TUESDAY, Sept. 14, 2004 (HealthDayNews) -- If a smallpox outbreak were to be declared today in the United States, just two in every five Americans would heed official instructions to head to a public vaccination site for immunization against the killer disease, a new study finds.
And in the event of a "dirty bomb" attack, just three-fifths of citizens would stay put in an undamaged building, as current guidelines recommend.
The bottom line, according to experts, is that current local, state and federal government emergency-preparedness responses may be doomed to failure should events like these occur.
"Officials are basing their plans on their assumptions of what the public cares about, and how the public might behave. But what our study shows is that those assumptions -- which are best guesses -- are just not right," said Dr. Roz Lasker, director of the Center for the Advancement of Collaborative Strategies in Health, part of the New York Academy of Medicine.
The Academy released its report, Redefining Readiness: Terrorism Through the Eyes of the Public, at a press conference held in Washington on Tuesday.
The attacks of Sept. 11, 2001, a spate of anthrax-laced letters soon after, and ongoing fears that terrorists might use biological or chemical weapons against an unsuspecting populace have led governments to put together emergency-preparedness plans.
But just how effective would these plans be in real-world situations? To find out, Lasker and her colleagues first conducted in-depth talks with public- and private-sector planners. Then, using a mix of discussion groups and a phone survey of more than 2,500 U.S. adults, they tested out the public's response to current plans aimed at minimizing the threat of two hypothetical terror events: a smallpox outbreak and the detonation of a radioactive dirty bomb.
In the smallpox scenario, current protocol advises citizens to head immediately to a vaccination center for immunization against the highly communicable disease.
"However, we found that twice as many people are seriously worried about the vaccine than are worried about catching smallpox if an outbreak occurred," Lasker said. Two-thirds of those interviewed also said they would simply be afraid of co-mingling with so many strangers for fear of infection.
Overall, three out of five adults surveyed said they might not follow instructions to head to a vaccination site.
Lasker said concerns about the vaccine are "well-founded," since it's estimated that nearly 50 million people are at risk for complications from the vaccine, including people with HIV or eczema, pregnant women, or very young children.
But under the current plan, Lasker said, "individuals would only find out if they had any of those contraindications at the site of vaccination, at which point they might have already been exposed to people with smallpox -- and then they can't get the vaccine."
But there are ways to quell these fears and still make sure the maximum amount of citizens get vaccinated, Lasker said.
"We're calling for strategies that would enable everyone in the country to know their risk status for the vaccine beforehand," she said.
In the case of a dirty bomb attack, government planners again got it wrong when it came to public attitudes toward such an event, Lasker said.
Current guidelines recommend that those in areas threatened by a dirty bomb explosion stay inside an undamaged building.
"But these attacks are most likely to happen during the day, when parents are at work and children are at school," Lasker pointed out. In that type of scenario, two out of every five adults surveyed said they'd be unwilling to stay put if they felt uncertain of the whereabouts and safety of loved ones.
"The trouble is that [under current plans] people don't know that now. And a lot of that is due to the fact that safe-haven plans haven't even been made," Lasker said. "That's important for other situations -- such as happened with the blackouts last summer in New York City and the East Coast."
To help people stay calm and well-informed during such an attack, Lasker advocates setting up and safe havens far in advance and promoting them in public places. Plans like these would also include important contingencies, such as ensuring proper stocks of food and clear communication with other centers.
But how much will all this cost?
"The bottom line is that, with all of the money we're spending now --- the logistics, technology, response teams -- these plans still aren't going to work," Lasker said. "So in a sense, that's money down the drain."
For a look at the full report, go to the New York Academy of Medicine.