What Does a Swine Flu National Emergency Mean?


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It’s déjà vu all over again. The Obama administration declared the H1N1 (swine) flu outbreak a “national emergency” over the weekend—just as it declared a “public health emergency” back in April, shortly after the outbreak began. So what’s the difference?

When the government first declared the public health emergency in April, it paved the way for a streamlined response for the swine flu threat. For example, the government was able to distribute stockpiles of antiviral drugs, and other supplies, and expand the recommended usage of those drugs under emergency authorizations.

The latest declaration was done to allow the federal government to waive certain regulatory requirements so that hospital emergency rooms and other health-care providers can respond more quickly. Such waivers have been provided to hospitals in past emergencies, such as floods and hurricanes.

The “national emergency” declaration doesn’t mean that the nature of the outbreak has changed dramatically. But the flu is indeed spreading rapidly. According to the CDC this flu is widespread in 46 states, and flu activity is higher than the peak of many seasonal flu seasons. Health officials are concerned about a busier than usual flu season, and want to make sure hospitals have the tools to deal with greater volume.

What can be waived?

Hospitals can request a waiver of certain regulatory requirements that generally protect patients during day to day activities, but may slow down an emergency response due to high volume. Here are some examples:

  • Hospitals can request to set up an alternative screening location away from the main hospital.
  • Hospitals can request to transfer patients between emergency rooms at different hospitals and inpatient wards (which is usually not allowed due to access and privacy concerns).
  • Critical access hospitals (facilities that are certified under a specific set of Medicare conditions) and skilled nursing facilities can request waivers to allow them to increase the number of beds available and the average time of patient stays, which typically have set maximums.

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The emergency waivers can also allow hospitals to bypass certain patient privacy provisions like:

  • Talking to family members and friends involved in a patient’s care without first obtaining the patient’s agreement
  • Not having to honor a patient’s request to opt out of the facility directory
  • Bypassing the requirement to distribute a notice of privacy practices
  • Not having to honor a patient's request for privacy restrictions or confidential communications

These provisions may or may not affect your community, but don’t be surprised if your hospital has tents in the parking lot to deal with admissions, or opens a clinic in a school gymnasium. And while hospitals need to make advance plans to deal with higher volume this flu season, that doesn’t men you should to rush to the emergency room with any cough or fever — the ER may just be the best place to catch the flu this year.

However, if you suspect that you or a child you care for has the flu and is having difficulty breathing or any of these other signs or symptoms, seek care immediately and don't hesitate to use an emergency room. Those with underlying conditions or other risk factors, should contact their health care providers at the first sign of flu. Others should try to treat themselves if the flu does not seem severe.

Keep up to date with our Swine (H1N1) flu coverage and recommendations.

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