Public would ignore authorities in terror event.

A newly released report from the New York Academy of Medicine found that the public may be impossible to control in the wake of a terror attack. "Redefining Readiness: Terrorism Planning Through the Eyes of the Public" warned that mistrust of the government and worries over loved ones many times supercedes any efforts to instruct the public during a crisis.

"This information is critically important because plans currently being developed to deal with these situations are based on expert assumptions about what people would be concerned about and how they would behave," the report said. "If planners' assumptions about the public are wrong--as they have been in the past--the plans being developed will not work as expected."

Academy researchers interviewed government and private sector officials and evaluated disaster plans. They then compared them to the results of a telephone survey and group discussions in 14 communities across the United States. The study found many disparities in the way the public is likely to react to government instructions in the case of a radiological "dirty bomb" explosion or release of smallpox.

Far fewer people than needed would follow protective instructions, the report found, with only two-fifths of the public going to a vaccination site in the case of a smallpox outbreak, and only three-fifths sheltering as long as instructed in the case of a dirty bomb.

A large part of the problem, according to the report, is mistrust of the government. "Many people would be seriously worried about something other than what the planners are trying to protect them from," the report said.

Nowhere is this mistrust greater than in vaccination programs. In the study's theoretical smallpox outbreak, one-fifth of the American people would be worried enough about accepting a vaccine to keep them away from a medical site. The report noted that three-fifths of the public would be worried about the vaccination side effects--twice as many as those who said they were worried about catching smallpox.

"The way the American people say they would react to instructions in the [hypothetical] smallpox outbreak is consistent with the actual behavior of health care workers in the Centers for Disease Control Smallpox Vaccination Program," the report said.

The researchers, a team of six PhD's led by a medical doctor from the New York Academy of Medicine, found that the public was hungry for decision-making support from familiar doctors. They noted this advice was important to have before and during either attack.

"Looking at preparedness planning through the public's eyes redefines the notion of protection," the report concluded.