摘要：Law influenced every aspect of the public health response to Hurricanes Katrina and Rita, from evacuation orders, to waivers of medical licensing requirements, to the clean-up of public health threats on private property. We used public health surveillance of news reports to identify and characterize legal issues arising during the disaster response in 5 Gulf Coast states. Data collected from news reports of the events in real time were followed-up by interviews with selected state legal and emergency management officials. Our analysis indicates the value of surveillance during and after emergency responses in identifying public health–related legal issues and helps to inform the strengthening of legal preparedness frameworks for future disasters. THE NEWS THAT HURRICANE Katrina was about to make landfall near New Orleans, La, on August 29, 2005, triggered a series of emergency orders from local, state, and federal jurisdictions intended to ensure the public’s health and safety. As the scope of the catastrophe unfolded in the following days, more orders and declarations were issued, and other legal issues came into play as all levels of government attempted to rescue, shelter, and evacuate stranded residents and to share information and mobilize mutual aid across jurisdictional boundaries. In the disaster’s aftermath, public health and emergency preparedness officials have attempted to understand the successes and failures of the legal frameworks governing the response to the events in the Gulf Coast. Despite the large body of published articles and analysis regarding the epidemiology of disasters and other public health emergencies, 1 – 4 legal issues arising from or implicated during public health emergencies have not been well characterized. For example, such articles generally address the epidemiology of health effects associated with disasters, such as volcanoes, earthquakes, or tornadoes, 5 – 8 and identify public health response options through improved management of derivative problems, such as disease, malnutrition, contaminated water, poor sanitation, mental health problems, and injury. 9 – 12 Although a limited number of articles have addressed legal issues in relation to bioterrorism and specific aspects of emergency legal preparedness, 13 – 15 the body of literature on the epidemiology of disasters largely has not examined the legal underpinnings of public health responses. However, such characterization can assist public health and emergency management officials in assessing the adequacy of laws for preparedness and response activities and in developing relevant educational, informational, and training resources. Hurricanes Katrina and Rita, among the most severe, acute natural disasters and public health emergencies in US history, provided a unique opportunity to identify, assess, and characterize the spectrum of legal issues implicated during public health emergencies and to do so in an ongoing, prospective fashion. On recognition of the impending landfall of Hurricane Katrina on August 29, 2005, the Public Health Law Program of the Centers for Disease Control and Prevention (CDC) made preparations for ongoing surveillance of public health–related legal issues. Issues were monitored through the use of publicly accessible news sources and other information sources already used in the production of the weekly CDC Public Health Law News . 16 We report the findings of this ongoing, systematic surveillance effort for the 6-month period of late-August 2005 through February 2006, as well as related information obtained from follow-up interviews with the principal state-level public health legal counsel and other officials in hurricane-affected states. The CDC decision to implement this prospective surveillance at the onset of this crisis was also based on lessons learned from the legal follow-up to the terrorist and anthrax attacks of fall 2001, including ongoing monitoring of the effects of the draft Model State Emergency Health Powers Act, 17 the 2003 severe acute respiratory syndrome epidemic, 18 and the national shortage of influenza vaccine during fall 2004. 19
