1.0 The role and leadership traits of Public Information Officer
In the present scenario, the public information officer is charged with the responsibility to advise the president on the public communication and the expected outcome on the communication. In the advent of the impending bioterrorist attack, the public information officer has to study the recorded video tape and advice the group on whether, how and when to communicate the information therein to the citizen. The aim of such communication would be to seek the citizen’s cooperation in the government’s plan and to prevent mass panic that would undermine the government’s plan while advancing the terrorists’ objectives. In view of this, the public information officer should be decisive and have excellent communication skills. In addition, s/he should be wise enough to come up with strategies for risk communication. The public information officer should not appear to be forceful but consult widely.
2.0 Need to inform citizens about the potential bioterrorist
It is vital to note that the fact that the bioterrorism threat targets the citizens makes the citizens principal stakeholders. As such, failure to inform the citizens of the potential bioterrorist threat would be unethical to say the very least. Risk communication should however be done strategically (in terms of when and how) with an aim not only to inform the public but to turn the public into an ally in whatever actions the government may use to protect the public health. For instance, should the government decide to use ring vaccination and quarantine in the cities targeted by the terrorist, it is impossible to implement the said actions with the public in darkness because the citizens would probably refuse to cooperate/participate. In the wake of a possible terrorist attack, it is necessary to maximize on the citizen’s capacity to be partners in averting and containing a bioterrorist event. This is only possible if the government effectively communicates the risk with the public. The public information officer should therefore come up effective risk communication to help the group implement a rapid, well thought out and coordinated plan in response to the threat and which is a vital component of risk management. It is particularly important to communicate the risk to the citizens because response to bioterrorism threat would most likely require mobilization of large proportions of the population and that requires the citizens to be informed in good time for preparation and the implementation.
In addition, the public could play a vital role in averting the terrorist attack by being vigilant and informing the authorities in case of any suspicious activities. It has been noted that effective risk communication regarding bioterrorism threat would even the completely unconcerned person to be vigilant and watch for signals and signs and alert the authorities. This can easily turn into mass panic but the public information officer should not be overly concerned with how to address the panic. Indeed, it is this very concern to avert mass panic that precipitated in inadequate, inconsistent and late communication in the events leading to the 2001 September 11 terrorist attacks and the subsequent bioterrorist attacks through mail delivery system. This delayed and inconsistent communication led to widespread public confusion which in turn undermined the community, state and federal responses to the threats. In fact, the success of the 9/11 attacks is often blamed on the secrecy surrounding the events leading to the attacks with the different agency failing to share information and the government choosing communicate the risk late in the day. This caused considerable damage on the already fragile government-public relationship, with the public’s trust in the government’s ability to protect her citizens. Therefore, there is need for the public information officer to formulate effective risk communication that would not only restore the lost trust but that would also engage the community as an active ally in managing the public health emergency resulting from possible bioterrorism attack.
3.0 Government’s best course of action
A lot can be learnt from the 9/11 terrorist attacks and the subsequent anthrax attacks on American soil, which can inform the government’s action, plan in the wake of bioterrorism threat. As earlier started, the success of the 9/11 attacks has been attributed to the failure of different state agencies to share information and the delayed and inconsistent communication of the risk to the public. Therefore, information sharing is a key component in the response to the threat and the president has led the way by calling his top personnel to share the information acquired by the CIA. As the investigations are carried out there is need to have constant sharing of information between both government agencies and the public to synchronize the action plan. Sharing of information will facilitate prompt decision making by the head of state and the agencies’ leaders.
There is an acute need to come up with educational and communication programs through the media e.g the radio, newspapers, the internet and the television to make citizens know what they can do to help out. This requires extreme caution and the media must be whipped to cooperate with the government in such a way that the information will not be communicated in an alarming manner but rather in a reassuring way. Effective risk communication helps the citizens to prepare mentally and to keep the updated on the what safety resources are necessary as well as what they can to prevent or defend against bioterrorist attacks. In anticipation of the communication challenges, the government should develop legal and administrative strategies that allow stationing of public health personnel with communication mandate at different hospitals. The personnel should have the same information to avoid inconsistencies and be trained in mass psychology to help the communities not to panic.
Another course of action is to prepare the healthcare facilities in readiness to treat and quarantine victims. The healthcare designated healthcare personnel must be vaccinated and trained on how to act in case of a large-scale emergency. The hospitals and other healthcare facilities must be given adequate resources beforehand. The resources include employing more healthcare personnel (the government could temporarily recall retired personnel), monetary resources and availing the necessary vaccinations and medications to combat small pox and anthrax infections. As can be seen from the intercepted video it is clear that the terrorists aim at paralyzing the healthcare system and thus it is necessary for the government to revamp the healthcare facilities. The necessary vaccines (particularly for smallpox, which was eradicated) and drugs need to be moved from the national reserves to the local hospitals. There is also need for the government to facilitate the production of more vaccines particularly because the current estimates of the smallpox vaccines in the CDC reserves is 5-7 million and because they have been stored for a very long time their viability is not guarantee . As such, the government needs to assess the viability of the stored vaccines and instruct the CDC and pharmaceutical companies to produce more vaccines.
