Top 5 Disaster Myths

Public Responses to Extreme Events – Top 5 Disaster Myths

Monica Schoch-Spana Center for Biosecurity of the University of Pittsburgh Medical Center

Homeland Security, the Environment, and the Public Resources for the Future First Wednesday Seminar – October 5, 2005

About a week ago, several colleagues at the Biosecurity Center and I were discussing future initiatives on the topic of “citizen engagement” in public health preparedness and response – whether a biological attack or an influenza pandemic. 

Commenting on “lessons learned” from Katrina, one colleague remarked that “We’ve seen what people do when they don’t have life’s basic necessities and they’re at the end of their rope – the situation reverts to a jungle-like scenario.” 

Now “jungle” is a word with very strong connotations, so I was taken aback when I heard it in the context of the Katrina tragedy.  The connotations that most quickly come to mind are: 

• The Hobbesian view of humanity’s true nature underneath the surface of civilization – “eat or be eaten.” 
• The racialized image of “native unrest and savagery.” 

Setting aside that troubling aspect of the conversation…what also struck me was the lack of analytic and empirical rigor that my colleague was applying to the problem of social behavior following a catastrophic event.

 

This individual, for instance, would hardly resort to understanding the clinical and epidemiological intricacies of a biological attack involving an aerosolized anthrax release, based on dominant media images and/or sporadic news reports issued in the midst of an evolving and chaotic situation.  Nor would he or she presume to know the biological “truths,” so to speak, about the course of inhalational anthrax infection and treatment without an empirical inquiry and medical evidence.   

Similarly, no team of engineers would argue with certainty that they understood why – from a dynamic process perspective – the World Trade Center Towers crumbled into a toxic, heaping pile of rubble and dust, until they had undertaken a forensic examination of the remaining structure and reviewed the initial building design and materials, among other things. 

Some would argue that science of all kinds has had a hard time maintaining its ground in public policy circles now and in the past.  BUT, I would argue that the social and behavioral sciences have had the toughest “row to how” in the current environment – particularly in the terrorist and counter-terrorist arena.  One finds a strong inclination to act on hunches and unquestioned “common sense” notions about public responses to extreme events.  

With a 15 minute talk today, I thought listing the top myths about mass responses to disaster would make the best use of our time and set the stage for discussion.  My plan is to relate the key disaster myths, present the facts that call them into question, and illustrate them through specific case studies. 

I am exploiting the work of other scholars, namely those in the history of medicine and the sociology of hazards and disasters.  

Special thanks to: • John Barry • Gregory Button • Lee Clarke • Alfred Crosby • Russell Dynes • Henry Fischer III • Tom Glass • Eric Klinenberg • Judith Walzer Leavitt • Denis Mileti • Walter Peacock • E.L. Quarantelli • Kathleen Tierney • Many others…

MYTH #1:  Disasters are equal opportunity events; they happen in random and quirky, but essentially democratic ways.1  Hurricanes, outbreaks, heat waves, earthquakes, and chemical spills kill indiscriminately.  They do not care “who” the victim is. 

FACT:  People are more or less vulnerable to the effects of disasters; social class, ethnicity and race, gender, and social connected-ness are factors that often determine the extent of harm.  These traits also play an important role in resilience to, and speedier recovery from crisis.  

1995 Chicago Heat Wave Singled Out the Poor, the Elderly, and the Isolated2 

• Between July 13 and July 20, Chicago experienced a record-breaking heat wave that claimed more than 700 lives. 

• Most victims were low-income elderly people who lived alone, were isolated from friends and family, and were left abandoned for days before being discovered. 73% of the victims were age 65 or older, a majority of whom were African-American.  

• Deaths were not caused by extreme temperatures alone; existing social conditions common to urban areas compounded the effects of the heat.  A substantial number of seniors live alone in unsafe, decrepit, low-income housing in neighborhoods that have been abandoned by businesses, service providers, and many residents.  

• These conditions create a culture of isolation and fear that discourages seniors from trusting neighbors or even leaving their homes. Minority seniors were especially vulnerable to the heat wave because they were largely homebound, with no one checking in on them and nowhere to turn for help.  

                                                

MYTH #2:  Whether people comply with evacuation plans, isolation and quarantine, or other public health and safety orders is strictly a matter of “personal choice.” 

