Bioterrorism Plan Sparks Protests

  1. Right on the heels of the last ER show comes this; what do you think?

    Lots of points worth pondering in this article.

    [ Fair Use: For Educational / Research / Discussion Purposes Only ]

    Bioterrorism Plan Sparks Protests

    Critics say model law infringes on personal liberties

    May 17 What would happen if another bioterrorist struck the U.S.?

    PROBABLY THE same confusion, fear and uncoordinated response that happened during last falls anthrax attacks. Federal and state plans to respond to bioterrorism have run up against civil libertarians and a host of others who worry their rights will be trampled. Even some hospital groups have fought against plans for bioterror attacks because they dont want contagious patients in their facilities.

    Just seven months ago, when anthrax was killing people and closing parts of the U.S. Postal Service and Washington D.C., nothing seemed more important than preparing for bioterror. A model law, drafted at the request of the Centers for Disease Control and Prevention, was rushed to state governments last fall to help their governors and public-health departments strengthen their quarantine powers to deal with a newer, larger and more dangerous bioterror attack with a contagious disease such as smallpox.

    But proposed legislation based on the model law was struck down in states including Idaho, Nebraska, Wyoming and Wisconsin and died in committee in Mississippi and Washington state. Groups ranging from the liberal American Civil Liberties Union to the conservative American Legislative Exchange Council decried what they saw as sweeping infringements of personal liberties. Although 11 states have passed some version of the act, it appears in many states the laws will be delayed or significantly diluted in scope, if implemented at all.

    In the meantime, the nation remains vulnerable to bioterror, public-health officials and bill supporters say ruefully. Lawrence Gostin, a law professor at Georgetown University in Washington and one of the authors of the model law, calls opponents ostriches with their heads in the sand.

    The Model Emergency Health Powers Act, was intended to be a template for state laws around the country. It allowed state governors 30 days of emergency power, with the right to quarantine, isolate, test, treat and vaccinate people. People refusing to be treated or vaccinated could be put into quarantine. It also allowed officials to take over hospitals and pharmacies during an emergency, allocate drugs and vaccines, and even ration food and fuel. It further permitted the state to close, evacuate and, when necessary, destroy contaminated property. People seeking release from quarantine were provided court hearings, as well as compensation for property seized under the law.

    The latest setback for the laws proponents came in California, where a sweeping Emergency Health Powers Act was gutted in a legislative committee and sent back for study. According to a glum Keith Richman, a physician and the Republican state legislator who introduced the legislation, My bill is dead.

    An autopsy of the California bill illustrates how far apart the two sides are.

    The American Civil Liberties Union of California blasted the model act for having too broad a definition of bioterror emergency, and too narrow a set of safeguards for due process, medical privacy, and religious objections to procedures like cremation, spokeswoman Valerie Small Navarro says.

    Also opposing the bill was the American Legislative Exchange Council, a free-market advocacy group. Sandy Liddy Bourne, a council official, said the proposed bill puts a stranglehold on our civil liberties. She charged the act constituted an unwarranted expansion of state public-health powers and warned it would lead to declarations of quarantine on the vague definition of a biological threat.

    Some groups, including the Association of American Physicians and Surgeons, a conservative medical lobby, objected to the laws provisions for compulsory shots in an emergency. Our group is against forcing vaccination on people, says Jane Orient, a Tucson doctor and executive director of the group, which lobbied statehouses from Albany to Sacramento conjuring images of forced treatment at gunpoint.

    Measures to limit the spread of deadly contagious disease by temporary isolation of the sick also provoked opposition. The Capitol Resource Institute, a nonprofit family-advocacy group based in Sacramento, rejects any bill that might separate families.

    Hospital quarantine of people with a disease such as smallpox is another flashpoint. At a hospital, unless you empty out quickly, you risk exposing a lot of innocent people, says Jan Emerson, spokeswoman for the California Healthcare Association, which opposes the model act. The association, a lobby for 470 acute-care hospitals, proposes that patients check into a motel, gym, or MASH-style field infirmary.

    Supporters say laws based on the model act would protect individual liberties better than existing laws. For instance, it provides court hearings for people improperly quarantined, rather than relying on writs of habeas corpus or laws against illegal imprisonment, as do some old state statutes.

    Whats wrong with the current system is that most state laws are highly antiquated, and predate most of the advances in public-health sciences and constitutional law in America, says Georgetowns Prof. Gostin. Some states, he says, retain one set of rules for old diseases like smallpox and plague; another for polio and tuberculosis; and still another for newer diseases like West Nile virus.

    Broad emergency health powers havent been invoked in America since the hot summer of 1954, when polio put children into iron lungs, and officials closed off summer camps and swimming pools. In light of the opposition to the model law, some CDC officials wonder if todays Americans are so unused to limits on their liberty that they wont tolerate disease-induced restrictions, even for the greater good.

