• HHS Pandemic Influenza Plan
  • Department of Health and Human Services
  • 396 pages
  • Public
  • November 2005

  This HHS Pandemic Influenza Plan provides a blueprint from which to prepare for the challenges that lie ahead of us. Being prepared and responding effectively involves everyone: individuals, communities, businesses, States, Federal agencies, international countries and organizations. Here at home, we can use this Plan to create a seamless preparedness network where we are all working together for the benefit of the American people.

  In the century past, we have experienced influenza pandemics three times: as recently as 1968 and 1957 and what has been called the Great Influenza in 1918, a pandemic that killed 40-50 million people worldwide. At some point in our nation’s future another virus will emerge with the potential to create a global disease outbreak. History teaches us that everything we do today to prepare for that eventuality will have many lasting benefits for the future. We will realize important advances in healthcare, and we will be better prepared for other types of emergencies.

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  6. Legal preparedness
  State and local health departments should ensure that appropriate legal authorities are in place to facilitate implementation of plans for distributing pandemic influenza vaccines. Health departments might undertake these legal preparedness steps:

  • Ensure that plans for distribution of vaccines are reviewed by appropriate legal authorities.
  • Determine whether state and local laws allow non-licensed volunteers or healthcare workers from other jurisdictions
  to administer influenza vaccines.
  • Work with professional organizations and unions to consider options for emergency performance of tasks outside of
  standard job descriptions.
  • Determine whether state and local laws allow mandatory vaccination to the protect public health, if needed.

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  Although states and localities have primary responsibility for public health matters within their borders, including isolation and quarantine, under the authority of Section 361 of the Public Health Service Act (42 USC 264), the HHS Secretary may make and enforce regulations necessary to prevent the introduction, transmission, or spread of communicable diseases from foreign countries into the United States or from one state or possession into another.

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  d) Widespread community quarantine (cordon sanitaire)
  In extreme circumstances, public heath officials may consider the use of widespread or community-wide quarantine, which is the most stringent and restrictive containment measure. Strictly speaking, “widespread community quarantine” is a misnomer, since “quarantine” refers to separation of exposed persons only and (unlike snow days) usually allows provision of services and support to affected persons. Like snow days, widespread community quarantine involves asking everyone to stay home. It differs from snow days in two respects: 1) It may involve a legally enforceable action, and 2) it restricts travel into or out of an area circumscribed by a real or virtual “sanitary barrier” or “cordon sanitaire” except to authorized persons, such as public heath or healthcare workers.

  Implementation of this measure during a pandemic is unlikely to prevent the introduction or spread of pandemic disease except in uncommon or unique circumstances (such as in a community able to be completely self-sufficient). In many cases, other less restrictive approaches such as snow days can be implemented to slow disease spread or decrease its magnitude in a community. Because of this, cordon sanitaire is not recommended during a pandemic unless a community is in a setting where it is likely to be applied effectively and has planned with neighboring jurisdictions how such an approach would be implemented and maintained during a pandemic.

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