New York Times
Anthrax Offers Lessons in How to Handle Bad News
October 23, 2001
By ERICA GOODE
In recent decades, social scientists have learned much about how government authorities can best inform and reassure an anxious public faced with a new and unfamiliar threat.
But in their initial handling of the anthrax crisis, government leaders did almost everything wrong, according to psychologists and other researchers.
The experts offered four guidelines for minimizing panic and helping people adapt to changed circumstances:
• Adopt a policy of full disclosure about what is and is not known and deliver information in a nonpatronizing manner.
• Avoid speculation and never mix facts with reassurance.
• Give a detailed accounting of what is being done to counter the threat.
• Recommend specific steps that people may take to protect themselves.
In the days after the first anthrax case was discovered in Florida, government officials often violated all of these precepts, the experts said.
Health and law enforcement authorities made confident statements that later proved false, tried simultaneously to inform and reasssure, and limited the flow of information to the public. Agencies issued conflicting statements. Officials speculated about what had happened or what might happen. And they simultaneously warned Americans about vague dangers while urging them to go about their lives.
"I must say the Bush administration has not done a good job of reassuring the public," said Dr. Jonathan B. Tucker, a bioterrorism expert in the Washington office of the Monterey Institute for International Studies. "There is a real need for a communication strategy."
The news media, acting both as the vehicle of official communications and as their interpreter, did not help matters either, some experts said. Hype and worst-case theorizing were common. Many news outlets labeled as "cases" people who had been exposed to anthrax, inflating the scope of the crisis. And reporting about hundreds of anthrax scares across the country did not always make clear that most were a result of hoaxes or misplaced fears.
These early failures, the experts said, in some cases undermined the credibility of officials and might have increased the public's fear.
In recent days, the federal government has taken some corrective measures, trying to offer a more unified communications front and specifically addressing the anxiety induced by the anthrax attacks. On Thursday, Tom Ridge, the Bush administration's new domestic security chief, flanked by representatives of health and law enforcement agencies, faced journalists' questions.
Dr. David Satcher, the surgeon general, began to offer specific advice on what people could do to minimize their risk. And the Centers for Disease Control and Prevention for the first time gave physicians the detailed information they needed to identify and treat people infected.
Michael A. Wermuth, a policy analyst at the RAND Corporation and executive director of the Gilmore Commission, which advises Congress on the nation's ability to respond to terrorism, said that in a December 2000 report, the commission had recommended that government officials draft a coherent plan for communicating with the public after a terrorist attack.
"Nothing obvious was done," Mr. Wermuth said. "The government just hasn't recognized before recent events how important it is to lay the groundwork ahead of time."
The government's response immediately after anthrax appeared gave little hint of any planning.
Among the most egregious lapses, many experts noted, were erroneous statements by Tommy G. Thompson, the nation's secretary of health and human services, and various lawmakers. Mr. Thompson said the first anthrax victim, Robert Stevens, might have contracted inhalation anthrax in the woods on a visit to North Carolina, an assertion quickly dismissed as improbable by many health experts.
Senator Tom Daschle, the majority leader, incorrectly described members of his staff as "infected." And J. Dennis Hastert, the speaker of the House, told reporters that the ventilation system in the Capitol complex had been contaminated with anthrax spores, though specialists in biological warfare and building design called that "extremely unlikely."
In contrast, several experts cited New York City's mayor, Rudolph W. Giuliani, who held daily press conferences about the city's anthrax exposures, as providing a model for how a crisis might be most effectively handled. They said the mayor had consistently done the right thing: appeal to people's most rational selves.
"People have these two sides," said Dr. George Loewenstein, a professor of economics and psychology at Carnegie Mellon. One, he said, "is the rational side which says only one person has died so far."
The irrational side views anthrax as a terrifying and unpredictable microbe likely to kill large numbers of people without warning.
Officials can help people hold onto a rational assessment of the threat by constantly putting numbers in context. For example, in giving the number of people exposed to the bacteria, they may underline how many hundreds of millions of Americans have not been exposed.
Admitting what is not known is far better than succumbing to the temptation to make firm but unfounded declarations in an attempt to reassure, Dr. Loewenstein and other experts said.
"People can absorb a lot more uncertainty than officials give them credit for being able to absorb," said Dr. Sheila Jasanoff, a professor of science and public policy at Harvard, and a pattern of false reassurances undermines public trust.
"Shooting from the hip with a definite answer is not a clever way to go," she said. "It's more credible to say, `We can't yet make predictions about this or statements about that.'"
Officials in countries where terrorism is a fact of life have already learned that lesson.
In Israel, for example, officials are careful to separate information about what has occurred from statements aimed at reassuring the populace, according to Dr. Arieh Shalev, a psychiatrist at Hadassah University Hospital in Jerusalem.
