Public Health Emergencies and Constitutionalism Before COVID-19: Between the National and the International

The World ◽

Legal Frameworks ◽

Technical Features ◽

First Time

Abstract The current chapter deals with public health emergencies and their linkages to constitutional law and theory. The ongoing COVID-19 pandemic poses myriad challenges to constitutional regimes around the world. However, it is by no means the first time that public health emergencies have led to questions of constitutionalism. Past instances of disease outbreaks had already highlighted how emergency legal frameworks unfold when facing the challenge of containing their spread. Against this backdrop, the chapter focuses on pre-COVID-19 instances of cross-border epidemics and pandemics, such as A(H1N1) Influenza, Ebola and Zika, and some of their implications for constitutionalism. These examples of infectious disease outbreaks are assessed by resorting to three models-archetypes of constitutional emergencies as a theoretical background. As they show a coupling between the international and national levels, a brief glimpse at applicable international law regimes is put forward. Ultimately, public health emergencies are not taken as a new genus within already existing classifications. Nevertheless, this contribution shows how they do warrant more detailed analysis, given how their technical features put theories related to constitutionalism under extreme conditions to the test. The contribution was initially drafted before the onset of the COVID-19 pandemic in 2020. Thus, it is a mostly retrospective analysis. Nevertheless, insights taken from outbreaks preceding COVID-19 can help build a broader outlook of the puzzle related to how the intertwinement between constitutionalism and public health emergencies can be addressed through a broader perspective not limited to one disease.

Legal Responses to Communal Rejection in Emergencies

The Journal of Law Medicine & Ethics ◽

10.1111/jlme.12061 ◽

2013 ◽

Vol 41 (2) ◽

pp. 529-534

Author(s):

James G. Hodge ◽

Daniel G. Orenstein ◽

Kim Weidenaar ◽

Nick Meza ◽

Laura Van Buren ◽

...

Keyword(s):

Public Health ◽

Hurricane Katrina ◽

Gulf Coast ◽

Influenza Pandemic ◽

Disease Outbreaks ◽

H1n1 Influenza ◽

Hurricane Sandy ◽

Legal Responses

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing and services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected.

Collaborating with Sovereign Tribal Nations to Legally Prepare for Public Health Emergencies

The Journal of Law Medicine & Ethics ◽

10.1177/1073110519857318 ◽

2019 ◽

Vol 47 (S2) ◽

pp. 55-58

Author(s):

Tina Batra Hershey

Keyword(s):

Public Health ◽

Emergency Preparedness ◽

Disease Outbreaks ◽

Public Health Preparedness ◽

Us Government ◽

Tribal Governments ◽

Tribal Nations ◽

Coordination And Collaboration

Public health emergencies, including infectious disease outbreaks and natural disasters, are issues faced by every community. To address these threats, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness, as well as improve coordination and collaboration across jurisdictions. As sovereign entities, Tribal governments have the authority to create their own laws and take the necessary steps to prepare for, respond to, and recover from disasters and emergencies. Legal preparedness is a key component of public health preparedness. This article first explains legal preparedness and Tribal sovereignty and then describes the relationship between Tribal Nations, the US government, and states. Specific Tribal concerns with respect to emergency preparedness and the importance of coordination and collaboration across jurisdictions for emergency preparedness are discussed. Examples of collaborative efforts between Tribal and other governments to enhance legal preparedness are described.

Challenges to biobanking in LMICs during COVID-19: time to reconceptualise research ethics guidance for pandemics and public health emergencies?

Journal of Medical Ethics ◽

10.1136/medethics-2020-106858 ◽

2021 ◽

pp. medethics-2020-106858

Author(s):

Shenuka Singh ◽

Rosemary Jean Cadigan ◽

Keymanthri Moodley

Keyword(s):

Public Health ◽

Common Good ◽

Disease Outbreaks ◽

Benefit Sharing ◽

Ethical Challenges ◽

Middle Income ◽

Biobank Research ◽

Low Middle Income Countries

Biobanking can promote valuable health research that may lead to significant societal benefits. However, collecting, storing and sharing human samples and data for research purposes present numerous ethical challenges. These challenges are exacerbated when the biobanking efforts aim to facilitate research on public health emergencies and include the sharing of samples and data between low/middle-income countries (LMICs) and high-income countries (HICs). In this article, we explore ethical challenges for COVID-19 biobanking, offering examples from two past infectious disease outbreaks in LMICs where biobanking activities contributed to the perpetuation of global inequities. We focus on how the ethical imperative to promote the common good during public health emergencies can conflict with protecting the interests of biobank participants. We discuss how conducting biobank research under a waiver of informed consent during public health emergencies is ethically permissible, provided guidance is in place to prevent biopiracy and exploitation of vulnerable communities. We also highlight the need for biobank collaborations between LMICs and HICs to promote capacity building and benefit sharing. Finally, we offer guidance to promote the ethical oversight of biobanks and biobank research during the COVID-19 pandemic or other future public health emergencies.

Spreading (dis)trust in Fiji? Exploring COVID-19 misinformation on Facebook forums

Pacific Journalism Review – Te Koakoa ◽

10.24135/pjr.v27i1and2.1166 ◽

2021 ◽

Vol 27 (1and2) ◽

pp. 63-84

Author(s):

Romitesh Kant ◽

Rufino Varea

Keyword(s):

Public Health ◽

Social Media ◽

News Media ◽

Communication Systems ◽

Disease Outbreaks ◽

Lack Of Information ◽

Social Media Platforms ◽

The Impact

The COVID-19 pandemic has caused significant challenges for the health system across the globe and fueled the surge of numerous rumours, hoaxes, and misinformation regarding outcomes, prevention and cure of the virus. The COVID-19 pandemic has also had severe political, economic and societal effects and affected media and communication systems in unprecedented ways. While traditional journalism has tried to adapt to the rapidly evolving situation, alternative news media on the internet have given the events an ideological spin. These voices have been criticised for furthering societal confusion and spreading potentially dangerous ‘fake news’ or conspiracy theories via social media and other online channels. The impact of the disease and the lack of information associated with it have allowed medical misinformation to rapidly surface and propagate on various social media platforms. Previous studies have highlighted a similar trend during recent public health emergencies, mainly the Ebola and Zika outbreaks. Such a phenomenon is alarming on both individual and public health levels to the extent that governments are realising the gravity and attempting to limit its effects. This article offers a unique perspective because it provides data-driven qualitative insights into Fijian Facebook posts related to infectious disease outbreaks. This study aims to understand public views and opinions on Fijian social media during the height of the pandemic in 2020 and to outline potential implications for health information.

Federal Legal Preparedness Tools for Facilitating Medical Countermeasure Use during Public Health Emergencies

The Journal of Law Medicine & Ethics ◽

10.1111/jlme.12033 ◽

2013 ◽

Vol 41 (S1) ◽

pp. 22-27 ◽

Cited By ~ 8

Author(s):

Brooke Courtney ◽

Susan Sherman ◽

Matthew Penn

Keyword(s):

Public Health ◽

Disease Outbreaks ◽

Federal State ◽

The Public ◽

Department Of Health ◽

Naturally Occurring ◽

Temporary Assistance ◽

Medical Countermeasures

Law can greatly facilitate responses to public health emergencies, including naturally-occurring infectious disease outbreaks and intentional or accidental exposures to chemical, biological, radiological, or nuclear (CBRN) agents. At the federal level, the Secretary of the Department of Health and Human Services (HHS), as the lead for federal public health and medical responses to public health emergencies and incidents, has a range of authorities to support federal, state, tribal, local, and territorial responses. For example, under the Public Health Service (PHS) Act, the Secretary may provide temporary assistance to States to meet health emergency needs or deploy medicine and supplies from the Strategic National Stockpile. The Secretary also may determine that a disease or disorder presents a public health emergency, which may be the first step in triggering other critical legal authorities for response.Since the 2001 anthrax attacks, one focus of public health preparedness has been on developing, distributing, and rapidly dispensing medical countermeasures (MCMs) for CBRN emergencies and pandemics.

A New Model for Predicting Infectious Disease Outbreaks

Medical Research Archives ◽

10.18103/mra.v8i10.2255 ◽

2020 ◽

Vol 8 (10) ◽

Author(s):

Peter Demitry ◽

Darren McKnight ◽

Erin Dale ◽

Elizabeth Bartlett

Keyword(s):

