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POTENTIAL BENEFITS

OF SOCIAL MEDIA IN A

WEAPONS OF MASS DESTRUCTION (WMD) EVENT

_________________________________________________________

A Thesis Presented to

the Faculty of the Graduate School

University of Missouri

_________________________________________________________

In Partial Fulfillment

of the Requirements for the Degree

Master of Arts

__________________________________________________________

ANDREW C. KIM

Dr. Margaret Duffy, Thesis Supervisor

DECEMBER 2011

INFORMATION TO ALL USERS The quality of this reproduction is dependent on the quality of the copy submitted.

In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed,

a note will indicate the deletion.

ProQuest LLC. 789 East Eisenhower Parkway

P.O. Box 1346 Ann Arbor, MI 48106 - 1346

UMI 1517394

UMI Number: 1517394

The undersigned, appointed by the Dean of the Graduate School, have examined the

thesis titled:

POTENTIAL BENEFITS

OF SOCIAL MEDIA IN A

WEAPONS OF MASS DESTRUCTION (WMD) EVENT

presented by Andrew C. Kim, a candidate for the degree of Master of Arts,

and hereby certify that, in their opinion, it is worthy of acceptance.

_______________________________________

Professor Margaret Duffy (Chair)

_______________________________________

Professor Glen Cameron

_______________________________________

Professor Shelly Rodgers

_______________________________________

Professor Glen Nowak

This work is dedicated to my thoughtful wife and family, for believing in my abilities and supporting this effort to glorify our God, our Savior, our Christ. We hope to provide others its meaning to His glory.

ACKNOWLEDGEMENTS

I would like to give my sincere gratitude to my thesis chair, Dr. Margaret Duffy.

She inspired me to work hard toward trying to make a difference, but making sure that I

had fun doing it. Her experience provided a rugged compass to chart my journey into my

new world, the universe of journalism, so that I would not be lost. Her intuition gave me

a steady beacon to navigate its shores with confidence. Her insights were like a brisk

wind that steadied my course when my meager sails seemed unable to finish the journey.

I would also like to thank my thesis committee members for their knowledge and

acknowledgement that my efforts would not be in vain. Dr. Glen Cameron gave me

confidence to pursue an alternative track from my original bearing so that my path would

find smoother seas. Dr. Shelly Rodgers’ precision in helping me visualize the channels

while avoiding the shallows gave me a way home without going aground and being

shipwrecked in a strange land. And, knowing the environment from which I was to

navigate, Dr. Glen Nowak provided a suitable prescient meteorological forecast of a

foreign port that saved my journey from utter disaster.

Finally, I would like to give my sincere thanks and respect to Ms. Sarah Smith-

Frigerio. Sarah adopted me with generosity in the preparation for my commission of this

study. She prepared me with logistical sufficiency so that I could not help but succeed.

Her professionalism could only be eclipsed by her meticulous knowledge of the details in

the safe navigation of graduate study requirements at University of Missouri at Columbia.

iii

TABLE OF CONTENTS

ACKNOWLEDGEMENTS ……………………………………………….……………..ii

LIST OF FIGURES ……………………………………………………………….……...v

LIST OF TABLES ………………………………………………………………….……vi

ABSTRACT ………………………………………………………………………….…vii

Chapters

1. INTRODUCTION ………………………………………………………………..1 Brief History of WMD Social Networks/Social Media

2. LITERATURE REVIEW ……………………………………………………….12 Twitter and Facebook as examples of SN/SM Health risk communications in emergent environments Tablet technology and social media Media content and creativity Health risk communications in routine everyday environments Cyberspace and new media in the context of national security WMD Disasters: Can social networks help? Biology of post-modern war Biology in pandemics Politics of WMD Diffusion of Innovation Theory

3. RESEARCH METHODOLOGY AND DESIGN …………………….. ………51

Research Question Sub-Question 1 Sub-Question 2 Sub-Question 3

Research Method and Design

4. RESULTS …………………………………………………………………….59

Web 1.0 Assessment: Survey of Websites Federal State Local/Municipal

Web 2.0 Assessment: Interviews

5. DISCUSSION AND CONCLUSION ………………………………………….73

Discussion Limitations of Methodology Limitations of Theory

Conclusions

APPENDIX …………………………………………………………………………86

Definitions Interview Script and Questions

REFERENCES ……………………………………………………………………...96

LIST OF FIGURES

Figure Page

1. Rogers’ Adopter Categorization on the basis of Innovativeness ….................... 48

2. Suggested Skewing of Roger’s Categorizations in Social Networked Systems ..48

3. FEMA Regions ………………………………………………………………….61

LIST OF TABLES

Table Page

1. Sampled Participants ……………………………………………………………58

2. Sampled government echelon’s use of Twitter and Facebook …………………66

vii

POTENTIAL BENEFITS

OF SOCIAL MEDIA IN A

WEAPONS OF MASS DESTRUCTION (WMD) EVENT

Andrew C. Kim

Dr. Margaret Duffy, Thesis Committee Chair

ABSTRACT

Weapons of mass destruction (WMD) can come in multiple forms. Regardless of

their nature being chemical, biological, nuclear, or high explosives, their use will disrupt

normalcy and governance of nations. Application of WMDs is no longer an improbability,

and life sciences can be easily manipulated to produce a biological WMD. If a biological

WMD is unleashed, strategic communications will be a critical facet for its management.

In mass casualty situations, the medium of social media and social networks may offer

communications solutions to institutions of public health and emergency preparedness to

mitigate the consequences of biological WMDs.

