Terror response study spurs concern
Many Americans would disobey
WASHINGTON -- Large numbers of Americans say they would probably ignore official instructions for how to respond to a terrorist attack involving a radiological dirty bomb or a smallpox attack, according to a new study.
Most public health plans created in the three years since the Sept. 11, 2001, attacks assume that the public would obey instructions to, for example, stay inside whatever shelter they are in during an airborne contamination attack or report to a central place to receive a vaccination shot during a disease outbreak.
But the first major survey of likely public behavior in the event of a terrorist attack calls into question that assumption, citing conflicting obligations such as responsibilities to family members and a distrust of official pronouncements. If planners do not adjust to that reality, there could be unnecessary deaths, the study said.
The study, conducted by the New York Academy of Medicine and the Center for the Advancement of Collaborative Strategies in Health, found that 60 percent of Americans would disregard instructions to go to a public vaccination site in a smallpox outbreak, and 40 percent would not stay inside an undamaged building other than their home after a dirty bomb went off.
''It's not that the rest of the people want to be uncooperative," said lead investigator Roz Lasker. ''The problem is that current plans unwittingly put them in extremely difficult decision-making predicaments. So even if first-responders work out all of the challenging logistics, far fewer people would be protected than planners want or the public deserves."
For example, parents may disregard personal danger and go out in the open to find and protect their children, even if they are told to stay inside until a radioactive or toxic cloud dissipates, she said.
And people may refuse to get smallpox shots in the event of an outbreak because they fear mingling with crowds at the gathering sites, are suspicious about the vaccine, or don't want to endanger family members with medical conditions that would make it dangerous to come in close contact with a recently vaccinated person.
Based on its survey of 2,545 randomly selected adults throughout the United States, Lasker made a series of suggestions for improving existing plans by rethinking how scenarios would play out through the eyes of a member of the public.
Those included getting trusted local community leaders involved in preparing for an attack and taking greater steps to ensure that people can always communicate with relatives.
The group also suggested screening people who may not be able to take a smallpox vaccine because of health conditions, such as those with AIDS or certain cancer treatments, ahead of time so they do not go to public vaccination sites.
The problem of distrust of official instructions was particularly acute among African-Americans, who make up a large percentage of the population in major urban areas likely to be targeted or affected by a terrorist attack, the study found.
About 68 percent of blacks expressed grave concerns about whether they would agree to receive a smallpox vaccine during an outbreak once they learned they would have to sign a waiver notifying them that the vaccine is considered ''investigative," or not fully tested. By comparison, 48 percent of the general population expressed concerns.
David Bositis, a specialist in African-American politics who worked on the project, said emergency health officials should reach out to trusted black elected officials and church leaders ahead of time to enlist their support in order to save more lives should an emergency arise. 