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Home > Our Work > Events Archive > 2003 The Public as an Asset

The Public As an Asset, Not a Problem
A Summit on Leadership during Bioterrorism


On February 3-4, 2003, the Johns Hopkins Center for Civilian Biodefense Strategies [now the Center for Biosecurity of UPMC] convened a summit on engaging "the public" in bioterrorism planning and response. The purpose of this event was to synthesize for government and public health authorities the essential principles of leadership, based on frontline experiences with recent terrorism events and other relevant crises, that encourage the public's constructive collaboration in confronting a bioterrorist attack.

More than 160 people attended representing senior operational decision-makers in public health and safety-including the bioterrorism coordinators from 35 state and local health agencies-as well as thought leaders and policy makers in medicine, public health, nursing, hospital administration, disaster relief, and national security.

Key issues included the following:

  • Moving beyond the prevailing image of a panic-prone public
  • Mobilizing a coordinated, collective response among diverse publics
  • Capitalizing on everyday institutions (e.g., schools, workplaces) to help people cope
  • Learning from leadership challenges during recent terrorizing events

Suggested reading list:

  • Barbera J, Macintyre A, Gostin L, et al. Large-scale quarantine following biological terrorism in the United States: scientific examination, logistic and legal limits, and possible consequences. JAMA. Dec 5, 2001; 286(21): Critically examines the feasibility, efficacy and social acceptability of large-scale quarantine as a measure to control the spread of contagious disease.

  • Covello VT, Peters RG, Wojtecki JG et al. Risk communication, the West Nile virus epidemic and bioterrorism. Journal of Urban Health. June, 2001; 78(2). Reviews risk communication perspectives and models in light of the case of the New York City outbreak of West Nile virus and an hypothesized biological attack.

  • Glass T & Schoch-Spana M. Bioterrorism and the people: how to vaccinate a city against panic. Clinical Infectious Diseases. Jan 15, 2002; 34(2): Outlines guidelines for integrating the public into bioterrorism response planning.

  • Hall MJ, Norwood AE, Ursano RJ et al. Psychological and behavioral impacts of bioterrorism. PTSD Research Quarterly. Fall, 2002;13(4): Review article on psychological consequences of bioterrorism that provides selected abstracts from relevant literature.

  • Inglesby TV, Grossman R & O'Toole T. A plague on your city: observations from TOPOFF. Clinical Infectious Diseases. Feb 1, 2001; (32): Conveys lessons learned from exercise with top government officials to test nation's ability to react to multiple terrorist attacks. Problems related to bioterrorism response included distribution of scare resources, contagious disease within health care facilities, and need for sound disease containment principles.

  • O'Toole T, Mair M, & Inglesby TV. Shining light on Dark Winter. Clinical Infectious Diseases. Apr 1, 2002; 34(7): Offers lessons learned from Dark Winter, a tabletop exercise in which former senior-level government officials simulated National Security Council meetings in reaction to a mock smallpox attack.

  • Schoch-Spana M. Implications of pandemic influenza for bioterrorism response. Clinical Infectious Diseases. Dec 2000; 31(6). Draws upon the 1918 influenza pandemic case to inform public health planning for bioterrorism response; discusses issues of public confidence in epidemic containment measures, fair allocation of resources, and protection against discrimination.

Conference Sponsors

This conference was supported under award #2000-DT-CX-K002 from the Memorial Institute for the Prevention of Terrorism (MIPT) and the Office of Justice Programs, National Institute of Justice, U.S. Department of Justice, and award number 2000-10-7 from The Alfred P. Sloan Foundation. Points of view expressed during the course of this meeting are those of the individual speakers and do not necessarily represent the official position of MIPT, the US Department of Justice, or The Alfred P. Sloan Foundation.

Agenda with Transcripts

Titles link to transcripts

Agenda: February 3, 2003

Agenda: February 4, 2006

Rethinking Preconceptions about Mass Response to Crisis: Is a panicked public, assumed in most bioterrorism planning situations, a myth or reality? Are epidemics like other disasters, or are they different? What do we know about the continuum of psychological and social reactions in the context of trauma and crisis, ranging from mental anguish and social demoralization to more salutary phenomena? How can leaders' decisions and actions exacerbate social tensions, making the public more or less of an asset in crisis?

