Responding to Bioterrorism in the Information Age: Public Reflections on Anthrax

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Responding to Bioterrorism in the Information
AgePublic Reflections on Anthrax

• Monica Schoch-Spana
• 26 June 2003

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Epidemic Communications Advice for
Decision-Makers during Bioterrorism

• Focus Groups June 02 to June 03
• Conference The Public as an Asset, Not a
  Problem, Feb 3-4, 03
• Working Group Feb to Sept, 03

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Focus Group Composition

• Official Responders
• General public Proxy groups
• Individuals potentially at occupational risk of
  anthrax exposure
• Civic community leaders

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Field Sites
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Discussion Format

• Facilitated discussion, 8-10 ppl 2.5 hrs
• Session I Evaluate 2001 anthrax public
  communications
• Session II Speculate about communication needs
  in hypothetical smallpox attack

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(No Transcript)
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Research Subjects

• 6 Responder Groups
• n 66 15 hours
• 2/3 male 4/5 cauc
• 17 Public Groups - 5 Spanish
• English, n 105 (1/2 male 2/3 cauc)
• Spanish, n 43 (2/3 female)
• Total, n 148 42.5 hours

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Discussion Threads

• Responding to anthrax in the information age
• Containing smallpox in a world of have have not

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Problems of Responding to Anthrax in the
Information Age

• CNN syndrome an epidemics reach
• Expectations of omniscient authorities
• Health expert role advise/offer choices?
• Emergency signal amidst all the noise?
• Beyond high tech, mainstream media
• Closure sustained public attention

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Mass Media the Blurring of Epidemic Boundaries

• I was on vacation in Mexico when all of this
  happened, and everybody was glued to the
  television set watching CNN in the bar at the
  resortAnd they finally made a decision to turn
  off the TVso people could enjoy their vacation.
• - Senior Citizens Advocate, Seattle, WA

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(No Transcript)
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Public Expectations of Omniscient Authorities

• I have a natural presumption thatits the
  governmenteverybodys going to do the most
  rational thing and were going to be on top of
  things and everything. But I reallylost some
  confidencebecause I just got the sense that they
  were kind of making it up on the fly.
• - Congressional Staffer, Washington, DC

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Health Expert Role in CrisisOffer Advice or
Choices?

• In the public health communityyou want to
  give information and empower the community to
  make their own decisions, but to a certain
  extent, many patients want to be told, What do I
  do?.Its a very fine line, but sometimes they
  do need that, Listen, this is really what we
  think you should do.
• - Physician in Emergency Management, NYC

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Wheres the Emergency Signal in all the Noise?

• I remember feelinglike the media was in
  stream of consciousness mode and everything was
  without context. Everything was just dumped on
  you, and youre just trying to process it. What
  do you do with all this information?
• - Immigrant/Refugee Advocate, Seattle, WA

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• If I was rating the media on overkill, they
  would get an F, but on information I would give
  them a B.The reason I was watchful but not
  fearful is because there was a blitz of constant
  information about where things were happening,
  what you should do, what you should not do.
• - Neighborhood Leader, Kansas City, MO

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Beyond Mainstream Media High Tech Fixes

• In my community, I dont believe much in
  papers. I strongly believe in, Look, lets go
  to that place, tonight, a meeting, and we can
  gather 500 without any problem.
• - Latino Community Organizer, NYC

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Closure Say, Whatever Happened to?

• Every once in a while itll pop up again. But I
  dont feel anyone ever said, Itll be okay or
  Its over now.Those are the two things that
  I havent heard either in the general news or on
  the occupational level.
• - Health Safety Rep, NYC Hospital

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• My bossSenator Xnever even spoke to me
  throughout the whole anthrax crisisIt was one
  of those things where youd like to know that
  somebody would at least acknowledge there was a
  risk.
• - Congressional Staffer, Washington, DC

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Considerations for Decision-Makers

• Accept the virtual reach of epidemics
• Recalibrate expectations of instantaneous results
• Be the health expert w/ limited data
• Amplify the emergency signal
• Use low tech outreach
• Update /or conclude the crisis

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www.hopkins-biodefense.org

• Audiotaped transcribed proceedings
• The Public as an Asset, Not a Problem
• A Summit on Leadership during Bioterrorism
  Response