 | Why do bioattacks present special challenges and high-stakes decisions for leaders? |
A deliberate epidemic poses compounded, unfamiliar dangers in today's setting. Most elected U.S. officials, health authorities, and the public have no direct experience with large outbreaks, nor do they know the best ways to control them. Even less familiar is the premeditated use of disease as a weapon.
Epidemics are complicated events due to their biology, but also because they provoke fear, contradictory impulses, and competing social aims:
- An epidemic's outcomes—suffering, death, lost livelihood and commerce—are troubling to consider. Leaders and the public may deny that a problem exists, or intervene too quickly without regard to the negative effects of their actions.
Case studies:
2003, Fearing SARS, New Yorkers Avoid Chinatown
1976, Swine Flu Vaccination Campaign Too Much, Too Soon
1918, Spanish Influenza Grips the Globe - People need to make sense of random and terrifying events, but epidemics elude quick and easy explanation. The nature of a disease, a population's vitality, and the responsiveness of health institutions affect how an epidemic unfolds.
Case studies:
2003, Information about SARS Elusive
2001, Anthrax Evades Easy Answers A mysterious disease can trigger the human reflex to isolate oneself and blame others for the tragedy or, in deep contrast, to care for victims without regard to one's own safety.
Case studies:
2003, SARS Victims Shunned Globally
2003, Fearing SARS, People Avoid Chinese-Americans
2001, Muslim Americans Face Hate Crimes in Wake of September 11
Features of modern society can speed up and disperse an epidemic's negative impact and make some people more vulnerable than others:
- Global media and around-the-clock news reports cause anxiety and dread in people, even those who are in places far from immediate danger.
Case studies:
2003, New Yorkers Perceive SARS To Be Local Outbreak
2001, Far from Anthrax Attacks, People Anxious - Today's transportation systems move people quickly across vast distances, potentially accelerating the spread of disease.
Case study: 2003, SARS Spread Facilitated by Global Travel
- Epidemics have broad, indirect financial impacts due to close ties among global, national, and local economies.
Case studies:
2001, The High Costs of the Anthrax Attacks
2001, Economic Repercussions of Foot and Mouth Disease
1986, Mad Cow Disease Devastates British Beef Industry - Poverty, lack of health insurance, and distrust of the healthcare system mean that those who are most vulnerable during disease outbreaks are least able to protect themselves.
Case studies:
Social and Economic Disparities Influence Public Responses to Bioattacks
1995, Chicago Heat Wave Singles Out the Poor and the Isolated - Personnel shortages and lean budgets limit the emergency response capabilities of U.S. hospitals and state and local public health agencies; they are spread thin on a "normal" day.
Case study: Hospitals Unprepared for Epidemic Control
A calculated attack further magnifies the consequences of an epidemic:
- An attacker's motivations and tactics—for example, attacks on multiple cities, over a prolonged period, or on random victims—heighten an epidemic's uncertainties.
Case study: 2001, Anthrax Evades Easy Answers
- Scapegoating will be more severe in the case of bioterrorism than in natural outbreaks as people demand to know, "Who did this?!"
Case studies:
Blaming "Outsiders" for Causing Disease
2001, Letters Laced with Anthrax - If a disease is weaponized or infects people through an unusual route (such as the mail), it may be harder to detect and treat. What is known about natural outbreaks of the same disease may not apply.
Case studies:
2001, Anthrax Letters Give New Meaning to "Handle with Care"
2001, Treatment Protocols for Anthrax Revised in Wake of Letter Attacks - The wide range of scenarios—scares, discrete non-lethal attacks, a campaign of mass casualty attacks—makes planning for every contingency impossible.
Case study: Laundry List for Bioterrorism Response Planners