Public Health ◽

Infectious Disease ◽

Infectious Diseases ◽

Early Warning ◽

Preventive Intervention ◽

Disease Outbreaks ◽

World Health ◽

Health Authorities ◽

The World

This project integrated tools and hybrid methodologies historically used for early warning, intelligence, counter space, public health, informatics, and medical surveillance applications. A multidiscipline team assembled and explored non-medical prediction and analytical techniques that successfully predict critical events for low probability but high-regret national and global scenarios. The team then created novel approaches needed to fill nuanced and unique gaps for the infectious disease prediction challenge. The team adopted and applied those proven procedures to determine which would be efficacious in foretelling infectious disease outbreaks around the world. One outcome of that effort was a successful two-year development and validation project designated ‘RAID’ (Risk Awareness Framework for Infectious Diseases), which focused on malaria prediction. The project’s objective was to maximize the warning (prediction) window of impending malaria epidemic outbreaks with sufficient time to allow meaningful preventive intervention before widespread human infection. It is generally recognized the more protracted the prediction window extends before an event, the more time available for health authorities to muster and deploy resources, which lessen morbidity, mortality, and harmful economic effects. Also, the value of early warning for an imminent epidemic must have mitigation options, or the warning window would have no beneficial impact on health outcomes. Finally, early notice is preferable over surprise epidemics, as unexpected waves of patients seeking acute care can easily overwhelm most local medical systems, as history repeatedly teaches. This cliché keeps repeating, with recurring Ebola epidemics and the recent COVID-19 pandemic as prominent exemplars. Predictive lead times need to be adequate for an intervention to be relevant. RAID’s focus on malaria prediction met these criteria from a relevant clinical and humanitarian perspective. Subsequent papers will address successful external generalization of these methods in predicting other similar infectious diseases. The model presented in this manuscript supports the conclusion that an additional two weeks advance notice could be available to public health authorities utilizing these techniques. This foreknowledge would allow the deployment of limited health resources into areas where they would do the most good and just in time. The geographical specificity was examined down to 5 km x 5 km grid squares overlaid anywhere in the world. Most of the model’s input data were derived from remote sensing satellite sources that could combine with historical WHO (World Health Organization) or nation-reported existential pathogen loads to improve model accuracy; however, such data harmonization is not required. If ground sensors were integrated into the modeling, the confidence of the risk of infection would logically improve. The model provides a successful global risk assessment via commercially available remote space sensors, even without ground sensing. RAID provides a necessary and useful preliminary means to predictive situational awareness. This improved predictive awareness is sufficiently granular to identify last chance windows for public health interventions globally. This need will become even more pronounced as infectious diseases evolve biologically and migrate geographically at ever-increasing rates.

No time to wait: Commandeering healthcare facilities in the age of COVID-19

Journal of Emergency Management ◽

10.5055/jem.2020.0524 ◽

2020 ◽

Vol 18 (7) ◽

pp. 41-43

Author(s):

Taleed El-Sabawi, JD, PhD ◽

Leo Beletsky, JD, MPH ◽

Cynthia Hernandez, JD ◽

Jennifer J. Carroll, PhD, MPH

Keyword(s):

Public Health ◽

Market Price ◽

Disease Outbreaks ◽

Eminent Domain ◽

Legal Basis ◽

Healthcare Facilities ◽

Local Municipalities ◽

Fair Market

In this editorial, we address the urgent need to rapidly expand hospital and ICU capacity during the COVID-19 pandemic and future infectious disease outbreaks. As a remedy to this problem currently plaguing many US municipalities, we discuss states' Emergency Takings Power, an alternative to eminent domain proceedings that allows the immediate commandeering of vacant hospitals without exorbitant costs or the need to litigate fair market price up front. We briefly describe the legal basis for emergency takings power and how states can empower local municipalities to act on that power during public health emergencies.

Declining Public Health Protections within Autocratic Regimes: Impact on Global Public Health Security, Infectious Disease Outbreaks, Epidemics, and Pandemics

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000424 ◽

2020 ◽

Vol 35 (3) ◽

pp. 237-246 ◽

Cited By ~ 8

Author(s):

Frederick M. Burkle

Keyword(s):

Public Health ◽

Disease Outbreaks ◽

Global Public Health ◽

Prevention Measures ◽

Health Security ◽

The World ◽

Increasing Risk ◽

Autocratic Regimes ◽

The Impact

AbstractPublic health emergencies of international concern, in the form of infectious disease outbreaks, epidemics, and pandemics, represent an increasing risk to the worldʼs population. Management requires coordinated responses, across many disciplines and nations, and the capacity to muster proper national and global public health education, infrastructure, and prevention measures. Unfortunately, increasing numbers of nations are ruled by autocratic regimes which have characteristically failed to adopt investments in public health infrastructure, education, and prevention measures to keep pace with population growth and density. Autocratic leaders have a direct impact on health security, a direct negative impact on health, and create adverse political and economic conditions that only complicate the crisis further. This is most evident in autocratic regimes where health protections have been seriously and purposely curtailed. All autocratic regimes define public health along economic and political imperatives that are similar across borders and cultures. Autocratic regimes are seriously handicapped by sociopathic narcissistic leaders who are incapable of understanding the health consequences of infectious diseases or the impact on their population. A cross section of autocratic nations currently experiencing the impact of COVID-19 (coronavirus disease 2019) are reviewed to demonstrate the manner where self-serving regimes fail to manage health crises and place the rest of the world at increasing risk. It is time to re-address the pre-SARS (severe acute respiratory syndrome) global agendas calling for stronger strategic capacity, legal authority, support, and institutional status under World Health Organization (WHO) leadership granted by an International Health Regulations Treaty. Treaties remain the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world.“Honesty is worth a lot more than hope…” The Economist, February 17, 2020.

Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018

Epidemiology and Infection ◽

10.1017/s0950268819001912 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 6

Author(s):

F. Mboussou ◽

P. Ndumbi ◽

R. Ngom ◽

Z. Kassamali ◽

O. Ogundiran ◽

...

Keyword(s):

Infectious Disease ◽

Disease Onset ◽

Disease Outbreaks ◽

Case Fatality ◽

World Health ◽

African Region ◽

Regional Office ◽

Member States ◽

The World

Abstract The WHO African region is characterised by the largest infectious disease burden in the world. We conducted a retrospective descriptive analysis using records of all infectious disease outbreaks formally reported to the WHO in 2018 by Member States of the African region. We analysed the spatio-temporal distribution, the notification delay as well as the morbidity and mortality associated with these outbreaks. In 2018, 96 new disease outbreaks were reported across 36 of the 47 Member States. The most commonly reported disease outbreak was cholera which accounted for 20.8% (n = 20) of all events, followed by measles (n = 11, 11.5%) and Yellow fever (n = 7, 7.3%). About a quarter of the outbreaks (n = 23) were reported following signals detected through media monitoring conducted at the WHO regional office for Africa. The median delay between the disease onset and WHO notification was 16 days (range: 0–184). A total of 107 167 people were directly affected including 1221 deaths (mean case fatality ratio (CFR): 1.14% (95% confidence interval (CI) 1.07%–1.20%)). The highest CFR was observed for diseases targeted for eradication or elimination: 3.45% (95% CI 0.89%–10.45%). The African region remains prone to outbreaks of infectious diseases. It is therefore critical that Member States improve their capacities to rapidly detect, report and respond to public health events.

The influence and enlightenment of five public health emergencies on public psychology since new century: A systematic review

International Journal of Social Psychiatry ◽

10.1177/00207640211002222 ◽

2021 ◽

pp. 002076402110022

Author(s):

Zhifeng Wang ◽

Dongmei Wang

Keyword(s):

Public Health ◽

Ebola Virus ◽

Psychological Intervention ◽

Virus Disease ◽

H1n1 Influenza ◽

Psychological State ◽

Wild Animals ◽

Post Traumatic Stress ◽

The People

Background: Since the 21st century, humans have experienced five public health emergencies: the severe acute respiratory syndrome (SARS), type A H1N1 influenza (H1N1), Middle East respiratory syndrome (MERS), Ebola virus disease (EVD), and the new coronavirus pneumonia (COVID-19). They caused a large number of casualties and a wider psychological crisis, which might cause severe consequences such as post-traumatic stress disorder and suicide. Aims: To reveal the law of formation of public psychological crisis in public health emergencies, and draw lessons from it. To provide ideas for effectively deal with these psychological crisis problems and fundamentally curbing the occurrence of public health emergencies. Method: Through the method of literature research, ‘public health incidents’, ‘psychological crisis’, ‘mental health’, ‘psychological intervention’, ‘SARS’, ‘H1N1’, ‘MERS’, ‘EVD’, and ‘COVID-19’ were used to search literatures in the databases such as PubMed, Springer, and Sciencedirect, and the literatures were summarized, sorted, and studied. Results: (1) The public health emergencies caused a universal psychological crisis. The main manifestations were depression, compulsion, despair, etc. The people involved mainly include patients, suspected isolated patients, medical staff, and the general public in the epidemic situation. (2) People’s psychological state often experienced stress stage, shock stage, acceptance, and reorganization. Only some susceptible individuals couldn’t complete effective psychological reconstruction, resulting in serious psychological disorders. Individual susceptibility is related to genetic factors, adversity, and traumatic stimuli experienced in early life. Conclusion: To reduce these psychological crisis problems, we should establish and improve the psychological crisis intervention or rescue system of public health emergencies, it was still necessary to live in harmony with nature, get rid of the inappropriate habit of preying on wild animals, in order to prevent the cross-species transmission of the virus between wild animals and humans, and to fundamentally avoid the occurrence of major infectious diseases.