CDC Drafts “Isolation Order” for H1N1

Kurt Nimmo

September 28, 2009

The following draft of an “isolation order” was discovered on the CDC’s website. It is a template for state and local officials to impose quarantines and what would effectively be martial law.

“Your illness [as determined by state and local officials] requires that you be isolated and requires further public health investigation and monitoring.”

Failure to obey will result in imprisonment without bail prior to trial and the possiblity of a two year prison term.

In other words, according to this document, officials can impose quarantine without evidence that somebody is actually infected with a virus that is now negligible at best. It may also be used to quarantine potentially millions of people suffering from any number of illnesses — or not suffering from any disease at the discretion of the state — that have nothing to do with H1N1. It is basically a carte blanche for martial law under the cover of protecting the public from a communicable disease that is demonstrably a manufactured and weaponized threat.

isolation order

NY Commissioner Tells Health Care Workers: Mandatory Flu Vaccine is in the Best Interest of Patients and Workers

ALBANY, N.Y. (Sept. 24, 2009) – State Health Commissioner Richard F. Daines, M.D., today released this open letter to health care workers in New York State:

As health care workers, we share one of the proudest traditions of all professions: we put our patients’ interests ahead of our own.

As a physician who spent more than 20 years working in hospitals, I had the honor of working side by side with other physicians, nurses, food service workers, technicians and transporters in the early and uncertain months of what would become the HIV epidemic, in those first confused days of the anthrax attacks, and when any new international traveler with a fever might have been carrying SARS. Never once, no matter what our private fears might have been, did we shirk from our duties or put personal anxieties ahead of the interests of our patients. We took the recommended precautions, worked carefully and cautiously, and gave our patients the compassionate and selfless care for which our professions and institutions are rightly given a special place in our society.

In furtherance of that tradition, on August 13th the New York State Hospital Review and Planning Council adopted a regulation recommended by the New York State Health Department making approved annual influenza vaccinations mandatory, unless medically contraindicated, for health care workers in hospitals, outpatient clinics and home care services. Legislation applying the same standards to nursing home workers has also been proposed. The new regulation will apply first to the routine annual seasonal influenza vaccine now available. With the recent FDA approval of the vaccine for novel H1N1 flu (“swine flu”), the regulation will also apply to that vaccine, just in time for the second wave of novel H1N1 influenza already returning this fall.

Questions about safety and claims of personal preference are understandable. Given the outstanding efficacy and safety record of approved influenza vaccines, our overriding concern then, as health care workers, should be the interests of our patients, not our own sensibilities about mandates. On this, the facts are very clear: the welfare of patients is, without any doubt, best served by the very high rates of staff immunity that can only be achieved with mandatory influenza vaccination – not the 40-50% rates of staff immunization historically achieved with even the most vigorous of voluntary programs. Under voluntary standards, institutional outbreaks occur every flu season. Medical literature convincingly demonstrates that high levels of staff immunity confer protection on those patients who cannot be or have not been effectively vaccinated themselves, while also allowing the institution to remain more fully staffed.

Throughout this fall and winter, more patients than ever may enter our hospitals and clinics without effective influenza immunity. Some will be too young or have other contraindications to vaccination or will have failed to receive vaccinations for a variety of reasons. Others will be too frail for vaccination to be effective. Large numbers of people quite clearly would like to take the new H1N1 vaccine as soon as it is available but will be denied that opportunity because they do not fall into one of the first prioritized groups. For all of these individuals, safety lies in being treated in institutions and by health care personnel with the nearly 100% effective immunity rates seen with other long-mandated vaccinations for health care workers, such as measles and rubella.

In recognition of health care’s noble tradition of putting patients’ interests first and understanding the need to keep our health care system functioning optimally during this challenge, federal authorities made a remarkable decision regarding the first groups to be given access to the new H1N1 vaccine. In addition to giving highest priority for the new vaccine to those who would receive the direct or personal benefit — pregnant women, caregivers to infants, children and the chronically ill — authorities declared that health care workers would also be given earliest access to the vaccine, ahead of millions of other individuals who have roughly equal or even higher risks of contracting H1N1 influenza with all the discomfort or worse that could mean for them as individuals.