"Information always has to be seen as accurate and reliable and not contaminated by efforts to encourage people," Dr. Shalev said.
He added that even in Israel, after each escalation in the level of terrorist threat, it had taken several months for people's fears to abate.
After terrorists began attacking buses, for example, "no one took a public bus," Dr. Shalev said, "and then progressively people started taking buses again."
Yet in the long run, he added, Israelis have proved extraordinarily resilient.
"We all need a degree of denial to survive," Dr. Shalev said. "You would think Jerusalem would be deserted but it's not. You can terrorize a people for some time but you cannot terrorize a whole nation for a long time."
Dr. Jasanoff said that American officials might also benefit from the experience of the British government in dealing with mad cow disease, a crisis that shared certain parallels with the current anthrax threat.
Dr. Jasanoff, who made a case study of the British experience, said government officials early offered categorical reassurances about the disease that turned out to be without basis.
In one case, a cabinet minister publicly fed a hamburger to his child, in an effort to demonstrate that there was no danger. The incident later became a favorite of cartoonists, who used it as a metaphor for the force-feeding of information to the public.
Ultimately, Dr. Jasanoff said, it was a nongovernment British group, the Consumers' Association, that provided people with specific precautions they could take depending on their tolerance for risk. Those who wanted to avoid risk altogether, for example, might stop eating beef. People who wished to be cautious but were less fearful might stay away from ground beef, the form most likely to contain infectious particles.
"They understood the psychology of where the consumers were coming from a lot better than the public health officials," Dr. Jasanoff said.
The next weeks will offer the authorities in the United States the chance to recover their bearings.
"We are in a new situation," said Dr. Baruch Fischhoff, a professor of social and decision sciences at Carnegie Mellon. "People are trying to figure out what's going on and they need to be able to build up a coherent mental model of how big the risks are, so that they can decide what to do."
The events of the last weeks, said Dr. Arthur Kleinman, a professor of anthropology and psychiatry at Harvard, have posed "a fundamental emotional, intellectual and moral challenge" to a country unused to vulnerability.
No one yet knows, Dr. Kleinman said, exactly how the anthrax attacks fit with any larger terrorist scheme. Nor is it clear if they are prelude or final act.
"It would be foolhardy to hide this uncertainty from people," he said. "It's very early to be able to come to any conclusions."
http://www.nytimes.com/2001/10/23/he...5d310afb6f3f4f
Copyright 2001 The New York Times Company
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Anthrax Offers Lessons in How to Handle Bad News
October 23, 2001
By ERICA GOODE
In recent decades, social scientists have learned much about how government authorities can best inform and reassure an anxious public faced with a new and unfamiliar threat.
But in their initial handling of the anthrax crisis, government leaders did almost everything wrong, according to psychologists and other researchers.
The experts offered four guidelines for minimizing panic and helping people adapt to changed circumstances:
• Adopt a policy of full disclosure about what is and is not known and deliver information in a nonpatronizing manner.
• Avoid speculation and never mix facts with reassurance.
• Give a detailed accounting of what is being done to counter the threat.
• Recommend specific steps that people may take to protect themselves.
In the days after the first anthrax case was discovered in Florida, government officials often violated all of these precepts, the experts said.
Health and law enforcement authorities made confident statements that later proved false, tried simultaneously to inform and reasssure, and limited the flow of information to the public. Agencies issued conflicting statements. Officials speculated about what had happened or what might happen. And they simultaneously warned Americans about vague dangers while urging them to go about their lives.
"I must say the Bush administration has not done a good job of reassuring the public," said Dr. Jonathan B. Tucker, a bioterrorism expert in the Washington office of the Monterey Institute for International Studies. "There is a real need for a communication strategy."
The news media, acting both as the vehicle of official communications and as their interpreter, did not help matters either, some experts said. Hype and worst-case theorizing were common. Many news outlets labeled as "cases" people who had been exposed to anthrax, inflating the scope of the crisis. And reporting about hundreds of anthrax scares across the country did not always make clear that most were a result of hoaxes or misplaced fears.
These early failures, the experts said, in some cases undermined the credibility of officials and might have increased the public's fear.
In recent days, the federal government has taken some corrective measures, trying to offer a more unified communications front and specifically addressing the anxiety induced by the anthrax attacks. On Thursday, Tom Ridge, the Bush administration's new domestic security chief, flanked by representatives of health and law enforcement agencies, faced journalists' questions.
Dr. David Satcher, the surgeon general, began to offer specific advice on what people could do to minimize their risk. And the Centers for Disease Control and Prevention for the first time gave physicians the detailed information they needed to identify and treat people infected.
Michael A. Wermuth, a policy analyst at the RAND Corporation and executive director of the Gilmore Commission, which advises Congress on the nation's ability to respond to terrorism, said that in a December 2000 report, the commission had recommended that government officials draft a coherent plan for communicating with the public after a terrorist attack.
