Saturday, July 4, 2009

The Role of the Department of Defense During A Flu Pandemic

[This document will also be posted in the right side-bar under "Preparations". Please click on the title for the full document to open.]

June 4, 2009
Excerpts:

Summary
A flu pandemic is a worldwide epidemic of an influenza virus. As such, the United States’response to a flu pandemic would have both international and domestic components. Additionally, the domestic response effort would include contributions from every governmental level (local, state, tribal, and federal), non-governmental organizations, and the private sector. This report will focus largely on the role of the Department of Defense (DOD) in supporting the nation’s domestic response effort, although it will also touch on DOD’s international role.

The Department of State would lead the federal government’s international response efforts, while the Department of Homeland Security and the Department of Health and Human Services would lead the federal government’s domestic response. The Department of Defense would likely be called upon to support both the international and domestic efforts. An analysis of the tasks assigned by the National Strategy for Pandemic Influenza Implementation Plan indicates that DOD’s role during a flu pandemic would center on the following objectives: assisting in disease
surveillance; assisting partner nations, particularly through military-to-military assistance; protecting and treating US forces and dependents; and providing support to civil authorities in the United States.

With respect to providing support to civil authorities in the United States, the types of defense support which would likely be in greatest demand during a flu pandemic include: providing disease surveillance and laboratory diagnostics; transporting response teams, vaccines, medical equipment, supplies, diagnostic devices, pharmaceuticals and blood products; treating patients; evacuating the ill and injured; processing and tracking patients; providing base and installation support to federal, state, local, and tribal agencies; controlling movement into and out of areas, or across borders, with affected populations; supporting law enforcement; supporting quarantine enforcement; restoring damaged public utilities; and providing mortuary services. Note, however, that DOD’s ability to support these requests would be limited by its national defense and force protection responsibilities. The two principal ways in which defense support could be provided to civil authorities are by way of an “immediate response,” or in response to a formal “request for assistance” (RFA). Additionally, in extreme circumstances the federal government may expedite or suspend the RFA process and initiate a “proactive federal response.”

National Guard personnel would almost certainly be involved in domestic response efforts as members of their state militia under the control of their governor. Current DOD plans do not anticipate federal mobilization of the National Guard or Reserves to respond to a flu pandemic.
However, these plans could be modified if circumstances warranted it (for example, if the severity of the pandemic significantly exceeded DOD’s planning assumptions). In the event such a federal mobilization is contemplated, an important consideration would be the impact it would have on any response efforts that were already occurring at the state and local levels. For example, the activation of Reserve and National Guard medical personnel may pull them out of local hospitals where they are already engaged in the response effort, thereby undermining state and local response efforts.

-snip-
Defense Support of Civil Authorities
During a serious flu pandemic, there is a strong possibility that local, state, and federal responders will request assistance from the Department of Defense. DoD has a broad range of capabilities that could be useful to civil authorities in emergency situations, including transportation assets, medical personnel and supplies, security forces, and communications equipment The NRF and the Implementation Plan refer to this type of assistance as Defense Support of Civil Authorities (DSCA), while DoD often refers to it as Civil Support (CS) or Military Assistance to Civil Authorities (MACA).27 This report will follow the NRF terminology unless otherwise specified.
-snip-

Proactive Federal Response
The NRF provides for a proactive federal response to a “catastrophic incident.”39 If a flu pandemic were severe enough – that is, if it caused extraordinary levels of death or illness which had severe societal impacts -- it could qualify as a catastrophic incident. A proactive response would allow for the prepositioning of federal assets in anticipation of state, local, or tribal requests for assistance; it would also permit the federal government40 to take charge of coordinating the response if the affected state, local, or tribal governments were unable to do so.41

39“A catastrophic incident, as defined by the NRF, is any natural or manmade incident, including terrorism, that results in extraordinary levels of mass casualties, damage, or disruption severely affecting the population, infrastructure, environment, economy, national morale, and/or government functions. A catastrophic incident could result in sustained nationwide impacts over a prolonged period of time; almost immediately exceeds resources normally available to State, tribal, local, and private-sector authorities in the impacted area; and significantly interrupts governmental operations and emergency services to such an extent that national security could be threatened.” Department of Homeland Security, National Response Framework – Catastrophic Incident Annex, November 2008, p. CAT-1,
http://www.fema.gov/pdf/emergency/nrf/nrf_CatastrophicIncidentAnnex.pdf .

Activating the National Guard for Pandemic Flu Response
National Guard personnel would almost certainly be involved in state efforts to respond to a flu pandemic as members of their state militia under the control of their governor. Current DOD plans do not anticipate calling the National Guard into federal service to respond to a flu pandemic.51 However, as with the case of the federal reserves, these plans could be modified if circumstances warranted it. DOD policy guidelines currently specify that, if Reserve Component
medical personnel are required to respond to a flu pandemic, the military services are to “use [federal] Reserve forces first, leaving National Guard forces to be available to meet their statebased missions.”52

-snip-
“Title 32” Status
Another way in which National Guard personnel can be activated and remain under the control of their governor is under the authority of 32 U.S.C. 502(f). This provision of federal law provides that “a member of the National Guard may...without his consent, but with the pay and allowances provided by law...be ordered to perform training or other duty in addition to [inactive duty for training or annual training].” The advantage of using this authority is that the National Guard
personnel called will receive federal pay and benefits and are entitled to certain legal protections55 as though they were in federal service, but they remain under the control of their governor and are therefore not subject to the restrictions of the Posse Comitatus Act. This is the provision of law which was used to provide federal pay and benefits to the National Guard personnel who provided security at many of the nation’s airports in the aftermath of the terrorist attacks of September 11, 2001. It has also been used to respond to major disasters such as Hurricane Katrina in 2005.
-snip-

No comments: