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Emergency Legal Preparedness & Wuhan Coronavirus: a Primer

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Emergency Legal Preparedness & Wuhan Coronavirus: a Primer Emergency Legal Preparedness & Wuhan Coronavirus: A Primer As of January 27, 2020 James G. Hodge, Jr., J.D., L.L.M. Peter Kiewit Foundation Professor of Law Director, Western Region Office, Network for Public Health Law ASU Sandra Day O’Connor College of Law [email protected] Primer Contents Brief Overview – Wuhan Coronavirus International Legal Response Efforts World Health Organization Foreign Governments U.S. Legal Preparedness/Response Additional Resources 2 Epi Snapshots Note: Limited information is currently available about the Wuhan coronavirus (2019-nCoV). Some data below are based on other coronaviruses (e.g., MERS, SARS) and are subject to change. Global Confirmed Cases: >2800 | Deaths: >80 | Mortality Rate: ~2% Transmission: • Possible animal source - initially infected persons in the Wuhan outbreak have been epidemiologically linked to a large seafood and animal market. • Transmissible person-to-person with potential infectivity rate approaching or exceeding influenza. Symptoms: • Respiratory symptoms, fever, cough, shortness of breath, breathing difficulties. • In severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and death. Treatment: • No proven vaccines or specific treatments are available. 3 Coronavirus Global Distribution 4 Source: https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-novel-coronavirus-cases Primer Contents International Legal Response Efforts 5 WHO Responses Jan. 22, 2020: WHO convenes emergency committee meeting but postpones decision on declaring PHEIC. Jan. 21, 2020: WHO confirms 1st case of 2019-nCoV in the Republic of Korea, identified as a Chinese national residing in Wuhan. Jan. 13, 2020: WHO confirms 1st case of 2019-nCovV in Thailand, identified as a traveler from Wuhan. Jan. 9, 2020: WHO statement on Chinese authorities making a preliminary determination of 2019-nCoV, identified in a hospitalized person with pneumonia in Wuhan. Dec. 31, 2019: Outbreak of pneumonia of unknown etiology in Wuhan initially reported to WHO. 6 WHO Emergency Declaration Jan. 23, 2020: WHO declines to declare a public health emergency of international concern (PHEIC). “It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO.” 7 China Public Health Responses Jan. 27, 2020: Chinese authorities prohibit travel into and out of Wuhan, Huanggang, Ezhou, Chibi, Zhijiang, and other cities with populations exceeding 50 million and extends Lunar New Year holiday by multiple days. Jan. 24, 2020: Affected Chinese citizens reporting distrust of government measures, lack of meaningful information, and concerns over accessing essential health care. Jan. 23, 2020: Hospitals running low on some essential supplies as increased numbers of persons seek treatment. Jan. 21, 2020: Ruling Communist Party committee temporarily posts that anyone deliberately hiding disease infection in China will be “forever nailed to history’s pillar of shame.” 8 Hong Kong Emergency Jan. 25, 2020 9 Primer Contents U.S. Legal Response Efforts 10 U.S. Preparedness/Response Jan. 22, 2020: Pres. Trump: “We have it totally under control. It's one person coming in from China. It’s going to be just fine.” Jan. 24, 2020: U.S. Senate Health and Foreign Relations Committees hosts a briefing on the 2019-nCoV outbreak and responses. 11 U.S. Public Health Emergency Jan. 24, 2020: Jan. 26, 2020: Senator Rick Scott Senator Chuck (R-FL) calls on Schumer (D-NY) HHS to declare suggests HHS public health declare a PHE 12 emergency (PHE) Requests for Close Monitoring Jan. 22, 2020: Senator Tom Cotton (R-AR) asks HHS’ Secretary Alex Azar to closely monitor Chinese information re: 2019-n- CoV and notify Congress of updates. 13 Federal Agency Responses 14 CDC Preparedness & Response Link here for additional, varied guidance and resources 1/23/20 Raised travel alert to highest Level 4. Added screening to Atlanta's Hartsfield-Jackson International and 1/21/20 Chicago's O'Hare International Airport. 1/21/20 Began entry screening of passengers on direct and connecting flights from Wuhan, China to 3 main ports of entry in the U.S. 1/20/20 Activated emergency operations center with Global Migration, Medical Care/ Countermeasures, and Epidemiology/Surveillance Task Forces. 1/17/20 Issued updated interim Health Alert Notice Advisory informing state/local health departments & providers about the outbreak. 1/17/20 Travel notice raised from Level 1; Practice Usual Precautions, to Level 2: Practice Enhanced Precautions for Wuhan, China. 1/7/2020 Established 2019-nCoV Incident Management Structure. 15 Domestic Cases of 2019-nCoV Jan. 21, 2020: CDC confirms 1st U.S. case of 2019-nCoV, a man returning from Wuhan and being treated in Washington State. Jan. 22, 2020: Public health workers are “actively monitoring” more than a dozen other people. Jan. 22, 2020: Snohomish County (WA) health district establishes coronavirus call center. Jan. 27, 2020: CDC confirms 5th U.S. case of 2019-nCoV in 4 states (AZ, CA, IL, WA); dozens of potential cases are under surveillance. 16 U.S. Cases of 2019-nCoV 17 Emerging Legal Issues Travel Restrictions/ Closures Testing/ Social Screening/ Distancing Treatment Measures Topics Public Health Surveillance Preparedness & Reporting Liability & Employment/ Insurance Privacy 18 Travel Restrictions Jan. 24, 2020: Senator Josh Hawley (R-MO) issues initial letter to HHS seeking travel restrictions, but later opines after Congress- ional briefing “[federal health officials] don’t think that that’s necessary quite yet. .” After the same briefing, NIH’s Dr. Anthony Fauci responded: “It’s not something that I think we're even considering.” 19 Airport Legal Preparedness Airport Public Health Preparedness & Response: Legal Rights, Powers & Duties Legal Considerations for Communicable Disease Response Planning: • Reporting of ill passengers • Measures to detect communicable diseases • Surveillance • Non-invasive procedures • Invasive procedures (with consent) • Contact tracing • Isolation & Quarantine Available at: http://www.trb.org/Main/Blurbs/177931.aspx Public Health Reporting Jan. 24, 2020: Ohio Department of Health classifies 2019- nCoV a “Class A” condition for which “confirmed or suspected cases . must be reported immediately to the local health district where the person lives (or . is being evaluated . ).” Required reporters include physicians providing care, administrators in charge of hospitals, clinics or other institutions providing care or treatment, laboratory administrators, or any individual having knowledge of a person with nCoV (emphasis added).” 21 For More Information Liability of Federal Public Social Latest Health Care Health Distancing Resources Workers and Emergencies Powers Entities Hospital Mental and Emergency Emergency State and Local Behavioral Declarations and Legal Preparedness Health Powers Preparedness Preparedness Emerging Model Public Health Threats Crisis Standards Emergency Emergency Preparedness of Care Laws Ethics and Response 22 Acknowledgements • Special thanks to Leila Barraza, JD, MPH, Erica N. White, Claudia Reeves and Brie Alford at the Network - Western Region Office for their research and assistance with this Primer • Ask the Network concerning questions or comments relating to this information or ongoing 2019-nCoV legal preparedness and response efforts • [email protected] 23.
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