"Nothing obvious was done," Mr. Wermuth said. "The government just hasn't recognized before recent events how important it is to lay the groundwork ahead of time."
The government's response immediately after anthrax appeared gave little hint of any planning.
Among the most egregious lapses, many experts noted, were erroneous statements by Tommy G. Thompson, the nation's secretary of health and human services, and various lawmakers. Mr. Thompson said the first anthrax victim, Robert Stevens, might have contracted inhalation anthrax in the woods on a visit to North Carolina, an assertion quickly dismissed as improbable by many health experts.
Senator Tom Daschle, the majority leader, incorrectly described members of his staff as "infected." And J. Dennis Hastert, the speaker of the House, told reporters that the ventilation system in the Capitol complex had been contaminated with anthrax spores, though specialists in biological warfare and building design called that "extremely unlikely."
In contrast, several experts cited New York City's mayor, Rudolph W. Giuliani, who held daily press conferences about the city's anthrax exposures, as providing a model for how a crisis might be most effectively handled. They said the mayor had consistently done the right thing: appeal to people's most rational selves.
"People have these two sides," said Dr. George Loewenstein, a professor of economics and psychology at Carnegie Mellon. One, he said, "is the rational side which says only one person has died so far."
The irrational side views anthrax as a terrifying and unpredictable microbe likely to kill large numbers of people without warning.
Officials can help people hold onto a rational assessment of the threat by constantly putting numbers in context. For example, in giving the number of people exposed to the bacteria, they may underline how many hundreds of millions of Americans have not been exposed.
Admitting what is not known is far better than succumbing to the temptation to make firm but unfounded declarations in an attempt to reassure, Dr. Loewenstein and other experts said.
"People can absorb a lot more uncertainty than officials give them credit for being able to absorb," said Dr. Sheila Jasanoff, a professor of science and public policy at Harvard, and a pattern of false reassurances undermines public trust.
"Shooting from the hip with a definite answer is not a clever way to go," she said. "It's more credible to say, `We can't yet make predictions about this or statements about that.'"
Officials in countries where terrorism is a fact of life have already learned that lesson.
In Israel, for example, officials are careful to separate information about what has occurred from statements aimed at reassuring the populace, according to Dr. Arieh Shalev, a psychiatrist at Hadassah University Hospital in Jerusalem.
"Information always has to be seen as accurate and reliable and not contaminated by efforts to encourage people," Dr. Shalev said.
He added that even in Israel, after each escalation in the level of terrorist threat, it had taken several months for people's fears to abate.
After terrorists began attacking buses, for example, "no one took a public bus," Dr. Shalev said, "and then progressively people started taking buses again."
Yet in the long run, he added, Israelis have proved extraordinarily resilient.
"We all need a degree of denial to survive," Dr. Shalev said. "You would think Jerusalem would be deserted but it's not. You can terrorize a people for some time but you cannot terrorize a whole nation for a long time."
Dr. Jasanoff said that American officials might also benefit from the experience of the British government in dealing with mad cow disease, a crisis that shared certain parallels with the current anthrax threat.
Dr. Jasanoff, who made a case study of the British experience, said government officials early offered categorical reassurances about the disease that turned out to be without basis.
In one case, a cabinet minister publicly fed a hamburger to his child, in an effort to demonstrate that there was no danger. The incident later became a favorite of cartoonists, who used it as a metaphor for the force-feeding of information to the public.
Ultimately, Dr. Jasanoff said, it was a nongovernment British group, the Consumers' Association, that provided people with specific precautions they could take depending on their tolerance for risk. Those who wanted to avoid risk altogether, for example, might stop eating beef. People who wished to be cautious but were less fearful might stay away from ground beef, the form most likely to contain infectious particles.
"They understood the psychology of where the consumers were coming from a lot better than the public health officials," Dr. Jasanoff said.
The next weeks will offer the authorities in the United States the chance to recover their bearings.
"We are in a new situation," said Dr. Baruch Fischhoff, a professor of social and decision sciences at Carnegie Mellon. "People are trying to figure out what's going on and they need to be able to build up a coherent mental model of how big the risks are, so that they can decide what to do."
The events of the last weeks, said Dr. Arthur Kleinman, a professor of anthropology and psychiatry at Harvard, have posed "a fundamental emotional, intellectual and moral challenge" to a country unused to vulnerability.
No one yet knows, Dr. Kleinman said, exactly how the anthrax attacks fit with any larger terrorist scheme. Nor is it clear if they are prelude or final act.
"It would be foolhardy to hide this uncertainty from people," he said. "It's very early to be able to come to any conclusions."
http://www.nytimes.com/2001/10/23/he...5d310afb6f3f4f
Copyright 2001 The New York Times Company
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