Yesterday's Fears Fade As We Adapt To Tomorrow's

By Joel Garreau
Washington Post Staff Writer
Saturday, August 2, 2008

We move on.

Only a year after planes exploded into the World Trade Center and the Pentagon in 2001, followed by the first major bioterrorist incident in American history, featuring anthrax, the Beltway snipers convulsed the region. People worried less about opening their mail and more about crouching behind their cars while filling their gas tanks.

Only weeks after 9/11 and the anthrax attacks, an American Airlines plane taking off from New York's Kennedy Airport crashed into a residential neighborhood of Queens. When it turned out to be "only" an accident, then-Mayor Rudolph W. Giuliani responded with palpable relief to the death of 260 on board and five on the ground, saying, "It could have been far worse."

Since then we have faced the possibility of a SARS epidemic that could have killed millions and a global avian flu pandemic that could do worse, not to mention the loss of much of an American city, New Orleans, in the aftermath of Hurricane Katrina.

Now Iran test-fires missiles while the world confronts the possibility of it creating an atomic bomb and having the will to use it.

This raises questions about how we adapt to risk and terror, both short term and long. How did we adapt back then? And how have we adapted now, seven years later, as anthrax memories surface with the suicide of an Army scientist being investigated by the FBI for the deaths?

It may be hard to remember the anxiety the anthrax attacks caused in 2001 and 2002. The run on supplies of Cipro, the antibiotic treatment for anthrax. The rush to buy duct tape and plastic sheeting to seal windows. The latex gloves in mail rooms under negative pressure. The little survival packs some corporations gave their employees. The debate over which gas mask you needed.

Our estimates of the probability of risk drop rapidly, says Baruch Fischhoff, the Carnegie Mellon psychologist who is a former president of the Society for Risk Analysis and the author of "Acceptable Risk."

At the peak of the crisis, he asked some 900 respondents what they thought the probability was of them taking antibiotics for anthrax in the next year. Five percent thought they would. He then went back to them a year later to test their memory. Only 1 percent thought they had once said that they would be taking antibiotics for anthrax. And none thought that their original response had been realistic.

Originally, "people were legitimately anxious. They really didn't know what the scope of the problem was," Fischhoff says. "They responded the way they usually do -- responsibly, bravely and somewhat nervously.

"A year later, the problem looked officially small. They couldn't remember how worried they were a year earlier. They had learned so much, they couldn't remember how it looked different."

Well, some of them. In 2005, Stephen Flynn, a terrorism expert at the Council on Foreign Relations, told The Washington Post's Sally Quinn: "The next attack is more likely to be catastrophic." He believed dirty bombs and assaults on chemical facilities near large population centers and on the food supply would be the next likely strikes by terrorists steadily gaining strength since 9/11.

"I've got my bottled water, a generator, canned goods, a radio and flashlight and two numbers to call," he said.

"Here's what you need," Quinn wrote in that 2005 opinion piece. "Water and food for at least a week. A radio and a flashlight with batteries. Contact numbers for the family, emergency routes and a full tank of gas (if you can afford it). First-aid kit, backpacks with medicine, the antibiotics Cipro and doxycycline (don't tell us to wait and get a prescription from the doctor after the anthrax attack. The doctor won't be in, and the drugstores will be closed). And yes, plastic sheeting and duct tape. An N95 mask, which sells for a few dollars at most drugstores, could save your life."

By and large, however, "the human animal cares what threatens it today, not what might have threatened it in the past," says David Ropeik, former director of risk communication at the Harvard Center for Risk Analysis. "Survival is a progressive, not retrospective issue. What could have happened to me seven years ago doesn't worry me. What worries me is about today and tomorrow."

Today, "seeing white powder on the counter at Dunkin' Donuts won't freak you out. Going past the duct tape at Home Depot -- the alarm bell is not readily ringable."

The anthrax case was particularly alarming because of when it happened. "On the heels of terrible plane crash attacks, the fear of terrorism was coursing through our veins," Ropeik says. "It was scarier than if it had happened in isolation, which would still have been scary enough."

The fear was exacerbated by government response.

"Communication was handled pretty sloppily," Fischhoff notes. "It wasn't clear whether people were being told the truth. There appeared to be a double standard -- a privileged status for some groups. People wondered, 'Am I a postal worker or a senator?' " The lack of credibility surrounding the later color-coded warnings hardly helped.

Stocking up on duct tape and plastic sheets, however, did serve a purpose, Ropeik says. "People coming out of the store would say: 'It makes me feel safer. At least it's something I can do.' " Feeling that you can exert some control over a dangerous situation matters to humans. It's why we fear plane crashes more than car crashes, despite all the statistics showing automobiles to be vastly more dangerous. No matter. We know we're not driving the plane.

"The word 'rational' is the wrong word to use," Ropeik says. "If you're worried about an anthrax attack, that worry is represented as a stress response in you, the physical human being. The stress is the same thing as a gun to your head or a lion attacking. Biochemically, it fires the fight-or-flight response. If you're worried about survival, it turns up the systems you need," from increased heart rate to increased blood sugar, to more acute eyesight to faster muscle twitch.

But staying at battle stations is bad. "If that stress lasts more than a few hours, it weakens our immune system, damages our heart, impairs our memory and our fertility, and increases the likelihood of clinical depression and adult-onset diabetes," Ropeik says. "Policymakers need to understand, rational or irrational doesn't matter. Stress is really bad for people's physical health."

In the six months after 9/11, according to studies at the University of Michigan and Cornell cited by Ropeik, "roughly 1,500 more people were killed in motor vehicle crashes than expected in that time period." One possible explanation was that these were indirect deaths from the terrorist attacks caused by people switching from planes to cars. "Should the government say they were being stupid? No, that's just how people are. The argument about whether it was right or wrong is just irrelevant. It's how human animals respond to risk."

This might explain why, even though the lack of terrorist attacks in North America might be viewed as a justification for a soaring homeland-security budget, public approval of the "war on terror" has dropped.

"The human animal is taking continuous soundings against evidence in the real world, maintaining stress to the extent it is needed to survive," Ropeik says. "We adjust to the 'new normal.' We get used to all kinds of stress in our lives."

If you spend all your time worried about "nanotechnology, genetically modified food, plastic bottles and radon from marble countertops -- these constant little threats that arrive -- if they are perceived as high risk, it's going to take a toll on folks."

Which is not to dismiss anthrax. It is particularly suited to inducing dread, says Paul Slovic, who studies the psychology of risk at the University of Oregon and is the author of "The Perception of Risk."

"People don't know exactly what it is. It's not very visible. It's linked to someone who's propagating this threat with the intent to harm people who are innocent of any wrongdoing, just being malicious -- that's frightening. You don't know who's doing it. What's the extent of this? Is this something that's going to be limited in one small geographic region? It's quite unique. We've done some studies within terrorism. The potential to frighten from anthrax is even higher than that of terrorism with explosive devices, not that that's low. Anthrax was even higher.

"After so many years, we can think calmly about it. But if something was spotted in a letter somewhere, it would spring to life very quickly."

Staff researcher Magda Jean-Louis contributed to this report.

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