The Health and Safety of Actual People, Not a Theoretical Public: How should leaders plan for the public health and safety requirements of special populations? How can leaders mobilize a collective, coordinated response to an epidemic when interacting with a socio-economically and ethnically diverse population?

Civil Society as an Asset during a Public Health Emergency: How can leaders make the best use of pre-existing volunteer networks and turn individual volunteers into an asset? How should leaders manage volunteer impulses in the bioterrorism context; is bioterrorism different from other humanitarian situations? How can workplaces, schools, and other everyday institutions be equipped to help populations cope with a crisis?

How to Lead a Community during Times of Trouble: What challenges do leaders face when interacting with the public in the context of grave peril? What communication pitfalls should leaders avoid during a public health emergency? How can an environment of trust and credibility be cultivated so that the public is inclined to act on public health guidance? When and how should leaders seek input from public stakeholders on tough decisions that could arise (e.g., prioritized distribution of scarce medical resources)? How can government decision-makers reach out to civic leaders prior to a crisis and establish alliances for communicating critical information? What challenges do leaders face during the crisis recovery period?

Roundtable discussion among the following panelists: [transcript]

  • Tara O'Toole, MD, MPH, Moderator
  • Georges Benjamin, MD, FACP, Executive Director of the American Public Health Association
  • Edward Clarke, Director of School Safety and Security, Montgomery County Public Schools - Washington DC-area sniper
  • Tom Day, Vice President of Engineering, U.S. Postal Service - 2001 anthrax letter attacks
  • Margaret Hamburg, MD, former Assistant Secretary of Health and Human Services, former New York City Commissioner of Health - 1993 World Trade Center bombing; multi-drug resistant tuberculosis; possible case of plague presenting at Kennedy airport
  • Ronald J. Norick, Mayor, Oklahoma City, 1987 to 1998 - 1995 bombing of the Murrah Federal Building
  • Sally Quinn, Columnist, The Washington Post - 2001 anthrax letter attacks
  • Ivan C.A. Walks, MD, former Chief Health Officer for Washington, DC, and Director, Department of Health - 9/11 Pentagon attack; 2001 anthrax letter attacks
  • Peter Sandman, PhD, Advisor to the New York Department of Health on bioterrorism preparedness and communication


  • Ernie Allen, President and CEO, National Center for Missing and Exploited

  • John Burke, JD, President, Strategic Communications, Inc.

  • Lee Clarke, PhD, Professor of Sociology, Rutgers University

  • John Clizbe, PhD, Interim Executive Director, Triangle Area Chapter, American Red Cross, Raleigh, NC; former Vice President of Disaster Services, American Red Cross

  • Neal Cohen, MD, Executive Director, AMDeC Center on Biodefense; former New York City Commissioner of Health

  • Diane S. Lapson, Vice President, Independence Plaza North Tenent Association, New York City

  • Judith W. Leavitt, PhD, Professor, History of Medicine, University of Wisconsin Medical School

  • Myrna I. Lewis, Assistant Clinical Professor, Department of Community and Preventive Medicine, Mt. Sinai School of Medicine

  • Ann E. Norwood, MD, Col. MC, USA, Associate Professor and Associate Chairman, Department of Psychiatry, Uniformed Services University

  • Kathleen Rand Reed, MAA, Applied Biocultural Anthropologist and Ethnomarketer, The Rand Reed Group

  • Monica Schoch-Spana, PhD, Senior Fellow, Johns Hopkins Center for Civilian Biodefense Strategies

  • Bradley D. Stein, MD, PhD, Health Services Researcher, RAND; Assistant Professor of Child Psychiatry, University of Southern California

  • Kathleen J. Tierney, PhD, Professor, Department of Sociology and Criminal Justice; Director, Disaster Research Center, University of Delaware

  • Robert J. Ursano, MD, Professor of Psychiatry and Neuroscience and Chairman, Department of Psychiatry, Uniformed Services University School of Medicine



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