With regard to healthcare, the government needs to prepare for mass quarantine in case of an attack. This requires the cooperation of the citizens and the healthcare providers and thus the need for effective risk communication. To enhance smooth mass quarantine the government needs to put in place an effective disease surveillance system that will facilitate early detection of smallpox and anthrax, reporting incidences of the diseases and monitoring of the spread of the disease. For the surveillance to be effective, the populace must be educated on the early signs of the infections and the need to visit health facilities as soon as the symptoms appear. Lastly, on healthcare the government needs to come up with enabling legal framework that would allow citizens to be the first responders eg. for anthrax citizens should be able to buy prophylaxis antibiotics such as Doxycycline prescribed for bioterror preparedness. This would in turn the holdups in the distribution of antibiotics. Allowing the citizens to voluntary access the necessary prophylaxis drugs and vaccines would reduce delays and panic as this puts the responsibility of personal prevention and protection on the citizens rather than on the government.
The most obvious course of action is to carry out further investigation to establish the targeted stadiums and subways. It would also be vital for the government to investigate the workers of the target stadiums and subways and identify those colluding with the terrorists. Another important course of action would be to suspend NFL games just before the season starts. This would catch the terrorists unawares and in a bid to change the plan or escape they would make a mistake and be caught.
4.0 Issues relating to relating to the use of smallpox and anthrax as weapons
4.1 Historical background on smallpox and anthrax in biological warfare
The use of biological weapons is well documented with rudimentary forms such throwing fungus in the enemies wells, use of venomous snakes , throwing infected animal carcasses and even throwing cadavers of humans who have died of plague in the enemy territories. Table 1 below summarizes the history of smallpox and anthrax as biological weapons
Table1: History of smallpox and anthrax as biological weapons
4.2 Mode of infection, person-to-person transmission, viability and environmental consideration
Anthrax is caused by Bacillus anthracis, which can be transmitted through ingestion, inoculation and inhalation by the victim. The bacterium causes three distinct forms of the disease i.e. gastrointestinal, cutaneous and inhalational. B. anthracis has an incubation period of 1-6 days and causes anthrax through the release of two toxins (lethal factor and edema factor). The inhalation of B.anthrancis is often fatal because it is often detected in the late stage of the disease that is associated with severe respiratory distress. However, early stages of anthrax can be treated with antibiotics such as ciprofloxacin or doxycycline. Anthrax is not considered contagious because person-to-person transmission is poor. On the other hand, smallpox is caused by variola virus and has an incubation period of 7-17 days. Unlike anthrax, smallpox is highly contagious and lead to up to 40% fatalities. At the early stages, smallpox can easily be confused for chicken pox and thus can easily spread before it is correctly diagnosed. These characteristics of the two pathogens make a chimera of the two highly effective as a biological weapon. In addition, there are other factors make the chimera very viable.
Several factors define the viability and effectiveness of a pathogen as a bioweapon. The pathogen must be highly lethal and easy to produce in large quantities, easy to disperse through aerosol route, stable in the environment, difficult to diagnose at an early stage, having not treatment (or difficult to treat) and vaccine and communicable from person to person. Based on these attributes, smallpox and anthrax are considered to have the greatest potential of causing civil disruption and mass casualty. If no treated early, anthrax can lead to mortality rate of 80-100%. Smallpox can cause high morbidity and a mortality of 30-40% in an unvaccinated population. Unfortunately, a high percent of the American (and the world at large) population is not vaccinated against smallpox because the vaccination program was stopped about 3 decades ago when WHO declared the disease eradicated. In addition, early diagnosis of smallpox is difficult because the disease has not been seen in a very long time. On the other hand, the anthrax vaccine has been known to cause unacceptable adverse effects in most people and thus considered unsafe for civilian use. Both agents have been produced in large quantities and can easily be dispersed through aerosol route, they are both difficult to detect early and treat at early disease stage and are stable in for decades. In addition, experts have categorized smallpox and anthrax in group A which includes agents with the potential for large-scale dissemination and can cause mass casualty.The effectiveness of biological, particularly where the route of dispersal is aerosol, depends on environmental factors. Biological weapons are very effective in a windy place because they spread faster. However, it is important to state that both anthrax and smallpox are very stable in all environments.
4.3 Children education
Children are also targets of bioterrorists and thus need to be educated and wisely made aware of the pending threat. Parents and educators should make their children aware of the bioterrorist threat. They should require their children to be extra careful and to watch out for people with symptoms of both anthrax and smallpox, having first educated the children on the symptoms of the two infections. In addition, children should be allowed to watch the news shows to get informed. Obviously when dealing with the children, the age of the children is a vital factor in determining what information should be availed to them. To very young children to much information may be harmful rather than helpful and thus the watching of news by this group should be limited. To that extent, during this event the government and the media should work together to filter the news.
4.4 Prevention before the attack occurs and treatment
The attack may be prevented with extra vigilance on both the public and investigating agencies. The investigating agencies should work towards identify the particular stadiums and subways targeted by the terrorists as well as the dates of the attack. Once targets have been identified, the investigators should move with speed to investigate the employees who could have ties with the terrorists. The government should also close the target stadium and subways unexpectedly at the time the terrorists plan to attack. The other thing that the investigators should work in is finding the actual location of biological weapon. In addition to the actual location of the weapons, the investigators should try and find the suppliers of the biological weapons. The suppliers and the implicated employees of the target stadiums and the subways could lead to the terrorists’ leadership and financiers.
With regard to treatment, anthrax and smallpox can only be effectively treated using during the early stages of the diseases but when the diseases move to late stage it is not possible to treat them. Passive immunization with protective antibody has been suggested as a means of providing immediate immunization. Monoclonal antibodies could be designed to target anthrax and smallpox which would arrest the disease before they get to the advanced stage. Through research it is possible to develop drugs that would target the late stages of the disease but this would be difficult and take very long to make and have approved. The difficulties would be confounded by the fact that these diseases, and particularly smallpox, are not common.
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