Terrorist Threats, Past And FutureI Heard The Sirens Scream: How Americans Responded To The 9/11 And Anthrax Attacks By Garrett Laurie Seattle (WA) : Amazon , 2011 533 pp.; $5.99 (e-book)
2012; Project HOPE; Volume: 31; Issue: 9 Linguagem: Inglês
10.1377/hlthaff.2012.0442
ISSN2694-233X
AutoresJulio Frenk, Octavio Gómez‐Dantés,
Tópico(s)Public Health Policies and Education
ResumoBook Review Health AffairsVol. 31, No. 9: Payment Reform To Achieve Better Health Care Terrorist Threats, Past And FutureJulio Frenk and Octavio Gómez-Dantés Affiliations Julio Frenk ( [email protected] ) is dean of the Harvard School of Public Health, in Boston, Massachusetts. From 2000 to 2006 he served as the minister of health of Mexico, where he led a reform effort aimed at enhancing health security in a comprehensive way. Octavio Gómez-Dantés ( [email protected] ) is a senior researcher at the National Institute of Public Health in Cuernavaca, Mexico. He has written on global health topics since the 1990s. PUBLISHED:September 2012Free Accesshttps://doi.org/10.1377/hlthaff.2012.0442AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSPublic healthBioterrorismDecision makingThe symbolic significance of the September 11, 2001, terrorist attack in New York City is enormous. Many have argued that it signaled the start of the present century, just as the assassination of Archduke Ferdinand in Sarajevo in 1914 marked the beginning of the twentieth century. The destruction of the Twin Towers is also one of the most viewed and studied disasters in history.Seven days after the 9/11 attack, letters with anthrax spores were mailed within the United States, killing five people and infecting seventeen others. The inquiry to identify those responsible for these aggressions became “one of the largest and most complex in the history of law enforcement,” according to the FBI. Few people in the world could have provided a more accurate chronicle and analysis of those events than Laurie Garrett. The title of her impressive e-book, I Heard the Sirens Scream: How Americans Responded to the 9/11 and Anthrax Attacks , balances a personal account with analytical explanation. Garrett’s book is not only a superb chronicle of past events, it is also an illuminating guide to use in dealing with threats that are still current. For example, the recent laboratory production of a deadly strain of H5N1, commonly referred to as avian flu, has reignited the global discussion on bioterrorism and has renewed interest in the lessons from the anthrax saga. A science journalist for more than thirty years, Garrett has covered a broad variety of global health issues. In 1996 she was awarded the Pulitzer Prize for her chronicles on the Ebola virus epidemic in Zaire. “For most of my adult life,” she writes in the preface to I Heard the Sirens Scream , “I have borne witness…. I go to epidemics, wars, places where people are struggling to cope with disasters, and I carefully log the accounts and events, trying to represent the lives and experiences of others.” In the case of 9/11, however, it was not “others”: It was her own community that was involved in a tragedy. From the rooftop of her apartment building, she saw United Airlines Flight 175 cut through the south tower of the World Trade Center. And weeks later, when people started becoming ill from inhaling anthrax dust, she reports that she was advised by a government official to stop opening her mail because she was a potential target.But it is not only her personal involvement in these tragedies that pushed her to chronicle the aftermath of these disasters. She writes that “it was mostly a response to recover, from the piles of lies and distorted facts, the lesson we needed to learn from these events.”The book is divided in two parts: the immediate aftershock of the 9/11 attacks and their repercussions. The first part, “The End of the Age of Innocence,” describes the initial horror followed by the supportive responses of many New Yorkers. As Garrett herself witnesses the final collapse of one of the World Trade Center towers, she hears someone saying: “We’ve been living a happy, simple life. And it’s all changing.” She also meets Biraj Dugar and Joe Whitaker, two strangers who emerge from the Chambers Street subway station just when a loud boom is heard. Covered with debris, they keep each other going until they reach the Brooklyn Bridge: “We just met, [but] we are brothers now,” Whitaker proclaims.In the days immediately after the attacks, hundreds of civilian volunteers show up in Manhattan, offering their support, registering the names of relatives searching for missing family members, sorting through donated clothing and food, and standing in huge lines at the blood donation centers. “The hysteria policymakers had long assumed ‘the public’ would exhibit following events like those of 9/11 did not materialize,” writes Garrett. “Indeed, The Public largely behaved heroically and compassionately.”Garrett also describes how 9/11 uncovered weaknesses in the US national security and public health systems. Response efforts lacked the integrated communications and unified command needed for this kind of disaster: Information crucial for decision making was not shared among agencies; first responders were poorly trained; and equipment for those responding was inadequate.In examining the anthrax attacks that followed soon after 9/11, Garrett recounts how the fragility of the public health system was also exposed. On September 18, the first letters containing anthrax were mailed to various media headquarters. Three weeks later, additional letters were mailed to two US senators. Following the first public reports of the attacks in October, then–US health and human services secretary Tommy Thompson appeared on TV and radio shows assuring the public that the nation was safe. Yet the reality was anything but.Efforts to upgrade the national capacity to respond to bioterrorist attacks at the Centers for Disease Control and Prevention (CDC) were only in an initial stage. The Health Alert Network, a public health information system for government officials, was still more of a concept than a reality. The National Pharmaceutical Stockpile was just being developed.More dramatically, a few months before 9/11, public health authorities had discovered that the vacuum-sealed tubes of the smallpox vaccine stockpile at the CDC were leaking, making their contents useless. Had there been a bioterrorist attack with the smallpox virus that day, the eventual deaths probably would have been counted in the hundreds of thousands.In contrast with the events on 9/11, “anthrax pushed the masses…toward individualized risk assessment, personalized fearfulness, and distrust of ‘others’—whoever they might be—that were responsible,” Garrett writes. Fortunately, the scale of the biological attacks was minor, and none of the anthrax strains were resistant to antibiotics. What Garrett calls the “extremely inadequate [public health response] system” was not put to a true test.The second part of the book, “New World Order,” discusses the prevailing mood in the United States a decade after these events. Do Americans feel safer? Are they, in fact, safer? Between 2001 and 2010, the US government spent more than two trillion dollars in an effort to increase security: A Department of Homeland Security was built, the Strategic National Stockpile was upgraded, and the CDC strengthened its Epidemic Information Exchange System and its network of more than 150 laboratories. This improved response system looked extremely flawed when tested by Hurricane Katrina, but it responded relatively well to the 2003 outbreak of severe acute respiratory syndrome (SARS) and to the 2009 H1N1 influenza pandemic.Although the measures adopted might have been too focused on bioterrorism, the platform built to connect hospitals to local health departments and laboratories can be used for almost any public health purpose. Yet a sense of almost existential restlessness still haunts the American public, as Garrett writes: “In the immediate wake of the 2001 al-Qaeda and anthrax attacks Americans were, understandably, fearful. Early measures taken by the Congress and the Bush Administration boosted public confidence, but Americans never again saw their place in the world with the sort of cocksure buoyancy that had dominated the country’s mood at the turn of the Century.”A final lesson from this outstanding, readable chronicle is an old one: Major calamities are often needed to attract the attention of powerful decision makers and to build solid preparedness plans and security systems. It can only be hoped that this book will serve as an antidote against this type of amnesic neglect. If that’s the case, the world will be better prepared against the inevitable next crisis. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 September 2012 Information Project HOPE—The People-to-People Health Foundation, Inc. PDF download
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