COVID 19 Webinar Series Part IV: Updates and COOP Discussion

Part IV of the CHHS Webinar Series on the CoVID 19 outbreak is below. CHHS Public Health Program Director Trudy Henson, Senior Law & Policy Analyst Christine Gentry, and Public Policy & External Affairs Program Director Ben Yelin provide updates on the outbreak, and discuss Continuity of Operations (COOP).

 

If your organization is interested in drafting or revising your Continuity of Operations (COOP) Plan, please check out our page: https://www.mdchhs.com/consulting/continuity-of-operations-coop-program/

CoVID 19 Webinar Series: Legal Issues with Quarantine and Isolation

Part III of the CHHS Webinar Series on the CoVID 19 outbreak is below. CHHS Public Health Program Director Trudy Henson, and Senior Law & Policy Analyst Christine Gentry discuss legal issues with quarantine and isolation.

 

CHHS Webinar on the Coronavirus: Part II

CHHS Public Health Program Director Trudy Henson and Senior Law & Policy Analyst Hassan Sheikh discussed the ongoing issues related to the coronavirus, in Part II of the CHHS webinar series.

Watch the video here:

Updates on the Coronavirus Outbreak

By CHHS Extern Benita David-Akoro

Over the last few weeks, the novel coronavirus known as 2019-nCoV has received significant media attention. 2019-nCoV is a coronavirus originating in Wuhan, China, but now with confirmed cases in at least twenty other countries. Yesterday, the World Health Organization announced it was declaring the 2019-nCoV outbreak a Public Health Emergency of International Concern, a declaration it declined to make just over a week ago. The decision to declare a PHEIC coincided with a sharp rise in cases and a spread of the virus to other countries; WHO’s director-general cited concerns with the virus’ spread into countries with less-robust healthcare systems as one reason for declaring a PHEIC.

Globally, there is need to take action: as of January 31, 2020, the Johns Hopkins 2019-nCoV surveillance tracker reports 9,976 confirmed cases with an estimated 213 fatalities since it was first detected in December 2019. These numbers now surpass the November 2002 to July 2003 outbreak of SARs. In that outbreak, public health officials reported 8,098 infections of SARS globally, with 774 SARS-related deaths.

Public health officials worldwide agree that swift and effective measures are necessary to curtail the spread of the virus. Countries with reported cases of infections have taken various steps – from investigation to screening, quarantine and risk communication. In the US, the CDC is taking measures to ensure the early and immediate detection of the virus, including issuing a level 3 travel warning for China—recommending that travelers avoid all nonessential travel to China—and implementing public health entry screenings at 20 airports and land crossings.

Many affected countries, including the United States, have learned significant lessons from previous outbreaks and have robust public health preparedness & response plans at the ready. Currently, the U.S. has identified 6 cases, five of which were acquired outside of the U.S., and one which was transmitted from an infected patient to their spouse. Elsewhere, countries have taken sweeping measures to control the virus’ spread:  Chinese authorities have declared a quarantine in Wuhan, a city of 11 million people, and imposed travel restrictions in other smaller cities in the province. Russia has closed its border with China; and some airlines have suspended flights into the country.

Certainly, the 2019-nCoV outbreak has already affected travel, economic activity, and global markets. Perhaps of more concern are the shortages of medical supplies, such as surgical masks, gloves, and disinfectants, as well as food and other household supplies. While some preparation is important, panic can lead to unintended consequences: as seen during the 2014 Ebola outbreak, surge in demand of personal protective equipment by the general public and even officials purchasing resources in preparation, can create shortages for responders and healthcare providers caring for patients in the affected areas. Additionally, misinformation about the effectiveness of prevention methods, such as disposable surgical facemasks, may lead to underutilization of more effective prevention methods, such as hand washing.

The spread of the 2019-nCoV is certainly cause for concern in a novel virus outbreak, and precautions and planning are essential to curtail the virus’ spread. Many U.S. health officials, however, are reminding people that domestically, seasonal influenza currently remains a much bigger concern, which, comparatively, kills 650,000 people worldwide every year, and in the U.S. alone this season, is responsible for 8,000 deaths. And, of course, it’s an important reminder that as you go about your day, whether you are looking at potential policies and plans for implementation if the 2019-nCoV spreads to your jurisdiction, or whether you are going about your regular day: washing your hands remains the best way to prevent the spread of viruses—whether it be the flu, or the novel coronavirus.

CHHS Webinar on the 2019 Novel Coronavirus

CHHS Public Health Program Director Trudy Henson and Senior Law & Policy Analyst conducted a webinar to discuss legal issues related to the 2019 Novel Coronavirus. Watch below:

Legal Preparedness and the 2019 Novel Coronavirus

In the last week, a novel coronavirus, first identified in the Chinese city of Wuhan, has dominated headlines as cases continue to rise. Fifteen countries have confirmed cases of the virus within their borders, and health officials in China and elsewhere are monitoring thousands of potential more cases. Although the mortality rate of the disease remains relatively low, the speed of transmission and its presence in densely-populated cities have public health officials across the globe on high alert.

