State of emergency communication

Crisis and emergency risk communication is the attempt by science- or public health

professionals to provide information that allows an individual, stakeholders, or an entire

community to make the best possible decisions during a crisis emergency about their

well being, and communicate those decisions, within nearly impossible time

constraints, and ultimately, to accept the imperfect nature of choices as the situation

evolves.

When dealing with communicable disease issues in an emergency, the public health

response may be complicated by the need to protect civil liberties versus the need to

stop the transmission of disease. Imposed quarantine, for example, has never been a

popular response to a disease outbreak. And, in some cases, when a new disease

emerged, clamor by a frightened public for quarantine began even before the true

nature of the disease was clarified. Who communicates what, when a public health

state of emergency is declared? This is an important question that must be addressed

in the pre-event planning. When a state of emergency is declared, public health

officials may use law as a basis for emergency response activities. It is vital to explain

what the public health emergency law covers and why the law exists. Most state public

health emergency laws will charge the public health authority with informing its citizens

when a state of emergency is declared and terminated, how people can protect

themselves during a public health emergency, and the actions being taken to control

the emergency. Most importantly, this information must be readily understood by

citizens, regardless of their language skills. In preplanning, determine in what

languages the information must be available and how to get that information to specific

populations. Also consider the special needs of the elderly, institutionalized persons,

and people with vision and hearing impairments. These messages should be

developed in template form and tested to ensure that they are widely understood. Most

emergency public health laws do or will cover reporting of disease cases; quarantine;

vaccination; protection of civil liberties; property issues; infectious waste disposal;

control of health care supplies; access to medical records; and effective coordination

with other state, local, and federal agencies. These laws cover vaccination and

quarantine because they are critical to stopping potentially devastating disease

outbreaks. The vital medical goal is to keep an infected person from infecting others.

This can be accomplished by vaccinating people who may have been exposed to the

disease (if a vaccine exists) or by separating them from others during the incubation

period of the disease. A draft model law, developed at the request of CDC by the

Center for Law and the Public's Health at Georgetown and Johns Hopkins universities,

is serving as a basis for state and local officials to strengthen America's capacity and

ability to respond to public health emergencies. Finding the right balance between

individual liberties and the common good requires effort. A major part of the process in

developing this draft model act has been to incorporate provisions that guarantee and

strengthen civil liberty protections in state public health emergency laws. For example,

the model law requires a court order to quarantine someone; although quarantine can

be ordered without court permission if delay could pose an immediate threat to the

public's health. In addition, a person in quarantine would have the legal right to a court

hearing to contest the court order; the hearing must be held within 72 hours of receipt

of the request. At the hearing, the public health authority must demonstrate that the

quarantine is warranted. Quarantined people can also request a hearing regarding

treatment and the conditions of quarantine. The draft law provides for court-appointed

legal representation for those in, or recommended for, quarantine or isolation. The

materials developed to support your state public health emergency laws should stress

the importance in finding the appropriate balance between individual liberties and the

common good. (1)

(1) Biological Attacks: Communication Challenges