What happens during a "public health emergency," and what's a "pandemic alert level"?

Answers to your questions about the news.
April 27 2009 11:41 AM

Pandemic Alert!

What happens during a "public health emergency," and what's a "pandemic alert level"?

Click here to read more from Slate on the swine flu. 

Janet Napolitano. Click image to expand.
Homeland Security Secretary Janet Napolitano 

As the number of reported domestic cases of swine flu climbed to 20 Sunday, the acting secretary of health and human services declared a "public health emergency." Meanwhile, an official at the World Health Organization said it would decide Tuesday whether to raise its pandemic alert level from 3 to 4. What's the significance of these official declarations?

One gives the government more freedom to act; the other merely describes what's going on. Under Section 319 of the Public Health Service Act, the secretary of HHS can declare an emergency in order to free up money, extend reporting deadlines, and generally loosen regulations in order to deal with a pressing public health problem. In practice, that means hospitals can keep patients for longer than usual, Medicare beneficiaries can go out of network to receive treatment, local doctors can be more flexible in prescribing drugs and administering tests, and the government can access emergency funds to pay for treatment efforts.

Public health emergencies are not that uncommon. The flooding in North Dakota in March and April sparked an official emergency declaration, as did Hurricanes Ike and Gustav. A PHE was even declared for the presidential inauguration in order to help Washington, D.C., hospitals prepare to handle a potential influx of patients.

The WHO created the six-level system in 1999 to deliver information quickly to member nations about viral threats. (See the current level here.) Each level corresponds to a different phase of a viral outbreak.  In Phase 1, the virus has been limited to animals; in Phase 2, it has started causing human infections; Phase 3 means there are small clusters of animal-to-human infection. (Both the avian flu virus H5N1 and swine flu virus H1N1 are currently in Phase 3.) The transition to Alert Phase 4 "marks a significant upwards shift in the risk for a pandemic," according to the WHO Web site. However, that "does not necessarily mean that a pandemic is a forgone conclusion." By Phase 6, a global pandemic is under way. (The Centers for Disease Control and Prevention also have a Pandemic Severity Index to measure an outbreak's reach. It ranges from Category 1 through Category 5, depending on how many people are infected. According to that system, the swine flu outbreak merits a Category 1 designation, since it has affected less than 0.1 percent of the population.)

In practice, raising the pandemic alert level to 4 would probably spur more countries to impose travel bans or to start screening people flying in from countries where outbreaks have occurred.

Got a question about today's news? Ask the Explainer.

AP: Fighting the swine flu outbreak

TODAY IN SLATE

War Stories

The Right Target

Why Obama’s airstrikes against ISIS may be more effective than people expect.

The One National Holiday Republicans Hope You Forget

It’s Legal for Obama to Bomb Syria Because He Says It Is

I Stand With Emma Watson on Women’s Rights

Even though I know I’m going to get flak for it.

Should You Recline Your Seat? Two Economists Weigh In.

Doublex

It Is Very, Very Stupid to Compare Hope Solo to Ray Rice

Or, why it is very, very stupid to compare Hope Solo to Ray Rice.

Building a Better Workplace

In Defense of HR

Startups and small businesses shouldn’t skip over a human resources department.

Why Is This Mother in Prison for Helping Her Daughter Get an Abortion?

Politico Wonders Why Gabby Giffords Is So “Ruthless” on Gun Control

Behold
Sept. 23 2014 4:45 PM An Up-Close Look at the U.S.–Mexico Border
  News & Politics
Foreigners
Sept. 23 2014 6:40 PM Coalition of the Presentable Don’t believe the official version. Meet America’s real allies in the fight against ISIS.
  Business
Moneybox
Sept. 23 2014 2:08 PM Home Depot’s Former Lead Security Engineer Had a Legacy of Sabotage
  Life
Outward
Sept. 23 2014 1:57 PM Would a Second Sarkozy Presidency End Marriage Equality in France?
  Double X
The XX Factor
Sept. 23 2014 2:32 PM Politico Asks: Why Is Gabby Giffords So “Ruthless” on Gun Control?
  Slate Plus
Political Gabfest
Sept. 23 2014 3:04 PM Chicago Gabfest How to get your tickets before anyone else.
  Arts
Brow Beat
Sept. 23 2014 8:38 PM “No One in This World” Is One of Kutiman’s Best, Most Impressive Songs
  Technology
Future Tense
Sept. 23 2014 5:36 PM This Climate Change Poem Moved World Leaders to Tears Today
  Health & Science
Science
Sept. 23 2014 4:33 PM Who Deserves Those 4 Inches of Airplane Seat Space? An investigation into the economics of reclining.
  Sports
Sports Nut
Sept. 23 2014 7:27 PM You’re Fired, Roger Goodell If the commissioner gets the ax, the NFL would still need a better justice system. What would that look like?