 

The World Health Organization has currently declined to declare the Wuhan Coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). However, in the U.S., legal preparedness and public health response mechanisms are already in motion to help monitor the disease’s spread. In times like these, knowing the public health emergencies powers available to officials at the federal, state, and local level is key to an effective, measured response.

 

The Center for Health and Homeland Security (CHHS) has over 18 years of expertise responding to public health emergencies. From legal preparedness, to planning and testing, to “boots on the ground,” CHHS has helped clients with responses to seasonal flu, H1N1, measles, tuberculosis, Zika, and Ebola.

 

Our expertise extends beyond the academic to the practical. In addition to teaching courses at the Maryland Carey School of Law on the Law and Policy of Public Health Emergencies, CHHS has advised clients on isolation and quarantine plans and setting up vaccination clinics for health department clients. We have also helped create legal toolkits for resource sharing and allocation. Through a cooperative agreement with the State Department, we have held training seminars for the West African countries’ public health officials most directly impacted by Ebola.

 

We regularly prepare emergency legal handbooks for states, cities, counties and quasi-governmental institutions (such as the Maryland Department of Health and Washington Suburban Sanitary Commission). These handbooks highlight both federal and state emergency declaration laws, and are invaluable for helping officials understand not only their powers, but their duties, as well the duties and powers of those around them, in order to affect a more coordinated response.

 

If the number of coronavirus cases grows in the U. S., many states will likely declare emergencies, which trigger extraordinary powers to the Governor and public health officials and can be challenged by civil liberty groups. Such emergency declarations were seen for SARS and Ebola, as well as H1N1. CHHS staff are ready and able to help clients with their legal and public health preparedness needs.

 

For additional information about CHHS, please visit our website. For questions, please email thenson@law.umaryland.edu.

 

For additional information about the novel Coronavirus, see:

 

Major Pharmacy Chains Bring Suit Against Physicians

This past November, the Washington Post published an article detailing how major pharmacy chains, including Walgreens, Rite-Aid, CVS,  and others are facing a trial later this year over their ”role” in the opioid crisis. Now, the Post is reporting that those same pharmacies have turned around and sued physicians across northeast Ohio. The pharmacies are arguing that if they are found liable at the trial later this year, doctors and other prescribers should have to pay some of the penalty. The article explains how two Ohio counties, Cuyahoga and Summit, sued the major pharmacy chains, stating “a failure on their part  to stop the diversion of prescription narcotics to the ”black market”. U.S. District Judge Dan Aaron Polster, who is overseeing the case, allowed the Counties to include “failures by pharmacists in dispensing the medications.”

Although only certain individuals are allowed to prescribe controlled medications, pharmacists bear an equal responsibility to ensure that each prescription is valid, and is not dispensed to an illicit user, or dealer. The argument by the pharmacy chains is that if their pharmacists are to be held liable for a failure in preventing the medications from reaching this population, the prescribing habits of the doctors that wrote these prescriptions must also be examined. All doctors who wrote the offending scripts should also be investigated. If those doctors were in the habit of writing prescriptions that were being diverted, then they should also hold some of the liability. A spokesman for Walgreen Company stated that,” …[W]e strongly believe that the overwhelming majority of prescriptions dispensed were properly prescribed by doctors to meet the legitimate needs of their patients.” Thus, one of the things that will be decided by this case is the nature of that ‘belief’, and to what degree should pharmacists rely on that belief when filling a script for a controlled medication.
The outcome of this case will be instrumental in shaping the professional relationship between providers, patients, and pharmacists. A pharmacist must know how to weigh several factors before making a professional judgement on whether to accept a prescription for a controlled medication. As a baseline, every pharmacist must always be aware of the federal and state laws that govern how and when a controlled medication may be dispensed to a patient. Additionally, every pharmacy chain has internal policies that are intended to help enforce compliance with those laws. There are, however, a number of other ”soft” factors that often play a role in the decision on accepting a controlled medication. Amongst those factors, this case directly impacts the trust that pharmacists build with the health-care providers that they work with.

During my time as a pharmacist, I was fortunate enough to work in a community where the healthcare providers largely understood that administering healthcare was a team effort. I have countless examples of providers who have gone above and beyond to make themselves and their offices available to me if I had any questions regarding the validity of a prescription presented to me. That availability built trust, and that trust in turn would lead to a better overall experience for our shared patients. It will be extremely interesting to see how this case develops, and what arguments are brought forward on either side of this issue.

If you’d like to read more on this subject I’d recommend this article by Joseph L. Fink III, BSPharm, JD, which discusses a suit wherein a provider sued several chain pharmacies alleging that, “first, that pharmacists at their pharmacies had refused to honor her prescriptions for controlled substances; and second, that when doing so, the pharmacists told patients that the basis for their refusal was that the prescriber was under investigation by the DEA.”  Secondly, for a more in-depth view on some guidance provided to pharmacists on when and how to refuse filling a prescription, take a look at this slide-deck by the American Pharmacists Association.

