hand Tied - Lawrence O. Gostin, Washington Post, May 1, 2009
- As Flu Virus Spreads, Solid Details Get Out Slower, Associated Press, Fox News Online, May 3, 2009 (quoting James G. Hodge, Jr.)
- Public Safety vs. Individual Liberty: Health Crisis Leads to New Case, Amir Efrati, Wall Street Journal, May 7, 2009 (quoting James G. Hodge, Jr.)
Centers' Checklists on Public Health Emergency Preparedness