A Population-Based Health Law
It is projected that a modern [influenza] pandemic could
lead to the deaths of 200,000 to 2 million people in the
United States alone.
—Homeland Security Council, National Strategy for
Pandemic Influenza: Implementation Plan
SINCE 2001, public health officials have focused much of their attention on preparing for and responding to a public health emergency, a grave crisis that could quickly wrack massive havoc on the public's health.1 Initially, in the wake of 9/11 and the subsequent anthrax attacks on the U.S. mail, bioterrorism received the lion's share of attention. Government spending on research related to bioterrorism mushroomed, the regulation of laboratories using dangerous pathogens was enhanced, vaccines and antitoxins were stockpiled, and model laws were drafted to expand state authority to quarantine, isolate, and forcibly treat individuals.2 Later, during the lead-up to the invasion of Iraq, the federal government launched a program to vaccinate health and emergency personnel against smallpox in anticipation of a possible smallpox attack.3
As time passed, the public health emergency agenda broadened to encompass an all-hazards approach that includes natural disasters, such as hurricanes and naturally occurring epidemics. More recently, concern has centered on the possibility of an influenza pandemic, a threat that seemed especially alarming in 2005 given the rapid spread of the so-called