Fall 2019 Newsletter – Now Available!

The University of Maryland Center for Health and Homeland Security (CHHS) is proud to release its quarterly newsletter for the Fallof 2019. This edition features in-focus reports on all of our program areas, as well as a a message from our Founder and Director, Michael Greenberger.

Check it out here:

 

CHHS Newsletter – Fall 2019

CHHS Partners With Cyberwire on “Caveat,” A New Cyber Law and Policy Podcast

For the past several years, CHHS has collaborated with the CyberWire podcast as an academic research partner. The CyberWire daily podcast is hosted by the Maryland-based CyberWire news service, which delivers real-time cybersecurity news updates to a global audience. CHHS Public Policy & External Affairs Program Director Ben Yelin has been a frequent guest on the daily podcast, discussing news items related to cybersecurity law and policy. CHHS Cybersecurity Program Director Markus Rauschecker has contributed as a guest as well.

As public interest in cybersecurity law and policy interest has intensified, CHHS and the CyberWire have partnered on a new podcast, Caveat. Yelin co-hosts the podcast with CyberWire daily podcast host Dave Bittner. The podcast’s first episode was released on October 23rd, 2019. Episodes will be released every Wednesday.

The Cyberwire issued a press release announcing the new podcast:

This latest addition to the CyberWire’s popular lineup of programs is hosted by Dave Bittner and Ben Yelin, the Program Director for Public Policy and External Affairs at the University of Maryland’s Center for Health and Homeland Security. Each week, Dave and Ben break down important current legal cases, policy battles, and regulatory matters along with the news headlines that matter most. It’s not just a podcast for lawyers and policymakers; security professionals, businesses, and anyone concerned about privacy and security in the digital age will find the discussions accessible, relevant, and thought provoking.

“Laws and policies haven’t kept pace as people’s personal and business lives have become increasingly and inextricably enmeshed in the rapidly evolving technologies that connect our world, drive commerce, and have become central tools of government and law enforcement,” said Peter Kilpe, the CyberWire’s Executive Editor. “With the addition of ‘Caveat’ to our lineup, we’re excited to have a more in-depth forum to discuss these critically important matters and make them accessible to a wider audience.”

CHHS is always interested in collaborating with public and private sector partners to share its subject-matter expertise, and discuss issues relevant to our work. We are particularly pleased that Caveat gives us an opportunity to reach a larger global audience through a 21st Century media platform.

Hurricane Dorian and Cybersecurity

By CHHS Extern Alexander Batton

On August 28th, 2019, a tropical storm strengthened into Hurricane Dorian off the coast of St. Thomas. The storm eventually elevated to a category 5 and tore through the northern Caribbean islands with 200 mph winds and 25-foot floodwaters. Destroying much of the land in its path, Hurricane Dorian left at least 50 people dead, with hundreds of people still missing. The United States experienced the worst destruction in Cape Hatteras, North Carolina. There, towns and islands were flooded, leaving people waiting for help in their attics.

Altogether, the storm is said to have left up to $8.5 billion in damage and therefore will require donations to cover the costs of reconstruction. In anticipation of the charitable efforts, the Department of Justice released a statement warning individuals to be vigilant with their money and to avoid cyber scammers who target Hurricane Dorian disaster victims. The agency says “[u]sers should exercise caution in handling any email with a hurricane related subject line, attachment, or hyperlink. In addition, users should be wary of social media pleas, texts, or door-to-door solicitations relating to severe weather events.”

The National Center for Disaster Fraud explains these links often collect login information, infect machines with malware, and swindle victims for money. Similarly, the FCC issued warnings about fraudsters looking to sell fake flood insurance and disaster relief charity scams.

In recent efforts to solicit funds from Hurricane Dorian, people have been posing as news anchors, or even seemingly legitimate charities. One ABC Action News Meteorologist, Denis Philips, made a statement on his official Facebook page that someone had been posing as him online to trick members of social media sites to send money through digital apps. The fake accounts claim that all funds would be directed to a Bahamas Hurricane Relief Site. Furthermore, FEMA warns of other scams that include fraudulent house inspections, building contractors, and fake state aid.

Unfortunately, these fraudulent efforts come as no surprise. During Hurricane Katrina, the FBI discovered nearly 4,600 websites advertising relief to victims, most of them were suspected to be fraudulent. To address similar scams after Hurricane Katrina, the Justice Department established the National Center for Disaster Fraud. Currently, the FTC advises everyone to report discovered scams to ftc.gov/complaint.

If you would like to donate to a relief fund, there are many verification tools available, including Charity Navigator, Charity Watch, GuideStar, and the Better Business Bureau’s Wise Giving Alliance. Art Taylor, of the Wise Giving Alliance adds, “[d]onors should watch out for newly-created organizations that emerge that are inexperienced in addressing disasters or may be seeking to deceive donors at a vulnerable time.” In the aftermath of Hurricane Dorian, people are more vulnerable than ever to cyber scams and phishing attacks. Internet users need to be careful of their online activity and take the appropriate steps to avoid an attack.