ABSTRACT
In the throes of national agony brought on by the September 11, 2001 terrorist attacks against the United States, letters contaminated with anthrax, a deadly infectious agent, were purposely sent through the U.S. mail. The juxtaposition of two profoundly tragic and unprecedented events stirred anxiety at every level of society.1 Inasmuch as the incidents, from the onset, were recognized as both criminal acts and public health threats, the official response to the anthrax events brought together the diverse cultures of law enforcement and public health. As the response unfolded, heightened tension between these contrary disciplines was predicable. Criminal investigators, on the one hand, followed their usual deductive approach, carefully accruing and guarding information in the interest of crime-solving; while on the other hand, public health officials were drawn to their standard inductive process of investigation, based on developing and testing hypotheses that could withstand the scrutiny of peers. While, ordinarily, scientific practice is not threatened and may actually benefit from open disclosure in the interest of timely notice of potential hazards, criminal investigators consider how premature release of information could aid suspects in evading capture or conviction. The anthrax attacks brought these cultural distinctions to the forefront and, ultimately, provided insight for capitalizing on the strengths of both disciplines. With a modern precedent now established for using biological agents as weapons, both clinical and public health professionals have been fully drawn into the realm of terrorism preparedness and response. The tragic events of 2001 underscored the need for greater familiarity – of both personalities and procedures – among leaders in these fields; and the resulting mutual appreciation of the core missions they represent has reduced cultural tensions in favor of willing collaboration.2,3 At the same time the anthrax tragedies revealed the importance of sound relationships among relevant but diverse government departments, the attacks also underscored the value of effective communication with the public and its selfappointed advocate, the news media. A new administration, still getting its sea legs before September 11 (and as shell-shocked as the rest of the country over those attacks), initially exercised tighter-than-usual controls over the release of official information. However well intentioned the policy may have been, the
results played out badly in the national media and among its readers, viewers, and listeners. The technical complexities surrounding the anthrax events required expert spokespeople. Yet in the early going, political leaders held sway, infusing an already tense period with inaccurate, contradictory, and misleading information. In the anxious weeks after September 11 (and just days before the first anthrax letter was confirmed), then Secretary of Health Tommy Thompson appeared on the CBS News magazine Sixty Minutes where he unwittingly violated two risk-communication admonitions against over-assurance and unbridled speculation. Considering the possibility of a biological attack, he said:
We have to make sure that people understand that they’re safe, and that we’re prepared to take care of any contingency, any consequence that develops for any kind of bioterrorism attack . . . [A biological attack in the U.S. is] possible, but quite doubtful. It’s not very effective in regards to the dissemination. If it’s anthrax, it’d have to be some way through the air, and if you’re going to put it through one of these crop-dusting planes that has been on the news lately, a lot of it is going to be dissipated throughout the air and the atmosphere.4
