Mass panic in the face of a crisis like a flu pandemic is something of a myth. People do not normally 'contaminate' each other with fear. On very rare occasions, a display of panic can spark a similar reaction in those who witness it - but only when there are extenuating circumstances and, even then, the effect is short-lived. On the contrary, most people in most disasters think and act with a great deal more wisdom and courage than they, and those around them, might have expected. They rise to the occasion. During the severe acute respiratory syndrome epidemic, Hongkongers effectively talked over fears in public forums and took sensible precautions like wearing masks and avoiding crowds when possible. There were some well-publicised overreactions due to confusion. But people who knew what they had to do, did it. Hospitals, the police force and public transport were not left unmanned. Quite the reverse: front-line staff displayed extraordinary bravery and dedication. Similarly, researchers at Johns Hopkins University report that Americans typically do not react with panic to alarming events like the September 11 terrorist attacks and anthrax mailings. Most people help each other, after a brief period of expressing their fears, by going on to react with effective and adaptive action. On the other hand, decision makers, leaders and the media do have an important influence on exactly the sort of actions and reactions people believe are open to them. They can prevent inappropriate reactions by providing timely and accurate information and instructions, so that the public can make informed decisions. People usually adapt to a situation based on the best information available; knowing what to do and not to do also bolsters the chances that a crisis will be taken as an opportunity to help others. The public is a participant in the response to a crisis. So it is important to remember that civic groups, such as churches and charities, can help circulate information. In an emergency, they could distribute medication and monitor disease outbreaks because, in the case of overwhelming demand, it may be necessary not to rely solely on the hospital system to care for the sick. As noted in a recent report in the Clinical Infectious Diseases journal, hospitals tend to operate on the 'just-in-time' principle to deliver care. So they do not have enough doctors, nurses, beds or equipment to care for a massive surge of patients. This means that communities and their leaders need to have thought through how to rely on volunteers and non-professionals to deliver some care. As the Sars crisis taught Hong Kong, developing trust between leaders and the community is crucial. This includes giving the public a say in planning for a pandemic, and developing collaborative relationships with the media to ensure an open flow of information leading up to, during and following an emergency. Worldwide, crisis planners tend to view the public as bystanders during a crisis, but that could not be further from the truth. The public must be taught concrete and practical steps they can take to avoid becoming infected or infecting others. This remains the first and most important line of medical and psychological defence: knowing what to do. Meanwhile, the media could give us fewer alarming statistics from past pandemics or comments about the 'inevitability' of another one soon. It would be more useful to use air time and newsprint to summarise the existing situation and to outline what to do now, and what one should anticipate having to do in an emergency. Jean Nicol looks at everyday issues from the point of view of a psychologist everydaypsychologist@yahoo.com