Knowing that our privileged access to the new vaccine is earned not by our personal risk factors but by the special trust society places in us, then how can we as health care workers maintain that our cooperation in protecting the most vulnerable members of society is nevertheless optional? Without mandated vaccinations, many ethically troubling situations may occur. A health care worker unconcerned about “ordinary flu” might refuse the routine seasonal vaccine, but then expect to be in the front of the line for the “good stuff” – the new and strictly rationed swine flu vaccine. Institutions may find themselves short staffed and less than fully capable if their workers fail to get the seasonal influenza vaccine but then proceed to consume hundreds of doses of the new vaccine, therefore denying those doses to other groups. This scenario will certainly not achieve the staff-wide immunity levels needed to assure patient safety and optimal staffing — the very reasons for which health care workers received their priority in the first place.

Influenza vaccination has saved thousands upon thousands of lives over the last three decades, and thousands more could have been saved if the vaccinations had been more widely used. This year, through effective use of vaccination, we have perhaps the best opportunity to save lives and keep our society and institutions running more smoothly than we have had in 50 years or more. This is not the time for uninformed or self-interested parties to attempt to pump air into long-deflated arguments about vaccine safety in general or to use a single 33-year-old episode to deny decades of safety and saved lives achieved by influenza vaccines prepared in the same way as this year’s formulations.

The seasonal influenza vaccine has completed, and before its approval the new H1N1 vaccine also underwent, the most careful development, production and testing processes leading scientists, clinicians and public health authorities can devise. Approval of the H1N1 vaccine was based on the application of the same scientific standards and methods that we believe should govern all our health care practices. We, as health care workers, owe it to our patients and to society in general to demonstrate our confidence in those scientific standards. Even more importantly, we should reconfirm our noble commitment to the tradition of putting patients’ interests first by supporting the mandatory influenza vaccination requirement.

Richard F. Daines, M.D.
New York State Commissioner of Health

NY nurses refuse swine flu injections video

Related information:


Commissioner Tells Health Care Workers: Mandatory Flu Vaccine is in the Best Interest of Patients and Workers

Health Advisory: Novel H1N1 Influenza Vaccine Information – September 14, 2009

Dear Administrator Letter: Health Care Personnel Mandatory Influenza Immunization:

August 26, 2009

Dear Administrator:

On August 13, 2009 an emergency regulation went into effect, which requires that all personnel of certain health care settings receive annual vaccinations against influenza by November 30 of each year unless they have a medical contraindication to the vaccination or the State Commissioner of Health determines that there is an insufficient supply of vaccine for the year. The primary purpose of this regulation is to protect the health and safety of vulnerable patients, whose risk of serious adverse effects from influenza is high. An added benefit is to maintain a healthy workforce during flu season.

The new regulation applies to:

  • Hospitals
  • Diagnostic and treatment centers licensed under Article 28,
  • Home care services agencies licensed under Article 36 of the Public Health Law including:
    • Certified home health agencies
    • Licensed home care services agencies
    • Long-term home health programs including AIDS home care programs
  • Hospice programs certified under Article 40 of the Public Health Law.

Personnel who must be vaccinated against influenza include all those affiliated with the employer, paid or unpaid, who have direct contact with patients or whose activities are such that they pose a risk of transmission of influenza to patients or to those who provide direct care to patients. “Personnel” is defined as anyone affiliated with any organization (noted above), including but not limited to employees; members of the medical staff, including attending physicians; contract staff; students and volunteers.

The organization is responsible for determining which individual members of the employer’s personnel pool fall into the group requiring vaccination consistent with the regulation. Additionally, the organization is responsible for identifying the measures that are needed to protect patients from influenza transmission from personnel who are exempt due to a medical contraindication. The organization covered by these regulations which provides the vaccination must provide it at no cost to their personnel. However, personnel are free to receive their vaccinations wherever they please as long as they provide documentation to the organization. The organization should confer with their Human Resources office and counsel to determine what actions to take for personnel who fail to meet the mandatory requirement; we suggest that organizations examine their existing policies for mandatory rubella, rubeola, measles, and TB testing for guidance.

Nursing homes, adult homes, enriched housing programs, adult day health care programs and any other facility providing residential housing and supportive services to 5 or more persons over the age of 65 who are unrelated to the operator continue to be governed by the requirements of Article 21-A of the Public Health Law, which remains unchanged from last year.

If the novel H1N1 vaccine is released as a fully licensed vaccine, as expected, this regulation will also require immunization against H1N1 as well as seasonal influenza this coming season. Further information will be provided when the Department receives updates on the vaccine, its licensure status and availability this fall.

The regulation and current version of the Question & Answer document are attached in anticipation of any further questions you may have. Please check the Health Provider Network (HPN) for updates.


  • Mark Kissinger
    Deputy Commissioner Office of Long Term Care
  • Richard M. Cook
    Deputy Commissioner Office of Health Systems Management