After (or in the midst of) the pandemic, public health and its constituencies have come under major media spotlight. While the most well-known public health emergency is the coronavirus, what exactly is a public health emergency, and what constitutes one? Does anything change after an emergency is formally declared?
According to the federal government’s Public Health Service Act, a Public Health Emergency (PHE) may be declared nationally by the Secretary of the Department of Health and Human Services. PHE’s may also be determined at other governmental levels, such as the state and city. These declarations are created in response to imminent or current threats such as illness, bio-terrorism, epidemics, infections, toxins, or other substantial risks to populations.
The CDC (Centers for Disease Control and Prevention) states that public health crises must meet four criteria by constituting an increasing burden to society that could be improved with preventative strategies that have not been put into place.
What happens when a PHE is declared?
In the case of the federal government, the Secretary is able to take more drastic actions to mitigate the crisis that were previously not options. For instance, in concert with a Presidential declaration of disaster, the Secretary can modify Medicare and Medicaid requirements to ensure that all necessary healthcare services are provided to civilians regardless of their healthcare provider.
A PHE also allows the CDC Director to pool money from the Infectious Diseases Rapid Response Reserve Fund (if the public health declaration is for a disease). This money is used to prepare for and respond to the emerging threat.
Beyond funding and treatment, a public health emergency also merits several other measures. The government can limit the liability of healthcare professionals, deploy military trauma care providers from the Secretary of Defense, or temporarily reassign state and local personnel.
These declarations will either last until the Secretary terminates the emergency or it automatically expires at the end of a 90 days, though certain long-lasting emergencies--such as the pandemic--may be extended for multiple 90-day periods.
Examples of Public Health Emergencies
Other than COVID-19, there are many examples of potential and past public health emergencies.
For instance, this November, Monkeypox--a zoonotic virus that results in rashes similar to the symptoms of smallpox--was declared a PHE. Natural disasters such as mudslides, wildfires, and hurricanes, as seen through South Carolina and Florida storms this year, may also qualify as public health emergencies.
Beyond disease, other health conditions also merit public health risks. Since 2017, the opioid crisis--a trend of opioid abuse, overuse, disorders, and related diseases--has been declared a PHE (See "The Opioid Crisis and the Racial War on Drugs" to learn more).
Racism in Public Health
In more recent news, many policymakers have declared a new public health crisis: racism.
Since 2019, at least 250 declarations have highlighted this discrimination as a crisis of public health. These advancements hope to apprehend inequality on the structural rather than individual level and also acknowledge the effect of race on health and life expectancy. Such a response is especially crucial in the context of other public health emergencies that exacerbate existing inequalities, such as the pandemic.
While obviously, racism is quite a different threat to populations than a flash flood or viral disease, its impacts on society are just as important to respond to. With the intertwining of racism in public health (take the disproportionate impact of COVID-19 and unsafe drinking water on communities of color, for example) and the directly harmful implications of racism itself, this epidemic is just as alarming and fatal as a pathogen.
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