MICHELE NORRIS, host:

Vice President Joe Biden has found himself on the hot seat for remarks he made about the swine flu. During an appearance on NBC's "Today Show," the vice president was asked if he would advise family members to use public transportation. And this is what he said.

Vice President JOE BIDEN: I would tell members of my family, and I have, I wouldn't go anywhere in confined places now. It's not that it's going to Mexico. It's you're in a confined aircraft. When one person sneezes, it goes all the way through the aircraft. That's me. I would not be, at this point, if I - if they had another way of transportation, suggesting they ride the subway.

NORRIS: A few hours after that interview, Mr. Biden's office issued a statement to clarify his remarks, saying he did not intend to suggest that Americans should avoid public transportation. Even so, the vice president has been widely criticized for his remarks. With the possibility of a pandemic on their hands, public health officials are very careful about what they say, and for good reason. The Congressional Budget Office estimates that a flu pandemic in the US could cost as much as $675 billion, with much of that due to fear and confusion.

Sandro Galea is an epidemiologist who studies human behavior in public health emergencies. He's the director of the Center for Global Health at the University of Michigan, and he joins us now. Dr. Galea, welcome to the program.

Dr. SANDRO GALEA (Epidemiologist; Director, Center for Global Health, University of Michigan) Thank you for having me.

NORRIS: So you study how and why people react to pandemics or other emergencies. Let's take the how first. What is the typical response?

Dr. GALEA: Well, there are some typical responses, although these responses tend to vary, as you can imagine, across contexts. But in general, we find at the beginning, there is confusion. People are not sure what's going on. But that confusion very quickly gives way to rational behavior. It's actually quite astonishing how across emergencies, across countries, across continents, you see people do the smart thing, meaning that they will go away from the hazard, or do what's appropriate to minimize transmission of a pandemic.

And usually, after the acute phase is over, there is time for reflection in populations, and measures are put into place to try to avoid these hazards happening again. And we've seen this happening, for example, after the SARS epidemic in Toronto and in Hong Kong. We saw similar patterns of it after September 11th in New York City. In many respects, the hazard can be quite different, and the behaviors can be quite similar.

NORRIS: When there are tabletop exercises to plan for this kind of thing, what are the things that are supposed to happen, and what are the things that should not happen if you're trying to avoid panic or fear or confusion?

Dr. GALEA: Well, I think it's pretty clear that a consistent, clear, but honest message about what is going on is essential. People realize that public officials may not know the answers to everything, but people react much better and have kind of much more predictable reactions when they know that they're being told as much information as is available and that they are being given sound, sane advice.

I think the one thing that we probably want to avoid is a cacophony of conflicting information from different sources and possibly misinformation.

NORRIS: Pardon me if I put you on the spot here, but as a public health official, what was your reaction when you heard Vice President Biden's statement?

Dr. GALEA: Well, that's the hardest question, wasn't it? I think it's problematic to have a public official providing information which people are going to listen to - I listened to it, as I'm sure you did, because he's the vice president - which is in direct contrast to what other public health and government officials are going. And it certainly seems like, from the statement that came out of his office a few hours later, he now understands that.

NORRIS: To the extent that he wants to clarify this, what's the best way to do that?

Dr. GALEA: Oh, that seems like a strategy discussion between the White House and the CDC and other relevant officials.

NORRIS: I just - millions of people watch "The Today Show." I wonder if that - if as many people will read the statement that his office released.

Dr. GALEA: That might not be the case. I think this incident of the vice president's comments really reinforces the need for public officials to be speaking from the same playbook, and with one voice. That doesn't mean it has to be only one person speaking, but in much the same way as in political campaigns, it is important that those in positions of authority are presenting the same message consistently.

NORRIS: Dr. Galea, thank you very much for your time.

Dr. GALEA: Thank you for having me.

NORRIS: That's Dr. Sandro Galea. He's the director of the Center for Global Health at the University of Michigan. He's also professor of Epidemiology at the University School of Public Health.

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