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The Role of Law Enforcement in Public Health Emergencies

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U.S. Department of Justice Office of Justice Programs Bureau of Justice Assistance U.S. Department of Justice Office of Justice Programs 810 Seventh Street NW. Washington, DC 20531 Alberto R. Gonzales Attorney General Regina B. Schofield Assistant Attorney General Domingo S. Herraiz Director, Bureau of Justice Assistance Office of Justice Programs Partnerships for Safer Communities www.ojp.usdoj.gov Bureau of Justice Assistance www.ojp.usdoj.gov/BJA NCJ 214333 Written by Edward P. Richards, Katherine C. Rathbun, Corina Solé Brito, and Andrea Luna This document was prepared by the Police Executive Research Forum using funding provided by the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice. The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, and the Office for Victims of Crime. The Role of Law Enforcement in Public Health Emergencies Special Considerations for an All-Hazards Approach September 2006 Acknowledgments The U.S. Department of Justice, Office of Justice Programs’ Bureau of Justice Assistance (BJA) and the Police Executive Research Forum (PERF) wish to acknowledge Clifford L. Karchmer for his contributions during the writing of the publication.We also express our gratitude to Nancy Demme of the Montgomery County Police Department (Maryland), Stephen Holl of the Arlington County Police Department (Virginia),Tom Imrie of the Toronto Police Service, and Larry Moser of the Fairfax County Police Department (Virginia) for their thoughtful reviews of and significant contributions to this publication. About PERF PERF is a national organization of progressive law enforcement chief executives from city, county, and state agencies who collectively serve more than half of the country’s population. Established in 1976 by 10 prominent police chiefs, PERF has evolved into one of the leading police think tanks.With membership from many of the largest police departments in the country and around the globe, PERF has pioneered studies in such fields as community and problem-oriented policing, racially biased policing, multijurisdictional investigations, domestic violence, the police response to people with mental illnesses, homeland security, management concerns, use of force, and crime- reduction approaches. In addition to PERF’s cutting-edge police and criminal justice research, the organization provides a wide variety of management and technical assistance programs to police agencies throughout the world.The organization also continues to work toward increased professionalism and excellence in the field through its training, leadership, and publications programs.To learn more about PERF, visit www.policeforum.org. About BJA BJA supports law enforcement, courts, corrections, treatment, victim services, technology, and prevention initiatives that strengthen the nation’s criminal justice system. BJA provides leadership, services, and funding to America’s communities by emphasizing local control; building relationships in the field; developing collaborations and partnerships; promoting capacity building through planning; streamlining the administration of grants; increasing training and technical assistance; creating accountability of projects; encouraging innovation; and ultimately communicating the value of justice efforts to decision makers at every level.To learn more about BJA, visit www.ojp.usdoj.gov/BJA. iii Table of Contents Acknowledgments . .iii Introduction . .1 The Role of Law Enforcement . .1 Preparing the Department . .3 Responding to and Managing Incidents . .3 Continuity of Operations . .5 Protecting Law Enforcement Officers . .7 Risks to Law Enforcement From Disease . .7 Casual Contact . .7 Food- and Water-Borne Diseases . .8 Blood-Borne Diseases . .9 Immunization and Personal Protective Equipment . .9 Immunization . .9 Personal Protective Equipment . .11 Major Infectious Diseases . .13 Treatment of Infectious Disease . .15 Protecting Officers’ Families . .15 Protecting the Community . .17 Working With Public and Private Agencies . .17 The Role of Law Enforcement in Mass Vaccination and Preventive Measures . .18 Law Enforcement’s Role During Voluntary Restrictions . .19 Law Enforcement’s Role During Involuntary Restrictions, Including Quarantine . .20 Special Populations . .22 Law Enforcement’s Role in Mass Casualty Planning . .23 Conclusion . .25 Appendix 1: Further Considerations . .27 Appendix 2:Ten Principles of Modern Quarantine . .31 Appendix 3:Available Vaccinations for Diseases . .33 Appendix 4: Standard Definitions of Key Terms . .35 Appendix 5:What Is a Pandemic? . .37 v Introduction ecently, increases in cases of avian flu in both humans and animals have raised concern about the R threat of another flu pandemic.The Centers for Disease Control and Prevention (CDC) characterizes a flu pandemic as the emergence of a virus for which most people have little or no immunity, causes serious illness, and then spreads easily person-to-person worldwide.The CDC states that a pandemic may come and go in waves (lasting 6–8 weeks each—perhaps longer), which could lead to high levels of illness, death, social disruption, and economic loss. The death toll of the 1968–1969 flu pandemic was more than 700,000 worldwide.1 On May 2, 2006, the White House released the Implementation Plan for the National Strategy for Pandemic Influenza, which reiterates the importance of state and local preparedness; clarifies roles and responsibilities; and includes information, guidance, and recommendations for preparedness.While preparedness may seem largely a public health responsibility, law enforcement has a very critical role in the response to these incidents. Chapter 8 of the Implementation Plan (“Law Enforcement, Public Safety, and Security”) states: “If a pandemic influenza outbreak occurs in the United States, it is essential that governmental entities at all levels continue to provide essential public safety services and maintain public order. It is critical that all stakeholders in State and local law enforcement and public safety agencies, whose primary responsibility this is, be fully prepared to support public health efforts and to address the additional challenges they may face during such an outbreak.”2 The Role of Law Enforcement3 Public health emergencies pose special challenges for law enforcement, whether the threat is manmade (e.g., the anthrax 1. U.S. Department of Health and Human Services, www.pandemicflu.gov/ general/#impact. 2. www.whitehouse.gov/homeland/nspi_implementation.pdf, p. 153. 3. For the purposes of this document, the term “law enforcement” refers generally to sworn personnel serving state, city, and county jurisdictions (e.g., police officers, sheriffs’ deputies, and state troopers). Specific references to other types of law enforcement officials, such as federal agents, park rangers, animal control officers, and others will be noted. 1 The Role of Law Enforcement in Public Health Emergencies terrorist attacks) or naturally occurring (e.g., flu pandemics). Policing strategies will vary depending on the cause and level of the threat, as will the potential risk to the responding officers. In a public health emergency, law enforcement will need to quickly coordinate its response with public health and medical officials, many of whom they may not have worked with previously. Depending on the threat, law enforcement’s role may include enforcing public health orders (e.g., quarantines or travel restrictions), securing the perimeter of contaminated areas, securing health care facilities, controlling crowds, investigating scenes of suspected biological terrorism, and protecting national stockpiles of vaccines or other medicines. In a large-scale incident, such as a pandemic, law enforcement resources will quickly become overwhelmed, and law enforcement officials will have to balance their resources and efforts between these new responsibilities and everyday service demands.All of this may have to be accomplished with a greatly diminished workforce, as officers and their families may become infected and ill, and some personnel may determine that the risk of continuing to report to work is just too great to themselves or their families.A department’s ability to respond effectively to any emergency—public health or otherwise—greatly depends on its preparedness, and this is directly linked to the law enforcement agency’s planning and its partnerships. This document will help state and local law enforcement officials and policymakers to understand communicable diseases (including terminology and methods of transmission) and the threat they pose to public health and safety.4 The document outlines key concerns that law enforcement officials must address in preparation for a virus-caused pandemic and other public health emergencies and identifies issues that may arise in the department’s “all-hazards” approach.The document has three main sections: • Preparing the department (e.g., maintaining operational continuity). • Protecting the officers (e.g., educating them about transmission, vaccination, and treatment). • Protecting the community (e.g., maintaining public order). In addition, five appendixes
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