Fear This

Your typical government-sponsored publication is rather bland, designed to foster the calming sensation that your tax dollars are working hard to keep you safe, to keep your loved ones healthy, and to ensure your safety and civil rights.

The Terrorism and Other Public Health Emergencies reference guide is not your typical government-sponsored publication, though. Starting with the cover, the guide is blunt and alarming, and perhaps the first publication of its kind that seems to acknowledge—albeit indirectly—that we live in a world that our government does not have control over.

The introduction to the guide notes that it is a tool to help journalists understand how the government and public-health officials are "planning for the unthinkable." It addresses the biological, chemical, and nuclear tools most likely to be employed in terrorism attacks on the United States, the emotional impact on the public should such attacks happen, and specific details on how different attack agents threaten human health. Want to know how quickly food-borne botulism will cause paralysis? It's in the guide. The mortality rate for pneumonic plague? It's in there, too. How viral encephalitis or ricin toxin can infect humans? It's in there.

Though making such information available to the public seems antithetical to what the Bush administration is about (keeping the public in line with its agendas and assuring citizens that it has everything under control), Marc Wolfson, spokesman for the U.S. Department of Health and Human Services, says the goal of the guide is to arm the media—and, indirectly, the public—with accurate information, including worst-case scenarios, when a terrorist threat occurs.

"In small markets, whenever a general assignment reporter gets the assignment to go cover [terrorism], they don't know what it is," Wolfson says. "They don't know what anthrax is, they don't know how it's spread. . . . Go back to the initial anthrax letter story, back in the fall of 2001 there was a lot of confusion, part of it was that we'd never dealt with a situation like that before. Not only the press, but everybody. It was sort of a wake-up call."

As part of its bioterrorism-preparedness appropriations package, Wolfson says, Congress gave Health and Human Services money to create the guide. It cost "several hundred thousand dollars" to print 60,000 copies of the guide, Wolfson says, and so far 26,000 have been distributed to the media, journalism schools, and public-health agencies.

The guide acknowledges that there are "some things that people need to know that are not easy for them to hear: that people are dying, that the risks are not really understood, that it is not known when an emergency will be over, and that decisions have to be made with imperfect information."

That's a far cry from the information that's been available for the public from, say, the U.S. Department of Homeland Security's Be Ready campaign, which offers brochures and maintains a web site (www.ready.gov) featuring smiling children, families, and business executives. The campaign carries the message "don't be afraid" and offers simplified advice in the case of emergencies (get an emergency supply kit, make a plan, be informed).

Why this seemingly sudden change in tactic in dealing with terrorist threats to the public? Wolfson says it's simply about disseminating smart, accurate, unsensationalized information through the right sources.

But an essay contained in Terrorism and Other Public Health Emergencies, written by risk-communication consultant Peter Sandman, offers a more elaborate, if somewhat disturbing, answer:

"The public can usually tolerate its own fear fairly well, especially if there are things people can do to protect themselves," he notes. "Fear is not a problem in a crisis. It is part of the solution."

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