U.S. System Of Public Health Emergency Response Is ‘Highly Decentralized,’ Needs Leadership

Washington Post: Letters to the Editor: In case of epidemic: Get organized
Allan R. Glass, physician in Bethesda, MD

“The April 9 news article ‘Trump team ill-prepared for pandemic’ focused on the impact of vacancies in the offices of high-level federal officials, but such federal officials have very limited real authority in pandemic situations because of our highly decentralized system of public health emergency response. Governors, acting through their state and local public health directors, have the real authority to take action during pandemics. The role of the federal government is primarily to offer advice and assistance when state and local health officials request it, and, not surprisingly, there is a widespread lack of uniformity of policies and procedures among state health departments. … When it comes to pandemic response, the key question is not so much who occupies a particular office but rather a more prosaic concern that has bedeviled us for decades: Who has the authority to take charge and direct others to take action?” (4/13).