I interviewed Majority Leader Bill Frist on February 21, and one subject was preparedness for the avian flu. He e-mailed some additional thoughts on the question of quarantine authority this morning:
Regarding your question the other day on the radio….
Generally, states maintain primary quarantine authority. But, the official with authority and enforcement varies from state to state. The federal government may also prescribe quarantine regulations and assist local efforts. The Public Health Service Act gives the Secretary of HHS the authority to issue a public health emergency and trigger federal quarantine authority. Last year President Bush added pandemic flu to the list of diseases for which the Secretary may order and enforce quarantines.
Pandemic flu presents a unique challenge. Keep in mind that patients are infectious before symptomatic, so quarantine may be of little effect. We expect voluntary self-quarantining to occur. And, whether state or federal quarantine powers are triggered, both are woefully underprepared to enforce it and to provide the support services it would require (i.e. distribution of medicines, food, and other essential supplies). Over the next couple of months, I will be spending a good deal of my time evaluating our “lessons learned” from Katrina and how to improve our preparedness in the event of a pandemic.
More information than you wanted, but I hope it’s useful.
Senator Frist’s invocation of Katrina is very instructive, because it is the same sort of problem we face with the approach of H5N1: State and local governments are either unprepared or underprepared, and because it is a potential as opposed to certain event, generally unwilling to expend scarce resources on a pandemic, which seems even more remote than a huge hurricane. Attempts to prepare are met with press indifference or skepticism.
When the bird flu arrives, even if only among birds, some level of panic will ensue –churned by media that had previously ignored or downplayed the virus– and a hunt for scapegoats will begin.
If the levee breaks –in this instance, the human levee– the toll will be much, much higher than Katrina, but the playout among the MSM will be the same: The demand will grow for the feds to do something, and demands for investigations into unpreparedness will issue from all sides. This time, I hope the president does not wait for the state and local governments to fully display their paralysis and incompetence before using the quarantine authority the law provides his Administration.