FACT:  The problem of “non-compliance” has less to do with handling willful, obstinate or ignorant individuals than with rectifying life circumstances that interfere with an ability to act according to authorities’ reasonable requests. 

• University of New Orleans researchers who surveyed the city's residents about their personal hurricane evacuation plans in 2004 estimated that at least 100,000 New Orleans residents had no means to evacuate: no car, not enough money for airfare or a bus ticket, no friends or family to help them leave town.3 

• Fear of loss of income was the most common reason given by Toronto residents who met the eligibility criteria for home-quarantine during the city’s SARS epidemic but who did not act on this knowledge.4  

• Homelessness, drug addiction, and mental illness, for instance, impeded many disadvantaged tuberculosis patients in the 1990s from fully completing their rigorous, medical treatment schedule, thus posing the risk of developing drug resistant strains of TB during the larger HIV/AIDS epidemic.5   

• During the 1918 Spanish Flu pandemic, some Baltimore city residents berated health officials for curtailing retail business hours to control influenza’s spread:  hourly workers lost wages including income to pay for extra heating fuel, an item they considered more critical to protecting their families.6   

MYTH #3:  When life and limb are threatened on a mass scale, people panic.  They revert to their savage nature, and social norms readily break down.  

FACT:  According to extensive social research, people rarely fall apart and put themselves first.7,8,9,10  This finding contradicts what people tend to say on surveys that ask them how they think they will behave when disaster hits.  In reality, people may feel fearful, anxious and capable of doing just about anything to protect their loved ones.  They may be irritable with politicians and safety professionals and ignore their advice when it is irrelevant to their situation.  But, contrary to the scary stories authorities tell each other, panic is the exception. Creative coping is the norm.
     

• Ordinary people emerge as innovative problem-solvers who are responsive to the needs of others around them.  This pro-social response has been documented by researchers over several decades in countless disasters, and has been bolstered by reports of the reasoned and altruistic responses of those directly affected in the 9/11 attacks and the recent London bombings.  People react in disaster the same way they live:  as parents, as co-workers, neighbors, members of faith communities.
  

• Regular people are not merely disaster victims who must rely on trained responders for protection. Studies show that the majority of people rescued are saved by nonprofessionals who happen to be in the immediate vicinity. 49 of 50 people saved from the rubble of the 1989 Loma Prieta earthquake in California were rescued by a group of 8 Mexican construction workers who have long since been forgotten in the larger U.S. cultural narrative of the heroic efforts by trained, search-and-rescue professionals.11
                                            

MYTH #4:  Centralized, insular decision-making and authority structures among trained professionals guarantee the least harm to people and property.  Ordinary civilians and everyday institutions are inadequate to deal with crises. 

FACT:  Shared problem-solving across sectors and social groups, rather than imposing authority from outside, is a more effective tool for handling extreme and/or unanticipated events.12
      

The very different outcomes of two U.S. smallpox outbreaks—one in Milwaukee in 1894 and the other in New York in 1947—suggest that disease controls that compromise democratic ideals of self-determination and equality of persons can inadvertently spread an epidemic further.13 

CASE STUDY – SMALLPOX IN MILWAUKEE 1894 

• Facing a citywide outbreak, Milwaukee health authorities forcibly removed infected individuals to isolation hospitals considered substandard, selectively using this technique among impoverished immigrants. 

• Wealthier smallpox patients were placed under quarantine and encouraged to care for their afflicted loved ones in the comfort of their own homes. 

• Perceived to be discriminatory and authoritarian, these public health measures caused month-long riots and ultimately abetted the spread of smallpox. 

• Outbreak Impact:  1,079 cases, 244 deaths 

CASE STUDY – SMALLPOX IN NYC 1947 

• NYC officials effectively quelled outbreak by implementing a voluntary mass vaccination campaign that was universally applied, carrying out an elaborate public relations campaign, and involving grassroots organizations.  

• Health officials were legally authorized to vaccinate people or move patients to hospitals forcibly, but coercive measures were unnecessary in the context of a community-wide and evenly applied containment campaign. 

• 6,350,000 people were vaccinated in 4 weeks (5 million along in the first 2 weeks) 

• Outbreak impact: 12 cases, 2 deaths

MYTH #5:  Acts of God and Nature are pre-ordained.  There is no real way to thwart their ultimate outcome.  The same goes for Bureaucratic Red-Tape, another so-called immutable force.  

FACT:  Modern disasters are complex, dynamic events.  They involve the interaction of multiple systems – society, the built environment, and the natural world.  Thoughtful tinkering to align these systems can help reduce hazards, though never remove them entirely.14  

• Hurricane and earthquake hazards have lessened over time in the U.S. as building codes have improved the resistance of buildings to damage, the prediction of weather and geologic events has become more precise, and public warning systems and evacuation plans have been put in place.  

• According to Storm Data, for the 1975 to 1994 period hurricanes were the second most costly natural hazard in terms of property losses and the third most injurious.  Because of advance warnings and emergency preparedness, hurricanes are only the seventh-leading cause of death due to natural disasters.15   

• In 1995, Washington Monthly chronicled the successful reform of FEMA, from what many considered to be the “worst” federal agency to the best.16 

• Transformation took place in the aftermath of Hurricane Andrew, August 24, 1992.  The storm leveled a 50-mile path across Southern Florida, leaving almost 200,000 people homeless and 1.3 million without electricity.  Food, clean water, shelter, and medical assistance were in short supply.  FEMA was absent for the first 3 days, and once on the scene, it poorly managed the relief effort. 
• FEMA was hampered by its lack of experienced managers and by its reactive posture to disaster, seeing itself as a “last responder” whose primary role was to distribute loans for rebuilding after a disaster.  FEMA had 10 times the proportion of political appointees of most other government agencies.  
• Organizational restructuring, mission re-evaluation, energetic oversight, and strong leadership turned the agency around…

CONCLUSIONS 

Emergency planning assumptions backed by empirical research, not hunches or common-sense notions: 

• Disasters have the most profound effects for the already vulnerable members of society.  Disasters are not equal opportunity events. 

• Life circumstances – such as economic means, educational levels, and states of social isolation or connection – are more frequently the contributors to people’s failure to heed reasonable official instructions, NOT individual traits of obstinacy or willfulness. 

• In conditions of grave danger, creative coping is the norm and panic the exception. 

• Shared problem-solving models, rather than ones of command-and-control, provide opportunities for flexibility and innovation, and a higher likelihood of enhanced preparedness, response, and recovery. 

• The outcomes of a disaster – whether so-called natural, technological or terrorist-driven – are not set in stone or predetermined.  That said, interventions must take into consideration complex interactions among citizens and government, as well as physical, natural, and built environments.

End notes

1 Walter Peacock.  Consequences of Disaster Myths, 30th Annual Hazards Research and Applications Workshop, Boulder, CO, July 12, 2005. 

2 Eric Klinenberg.  Heat Wave: A Social Autopsy of Disaster in Chicago.  Chicago, IL: University of Chicago Press; 2002. 

3 Cox News Service.  Many New Orleans residents had no evacuation plan.  September 2, 2005. 

4 Clete DiGiovanni, Jerome Conley, Daniel Chiu, and Jason Zaborski.  Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak, Biosecurity and Bioterrorism 2004;2(4). 

5 Ron Bayer and Laurence Dupuis. Tuberculosis, public health, and civil liberties, Annual Review of Public Health 1995;16:307–26. 

6 Monica Schoch-Spana. Psychosocial consequences of a catastrophic outbreak of disease: Lessons from the 1918 pandemic influenza. In: Robert Ursano, Ann Norwood, and Carol Fullerton, eds. Bioterrorism: Psychological and Public Health Interventions. New York: Cambridge University Press; 2004, pp. 38-55. 

7 Lee Clarke. Panic: Myth or reality? Contexts 2002; Fall:21–6. 

8 E.L. Quarantelli. The sociology of panic. In: Smelser N, Baltes PB, eds. International encyclopedia of the social and behavioral sciences. New York: Pergamon Press; 2001:11020–30. 

9 Henry W. Fischer. Response to disaster: Fact versus fiction and its perpetuation. Lanham, MD: University Press of America; 1994. 

10 Russell R. Dynes and Kathleen J. Tierney, eds. Disasters, collective behavior and social organization. Newark, DE: University of Delaware Press; 1994. 

11 Tom Glass.  Workshop remarks, Citizens’ Information Needs in Responding to Disaster.  Computer Science and Telecommunications Board of the NAS/National Research Council, Washington, DC, July 19, 2005. 