This study conducted a qualitative review of strategic communications

preparedness in three levels of government; federal, state, and local institutions of public

health and security. The findings show that public health and emergency preparedness

agencies are preparing themselves to leverage new media systems, specifically Twitter

and Facebook, as channels for strategic communications. Overall, this study found the

three tiers of government complementary in their collective vision managing the

communications challenges of WMD events. Modeling this study may suggest further

studies in the field of strategic communications in such a way to measure the progress of

integrating social media and social networks for WMD-related crisis communications.

Chapter 1

Introduction

Weapons of mass destruction (WMD) can come in different forms. Military

experts view WMD under the rubric of CBRNE (chemical, biological, radiological,

nuclear, or high explosive) designed to maximize death, fear and disruption of societal

normalcy. It has become a weapon of choice for politically motivated religious extremists,

such as Al Qaeda and Afghanistan’s Taliban, where organized stateless actors, funded by

undeclared private capital, have declared war on the United States and its allies. This

proposal suggests using Diffusion of Innovation theory (DOI) to frame and compare how

the communicators at various levels of the public health and safety infrastructure, from

local public health and first responder organizations to responsible federal agencies, have

positioned themselves to use social networking/social media platforms (SN/SM), to

disseminate and interact with the public in a biological WMD event.

Because WMD’s may result in mass casualties, this research proposal suggests

studying the efficacy of SN/SM as a mass communications medium in such national

emergencies. It proposes to assess qualitatively the perceptions of public health officials

and first responders of how SN/SM can mitigate the strategic and operational

communications complexities expected in the nexus of public health and homeland

security with the challenges faced by these authorities in preparedness for a biological

WMD event and the first 48 hours following the attack.

Strategic communications challenges have been experienced during emergencies

precipitated by WMDs, from the World Trade Center bombing (1993) to Oklahoma City

(1995) bombing to 9/11 eighteen years later. Extremists have used mass media as a

means of leveraging their lack of overt military power with extremely destructive terrorist

tactics against soft targets using WMDs as a tool for political speech and gain the

spotlight for their cause. Terrorists have developed expertise in their public relations

skills to provide a sympathetic narrative to the world audience, while branding their cause

as a righteous Islamic struggle against secularism and imperialism. For example, Al

Qaeda’s Manifesto for a Holy Jihad justified in the “Ladenese Epistle”, written and

posted on the internet in 1996, shows one method of Al Qaeda leveraging the Web 1.0 to

reach its sympathizers:

“It should not be hidden from you that the people of Islam had suffered from the aggression, iniquity and injustice imposed on them by the Zionist-Crusaders alliance and their collaborators; to the extent that the Muslims blood became the cheapest and their wealth as loot in the hands of the enemies. Their blood was spilled in Palestine and Iraq. The horrifying pictures of the massacre of Qana, in Lebanon are still fresh in our memory. Massacres in Tajakestan, Burma, [Kashmir], Assam, Philippine, Fatani, Ogadin, Somalia, Erithria, Chechnya, and in Bosnia-Herzegovina took place, massacres that send shivers in the body and shake the conscience. All this [happened] and the world watch[ed] … and not only didn’t responds to these atrocities, but also with a clear conspiracy between the USA and its’ allies under the cover of the iniquitous United Nations, the dispossessed people were even prevented from obtaining arms to defend themselves. The people of Islam awakened and realized that they are the main target [of] aggression … All false claims and propaganda about human rights were hammered down and exposed by the massacres that took place against the Muslims in every part of the world… The latest and the greatest of these aggressions … is the occupation of the land of the two Holy Places … by the Armies of the American Crusaders and their allies.”-Osama Bin Laden.1

This manifesto reveals persuasive weaving of ancient and post-modern history

into a narrative that frames the United States as a brutish and hypocritical superpower

that colludes with Zionists to subjugate the world’s Islamic faithful while the United

Nations condones such aggression.

1 (Shah, 2008), 48-49.

Another media technique used by terrorists is to provide a video narrative, using

social media such as YouTube, as a prepackaged broadcast program for further

dissemination through the mainstream media. Videos are disseminated on Jihadist

websites while copies are given to mass media outlets such as Al Jazeera for further

dissemination to traditional media outlets. A recent example is when the Taliban attacked

the US Embassy and NATO headquarters on September 13, 2011, which was preceded

by the 10th anniversary of 9/11.2 On September 12, a one-hour speech by Al Qaeda’s

current leader, Ayman Al Zwahiri, M.D., released to Jihadist web sites and Al Jazeera

marking the 10th anniversary of 9/11.3 Such coordination among the Taliban and Al

Qaeda is standard operating procedure for these organized but stateless actors.

In this environment, the possibility of another WMD attack in the United States

looms. Biological warfare (BW) is a major concern. It is incumbent on crisis

communicators in government to prepare for such an event. These preparations should

include strategic communications plans developed prior to the WMD, as well as post-

event plans. This research proposal seeks to assess qualitatively the state of preparedness

among public health and emergency preparedness organizations for WMD events. The

interviews consist of open-ended questions on how new media-based technologies are

being used or planned to be used in WMD crisis communications situations. The

interviews encompass “vertically” sampled public health offices and preparedness

organizations from local, state and federal levels. Although traditional media also play a

significant role in WMD communications environments, this research focuses on the how

the various agencies are visualizing the use of Web 2.0 platforms, specifically Twitter

2 (Harooni & Shalizi, 2011).

3 (CBS News On Line, 2011).

and Facebook, for WMD-related crisis communications.

