Governmental Public Health Powers During the COVID-19 Pandemic: Stay-at-home Orders, Business Closures, and Travel Restrictions

The president and all 50 governors have declared health emergencies to combat the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). While researchers race for vaccines, officials are implementing physical distancing, including orders to stay at home, restrict travel, and close non-essential businesses. To limit cross-border spread, a few states have issued mandatory quarantines for interstate travelers. Models suggest physical distancing would have to persist for 3 months to mitigate peak impacts on health systems and could continue on an intermittent basis for 12-18 months. What legal powers do governments have? What is the role of the courts? How can we balance public health with personal and economic rights

The International Response to Climate Change: An Agenda for Global Health

As the international community negotiates a successor to the Kyoto Protocol of the United Nations Framework Convention on Climate Change (UNFCCC), there is new reason to hope that meaningful action might be taken to prevent devastating climate change. Even the more ambitious mitigation targets currently under negotiation, however, will not be sufficient to avoid a profound effect on the public\u27s health in coming decades, with the world\u27s poorest, most vulnerable populations bearing the disproportionate burden. The influence of historic and current emissions will be so substantial that it is imperative to reduce global emissions while at the same time preparing for the effects. Recently, the UNFCCC has begun to turn its attention to adaptation—changes to human systems to ameliorate the consequences of climate change. This Commentary proposes a new agenda for mitigation as well as adaptation approaches that emphasize the considerable health effects of climate change, which include increasingly intense and more frequent natural disasters, potential increases in vector-, food-, and water-borne infectious disease, and exacerbation of cardiovascular and respiratory disease. The effects of climate change will be experienced in every region but will disproportionately burden the global poor, exacerbating global health disparities and challenging the international community to address the inevitable questions of global social justice. Three key recommendations are proposed: (1) focus mitigation targets on broader health impacts, rather than framing climate change as a coastal issue; (2) incorporate land-use and agricultural approaches to mitigation alongside measures in the energy and transportation sectors to take advantage of co-benefits for health; and (3) fully fund adaptation projects as a global priority with an emphasis on strengthening health systems

Food and Drug Administration Regulation of Food Safety

Food-borne illness remains a major public health challenge in the United States, causing an estimated 48 million illness episodes and 3000 deaths annually. The FDA Food Safety Modernization Act (FSMA), enacted in 2011, gives the Food and Drug Administration (FDA) new tools to regulate food safety. The act emphasizes prevention, enhanced recall authority, and oversight of imported food. The FSMA brings the FDA’s food safety regulation in line with core tenets of public health by focusing on preventing outbreaks, rather than reacting to them, and differentiating between foods and food producers based on the degree of risk they pose. The FSMA also recognizes the increasing importance of imported food and enhances the ability of the FDA to safeguard the U.S. food supply from hazards originating abroad. The act achieves its prevention objectives through requiring food production facilities to establish preventive control plans and by increasing inspection frequency—a shortcoming of the FDA in recent years. The act also enhances the FDA’s ability to respond to food safety problems when they occur. Through pilot projects on food tracing systems and an enhanced surveillance system, the FDA will be have better tools to determine the source of outbreaks. Additionally, the act gives the FDA new mandatory recall authority—a badly needed addition to its enforcement capabilities. In an increasingly globalized food environment, the FSMA gives the FDA new authority to regulate imported food. Among other provisions, the act allows FDA to inspect foreign facilities and to partner with foreign food regulatory agencies to help build capacity. Through new tools and increased enforcement, the FSMA holds great promise for public health. The act, however, leaves several regulatory gaps, including keeping the food safety functions of the USDA and FDA separate. Additionally, the potential of the act to improve food safety may be thwarted by inadequate funding in the current budget environment. The act includes numerous programs for building the capacity of domestic and foreign regulators and food producers. Such programs are essential to an improved food safety system, but require adequate funding from Congress to be fully implemented. In addition to national capacity building, FDA and Congress should fully engage partners in government and industry to improve global food safety at the international level

Health Data and Privacy in the Digital Era

In 2010, the social networking site Facebook launched a platform allowing private companies to request users’ permission to access personal data. Few users were aware of the platform, which was integrated into Facebook’s terms of service. In 2014, Cambridge Analytica, a UK-based political consulting firm, developed a data-harvesting app. That app prompted Facebook users to provide psychological profiles, including responses such as “I get upset easily” and “I have frequent mood-swings” as part of a “research project.” The Facebook platform allowed users to share their friends’ data as well, enabling Cambridge Analytica to access tens of millions of personal profiles, identifying voters’ political preferences. The controversy revealed risks to identifiable health data posed by social media and web services companies’ practices. After the Cambridge Analytica controversy, Facebook suspended a project that aimed to link data about users’ medical conditions with information about their social networks. Individuals often reveal detailed, sensitive health information online. Through wearable devices, social media posts, traceable web searches, and online patient communities, users generate large volumes of health data. Although some individuals participate in online patient forums and wellness information sharing apps under their own names, others participate via pseudonyms, assuming their privacy is preserved. Many users believe their data will be shared only with those they designate

Lawrence F. O\u27Brien to Senator James O. Eastland, 25 July 1964

Carbon typed letter dated 25 July 1964 from Lawrence O\u27Brien to Eastland, re: signed photo of president for Hollis Humphrey, granddaughter of Eastland\u27s cousin Oliver Eastland. Attached: typed letter signed dated 14 July 1964 from O\u27Brien to Eastland, re: above topic. Attached: carbon typed letter dated 10 July 1964 from Eastland to O\u27Brien, re: above topic.https://egrove.olemiss.edu/joecorr_e/1026/thumbnail.jp

Lawrence F. O\u27Brien to Senator James O. Eastland, 20 December 1963

Typed letter signed dated 20 December 1963 from Lawrence O\u27Brien, Special Assistant to the President, to Eastland, re: Higher Education Facilities Act of 1963, Vocational Education Act of 1963, Mental Retardation Facilities Construction Act; 2 pages. Attached: typed document entitled Breakdown of States to Attend Information Meetings on New Legislation.https://egrove.olemiss.edu/joecorr_e/1054/thumbnail.jp

Lawrence F. O\u27Brien to Senator James O. Eastland, 25 September 1961

Typed letter signed dated 25 September 1961 from Lawrence O\u27Brien to Eastland, re: 18 September letter on Tariff Commission\u27s recommendations in the Wilton and velvet carpet case.https://egrove.olemiss.edu/joecorr_d/1021/thumbnail.jp

Lawrence F. O\u27Brien to Senator James O. Eastland, 29 September 1961

Copy typed letter dated 29 September 1961 from Lawrence F. O\u27Brien to Eastland, re: 27 September letter on Department of Agriculture\u27s plans for cotton program.https://egrove.olemiss.edu/joecorr_d/1022/thumbnail.jp

Lawrence F. O\u27Brien to Senator James O. Eastland, 31 January 1964

Typed letter signed dated 31 January 1964 from Lawrence F. O\u27Brien to Eastland, re: enclosed book on economic development in emerging nations.https://egrove.olemiss.edu/joecorr_e/1055/thumbnail.jp

Lawrence F. O\u27Brien to Senator James O. Eastland, 11 May 1965

Typed letter signed dated 11 May 1965 from Lawrence F. O\u27Brien to Eastland, re: enclosed pen used by president when signing the proclamation Adding Ellis Island to the Statue of Liberty National Monument.https://egrove.olemiss.edu/joecorr_e/1033/thumbnail.jp