    That possibility worries doctors in the trenches. The best intelligence tells us that with bioterror, its not a matter of if, but when, says Poki Namkung, director of public health for Berkeley, Calif. Every drill that has been run has shown people are not prepared.

    But in New York, Barry Steinhardt, director of the technology and liberty program of the ACLUs national office, is relieved most states are refusing to rush the new bioterror act into law. The worst laws, he warns, are made in time of emergency.
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    About Cascadians

    Joined: Dec '01; Posts: 164; Likes: 1
    caregivers, ushers to the portal of heaven


  3. by   oramar
    The ACLU is right about a lot of things but they are living in a dream world in this case. Did he not ever see the Stand by S. King. When disease outbreaks reach a certain point civilization breaks down and civil liberties become a moot point. What about my right not to have small pox carrier wondering around my neighborhood spreading death and destruction. Perhaps Mr. Barry Steinhardt would like to have people with an infectious disease spread by droplet showing up to teach at his childs school but I would prefer not to have it that way.
  4. by   Cascadians
    Oramar, you are right, and it seems to us that the public, never having worked with diseases and barrier precautions, has no idea how difficult or exhausting it is, or how easily these diseases spread.

    If any biowarfare outbreak causes this topic to be more in the public eye, the debate will become very interesting, to put it mildly.

    To all who still work in hospitals, sympathies and prayers should anything happen.
  5. by   Huganurse
    They can fight and argue and make all the laws they want and in a real emergency, we will do whatever it takes to get the job done, when you are talking about things like mass vaccination and illness and deaths r/t any state of emergency, including terrorism and bioterrorism, hurricaines, war.... It will be people like me who are public community health care providers that are in the trenches with the hospital nurses also providing services. I have just completed training for emergency shelter in our area. In times of disaster I must admit I'd rather be in the hospital working. My resources are very limited. I get minimal supplies but will have backup in the best of situations, from the paramedics who will go to the local drug store and take what I need and bring it back. You see in a state of emergency we are going to take over the control of drug stores, complete with police gaurds and public providers taking what ever they need. A government take over of a private business is what it essentially boils down to, but what else are we going to do? In a true emergency this will be my only resource. I'll take it to provide for those who are in the shelter. Our next class is r/t providing services after a chemical or bio or any attack. I must say that we will do what ever it takes. There are not many of us who are trained and I hope that plenty will come out and volunteer if something does happen. I could sure use a hand. We did mock senerios, it was surprising how much better we got at dealing with mass casualties and other people as we practiced. If it was a situation where we needed to vaccinate and the supply was on hand, I'd vaccinate everyone in the shelter and those who refused I would quarentine or send out of the shelter. I am the one who will be responsible for the safety and care of the occupants of the shelter and I will not allow anything to place risk to innocent people, law or no law. As far as medical privacy, I intend on keeping the records that I am responsible for confidential just like any other time. I see it as a non issue. As far as cremation, well, if it got that bad and we had mass numbers of deaths on our hands, it's 90 degrees outside, I'd bet we'd find a way to get the bodies out of the shelters and into mass graves or to a cremation area. What else can you do? Let's be real here. We who are providing emergency management services in time of disaster will do what ever is safest and what ever it takes to get the job done.
    Last edit by Huganurse on Jun 30, '02
  6. by   oramar
    Huganurse, I salute you, I also trust you totally, hope there are many more like you.
  7. by   Cascadians
    Huganurse, hope many more are trained soon!

    We're members of NERT / NET / CERT
    Community Emergency Response Teams,

    an excellent FEMA program taught and coordinated by local Fire Departments, which gives classes and hands-on training and certification for emergency preparedness and response, with advanced classes and drills and lots of opportunity to practice skills.


    Following a major disaster, first responders who provide fire and medical services will not be able to meet the demand for these services. Factors as number of victims, communication failures, and road blockages will prevent people from accessing emergency services they have come to expect at a moment's notice through 911. People will have to rely on each other for help in order to meet their immediate life saving and life sustaining needs.

    One also expects that under these kinds of conditions, family members, fellow employees, and neighbors will spontaneously try to help each other. This was the case following the Mexico City earthquake where untrained, spontaneous volunteers saved 800 people. However, 100 people lost their lives while attempting to save others. This is a high price to pay and is preventable through training.

    If we can predict that emergency services will not meet immediate needs following a major disaster, especially if there is no warning as in an earthquake, and people will spontaneously volunteer, what can government do to prepare citizens for this eventuality?

    First, present citizens the facts about what to expect following a major disaster in terms of immediate services. Second, give the message about their responsibility for mitigation and preparedness. Third, train them in needed life saving skills with emphasis on decision making skills, rescuer safety, and doing the greatest good for the greatest number. Fourth, organize teams so that they are an extension of first responder services offering immediate help to victims until professional services arrive.


    The Community Emergency Response Team concept was developed and implemented by the Los Angeles City Fire Department (LAFD) in 1985. The Whittier Narrows earthquake in 1987 underscored the area-wide threat of a major disaster in California. Further, it confirmed the need for training civilians to meet their immediate needs. As a result, the LAFD created the Disaster Preparedness Division with the purpose of training citizens and private and government employees.

    The training program that LAFD initiated makes good sense and furthers the process of citizens understanding their responsibility in preparing for disaster. It also increases their ability to safely help themselves, their family and their neighbors. The Federal Emergency Management Agency (FEMA) recognizes the importance of preparing citizens. The Emergency Management Institute (EMI) and the National Fire Academy adopted and expanded the CERT materials believing them applicable to all hazards.

    The CERT course will benefit any citizen who takes it. This individual will be better prepared to respond to and cope with the aftermath of a disaster. Additionally, if a community wants to supplement its response capability after a disaster, civilians can be recruited and trained as neighborhood, business, and government teams that, in essence, will be auxiliary responders. These groups can provide immediate assistance to victims in their area, organize spontaneous volunteers who have not had the training, and collect disaster intelligence that will assist professional responders with prioritization and allocation of resources following a disaster. Since 1993 when this training was made available nationally by FEMA, communities in 28 States and Puerto Rico have conducted CERT training.


    We recommend a number of steps to start a CERT:

    * Identify the program goals that CERT will meet and the resources available to conduct the program in your area.
    * Gain approval from appointed and elected officials to use CERT as a means to prepare citizens to care for themselves during a disaster when services may not be adequate. This is an excellent opportunity for the government to be proactive in working with its constituency.
    * Identify and recruit potential participants. Naturals for CERT are community groups, business and industry workers, and local government workers.
    * Train CERT instructor cadre
    * Conduct CERT sessions.
    * Conduct refresher training and exercises with CERTs.


    The CERT course is delivered in the community by a team of first responders who have the requisite knowledge and skills to instruct the sessions. It is suggested that the instructors complete a CERT Train-the-Trainer (TTT) conducted by their State Training Office for Emergency Management or the Emergency Management Institute in order to learn the training techniques that are used successfully by the LAFD.

    The CERT training for community groups is usually delivered in 2 1/2 hour sessions, one evening a week over a 7 week period. The training consists of the following:

    * Session I, DISASTER PREPAREDNESS: Addresses hazards to which people are vulnerable in their community. Materials cover actions that participants and their families take before, during, and after a disaster. As the session progresses, the instructor begins to explore an expanded response role for civilians in that they should begin to consider themselves disaster workers. Since they will want to help their family members and neighbors, this training can help them operate in a safe and appropriate manner. The CERT concept and organization are discussed as well as applicable laws governing volunteers in that jurisdiction.
    * Session II, DISASTER FIRE SUPPRESSION: Briefly covers fire chemistry, hazardous materials, fire hazards, and fire suppression strategies. However, the thrust of this session is the safe use of fire extinguishers, sizing up the situation, controlling utilities, and extinguishing a small fire.
    * Session III, DISASTER MEDICAL OPERATIONS PART I: Participants practice diagnosing and treating airway obstruction, bleeding, and shock by using simple triage and rapid treatment techniques.
    * Session IV, DISASTER MEDICAL OPERATIONS, PART II: Covers evaluating patients by doing a head to toe assessment, establishing a medical treatment area, performing basic first aid, and practicing in a safe and sanitary manner.
    * Session V, LIGHT SEARCH AND RESCUE OPERATIONS: Participants learn about search and rescue planning, size-up, search techniques, rescue techniques, and most important, rescuer safety.
    * Session VI, DISASTER PSYCHOLOGY AND TEAM ORGANIZATION: Covers signs and symptoms that might be experienced by the disaster victim and worker. It addresses CERT organization and management principles and the need for documentation.
    * Session VII, COURSE REVIEW AND DISASTER SIMULATION: Participants review their answers from a take home examination. Finally, they practice the skills that they have learned during the previous six sessions in disaster activity.

    Here is a well-organized active team:
  8. by   boobaby42
    These posts are very educational. Educating the masses is the key to success. Every individual should talk to their family unit and plan for emergencies. That is the only way to have hope of survival if the unthinkable happens.
    One thing that can be done now that some folks don't take seriously is childhood immunizations. An increasing number of parents are refusing to immunize their children. Some are going as far as lying about a medical or religious reason to get certificates for the school systems. It is a shame that the media has made such an impact. It makes no difference when you try to explain the consequences. We admitted an infant with pertussis on Friday. She's one sick little girl. On a ventilator and choking every breath.

    Anywho, we have a vaccine shortage now, but as soon as the small pox vaccine is available, I'm shooting my family with the medicine. Dang straight I am.