Brief History of WMD

Some historians consider the United States the 68th empire in known history4. As

an empire, the United States has been committed to an open, secular and democratic

society while respecting the religious freedom for all. Having harnessed the industrial

revolution with science and technology, this nation has prospered. During the course of

the 20th century through two world wars and the atomic age, study of life sciences

enabled American democracy to thrive through advancements in medical research that

nearly doubled the life expectancy of its citizens.5 In 1900, the life expectancy was 47

years among whites and 33 years among African-Americans. Today, they are 78 and 73

years, respectively. In the midst of general level of well-being, the same knowledge in the

life sciences allows the threat of bioterrorism to loom ever the globe where countless

lives are threatened from political extremism and their declared application to weapons of

mass destruction (WMD) to enable a global Jihad.

For the past several years, there has been a disquieting conversation among public

health professionals about the WMD dilemma.6 Since the collapse of the Soviet Union,

the possibility of state-sponsored threats of biological warfare has diminished. However,

from non-state actors, this type of risk is increasing, as terrorists are willing to use bio-

technology for WMD applications. It has transitioned from nuclear WMDs to stateless

sponsors of bio-terrorism as the terrorist weapon of choice.7,8 For the West’s adversaries,

4 (Furguson, 2004), 14.

5 (CDC, 2011), 134.

6 (Bhardwaj, Srivastava, & Karan, 2009).

7 (Biosecurity 2.0-Enduring threats in the former Soviet Union, 2011), 78.

the “do-ability” of a biological WMD event is getting easier, not harder. The disastrous

impact that an audacious WMD attack would have on the United States provides great

incentives for organized extremists like Al Qaeda to inflict lasting psychological and

economic devastation.

An example of such an attack is the 1995 Japanese cult Aum Shinrikyo (Supreme

Truth) that attacked the Tokyo subway system with the sarin nerve agent, a manufactured

chemical weapon used as a WMD.9 This attack was the cult’s second WMD attack

accomplished in Japan. The first attack occurred in Matsumoto City nine months earlier,

where seven citizens were killed and 58 hospitalized.10 This second successful attack in

Tokyo resulted in twelve deaths and forced six thousand subway patrons to obtain

emergent medical attention. Due to the rush of patients seeking emergency treatment, the

public health system buckled in the Tokyo metropolitan area following the attack.11 Even

after four years, 77% of the victims displayed neurological deficits, and 57% continued to

suffer from post-traumatic stress disorder (PTSD), including panic attacks when near

trains.12

Nine years later, WMD attacks continue. In 2004 terrorists used a bomb in their

attack in Madrid, Spain, killing 191 and injuring 2000.13 Although biological or nuclear

weapons were not used in this attack, it must be understood clearly that another WMD

attack is likely, and our enemies are capable of more egregious attacks because the

enabling technologies have become more common and obtainable. No nation or society is

8 (Bansak, 2010).

9 (Fletcher, 2008).

10 (Tokuda, Kikuchi, Takahashi, & Stein, 2006), 196.

11 (Tokuda, Kikuchi, Takahashi, & Stein, 2006), 196.

12 (Watts, 1999), 569.

13 (Algora-Weber, 2011), 216.

immune. It is incumbent on today’s thought leaders to prepare Americans for this

eventuality. The Graham-Talent Commission reported to Congress in 2008:

“The Commission believes that unless the world community acts decisively and with great urgency, it is more likely than not that a weapon of mass destruction will be used in a terrorist attack somewhere in the world by the end of 2013.”14

In 2008 following the recommendations of the 9/11 Commission, Congress

funded the Graham-Talent Commission to (1) assess the nation's current activities and

capabilities to prevent WMD proliferation and terrorism; and (2) detail recommendations

for addressing these threats in the future.15 This report received President Obama’s

attention, given the sense of its risk to national security. Recognizing this very real threat

of WMDs, in the first year of his presidency, the White House made the following point

in his National Security Council Policy Directive.

“The effective dissemination of a lethal biological agent within an unprotected population could place at risk the lives of hundreds of thousands of people. The unmitigated consequences of such an event could overwhelm our public health capabilities, potentially causing an untold number of deaths. The economic cost could exceed one trillion dollars for each such incident. In addition, there could be significant societal and political consequences that would derive from the incident’s direct impact on our way of life and the public’s trust in government.”16 - Barack Obama

One year later, the Commission’s report card, published in January of 2010, gave

the US government a grade of F on the question of the US’s posture on enhancing “the

nation’s capabilities for rapid response to prevent biological attacks from inflicting mass

casualties.”17

(Graham & Talent, World At Risk-The Report of the Commission on the Prevention of WMD Proliferation and Terrorism, 2008), xv. 15

(Graham & Talent, Hearing on the Weapons of Mass Destruction Prevention and Preparedness Act of 2010, 2010) 16

(National Security Council, 2009), 1. 17

(Graham & Talent, Prevention of WMD-Proliferation and Terrorism Report Card, 2010), 6.

Given this real possibility and the ease of which WMD’s may be used for

terrorism against Americans, professional communicators have to prepare for rapid and

accurate information generation and distribution in such a way to provide maximal public

health effects with minimal disruption in its efficacy. The goals of crisis-related

communications campaigns are to prevent generalized panic and civic unrest, and to

preserve the effected area’s public health infrastructure and our faith in institutional

governance.