12 Russell R. Dynes.  Community emergency planning: false assumptions and inappropriate analogies.  International Journal of Mass Emergencies and Disasters 1994;12(2):141-158. 

13 Judith W. Leavitt. Public resistance or cooperation? A tale of smallpox in two cities. Biosecurity and Bioterrorism. 2003;1(3):185-92

14 Dennis S. Mileti.  Disasters by design: a reassessment of natural hazards in the United States.  Washington, DC: John Henry Press, 1999. 

15 Ibid, p. 76, 78.  

16 Daniel Franklin.  The FEMA phoenix: reform of the Federal Emergency Management Agency.  Washington Monthly July/August 1995.  Available at http://www.washingtonmonthly.com/features/2005/0509.franklin.html; accessed September 2, 2005.

Source: http://www.start.umd.edu/publication/public-responses-extreme-events-top-5-disaster-myths

The Unthinkable: Who Survives When Disaster Strikes and Why

The Unthinkable: Who Survives When Disaster Strikes and Why
Author: Amanda Ripley
Three Rivers Press
2009

Review by William Taylor

        The book The Unthinkable by Amanda Ripley discusses how people react during a crisis or catastrophe, noting how particular reactions can kill some and yet help others survive. The value of The Unthinkable is tremendous to whoever decides to read it as it addresses the average citizen, narrates real life events, and applies to everyday life in a direct and meaningful way.
On December 6, 1917, in Nova Scotia, a freighter carrying 25 tons of TNT exploded in the harbor after an accidental collision. The freighter caught fire as a result of the collision, but when it also brushed up against a dock in the harbor, it set the whole town of Halifax ablaze, killing 1,963 people. Such an accident had an enormous effect on many of the survivors, including a priest in Halifax. After the disaster, he opened his church to the injured, but eventually decided to leave his parish to pursue a PhD in sociology in New York City. He was the first to analyze how humans react during disasters in a paper entitled “Catastrophe and Social Change.”
        The survival arc, depicted below, describes three phases people go through during any type of disaster situation. Ripley bases the majority of her book on these three phases, as they are important to everyday citizens, her target audience.

Denial
During this initial phase, a person’s brain tries to process what has happened after a disaster. People typically don’t just start running for the doors when something happens; instead, they tend to procrastinate. Ripley gives an example of a lady during the 9/11 attacks who was in the first tower to be hit. While this lady was making sense of what happened with each piece of information she received, she went from, “Poor pilot, he must have had a heart attack,” when the first plane hit to, “It was intentional,” after the second plane crashed.
  There are many interesting things that Ripley discusses about the Denial phase. One of these is the ability people have to become paralyzed. There are physiological reasons for this that stem from a natural instinct our bodies have. An example of this is a young man who did absolutely nothing during the Virginia Tech massacre, and lived because of it. He never left the denial phase, but stayed there the entire time. The young man recounted how he got under a desk and simply played dead. He said that it felt natural to act this way—so natural that when he tried to move hours later, it was very difficult. Such a phenomenon occurs naturally when the brain sends a stress hormone through the body during an emergency to act as a natural painkiller and creates paralysis. In studies of animals, researchers have found that if an animal is left in this state of natural paralysis, they can actually die from cardiac arrest. Rollo May, in his book The Meaning of Anxiety, stated the following about paralysis:
       These instances demonstrate that anxiety involves a paralyzing, to a greater or lesser degree, of the productive activates of the individual on various fronts—his thinking and feeling capacities as well as his capacity to plan and to act. This impoverishing effect of anxiety underlies the common dictum that “anxiety cancels out work. (May 1977, p.383)

