Swine flu declared a national emergency

WASHINGTON — President Obama has declared swine flu a national emergency, clearing the way to give hospitals and doctors' offices wider leeway to handle a surge of patients, administration officials said Saturday.

The president will grant Health and Human Services Secretary Kathleen Sebelius the power to authorize waivers as individual medical facilities request them, officials said.

Obama administration officials downplayed the dramatic language, saying the president's action did not stem from a new assessment of the dangers posed to the public by the flu.

"This is not a response to any new developments," said Reid Cherlin, an administration spokesman. "It's an important tool in our kit going forward."

Officials said the action provides greater flexibility for hospitals that may face a surge of patients as the H1N1 virus sweeps through their communities.

For instance, Sebelius now has authority to bypass federal rules when opening alternative-care sites, such as offsite hospital centers at schools or community centers if hospitals seek permission.

Some hospitals have opened drive-thrus and drive-up tent clinics to screen and treat swine-flu patients. The idea is to keep infectious people out of regular emergency rooms and away from other sick patients.

Hospitals could modify patient rules — for example, requiring them to give less information during a hectic time — to quicken access to treatment, with government approval, under the declaration.

The declaration also addresses a financial question for hospitals: reimbursement for treating people at sites not typically approved. For instance, rules do not allow hospitals to put up treatment tents more than 250 yards away from the doors.

"This is much more than a formality — with this proclamation the president has now firmly established that H1N1 constitutes a national emergency, and not just a public-health emergency," James Hodge Jr., a professor of health law and ethics at Arizona State University, wrote in an e-mail.

The waivers authorized by the president still require individual requests by the hospitals, Cherlin said.

Public-health experts praised the move, saying it was an important precautionary step that could help hospitals and other first responders care for sick people as the outbreak continues.

"We know a number of hospitals are already experiencing high but manageable loads. It's not a stretch to imagine that hospitals could be strained," said Jennifer Nuzzo, of the University of Pittsburgh's Center for Biosecurity. "It's just a precautionary move so if need be we can focus on the care of patients rather than focus on administrative hurdles. In disasters, you often don't have the time or luxury to keep the paperwork in order. "

Others agreed, likening the move to getting snowplows and salt supplies ready before a large snowstorm.

"You get ready, make sure everything is battened down," said Arthur Caplan, a University of Pennsylvania bioethicist.

But Caplan was concerned that the dramatic language could create unnecessary anxiety, in the same way that the World Health Organization's progressive elevation of pandemic alerts last spring caused widespread concern.

"From the point of view of the public, I think it's, 'Holy cow,' " Caplan said. "It gets heard very differently."

Obama's declaration could sharply increase demand for the vaccine, which is becoming available much more slowly than originally expected.

"I've already gotten a couple of calls from people today asking, 'Where can I get the vaccine?' whereas yesterday it was, 'I don't want that vaccine,' " Caplan said. "I'm worried about people getting panicky and the vaccine being diverted away from those who need it most."

The Centers for Disease Control and Prevention reported (CDC) Friday that the flu was spreading widely in at least 46 states, including Washington, and had already caused the hospitalization of at least 20,000 Americans. More than 1,000 confirmed deaths have occurred due to the virus and more than 2,400 additional deaths were likely associated with it, officials said.

Health authorities are especially concerned about pregnant women, young adults and children. At least 95 children have died from the virus, far more than usually die during an entire typical flu season.

The seasonal flu typically hospitalizes 200,000 people in the U.S. each year and kills 36,000. But more than 90 percent of the deaths from seasonal flu are among the elderly, while the swine flu mostly affects the young.

Although officials had hoped at least 40 million doses of vaccine would be available by this time, production problems have delayed the massive inoculation campaign. Only about 16 million doses have become available.

Material from The Associated Press and The New York Times

is included in this report.