What do Monkeypox, the opioid crisis, New Mexico fires, Kentucky flooding, and COVID-19 have in common? All have been declared public health emergencies.  So what exactly does a declaration of a public health emergency mean?
A public health emergency (PHE) is declared when
“…a severe disease or disorder has become, or threatens to become, a significant threat to citizens.”
It is a qualitative judgment; it doesn’t require numbers, although consultation with public health officials might provide some quantification of the threat. That is why Monkeypox was declared a PHE when there were roughly 7,100 cases and COVID-19 declared a PHE in January 2020, when there were only six cases in the US. This declaration by the secretary of health and human services opens up a variety of new funding and management options, allowing them to:
- Make grants, enter contracts, and investigate the “cause, treatment, or prevention of the disease or disorder.”
- Provide supplies, equipment, services and “loan out” HHS employees to aid in this work
- Fund work to facilitate coordination among federal, state, local, tribal, and healthcare “entities.”
- Waive sanctions related to data and report submission by hospitals and healthcare providers
- Allow physicians with out-of-state licenses to temporarily practice in the disaster area – providing a trained “labor force” to meet unexpected demand
A PHE remains in effect for 90-days, or less if the secretary rescinds the declaration. To continue for more extended periods, such as that associated with COVID-19, the secretary must continuously “extend” the period for an additional 90 days.
A PHE is not necessary
- To deploy the National Medical Disaster System – trained teams of professionals that provide healthcare, information services, and even mortuary services as part of disaster relief.
- To access the supplies within the Strategic National Stockpile
- To approve Emergency Use Authorization for unapproved medications or the “unapproved use” of approved drugs. A PHE does not confer immunity from liability for those medications. That must be a separate “declaration."
Finally, a presidential declaration of a major disaster or emergency opens up many of the same funding channels as a PHE, but a state request initiates these declarations. A PHE is a separate legal declaration that may or may not be necessary.
A public health emergency indicates that a threat exists; it cannot be based on the possibility of a threat. But it doesn’t mean flashing lights, sirens, or a healthcare system crumbling under the weight of unanticipated demand. It is a legal means to open the financial spigot and cut the bureaucratic red tape to act urgently on behalf of the citizens.
 US Department of Health and Human Services Public Health Emergencies