The Pandemic Influenza Plan: Implications for Local Law Enforcement

Author: Lee Colwell, DPA, President, Pegasus Research Foundation
November 4, 2005

"The question of the next pandemic is when, not if." Rep. Tom Davis, R-VA, Chairman, Government Reform Committee

In November 2005, following several years of concern, discussion and planning in related matters, the U. S. Department of Health and Human Services released the HHS Pandemic Influenza Plan (the "Plan"). Post-outbreak action under the Plan-if and when that becomes necessary-will require taking steps in the public square that are highly unusual, possibly unprecedented in both nature and scope, and almost certainly highly controversial, particularly in hind sight. Because local law enforcement will be deeply involved in any such steps, significant pre-planning is called for by law enforcement to be taken in coordination with others with post-outbreak responsibilities.

The Plan begins to articulate the significant additional responsibilities that local law enforcement will have in the event of a pandemic-duties which are in addition to the day-to-day duties already carried out by law enforcement-and presents local law enforcement leaders and their communities with a significant challenge to develop regional pandemic preparedness plans at the local level. Over the coming months, as President Bush and HHS continue to push forward with pandemic preparedness efforts, local law enforcement leaders will face a variety of decisions about how they and their communities will respond to the pandemic threat. This article is written to provide background information on the Plan for local law enforcement leaders who will be facing those decisions.

Overview

The Plan states that a pandemic influenza event occurs "when a novel influenza virus emerges that can infect and be efficiently transmitted among individuals because of a lack of pre-existing immunity in the population." Although it is possible that post-outbreak action under the Plan will never be necessary, the Plan has been prepared by HHS, and over $7 Billion in Federal funding requested for its implementation, because there is great concern about the likelihood of a worldwide influenza epidemic occurring in the very near future-claiming hundreds of millions of lives, including as many as 700,000 Americans within 6 months of an outbreak. Current pandemic concerns have been triggered by the strain of avian influenza (or "bird flu") circulating in Asia and Europe, with a reported 50% mortality rate among those humans infected.

The Plan is nearly 400 pages in length, and each page is packed with detailed considerations that should be considered by public and private sector officials-public health, hospitals, law enforcement, transportation, and local, tribal, state and Federal officials-in putting together specific local-level and regional plans to respond to a pandemic influenza event. With respect to "State and Local Pandemic Influenza Plans", the Plan states:

These plans should detail how health departments and other agencies of state and local governments and tribal nations will prevent, mitigate, respond and recover from an influenza pandemic. They should be community specific where appropriate and should contemplate specific local and community needs.

Fully recognizing that non-Federal health departments, hospitals, emergency responders and private sector firms will, of necessity, play critical front-line roles in the event of a pandemic, the Plan is heavily built around providing detailed guidance for local law enforcement, emergency responders and other state and local partners in areas such as "Community Disease Control and Prevention" and "Managing Travel-Related Risk of Disease Transmission."

Characteristics of a Pandemic and Implications for Law Enforcement

Among other things, the Plan assumes that an influenza pandemic would have the following characteristics which would directly impact local law enforcement:

• Simultaneous or near-simultaneous outbreaks in communities across the U.S., thereby limiting the ability of any jurisdiction to provide support and assistance to other areas;
• Delays and shortages in the availability of vaccines and antiviral drugs; and
• Potential disruption of national and community infrastructures including transportation, commerce, utilities and public safety due to widespread illness and death among workers and their families and concern about on-going exposure to the virus.

A key principal of the Plan is that preparedness will require coordination among federal, state and local government and partners in the private sector, including significant requirements for coordination with local law enforcement. Although the Plan recognizes that law enforcement will also have key roles in other aspects of a pandemic, the Plan especially focuses on the need for local law enforcement to be prepared and assist in controlling diseases at the community level and in managing the risk of disease transmission through enforcement of travel restrictions.

Law Enforcement Role in Community Disease Control

Prior to a pandemic event, the Plan urges that local leaders prepare their communities for implementation of pandemic influenza containment measures which may be called into play during a pandemic. Community disease control measures range from individual containment measures to community-based containment measures.

At the individual level, law enforcement personnel may be called upon to contain the spread of infection by enforcing the isolation of individual patients and by managing individuals who may have come into contact with sources of infection. These steps may be carried out by enforced isolation at healthcare facilities, individual homes or alternative facilities which may become necessary. The Plan urges local law enforcement leaders to prepare to provide guards and other personnel necessary to isolate patients with a highly infectious disease, and persons who have come in contact with them, at multiple facilities in their communities.

At the community level, the Plan describes containment measures involving local law enforcement which range from voluntary "snow days", to closure of office buildings, shopping malls, schools and public transportation, to widespread community quarantine (or "cordon sanitaire"). In the voluntary "snow day" scenario, when the public is asked to stay at home rather than go about their normal daily business, law enforcement leaders will need to communicate staffing decisions about non-essential personnel who should honor the "snow day" declaration. If public facilities and public transportation are closed, local law enforcement will doubtless also be called upon to enforce facility and transportation closure orders, and to provide essential transport for supplies, patients and public health personnel. And, if a community quarantine is ordered, local law enforcement agencies will further be called upon to legally enforce the order, in coordination with involved public health officials and personnel in neighboring jurisdictions.

Law Enforcement Role in Managing Travel-Related Risks of Disease Transmission

In the event of a pandemic, law enforcement will be involved with managing all types of travel, but local law enforcement will have particular responsibility for managing travel-related risk for travel within the United States. The Plan urges that travel-restriction planning in preparation for a pandemic engage a broad range of health and community leaders, including public health and hospital personnel, local law enforcement, firefighters, political leaders, and representatives of airports, seaports, transportation service providers and others.

The Plan identifies a number of additional new travel restriction-related activities which local law enforcement personnel will need to be prepared to carry out, once a pandemic event has commenced. These activities will include: meeting and transporting ill or possibly infected passengers and animals at airports and seaports; notifying the public and neighboring jurisdictions of official closures and enforcing those closures; addressing and coordinating multi-jurisdictional issues involved in official closures; and establishing legal authority and protocols for restricting departure and entry and use of mass transit systems, bus and train routes, streets and highways.

Observations and Conclusions

It is clear, even from this brief discussion, that a pandemic event would require a number of complex decisions to be made by local law enforcement leaders, and trigger a number of complex problems for law enforcement leaders and personnel. The Plan triggers a number of questions and issues for local law enforcement, such as:

• What is the chain of command, and who will make decisions, during a pandemic event?
• What legal authority is there for the actions to be taken by law enforcement?
• What orders will be lawful or unlawful in such circumstances?
• What vaccines and anti-viral and other medications will local law enforcement personnel (and their families) be offered, and how can leaders assure their personnel that the offered vaccines and medication are safe and effect?
• What problems will local law enforcement leaders face if vaccines and medication are not provided to law enforcement personnel and their families?
• How can law enforcement leaders assure their personnel that it is safe to carry out their sworn duties requiring close contact with highly-infectious persons?
• How will local law enforcement securely communicate with public health partners, their own agency personnel, and personnel in neighboring jurisdictions?
• What will local law enforcement leaders communicate to the media and the public regarding the law enforcement actions taken in the face of a pandemic event? How will rumors inside agencies and in public circulation be countered?
• What level of force will law enforcement use to enforce an individual containment or community-based quarantine measure?
• What steps should law enforcement leaders take to maintain control and authority without over-stepping roles and over-stating or under-stating risks?
• What lessons have been learned from recent experiences with Hurricanes Katrina and Rita and the 2003 SARS outbreak, especially travel-related containment measures imposed in Toronto?
• How will law enforcement carry out their traditional duties while also carrying out these significant additional responsibilities, and where will the financial and personnel resources required to carry out these additional responsibilities come from?
• How will local law enforcement leaders and their counterparts in hospitals, public health, transportation sectors, local government and local and State political leaders-not only in their own jurisdictions but in neighboring jurisdictions-come together to make meaningful plans as urged in the HHS Plan?

On this last and most important issue, the HHS request for funding includes $100 million "to help states complete and exercise their pandemic plans before a pandemic strikes." Based on previous efforts at State-directed planning of community-level and local agency-level activities-many of which have been highly unsuccessful-it is not at all clear that leaders of communities and local agencies will have the tools or resources sufficient to catalyze local-level planning for an uncertain new threat. Although much of the planning for a pandemic needs to be carried out by State public health departments, certainly much of the planning also needs to take place at the local level, between and among local level emergency responders and others in their communities. Local law enforcement leaders should express their views to Congress on the likelihood of success of State-directed planning of activities which inherently must be carried out by local level personnel.

The Plan makes it clear that it does not provide answers to these or many, many, other questions, and that, as "one size does not fit all", each community must develop its own plan in order to be prepared. Recent events show the peril faced by communities when Federal, State and local agencies and their leaders are unable to work as a seamless force fully prepared to respond to the threat at hand. Because local law enforcement will play such a key role in the event of a pandemic, forward-looking local law enforcement leaders will take steps to prepare their agencies and their communities to very promptly and effectively respond to the possibly devastating effects of a pandemic event.

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About Lee Colwell, DPA
Dr. Lee Colwell is President of the Pegasus Research Foundation. In that capacity, Dr. Colwell leads the National Pegasus Program, a Congressionally-led initiative developed by the Nation's Sheriffs to enable information exchange among local law enforcement agencies nationwide. Formerly, Dr. Colwell was Associate Director of the FBI, the number two position in the Bureau, and led a nationwide program to provide Internet access to local law enforcement.