We also need to go beyond the news media in terms of developing communication plans that allow our messages greater visibility, scope, and frequency of delivery to the public (Glass and Schoch-Spana, 2002). To do so will be costly because broad coverage means getting the message across in the vast numbers of existing mass media outlets.

Finally, ensuring the effectiveness of public communication during an influenza pandemic will require a greater understanding and use of risk communication principles (Sandman, 1993). Health officials will need to learn how to share the dilemmas they face with the public in a productive and effective fashion. We are going to have to acknowledge uncertainty and gaps in scientific knowledge. When faced with the necessity of setting priorities for who will receive limited amounts of vaccine, we must be ready to provide effective coping strategies and advice to those who must wait their turn.


Monica Schoch-Spana, PhD

Center for Biosecurity

University of Pittsburgh Medical Center

“How will the public react to a biological attack?” is a fundamental question underpinning U.S. policy and practice in the realm of terrorism preparedness and response. Over the past 6 years, widely divergent approaches to the issue of mass responses to bioterrorism have emerged.6 When catastrophic terrorism was a serious but postulated danger, officials frequently conceived public reactions to a biological event as part and parcel of the crisis to be contained: for example, the “worried well” who would pour into hospitals, hindering health care workers’ ability to treat “real” victims. The complex realities of September 11, 2001, and the anthrax letter attacks have helped refine many authorities’ understanding of the public not simply as a problem to be managed, but a constituency to be served—anxious people who need good information about the danger and what to do about it. This essay advances a third approach, encouraging authorities to place current commitments to improving public communication within a broader understanding of the governance dilemmas that bioterrorism and other health emergencies pose.


Comments pertain to the U.S. context, though they may also have relevance elsewhere. I write from my vantage point as someone who has worked for the past 6 years with a multidisciplinary group committed to preventing the development and use of biological weapons and to advancing an adequate medical and public health response should prevention fail.

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