President Barack Obama declared the swine flu outbreak a national emergency Saturday, a procedural step designed to allow health care providers to speed treatment and slow the spread of the disease.
The action gives Secretary of Health and Human Services Kathleen Sebelius temporary authority to grant waivers that would expedite steps such as setting up off-site emergency rooms to treat potential flu victims apart from other patients.
Administration officials said the move was not made as a result of any particular troubling development, but as a pre-emptive measure to ensure that the tools for a quick response were in place.
"The potential exists for the pandemic to overburden health care resources in some localities," the White House proclamation said. "Thus, in recognition of the continuing progression of the pandemic, and in further preparation as a nation, we are taking additional steps to facilitate our response."
According to the Centers for Disease Control and Prevention, 46 states have reported widespread activity of the swine flu, also known as H1N1. Since the outbreak of the pandemic in April, there have been more than 20,000 hospitalizations from laboratory-confirmed infections and more than 1,000 deaths.
The spread of the virus is causing an overwhelming demand for vaccinations. Several thousand people showed up for an H1N1 clinic at Perry Hall Middle School in Baltimore County on Saturday, with some camping out the night before to make sure they received a shot. Many were turned away after injectable doses ran out.
The federal declaration is the second step in the government's response effort. In late April, HHS declared a public health emergency, which allowed the government to release antiviral medications from federal stockpiles to states that might need them.
The national emergency declaration allows Sebelius, on a case-by-case basis, to waive federal rules governing routine medical operations if requested by doctors or hospitals.
For example, to isolate infected patients, some hospitals are planning to establish separate treatment locations in off-site tents or community centers. But without a waiver of current rules, the hospital may not get federal reimbursement if the facility is too far from the hospital property. Hospitals could also ask for a waiver of paperwork procedures if they are besieged by an influx of flu patients.
"If there's a surge in patients, you want to be able to put in place more efficient methods of triaging and treating people," said Reid Cherlin, a White House spokesman. "It's a priority for providers not to have to waste time on the phone with federal managers."
Mile-long line
In Perry Hall, residents waited for hours on folding chairs and under umbrellas, forming a line that snaked for a mile through the Baltimore County community.
So many people arrived early for the free vaccinations - some the night before - that the 125 county health department staffers pulled out their vaccine needles and sprays two hours before the 10 a.m. start time, said Baltimore County Health Officer Dr. Gregory Branch.
"It was worth the wait," said Robin Searles-Adenegan of Baltimore, as she and her children emerged from the clinic at 1:40 p.m., more than five hours after they got in line.
As with hundreds of other parents at the school, Searles-Adenegan, a University of Maryland University College biology instructor, was not able to receive the shot. She is not pregnant or a health care worker, and does not suffer from medical problems. But many adults did fall in the priority grouping, and were able to receive shots.
Glen Smith, a hospital worker from Towson, got his vaccination on his left arm - right on the lip of a tattoo of his granddaughter. His wife, Sandra, and teenage son Malik also got shots.
Ushers guided individuals and groups to 10 vaccination stations in a school multipurpose room, filled with the din of parents calming antsy toddlers and babies screaming.
"Two children. No naps," said Ridgely Bowman of Homeland, who was trying to corral her toddlers with help from her pregnant sister, Lizzy Sweeney, also of Homeland. The children cried and dropped toys as they got their immunizations.
The group waited only about two hours. They got a prime spot because another member of the family arrived before dawn and saved a place in the line for them, allowing the children to sleep in.
"My godmother actually got here at 5:30 in the morning," Sweeney said. "Then we met her at 9 o'clock."
Others stood in line to save a place for college-age children, for whom they'd become especially concerned since an 18-year-old Anne Arundel Community College student died Wednesday. While the cause of death has not been confirmed, the parents of Walter Brooks said doctors called it swine flu.
Food, space shared
The well-behaved crowd shared cookie stashes, space beneath umbrellas and stories with strangers. They carried empty food wrappers and drink cups to the trash bins.