Public health practitioners successfully promoted health campaigns in non-crisis

situations, for targeted segments of societies through community-based prevention

marketing programs (CBPM), such as breast cancer screening, counter-drug abuse

messaging, HIV preventions and screening, and breast-feeding campaigns18. Ultimately,

the public may be able to accept the possibility of a WMD event and absorb it when it

happens, because modern communications platforms in conjunctions with SN/SM, such

as Facebook and Twitter, allow for rapid, credible, and reasonable information

conveyance to prepare and mitigate the consequences of a WMD attack.

Public health communications systems must be designed and maintained for a

WMD attack. Effective and credible strategic communications are of prime concern, and

this point was one of the key lessons learned from the Tokyo sarin attack.19 Crisis

management is quite different from crisis communications, but without good crisis

communications, crisis management becomes much more difficult. Stakeholders in and

out of government must carefully manage available communications platforms in post-

WMD environments through planned public and private collaborations. SN/SM platforms

(Bryant, et al., 2007), 154. 19

(Beaton, et al., 2005), 103.

may provide important adjunctive channels through which government agencies can

augment traditional mass media communications in public health crisis scenarios.

Social Networks/Social Media

Social networking and social media (SN/SM) have become ubiquitous in our

society. They are efficient and effective for both visual and text messaging and have

grown exponentially. Social media have the potential to moderate and facilitate the

information needs of a nation prior to and during national crisis situations when WMD

events occur.

One of the health trends enabled by digital technology is the professionals’

facilitation of the public’s use and consumption of health information. Internet-based

medical knowledge has become more convenient and credible.20 Consumers have

recognized that quality health information exists at their fingertips from reputable sources

at both public and private websites. The CDC offers robust Web 1.0 resources through

their official website. Its audience is the general public and health professionals alike. On

their Twitter account, CDC added over 1.3 million unique followers.21 Hospitals have

established their presence in the SN/SM because of their demand. Twitter is represented

in over 583 hospitals and Facebook by 551 hospitals for various functions including

community outreach, patient education, customer service, public relations (PR), and crisis

communications (i.e. outbreaks of disease).22

Commercial web sites such as Web MD provide a valuable resource for two-way

communications among health consumers. For medical professionals, expert practice

(Macario, Ednacot, Ullberg, & Reichel, 2011), 145. 21

(Lubell, 2011). 22

(Eckler, Worsowicz, & Rayburn, 2010), 1049.

guidelines are easily accessible from fee-based usage sites, “Up To Date” being one

example.23 This access model allows cataloging and indexing of rapidly changing clinical

practice guidelines from a number of leading clinical research centers. Taken holistically,

these trends have empowered consumers and professionals to be more savvy in searching

for and using health information, "pulling" what they want to know and when they want

to know it.24 Although the validity of health information found on the Web can be of

dubious quality and even dangerous, websites from the CDC and Web MD garner a high

degree of consumer trust in health care information.25 Such sites are generally useful

when coupled with appropriate validation from their personal physicians, which has

become the norm for clinical practice today.26 In crisis health communications, such

"pulling" behavior would likely take place, as experienced by the CDC in the 2009 with

the H1N1 pandemic.27

One can also view SN/SM technology as two-way communications channel that

doubles as a “pre-deployed sensor array” that public health professionals can leverage to

monitor WMD “disease plumes” over a large populated area in real time. As Tweets and

Facebook messaging can be data-mined for key phrases that reflect a community’s

perceived wellness and health, appropriate data-mining algorithms can be designed with

geo-location feature of the platform's hardware to develop plume models for potential

disease wave propagation. “Search” would also be another crucial defensive technology,

already used by the CDC in certain disease prevalence models.28

(Up To Date, 2011). 24

(California Health Care Foundation, 2008). 25

(California Health Care Foundation, 2008), 7. 26

(Eckler, Worsowicz, & Rayburn, 2010). 27

(Lubell, 2011). 28

(CDC, 2011).

In general, professionals will provide the technical content, but journalists and

other information providers will likely be the conduits for communicating to publics

about health information in WMD attacks. As public health issues are tracked closely by

news organizations, journalists with health care credentials, such as Dr. Sanjay Gupta of

CNN, and Dr. Besser of ABC, medical reporters will play key roles in mediating

information in WMD-related public health issues. Major print media outlets also employ

medical journalists, assuming the role of information intermediaries in reporting the

complexities of health information.29 Given these roles, reporters and journalists will be

able to leverage their experiences in potentially minimizing errors, falsities and

uncertainties in a SMS, Facebook, and Twitter environment. It should be noted that

audiences for traditional print media are believed to be becoming smaller as the Web

become more mature.30 In long-term crisis management strategies and plans, it is

important that public health officials have multiples streams of communication to their

audiences.

Given the broadness of the available technologies for crisis management, this

research begins to develop some of the various communications modalities to maximize

crisis prevention, mitigation, and restoration so that any WMD event can be absorbed and

overcome, SN/SM technologies being one of the solutions to complex WMD

communications problems. It is suggested that WMD mitigation efforts can be enhanced

when SN/SM platforms are used to provide reliable “push-pull” information to the

publics. Americans are a resilient people, and the SN/SM platforms will reinforce this

resiliency when managed appropriately by our leaders well-versed in crisis

(Johnson, 2006). 30

(Moses, 2010).

communications. The scope of this research will be limited to bio-terrorism, but strategic

communications concepts in a WMD environment are likely to apply in nuclear or

chemical WMD attacks as well.

