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How genuine is the risk?

By Gareth Cook, Globe Staff, 11/4/2001

   
 KEEPING SAFE

Articles:
How genuine is the risk?
Taking practical steps
Staying safe on the job
Handling new kind of stress
Talking with children
Is it just the flu?
What to do when in doubt
Hospital readiness
How the body fights back
Are there other threats?
Not all terror threats equal

Graphics:
How to talk to your kids
5 signs you need help
What works, what doesn't
How anthrax is diagnosed
Inside a bacterial invasion
In case of emergency...
Identifying a mail threat
Safety resources

Compare cold & flu to other bioterror threats:
Cold & Flu
Anthrax
Botulism
Hemorrhagic Fever
Plague
Smallpox
Tularemia

Return to front
More anthrax coverage

Most likely, you are already a victim.

Perhaps the first symptom - fatigue, a heaviness in the chest? - appeared early, in the days after a Florida photo editor was overcome by anthrax. Or maybe the first symptom appeared more recently, as postal workers who were told not to worry became ill and died.

But by last week, when a New York woman far from the danger zones fell to anthrax and the FBI asked everyone to be yet more alert, most Americans were experiencing the symptoms of an epidemic: fear.

The most powerful antidote to fear is information, but the central questions of the moment are tough ones. How safe am I? How safe is my family? To answer them means drawing on specialists in fields as far apart as microbiology, paper manufacturing, and international terrorism. Yet, say analysts, answering them also means drawing on our experience as a nation, looking to other episodes - such as the school shootings in Littleton, Colo., or the nuclear missiles in Cuba - when the world, for a time, seemed irrevocably changed and impossibly dangerous.

''Any time a new vista in risk opens up, it is so fresh and so unsettling that it makes us call into question everything we do,'' said John F. Ross, a senior editor at Smithsonian magazine and the author of ''Living Dangerously: Navigating the Risks of Everyday Life.'' ''What is so frightening is that before we didn't even understand that there was a possibility they could happen.''

The news that four people have died from anthrax is scary in the same way that, for example, a foreigner might be terrified to walk Boston's streets after learning that 39 people were killed in the city last year. With time comes context, though, and any given threat seems less and less overwhelming as people come to terms with it.

Yet in the unfolding anthrax scare, Ross said, the public remains stuck in the initial period of shock and confusion, because the facts change daily as investigators uncover more and officials struggle in their attempts to communicate with one another and the public.

Even in times of relative calm, people are not well equipped to understand long odds: The anthrax deaths are tragic, but how is a person to interpret the meaning of four deaths in a population of about 280 million.

And then there is what some psychologists call the dread factor. Some threats resonate with deep-seated fears. Biological weapons are dreadful, silent killers that can strike without warning, turning our bodies against us. When the evening news looks like scenes from the ''X-Files,'' these fears naturally well to the surface.

''There isn't a culture anywhere that doesn't have a fear of invisible spirits that cause sickness,'' said Jeanne Guillemin, who has studied biological weapons extensively and is a senior fellow at the Massachusetts Institute of Technology and a professor of sociology at Boston College.

Through modern medicine, scientists have learned a remarkable amount about what makes us sick. What many people fail to appreciate, doctors say, is that the body is already armed to defend itself against a biological assault because it is attacked every day by viruses and bacteria.

Most organisms in the world simply are not able to get beyond the body's powerful natural defenses. Even with anthrax, for example, the body can fight off the more common skin form of the disease 80 percent of the time, without any help from antibiotics.

To understand what a terrorist might use in a biological attack, analysts have compiled long lists of agents that are dangerous to people. A draft report on bioterrorism by the World Health Organization, for example, lists 44 agents, from Bacillus anthracis to yellow fever, which are dangerous enough to be weapons.

But when specialists go though this frightening list, they cross off many of these would-be killers because they are too difficult to work with or deliver to their targets. The organisms need to be kept alive, and many will simply die outside their natural environment without special care.

Only five diseases - smallpox, anthrax, plague, botulism, and tularemia - are considered by most specialists to be realistic bioweapons. (For more on the full spectrum of potential weapons, from biological to nuclear, see Page 14.)

Yet even these pose problems for terrorists.

Of the five, only smallpox and plague are contagious from person to person. Smallpox is a horrible, untreatable disease, but it has been eradicated; the few remaining samples would be very difficult to obtain, analysts say. Plague is readily treatable with antibiotics and would require special equipment to infect substantial numbers of people.

Anthrax is virtually the only practical biological weapon that doesn't die quickly in the environment - sunlight kills plague - so it has been considered by many analysts the worst-case scenario for noncontagious weapons.

By the conventional standards of weapons makers, the anthrax attack on the United States has been a colossal failure. Even with access to the relatively sophisticated form sent to Senator Tom Daschle's office, the attackers have still claimed far fewer victims than murderers claim every day in this country.

Yet anthrax has also proved to be a remarkably potent weapon of mass disruption. Scientists still don't know exactly how many spores of anthrax it takes to cause disease in a person. This makes it more difficult to declare a building, or the mail, absolutely safe.

But scientists seem quite sure of two things. First, anthrax is a very treatable disease, even more so than they first suspected. (For more on anthrax, and its treatment, see Pages 8 and 12 .) And, second, your odds of dying from a biological attack remain vanishingly small.

Dividing the number of anthrax fatalities by the US population gives a rough idea of the odds of death - about 1 in 70 million.

For comparison, consider a study done by Harvard researchers. The study compiled a list of things that increase the odds of dying by one in a million. All of these are more dangerous than the anthrax attack has been: smoking 1.4 cigarettes, eating 39 tablespoons of peanut butter (food poisoning), and traveling by canoe for six minutes (accident).

It is impossible, of course, to describe the risk of terrorism with any precision because there are so many unknowns. But as officials consider more aggressive ways of countering potential threats, biological or otherwise, psychologists have been warning the public against falling into the shark attack fallacy.

This summer, a few high-profile shark attacks sparked hysteria, even though there were fewer than in previous years. People have a tendency to inflate certain risks, especially ones that are involuntary (a shark attack versus driving a speed boat after downing a six- pack), unseen, and dramatic, psychologists have found.

''Even if you are a postal worker right now, you are still not in any serious risk compared to other things in our lives,'' Ross, of the Smithsonian, said.

Nonetheless, there are practical steps that you can take to protect yourself at home (Pages 3 and 10) and at work (Page 5). There are also ways to calm your children, who have even more trouble putting the danger in context (Page 7).

The aim of terror is to fixate the mind on danger, with fear begetting more fear. Life is dangerous -- we need no reminder of that -- but remember to consider the other odds at play.

What is the risk that anxiety will break up holiday plans with relatives? Or what is the danger that fear will keep you from remembering to savor a bright fall morning, the taste of apple cider, the last brushes of autumn's reds and golds? From these kinds of risks, too numerous to list, how safe will you choose to be?

This story ran on page 2 of the Boston Sunday Globe's Common-sense Guide to Keeping Safe on 11/4/2001.
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