Communication triage: an anthrax case study.

Abstract

DURING A TERRORISM ATTACK, harried government officials can’t always communicate equally well to everyone. Thus, agencies must decide how to allocate time and personnel, the scarcest resources of all. Just as medics triage the wounded on the battlefield, communicators on the front lines of the war on terrorism separate “urgent” from “later” tasks. They must decide: Which populations are the most important to reach? When? What information is the most critical to convey? Risk communication research in an area of New Jersey that had no cases of anthrax illustrates the need for communication triage. During the anthrax attacks of 2001, phone calls, e-mails, and faxes overwhelmed local, county, and state agencies in New Jersey. Most state and federal resources were directed at the Hamilton postal facility, which was closed on October 18 because anthrax was diagnosed in a worker there (see Fig. 1 for timeline of events). While others have documented the events on the front lines at the Hamilton facility,1 in this article we describe the communication siege at the Monmouth Processing and Distribution Center that included erroneous media reports of two cases of anthrax. The Monmouth experience illustrates the need for government officials to develop ways to communicate with populations who consider themselves to be at risk, even though they may not be in the immediate area of exposure. Developing criteria for audience triage might help define specific secondary audiences. Our research is based on more than 20 interviews with public health professionals, emergency responders, police officers, elected officials, health practitioners, and other decision makers, combined with extensive document review (including media coverage, agency documents, and electronic correspondence to listservs). All quotes, unless otherwise noted, were obtained in these interviews. To ensure the confidentiality of sources, we use ambiguous references to interviewees’ gender. Because one of the goals of terrorism is to make many people feel like they are vulnerable to attack, we argue that the lessons learned about communication triage from Monmouth are particularly important for leaders in areas that may never be directly exposed to a weapon such as anthrax: