Sifting Through Official Speak on Bird Flu The most recent wave of bird flu began spreading across Asia in 2003. So why is the U.S. government sounding the alarm now? Risk experts assess what's true, and what's misleading, in the Bush administration's statements on the risk of a flu pandemic.
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Sifting Through Official Speak on Bird Flu

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Sifting Through Official Speak on Bird Flu


This is MORNING EDITION from NPR News. I'm Steve Inskeep.

In this part of the program, we're examining the government's dire warnings about bird flu.

Secretary MICHAEL LEAVITT (Department of Health and Human Services): There's little question that it could become one of the most terrible threats to life that this world has ever faced.

INSKEEP: That's health secretary Mike Leavitt speaking earlier this month. It's one of a number of statements the government has made recently. And to know just how worried we should be, it helps to check on what the government is saying. NPR's Jon Hamilton has been doing just that.

And, Jon, before we get into more specific statements, what is the status of bird flu that's being tracked around the world?

JON HAMILTON reporting:

Well, it's important to remember that bird flu has been around since 1997, at least in the form that kills people. That's when it emerged in Hong Kong. And it went away for a while, after a whole lot of chickens were killed, and then re-emerged in 2003. And since then, it has spread through Asia and into Eastern Europe and it's been really bad if you're a chicken. There are--about 150 million chickens have died as--either culled or died of the virus itself. But so far, it's only infected about 140 people and it is still not being transmitted from person to person in any efficient manner.

INSKEEP: Which means it's not any worse than it was a couple of years ago.

HAMILTON: No. In fact, there's no particular reason you should be more worried right now than you should have been a year ago.

INSKEEP: Which raises the question of why the government is issuing so many dire warnings now.

HAMILTON: That's what I wanted to know. And so I listened to all the stuff the government had to say and found a lot of taped clips and I went and played them for a couple of risk communications experts up in Princeton, New Jersey. He's a man named Peter Sandman and his wife, Jody Lanard. They work together doing risk communications consulting for a variety of clients. And they say what has changed is not the virus; it's the political backdrop. Specifically, Hurricane Katrina hit and it made the government look like it was unprepared for something that was a well-known threat. Peter Sandman says the government doesn't want to seem unprepared for the flu.

Mr. PETER SANDMAN (Risk Communications Expert): Prior to Katrina, the federal government in my judgment was profoundly over-reassuring about the risk of a pandemic. Katrina had, I think, a lot to do with the federal government reversing its rhetoric and sounding much more alarming about pandemics which is absolutely on target.

HAMILTON: Sandman and Lanard had done work on pandemic preparedness for the World Health Organization, the Centers for Disease Control and Prevention and the Department of Health and Human Services. Sandman also works for a range of corporate clients. Together, they've written dozens of articles on how to communicate the risks associated with bird flu and other infectious diseases. Lanard says her own interest in bird flu began well before the Bush administration started talking about it so publicly.

Ms. JODY LANARD (Risk Communications Expert): I became concerned and then alarmed about pandemic influenza in about January 2004 while Thailand was still covering up the very obvious signs that they had bird flu outbreaks in their poultry. I thought about what we should do. I thought about stockpiling food. I felt the fear of this thing spreading in Thailand.

HAMILTON: So she spent months learning everything she could about the virus and its risks. Lanard and Sandman says risk communicators must walk a tightrope. On one side is the risk of promoting irrational fear. On the other side is irrational complacency. The goal is to instill appropriate fear that gets people to take appropriate precautions. Lanard says accomplishing this means presenting information that is accurate, complete and often frightening.

Ms. LANARD: Good information should increase the level of fear in people that haven't been thinking about it at all. It should decrease the level of fear in people who are overimagining how bad it could be.

HAMILTON: Sandman and Lanard praise the Bush administration for finally sounding the alarm about pandemic flu, but they say the administration's message has been undercut at times by statements that are misleading, self-serving or simply wrong. One example is an image federal officials frequently use to describe the pandemic. Here's President Bush in a speech at the National Institutes of Health.

