Domestic Legal Preparedness and Response to Ebola

2015 ◽  
Vol 43 (S1) ◽  
pp. 15-18 ◽  
Author(s):  
James G. Hodge ◽  
Matthew S. Penn ◽  
Montrece Ransom ◽  
Jane E. Jordan
Keyword(s):  
Public Health ◽  
Virus Disease ◽  
Developed Countries ◽  
The United States ◽  
University Hospital ◽  
African Countries ◽  
Extensive Discussion ◽  
Local Public Health ◽  
Emory University ◽  
State And Local

While the global threat of Ebola Virus Disease (EVD) in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers (HCWs) volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.The first domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD.

scholarly journals Ebola virus disease: Case management in the Institute of Infectious Diseases, University Hospital of Sassari, Sardinia, Italy

2016 ◽  
Vol 10 (05) ◽  
pp. 537-543 ◽  
Author(s):  
Giulia Bertoli ◽  
Marco Mannazzu ◽  
Giordano Madeddu ◽  
Riccardo Are ◽  
Alberto Muredda ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Ebola Virus ◽  
Virus Disease ◽  
Developed Countries ◽  
The United States ◽  
Ebola Virus Disease ◽  
University Hospital ◽  
Governmental Organization ◽  
Medical Division ◽  
Disease Case

Since the onset of the worst epidemic of Ebola virus disease in December 2013, 28,637 cases were reported as confirmed, probable, or suspected. Since the week of 3 January 2016, no more cases have been reported. The total number of deaths have amounted to 11,315 (39.5%). In developed countries, seven cases have been diagnosed: four in the United States, one in Spain, one in the United Kingdom, and one in Italy. On 20 July 2015, Italy was declared Ebola-free. On 9 May 2015, an Italian health worker came back to Italy after a long stay in Sierra Leone working for a non-governmental organization. Forty-eight hours after his arrival, he noticed headache, weakness, muscle pains, and slight fever. The following day, he was safely transported to the Infectious Diseases Unit of University Hospital of Sassari. The patient was hospitalized for 19 hours until an Italian Air Force medical division transferred him to Rome, to the Lazzaro Spallanzani Institute. Nineteen people who had contacts with the patient were monitored daily for 21 days by the Public Health Office of Sassari and none presented any symptoms. So far, neither vaccine nor treatment is available to be proposed on an international scale. Ebola is considered a re-emerging infectious disease which, unlike in the past, has been a worldwide emergency. This case study aimed to establish a discussion about the operative and logistic difficulties to be faced and about the discrepancy arising when protocols clash with the reality of facts.

Different Responses to COVID-19 in Four US States: Washington, New York, Missouri, and Alabama

2021 ◽  
pp. e1-e5
Author(s):  
Paul C. Erwin ◽  
Kenneth W. Mucheck ◽  
Ross C. Brownson
Keyword(s):  
Public Health ◽  
New York ◽  
Large Scale ◽  
United States Public Health ◽  
H1n1 Influenza ◽  
The United States ◽  
Local Public Health ◽  
The Us ◽  
Us Constitution ◽  
State And Local

In the United States, public health is largely the responsibility of state governments’ implementing authority specified in their constitutions or reserved to states under the 10th Amendment to the US Constitution. The public health–related powers granted to the federal government are substantially less and derive primarily from the Commerce Clause (Article 1, Section 8) of the US Constitution. In public health emergencies over the past several decades, however, the Centers for Disease Control and Prevention (CDC) has played a major role in providing guidance, resources, and other support to state and local public health departments, for example, in large foodborne disease outbreaks, in response to major natural disasters, and especially in response to large-scale infectious disease threats (e.g., West Nile virus, severe acute respiratory syndrome, and H1N1 influenza).1 (Am J Public Health. Published online ahead of print January 28, 2021: e1–e5. https://doi.org/10.2105/AJPH.2020.306111 )

Public Health Laboratory Preparedness; Bioterrorism the New Challenge

2001 ◽  
Vol 7 (S2) ◽  
pp. 180-181
Author(s):  
Richard F. Meyer
Keyword(s):  
Public Health ◽  
Soviet Union ◽  
Former Soviet Union ◽  
The United States ◽  
Rapid Screening ◽  
Biological Weapons ◽  
Local Public Health ◽  
New Public Health ◽  
State And Local ◽  
High Level

In the event of a bioterrorist attack, rapid screening, agent identification, and confirmatory diagnosis will be critical, so that prevention and treatment measures can be implemented quickly. However, because few biologic agents thought likely to be used as biological weapons represent major public health problems in the United States, we have limited capacity to diagnose them, either at the state and local or the federal level. to begin to address this new public health challenge the Laboratory Response Network for Bioterrorism (LRN) was established.The LRN is a multi-level system designed to link state and local public health laboratories, clinical, military, veterinary, agricultural, water and food-testing laboratories. Operational in August of 1999, the LRN was established as a consequence of Presidential Decision Directive 39, increased congressional awareness of the huge biological weapons program in the former Soviet Union, the high level of risk to national security and subsequent emergency funding to the Centers for Disease Control and Prevention under the DHHS Operating Plan for Anti- Bioterrorism Initiative.

scholarly journals Controlling Tuberculosis in the United States: Use of Isolation and Other Measures Throughout the Country