Chapter 2

Literature Review

Twitter and Facebook as Examples of SN/SM

Twitter’s demographic user base is represented in the ages 25-44, with sharp drop

offs for ages 55+ and 12-17 and it is considered both as a social network site and a micro-

blogging tool.31 In terms of its functionality, it is a text messaging system that can rapidly

go viral due to its re-tweeting architecture.32 Globally, it is the 8th most popular site

according to Alexa.33 Because of how voluminous numbers of tweets has become, its

usage database offers large quantities of raw tweet data for research.

Sociologists and other researchers have used Twitter’s vast database to approach

new ways of framing behavior.34 Market researchers routinely extract opinions from the

Twitter database to measure views about various consumer brands.35 A relatively new

field of sociology has emerged through Twitter, coined “opinion mining” that has the

utility of gauging the mood of whole communities during popular events.36

Facebook is another important platform for social networking. It is currently the

largest online social network site with 750 million users and the second most popular web

site in the world.37,38 Developed in 2004, its users use it for friendship maintenance of

pre-existing friendships (bonding social capital) used mostly by users under age 44.39

(Thelwall, Buckley, & Paltoglou, 2011), 407. 32

(Thelwall, Buckley, & Paltoglou, 2011). 33

(Alexa). 34

(Thelwall, Buckley, & Paltoglou, 2011), 406. 35

(Thelwall, Buckley, & Paltoglou, 2011), 406. 36

(Thelwall, Buckley, & Paltoglou, 2011), 406. 37

(Alexa). 38

(Strauss & Swartz, 2011). 39

(Alexa).

Research has shown that Facebook is rarely used to develop new friendships and the

average nodal links range between 150-200 friends.40 One of the unique features about

Facebook is that it still is a private company, and its true market value in the future is

unknown.41

Park et al. recently analyzed health organizations’ use of Facebook and its

features of interactive linking with other social media channels.42 After categorizing

health organizations into five sub-headings (government, hospitals, schools, businesses

and non-profit organizations), the study revealed a broad disparity in which different

types of health organizations employed the techniques available to users of Facebook in

engaging their stakeholders and communities. In this descriptive study, the authors

showed that non-profits tended to have the largest participatory postings on Facebook but

the least amount of interactive features. In contrast, health care and educational

institutions tended to use social media channels more frequently, while government

health institutions were the most prolific in using Facebook’s interactive features.43 These

contrasting institutional behaviors suggest that the SN/SM medium has not yet matured

into a technology that has been optimized for its audience and stakeholders consistently.

Given that social trends and usage patterns for Facebook and Twitter platforms

are as dynamic as each new application is invented, it is my belief that a type of

paradoxical convergence seems to be emerging as virtual communities replace orthodox

communities in certain ways. Some of these communities allow people with similar

(Quan-Haase & Young, 2010), 352. 41

(Das & Efrati, 2011). 42

(Park, Rodgers, & Stemmle, Health Organization's Use of Facebook and for Helath Advertising and Promotion, 2011). 43

(Park, Rodgers, & Stemmle, Health Organization's Use of Facebook and for Helath Advertising and Promotion, 2011), 71.

interests to organize on-line and wirelessly with minimal effort.44 Barriers to entry and

participation are low to non-existent.45 Although the level of commitment of such

communities to one another is not well understood, the historical barriers to organizing

such groups are diminishing. Where social clubs and advocacy groups required

geographic proximity, such is not the case for virtual SN communities.46 Online

communities may catalyze the formation of micro-offline communities and allow

seamless coordination among interest groups that self- identify in proximal locations.47

Thus, in large-scale terrorist attacks, the online community members may rapidly identify

their locations so that their virtual community can easily co-locate themselves in safer

areas in crisis events, as seen in the Virginia Tech shooting of 2007.48 It is possible that

during crisis communications environments, these virtual communities may find itself the

backbone of societal coordination efforts at the street level in the first hours of a man-

made catastrophe, especially when bandwidth may be at a premium or temporarily

disrupted.

Health Risk Communications in Emergent Environments

From the framework of maximizing efficient health risk communications in a

crisis environment, health communicators identified some of the best practices in

communicating effectively with their audiences and stakeholders. For example, Covello

suggested seven considerations in organizing crisis communications activities:49

(Ansari, Koenigsberg, & Stahl, 2011), 723. 45

(Greenwood, 2009). 46

(Himelboim, 2011). 47

(Lalonde, 2011). 48

(Palen, Vieweg, Liu, & Hughes, 2009), 475. 49

(Covello, 2003).

1. Accept and involve stakeholders as legitimate partners

2. Listen to people

3. Be truthful, honest, frank, and open

4. Coordinate, collaborate, and partner with other credible sources

5. Meet the needs of the media

6. Communicate clearly and with compassion

7. Plan thoroughly and carefully

Covello’s best practice guidelines emphasize an open and well-thought out risk

communications plans for public health communicators to their audiences and

constituents. The guidelines involve respecting the sensitivities of the public’s needs in

crisis situations while avoiding ambiguities and complexities in such environments.

Crisis communications researchers also recognize that in mass emergency

situations, people use repetitive, active and passive means to gain new information.50 In

the 21st century, this “push-pull” behavior is magnified by the ubiquity and access points

for new media technologies such as tablets, smart phones and mobile web services.

Online news services and journalist’s blogs are available universally. Stephens and

Malone noted that “during crises, such as 9/11, Hurricane Katrina, and tsunamis, people

are turning to new media and World Wide Web for information and support.”51 Because

WMD events are designed to be both newsworthy and exploitive of ambiguity, it would

also reveal the public’s propensity to use new media channels to “pull” information more

(Walter, 2009). 51

(Stephens & Malone, 2009), 230.

actively and repeatedly. Stephens recommended that press releases should be written to

the public and not just towards the media during crisis situations.52

It is likely that a WMD event will occur in an urban environment where high-

density populations exist. In such settings, society’s vulnerabilities are maximized from

the viewpoint of the terrorists, especially if they plan for a biological WMD attack. In

such environments, the relationship between government officials, journalists, and the

citizenry may become strained as the “unknowns” are far greater than the “knowns”. This

ambiguity is the nature and disproportionate power against open societies targeted by

biological WMDs. However, by keeping the SN/SM medium open and dominated by

credible and usable content from experts of public-trust organizations, such as public

health and preparedness agencies, mitigation efforts and information (e.g. self-help and

self-protection videos, text, photos, geo-locations) can be diffused rapidly. Time-saving

and life-saving information can be disseminated and made available easily and repeatedly

on Web 2.0 platforms.

Strategic communications plans should include contingencies for rapid

dissemination-capable technologies using multiple channels. Speed, accuracy, and

usefulness of emergency information would likely reduce health concerns and

ambiguities appearing prior to an imminent or the first few days after a WMD attack. By

its nature, the SN/SM allows for rapid node-mediated information exchange from single

point sources to many with good information fidelity. Each point of reception, in turn,

can act as another point of relay to many others. Such information sharing has gained the

term “going viral” in today’s vernacular, reflecting the multiplicative value of news-

worthy information or innovative ideas. 52

(Walter, 2009).

At each point of relay, the SN/SM users may act as a sort of logic filter by judging

the information as being credible, usable and/or reliable for further dissemination to their

friends. This propagating and self-checking process, in aggregate over time, has the

potential to be a self-correcting information exchange system within the social network

seeking collective protection from perceived threats. This propagation of information also

could incur dissonance and errors in meaning as messages are shared. But, in case

information errors (or abuse), each relay point is a nodal point to reject or correct it,

assuming that most participants are not malicious. It would be a false symmetry that net-

sourced health information be equally benign or malicious. Information sourced from

unknown entities would not easily be accepted while information from known or credible

sources would likely be considered for sharing. Boyd, through a longitudinal study, found

such self-correcting behavior for guarding privacy over a two year study as he concludes

that "users develop[ed] ad-hoc risk mitigation strategies to address privacy threats."53

Information and content from the Web may be correct as well as incorrect. The

credibility of sources would weigh in greatly in how individuals judge their content about

health information. It makes sense that the source (brand) of the message would have a

positive bearing on the receiver's acceptance of the information. Roberts showed that the

credibility of the source of the information and the messenger have correlative effects of

the public trusting the message.54 The CDC recognizes that their “brand” is perceived as

credible, and therefore expends great efforts to preserve their Web content through an

(Boyd, 2011), 1. 54

(Roberts, 2010), 43.

elaborate internal vetting process prior to dissemination.55 Preservation of the CDC brand

is a very high priority for CDC’s communicators.

This approach assumes that the majority of the SN/SM community members are

seeking validated and useful information in health crisis events. An example of this effect

was the CDC campaign to promote “social distancing” as one of the key mitigation

efforts during the 2009 flu pandemic.56 The campaign was simple, and its credibility was

dependent on CDC’s reputation. (This campaign was implemented while awaiting the

delayed manufacture and distribution of the H1N1 flu vaccine.) The social distancing

campaign was rapidly accepted because it was designed to be workable and found

resonance despite some counter-arguments against its efficacy.57

In this relaying process, each stage of message reception and re-transmission can

be considered a “logic gate”, with each iteration being open to corrective influence by

updated information. Mis-information or mis-interpretation also could be relayed by

well-meaning intermediaries. It also could be subject to intentional malicious message

changes. Message changes, however, would be obviated by looking at the internet source

and the IP address.

In the abstract, one can model this process as an information quality assurance

process in a knowledge “supply chain”. If each relay point (node) has a probabilistic

incentive to preserve the quality of the information closer to 1 (p≈1) rather than less than

one prior to re-transmission, the digital fidelity of the information in digital form would

likely be preserved. Psychologically in crisis situations, the incentive to preserve fidelity

would far outweigh the incentive to be malicious with the information. Since participants

(Lubell, 2011). 56

(CDC, 2009). 57

(Jones, 2009).

of SN/SM tend to interact with people they know, this assumption is reasonable in this

abstract model.

It is also important that the source of the original information is credible for

participants to continue to relay the information. In public health crisis situations,

legitimate information sources would be of a premium as the public pulls information.

Statistically speaking, information fidelity is more likely to be sustained than not as the

incentive to preserve it by the collective far outweighs the incentive to disrupt it.

In general, it is reasonable to assume that active SN/SM participants will consider

relaying useful information to their social network. The threshold to allow relaying would

be variable depending on many factors. Some of these factors may include applicability,

criticality, credibility of source, collegiality, common interests, professional inclinations,

level of intimacy, and social acceptability. Disruptive individuals within the group may

have malevolent or criminal intentions for information relaying as well. Over time,

social networks would try to weed out the disruptions from the stakeholders of the group

for the benefit of the group. Although social networks are, by definition, semi-open

forums, virtual social groups have self-interests to preserve their community from harm

by malicious participants.

If one views social networks as a form of team in a virtual medium, then one can

visualize these teams having team group dynamics. Behavioral psychologists theorized

that team dynamics has a propensity to generate self-regulatory mechanisms for the good

of the whole, despite disruptive forces that may in play.58 Some of the factors that drive

this behavior are clarity of purpose, commitment, group cohesion, and autonomy.59

(Millward, Banks, & Riga, 2010). 59

(Millward, Banks, & Riga, 2010), 52.