Deliberation
The deliberation phase is one that can also get people killed. During the 9/11 attacks, there was a man in the first tower, who, with five other people, deliberated about what to do for over thirty minutes before taking the stairs. Though deliberating can be an essential element during a crisis phase, spending too much time there can be deadly, just as it is in the denial phase. [In the example you gave of the denial phase, though, the man actually survived precisely because he stayed in that phase so long. You might want to include another example of someone who was less fortunate and didn’t survive.] During this phrase, many people relate that they experience time speeding up or slowing down. Part of this has to do with the brain looking at the options and deciding what to do; the brain may seem to slow down time because of the energy being used up in other vital parts of the body, but then it may seem to speed up as the brain does the same thing.
Deliberation doesn’t necessarily happen during a crisis, but often does leading up to one, as in the case of a hurricane. Two days before hurricane Katrina made a landfall on New Orleans, the mayor thought about giving a mandatory evacuation order, but had to consult his lawyers first to make sure that there couldn’t be a lawsuit brought against him. Such deliberation, I am sure, wasted valuable time.
According to Ripley’s book, there aren’t many people who stay in deliberation very long; if they get out of the denial phase, then they are usually on their way to the decisive moment, or action. Many of the people interviewed went from denial to action; some even skipped denial and deliberation and just acted.

Decisive moment
During the decisive moment, a person acts. The one thing that most people have in common who skip almost immediately to this phase is military training, or at least some sort of training. During a plane disaster, the one thing that most survivors have in common is that they had all read the emergency pamphlet in the back of the seat. This allowed their brain to easily recall what to do and kicked them into the action phase almost immediately.
The Pan Am flight, which collided with another airliner in 1977, killing 326 of the 396 people on board, should have had limited casualties on their plane. One couple was saved because the husband skipped the denial phase and went straight into action. His wife explains her reaction: “My mind was almost blank. I didn’t even hear what was going on.” But her husband, Paul Heck, reacted immediately:
         He unbuckled his seat belt and started toward the exit. “Follow me!” he told his wife. Hearing him, Floy [his wife] snapped out of her daze and followed him through the smoke “like a zombie.” Just before they jumped… Floy looked back at her friend, who was just sitting there, looking straight ahead, her mouth slightly open, hands folded in her lap. Like dozens of others, she would die not from the collision but from the fire that came afterward. (Ripley, 2009, p.176)
          What Paul did that day could be described as Recognition-Primed Decision (RPD). As previously mentioned, reviewing the emergency pamphlet in the back of the plane seat can save lives, and the RPD model is why. “In the recognition-primed decision model, proficient decision makers are described as being able to detect patterns and typicality. They can size up a situation in a glance and realize that they have seen it, or variants of it, dozens or hundreds of times before” (Klein 1999, p. 151). While Paul didn’t have experience in actually evacuating a plane, he had the information he needed, which helped him become an expert. Being an “expert” doesn’t have to be an intensive training course or years of experience; it can be as simple as reviewing some information. This isn’t true across the board, but was for Paul and Floyd. Part of the power that Paul did use to help his RPD be effective is mental simulation. “Mental simulation covers the ability to see events that happened previously and events that are likely to happen in the future” (Klein 1999, p.149).
As this book demonstrates, ordinary people can survive disasters. While fire-fighters, officers, and paramedics are great and do wonderful things, they aren’t always going to be there. Amanda Ripley shows the importance of self-preparation in self-preservation. Part of the ability to make decisions like Paul, comes from individual preparation, something as simple as reading a pamphlet. Through such preparation, the brain can imagine what something might be like and prepare to act in advance. In his book Blink, Malcolm Gladwell explains our subconscious:
       Our brain uses two very different strategies to make sense of the situation… The first is the conscious strategy. We think about what we’ve learned, and eventually we come up with an answer. There’s a second strategy though. It operates a lot more quickly. It has the drawback, however, that it operates-at least at first-entirely below the surface of consciousness. It’s a system in which our brain reaches conclusions without immediately telling us that it’s reaching conclusions. (Gladwell 2007, p.10).
        The Unthinkable describes how the process of doing simple things makes a whole lot of difference. This is why our subconscious figures it all out long before we do; however, it can only do so if information is readily available to it.
The Unthinkable by Amanda Ripley provides a wealth of information to help the average person better deal with everyday possible disasters. The stories told of people evacuating the World Trade Center are very applicable to everyday life as most people are in buildings constantly. The question is, does everyone read the emergency plans and imagine what he/she would do and where he/she would go? Amanda Ripley has done an excellent job of helping others become better prepared.

References

Gladwell, M (2007). Blink. New York, New York: Little, Brown and Company.
Klein, G (1999). Sources of Power. United States of America: Massachusetts Institute of
Technology.
May, R (1996). The Meaning of Anxiety. New York, New York: Norton.
Ripley, A (2009). The Unthinkable. Crown, New York: Three Rivers Press.