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House Science Committee Holds Hearing on Flu Preparedness, Fischhoff Testifies
By Clare Porac
On December 14, the House Committee on Science sponsored a briefing on "Gaps in the National Flu Preparedness Plan: Social Science Planning and Response." The briefing was moderated by Representative Brian Baird (D-WA), a member of the Science Committee and a psychologist. Rep. Baird introduced the three principal speakers all of whom spoke to the theme of the briefing -- that the national strategy dealing with pandemic influenza has serious deficiencies when it comes to addressing the social dimensions of a possible pandemic.
Clete DiGiovanni, Chief Scientist, Defense Threat Reduction Agency (DTRA) spoke first and briefly discussed the history and occurrence of past flu pandemics and the effectiveness of various public health initiatives, such as quarantines, in dealing with these previous outbreaks. DiGiovanni then turned the floor over to two social scientists, Baruch Fischhoff, Center for Risk Perception and Communication, Carnegie Mellon University, and Monica Schoch-Spana, Center for BioSecurity, University of Pittsburgh. Fischhoff is a psychologist and Schoch-Spana is an anthropologist.
Fischhoff emphasized that social scientists have been studying human responses to risk since WWII, so there is a large body of research in this area. From this research, he extracted some basic patterns of behavior that can be expected to occur in the face of a pandemic flu or any such widespread risk. For example, the general public wants to hear the truth about the risk from government and other officials, even if the truth causes worry. Also, people can absorb only limited amounts of information at a time, so communications to the public must deal with only the critical facts in an organized fashion. Fischhoff argued that four types of experts are needed to design and evaluate communications involving risk factors. These experts are: 1.) subject matter specialists, such as public health officials; 2.) risk and decision analyists who can identify the different types of messages needed to communicate with different subgroups of the public, such as the elderly; 3.) psychologists who can identify belief systems and, thus, design appropriate messages; and, finally, 4.) communication specialists who can ensure that the messages get disseminated properly and in a coordinated fashion.
Schoch-Spana's remarks centered on the issue of whether or not the current DHHS plan embodies realistic expectations about the public's response to a flu pandemic. She argued that authorities often mistake reasonable reactions to a threat, such as repeated phone calls requesting disease-related information, as unreasonable panic reactions. Authorities should not try to fix the public but rather they should concentrate on streamlining production and distribution of information and treatment for the disease. Schoch-Spana also pointed out that the current DHHS plan talks in terms of individual action and seems to ignore the importance of coordinated community reaction to a threat that organizes itself around neighborhoods, communities of faith, social clubs and places of employment. She also took issue with the assumption that an individual's preparedness for a threat and one's compliance with instructions designed to alleviate the threat are based on personal choice. She emphasized that life circumstances, such as poverty and the need to continue to go to work, may interfere with an individual's ability to comply with flu preparedness instructions and/or quarantine restrictions if the latter are deemed to be necessary by authorities.