Although this method of framing the SN/SM as a form of team building may be

simplistic, it is with some merit considering Milgram's six degrees of separation having

now been reduced to 4.37 in the US among Facebook users, and their sense of virtual

proximity being more prevalent.60

The gate is that the SN/SM participant “tests” the new information (innovation)

before he decides to relay it further to his personal network. If he relays it then the

participant is opening a “logic gate” for further diffusion to take place. This phenomenon

can also be thought of as a type of diffusion of innovation (DOI) process framed in

macroscopic socio-behavioral terms that develops a collective intelligence among its

participants.61 Thus SN/SM can be framed as a derivative concept of the new science of

networks.

Stated differently, Rogers, in the decision stage, noted that “Most individuals who

[sic] try an innovation then move to an adoption decision, if the innovation proves to

have at least a certain degree of relative advantage.”62 An individual’s decision to relay

the information is analogous to logic gate event in network science, where useful health

information, viewed to be credible, has a higher probability of being forwarded to the

next recipient. In digital circuit design, the role of transistors is to allow certain "good"

signals to pass through while blocking others, allowing for the design of complex digital

logic circuits for signal amplification and control. In the life sciences, such self-correcting

processes are how biologists and immunologists conceptualize complex adoptive systems

like ant colonies and the human immune system, respectively.63 In other words, it may be

(Markoff & Sengupta, 2011). 61

(Mitchell, 2009). 62

(Rogers E. M., 2003) (Rogers E. M., 2003), 177. 63

(Mitchell, 2009).

a fallacy to perceive SN/SM as a chaotic one-to-many communications process. Instead,

it is a communications medium that forms an intelligent sociological collective that

attenuate complexities and generate solutions to shared problems in pre-established

virtual communities defined by its SN/SM participants.

This concept of collective learning and distribution, coined as distributive or

participatory learning, has received grants from the MacArthur Foundation who

collaborates with Duke University, University of California and HASTAC (Humanities,

Arts, Science, and Technology Advanced Collaborative) to consider new models for

learning environment optimization through modern communication technology for the

critical thinking process.64 One can perceive the distributive learning process as being

similar to collective network learning by complex adoptive organisms.

Collective learning processes are iterative, dynamic, and relatively more efficient

for group cognition in the virtual world as social networks interact in crisis

communications. One example of how this collective intelligence played out was the

behaviors displayed in the Virginia Tech shootings.65 In this tragedy, social networks

were used by the collective as an “I’m OK-Are you OK?” networked relay system within

hours after the first murder taking place.66 This back-channel virtual network allowed the

authorities to confirm an accurate accountability of the student body rapidly within hours

after the perpetrator committed suicide.

(HASTAC, 2011). 65

(Palen, Vieweg, Liu, & Hughes, 2009), 474. 66

(Palen, Vieweg, Liu, & Hughes, 2009), 471.

Tablet Technology and Social Media

The DOI concept can also be applied to the consumer technology industry. On the

hardware side for SN/SM, technological innovations continue. A unique trend in 2011 is

the sales growth of tablets as an access platform for Web 2.0 contents. Tablet shipments

are projected to increase by 245% in 2011, according to Morgan Stanley, with the

increased likelihood of cannibalizing the PC market.67 This trend will also likely

accelerate over the next several years. Tablets are seen as a disruptive technology, and the

cannibalization rate is projected to be 29% relative to PC’s in 2011. High demand is

projected both in the United States and internationally because “tablets may be viewed as

content-creation devices.”68

Tablets are unique devices in that they provide a content accessibility as a fusion

of the smartphone and the laptop/pc in a very portable and graphically enriching device.

The tablet offers the technological advantage of intuitive touch screens as the human

interface, which is ergonomically more efficient as it is easy. It offers low or no-cost

downloadable applications with over 500k apps in the Apple App Store and 250k apps in

the Android marketplace, respectively.69 Users of mobile technologies, like smartphones

and tablets, are positioned to find more and more utilitarian applications over time. As the

consumer accepts rapidly this diffusion of this technological innovation, its presence may

become the dominant hardware platform for which SN/SM resources are consumed.

Industry watchers suggest that the current consumer attraction to tablets is for “media

consumption”, and that 24 million tablets were projected to be sold in the US in 2011,

(Morgan Stanley Research-Global, 2011), 7. 68

(Morgan Stanley Research-Global, 2011), 4. 69

(Rodriguez, 2011).

more than doubling the 2010 sales of 10.3 million.70 Inaugurating the market, iPad sales

currently stand at 29 million since its introduction in 2010, representing its dominance in

the tablet market.71

Given these trends, the sales represent that one out of five adult Americans may

have purchased a tablet by the end of this year. This trend is likely to be enhanced by

Fortune 500 companies adopting tablets to increase their employee’s productivity. For

example, all 1400 Alaska Airlines pilots have an iPad, and Lowe use their 42,000

iPhones for their inventory control.72 With the successful marketing of iPads, Barnes and

Noble’s Nook, and Amazon’s Kindle Fire, CIO’s are considering adopting tablets for

enterprise integration in their business models, validating this hardware’s possibility of

increasing human productivity, lowering costs, or both.73

On the “pull” side of the information push-pull paradigm, the tablet’s projected

popularity may be in part attributable to the fact that streaming media and content would

no longer be limited by small cell phone screen sizes. Continued development in

hardware has allowed tablets to overcome previous limits of relative bulkiness and

battery power capacities of laptops without losing portability or computing capacity.