2016 ◽  
Vol 11 (3) ◽  
pp. 337-342 ◽  
Author(s):  
Rebecca Katz ◽  
Andrea Vaught
Keyword(s):  
Public Health ◽  
Community Support ◽  
The United States ◽  
Health Departments ◽  
Local Public Health ◽  
Social Distancing ◽  
Public Health Officials ◽  
State And Local ◽  
Evidentiary Standards ◽  
Depth Interviews

AbstractObjectivesWe sought to better understand the tools used by public health officials in the control of tuberculosis (TB).MethodsWe conducted a series of in-depth interviews with public health officials at the local, state, and federal levels to better understand how health departments around the country use isolation measures to control TB.ResultsState and local public health officials’ use of social distancing tools in infection control varies widely, particularly in response to handling noncompliant patients. Judicial and community support, in addition to financial resources, impacted the incentives and enablers used to maintain isolation of infectious TB patients.ConclusionsInstituting social distancing requires authorities and resources and can be impacted by evidentiary standards, risk assessments, political will, and community support. Awareness of these factors, as well as knowledge of state and local uses of social distancing measures, is essential to understanding what actions are most likely to be instituted during a public health emergency and to target interventions to better prepare health departments to utilize the best available tools necessary to control the spread of disease. (Disaster Med Public Health Preparedness. 2017;11:337–342)

scholarly journals COVID-19 and US Health Financing: Perils and Possibilities

2020 ◽  
Vol 50 (4) ◽  
pp. 396-407 ◽  
Author(s):  
Adam Gaffney ◽  
David U. Himmelstein ◽  
Steffie Woolhandler
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Financing ◽  
Early Response ◽  
The United States ◽  
Federal State ◽  
Medical Care System ◽  
Local Public Health ◽  
State And Local

While the COVID-19 pandemic presents every nation with challenges, the United States’ underfunded public health infrastructure, fragmented medical care system, and inadequate social protections impose particular impediments to mitigating and managing the outbreak. Years of inadequate funding of the nation’s federal, state, and local public health agencies, together with mismanagement by the Trump administration, hampered the early response to the epidemic. Meanwhile, barriers to care faced by uninsured and underinsured individuals in the United States could deter COVID-19 care and hamper containment efforts, and lead to adverse medical and financial outcomes for infected individuals and their families, particularly those from disadvantaged groups. While the United States has a relatively generous supply of Intensive Care Unit beds and most other health care infrastructure, such medical resources are often unevenly distributed or deployed, leaving some areas ill-prepared for a severe respiratory epidemic. These deficiencies and shortfalls have stimulated a debate about policy solutions. Recent legislation, for instance, expanded coverage for testing for COVID-19 for the uninsured and underinsured, and additional reforms have been proposed. However comprehensive health care reform – for example, via national health insurance – is needed to provide full protection to American families during the COVID-19 outbreak and in its aftermath.

Public Health Preparedness Laws and Policies: Where Do We Go after Pandemic 2009 H1N1 Influenza?

2011 ◽  
Vol 39 (S1) ◽  
pp. 51-55 ◽  
Author(s):  
Jean O’Connor ◽  
Paul Jarris ◽  
Richard Vogt ◽  
Heather Horton
Keyword(s):  
Public Health ◽  
H1n1 Influenza ◽  
The United States ◽  
Federal State ◽  
High Morbidity ◽  
Public Health Preparedness ◽  
Local Public Health ◽  
2009 H1n1 ◽  
State And Local ◽  
Laws And Policies

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services (HHS) declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans.

Voices from the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C

2021 ◽  
pp. 114-136
Author(s):  
Martha Williamson ◽  
◽  
Karen Pearson ◽  
Amanda Burgess ◽  
Jennifer Lenardson ◽  
...  
Keyword(s):  
Public Health ◽  
Hepatitis C ◽  
Rural Areas ◽  
Community Education ◽  
Treatment Strategies ◽  
The United States ◽  
Structured Interviews ◽  
Persons Who Inject Drugs ◽  
Local Public Health ◽  
State And Local

Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. We conducted semi-structured interviews with 36 state and local public health professionals from six rural states to gain an understanding of the challenges rural communities face and strategies they are using to prepare for, identify, and respond to HIV and/or HCV outbreaks due to intravenous drug use. Key informants described inadequate funding, insufficient staffing, limited health care infrastructure, and other factors as limiting the public health capacity of rural areas. Promising prevention, surveillance, and treatment strategies in rural areas included the use of mobile treatment units, telemedicine approaches, and community education initiatives to overcome resistance to evidence-based harm reduction programs.

scholarly journals The Evolution of the Healthy Brain Initiative

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 720-720
Author(s):  
Lisa McGuire
Keyword(s):  
Public Health ◽  
Population Based ◽  
Public Health Issue ◽  
Dementia Caregivers ◽  
Local Public Health ◽  
Success Stories ◽  
Road Map ◽  
Indian Country ◽  
State And Local ◽  
Map Series

Abstract The Healthy Brain Initiative (HBI) seeks to advance public health awareness of and action on ADRD as a public health issue. The HBI Road Map Series, State and Local Public Health Partnerships to Address Dementia: The 2018–2023 Road Map (S&L RM) and Road Map for Indian Country (RMIC), provide the public health with concrete steps to respond to the growing burden of ADRD in communities, consistent with the aim of the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L. 115-406). This series of RMs for state, local, and tribal public health provide flexible menus of actions to address cognitive health, including ADRD, and support for dementia caregivers with population-based approaches. This session will describe how the initiative evolved over the past 15 years including policy and implementation success stories.

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