President GEORGE W. BUSH: A pandemic is a lot like a forest fire. If caught early, it might be extinguished with limited damage. If allowed to smolder undetected, it can grow to an inferno that spreads quickly beyond our ability to control it.

HAMILTON: Lanard says the forest fire image can be useful.

Ms. LANARD: It's an excellent metaphor for how a pandemic may start.

HAMILTON: But she says it's profoundly misleading to suggest that a flu pandemic can be snuffed out like a smoldering cigarette.

Ms. LANARD: The quote as it stands gives an overly optimistic impression of the likelihood of stomping it out. This has never been done. Surveillance is terrible in most of the developing world. It's highly unlikely that anybody's going to find it when there's 30 or 40 cases in one village.

HAMILTON: And even if someone did, scientists say it's far from certain the virus could be stopped. Sandman says a better model for a pandemic might be a natural disaster like a tsunami or Hurricane Katrina.

Mr. SANDMAN: The vision of a natural disaster is not only that you can't prevent it but that you can prepare for it. And if you prepare for it, you will ameliorate its bad effects.

HAMILTON: Sandman says government officials sometimes mix true statements with statements that are demonstrably false. Here's HHS Secretary Michael Leavitt.

Sec. LEAVITT: When it comes to a pandemic, we're overdue and we're underprepared.

HAMILTON: Sandman says the US is underprepared, but he says it's nonsense to think that just because there hasn't been a pandemic since the 1960s we are somehow overdue.

Mr. SANDMAN: There's a name for that. It's called the gambler's fallacy. It's exactly like somebody who's playing the roulette wheel who notices that number 17 hasn't come up all night and bets on 17 because 17 is overdue. And what any statistician would say is every spin of the roulette wheel is a new random event. So there's no sense at all in which we're overdue.

HAMILTON: Sandman says if people believe the gambler's fallacy, they'll expect the risk of a pandemic to rise every year we remain untouched. The fact is it won't. He says they'll also tend to think that if a pandemic does arrive, the risk of another one has been somehow reduced. That's not true either. Sandman and Lanard say even some true statements can be misleading. Here's President Bush describing his plan to prepare for bird flu.

Pres. BUSH: We must protect the American people by stockpiling vaccines and antiviral drugs and improve our ability to rapidly produce new vaccines against a pandemic strain.

HAMILTON: Lanard says the government should be doing exactly those things, but they shouldn't be suggesting these measures will protect us, at least not any time soon. At the moment, there is no human vaccine against bird flu and it's far from clear that antiviral drugs will offer people much protection. Lanard says the president's message has another problem.

Ms. LANARD: It's a passive message to the public. It's the government as big father, the government's going to take care of you, and that is not what the public needs to hear in order to provoke preparedness.

HAMILTON: Lanard and Sandman say that in the short run, individuals can do far more than the government to protect themselves. They can keep extra food in case a pandemic disrupts distribution systems. They can prepare to work from home in case it becomes hazardous to be in contact with other people. They can learn proper hand-washing techniques to keep from spreading the virus. And Sandman says there's another reason the government should involve the public in preparing for bird flu.

Mr. SANDMAN: Everything that's known about the psychology of fear tells us that people can tolerate more fear if there's more for them to do. So it's not just inaccurate for the government to imply that the government will take care of it. It's not only getting in the way of publics beginning to take preparedness more seriously. It's even getting in the way of publics finding it easy and intolerable to endure the threat of the pandemic itself.

HAMILTON: Sandman and Lanard say the government seems overly afraid that it will panic the public. They say history suggests that's not likely and that the right information now would reduce the risk even more. Lanard says she's a good example that the more a person knows, the more realistic they'll be about pandemic flu.

Ms. LANARD: It's one of the main things I think about, but I don't lose sleep over it. I don't think that every new case that comes out of China is it. It's already sort of settled in my mind as one of the risks in the world.

HAMILTON: So, Steve, what she's saying is that it's a risk like any other risk we have in the world, like a car accident or cancer or even like the risk of another hurricane like Katrina.

INSKEEP: OK. Thanks very much. That's NPR's Jon Hamilton.

You can find facts about bird flu, how many human cases, how many bird cases and where there are outbreaks by going to our Web site,

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