Tablets offer robust performance and features rivaling laptops and home computers.

Currently, the iPad and Kindle Fire, respectively, represent that range of cost and

form factors for tablet technology. All offer dual processors and full motion wireless

(Brustein, 2011). 71

(Streitfeld, 2011). 72

(Wingfield, 2011). 73

(Morgan Stanley Research-Global, 2011), 4.

streaming video at reasonable consumer entry costs of $499 and $199 respectively. Many

useful apps are available for communications using tablets and are inexpensive or free.74

Social Media Content and Creativity

As a technology, tablets offer the possibility of delivering robust and vivid

content that is both customizable and interactive. Its processing power, audio-visual

richness and wireless broadband connectivity allow for customized content to be

produced and shared almost without limits in the connected world. As television had

revolutionized communications from radio without replacing it, the promise of tablet

technology is no less potent, because television programming is available on tablets plus

the added benefit of decentralized collaboration and ability to share audio-visual content

as created by the users. A poignant example is in the medium of YouTube, where one

cancer patient posted his audio-visual diaries of his struggle with terminal cancer to help

other cancer patients deal with the disease with dignity.75

Complexity of subject matter does not necessarily preclude rapid discrimination

and usable comprehension of complex issues by these social networks. The emergence of

tablets and smart phones have the potential to redefine the capacity of creative content,

regardless of content’s file size, where understanding complexity can be made easier by

clever packaging of information to usable knowledge through the Web 2.0 as the vehicle

of knowledge diffusion. The Kahn Academy has gained substantial popularity and

credibility in leveraging this possibility.76 The Kahn Academy is a free virtual classroom

available through the internet (see http://www.khanacademy.org/). This service posts

(Bell, 2011). 75

(Kline, 2010). 76

(Thompson, 2011).

http://www.khanacademy.org/

videos of science, finance, humanities and math subjects taught on line to anyone seeking

a virtual tutor both at home and in the classroom.77 The concept is similar to podcasts, but

the technology offers much more of an enriching and learning experience. Although

many of the courses are graphics intensive, requiring faster processors and broadband

connectivity, this is not a problem for currently available tablets or smart phones. The

content is designed for ease of access and use by a broad range of ages, from elementary

school to university students. Its video library has over 2700 lessons and still growing in

content diversity. The website has delivered over 87 million high quality micro-lectures

in the few years that it has been available.78

The technological infrastructure SN/SM can be considered as a pre-existing and

imminently manageable communications medium that is both socially dynamic, and

dynamically social. It is hoped that the declining barriers of participation in terms of cost

will increase its use and penetration in all levels of society. The Federal Communications

Commission (FCC) announced recently its plans to facilitate broadband access to low

income households for $9.95 per month. It is called the "Connect to Compete" program

that partners with the free National School Lunch Program.79 The "Connect to Compete"

program is a major federal initiative to narrow the digital divide for lower income

families, estimated to be over 100 million people not having broadband access in the

US.80 Smart phones and tablets are capable for "transceiving" rich and dynamic content

already available on the Web. Given the potential for knowledge and information

dissemination to anyone desiring them, regardless of socio-economic barriers, it is a

(Thompson, 2011). 78

(Khan Academy, 2011). 79

(Gottheimer & Usdan, 2011). 80

(Gottheimer & Usdan, 2011).

reasonable assumption that SN/SM's growth is poised to become more geometric rather

than of arithmetic in the next few years.

An interesting novel example of how a type of collective intelligence emerges in

SN/SM communities will be recounted here. In Los Angeles, a clever marketing

consultant found a way to incentivize a collective intelligence among lunch truck patrons

in search of a tasty meal in the LA metropolitan area. Using guerrilla advertising tactics

on Twitter, the time and location of his client’s mobile lunch truck were disseminated to

would-be patrons on Twitter. Targeted Twitter account followers were encouraged to

check out a unique taco called Kogi Tacos. Twitter followers were geo-located to where

the truck would be in a given day, a type of behavior analogous to swarming, but in this

case the pheromone was a simple tweet received by pre-formed virtual communities.

The success of this marketing was reported in Los Angeles Times as having

“emerged as a social-networking juggernaut, drawing 300 to 800 people each time it

parks (often several times in an evening) and spawning a burgeoning cyber-hippie

movement affectionately referred to as "Kogi culture.”81 This collective behavior was

later reported by National Public Radio (NPR) that “It took the virtual world of Twitter to

bring about all this face-to-face interaction” with the power to impact behavior and

culture of hundreds of people.82 From a simple Twitter content (new media), the SN/SM

marketer reached a national broadcast audience (old media-radio) seamlessly of an

unexpected but novel social outcome for a lunch truck proprietor.

(Gelt, 2009). 82

(Bergman, 2009).

Health Risk Communications in Routine Everyday Environments

In normal times, health communicators have defined the public health model “as

an approach that sees the cause of death and injury as preventable rather than

inevitable.”83 From this definition, Coleman et al. suggests a binary inter-play among

public perceptions framed in episodic and thematic frames as originally suggested by

Iyengar in 1991.84 Episodic framing, (i.e. food choices and obesity), of health reporting

tended to lead to individual causes while thematic reporting (i.e. abundance of fast food

restaurants in poor neighborhoods), lead to societal causes for poor health.85 These two

frames tend to attribute the causal relationship of disease to individuals verses to their

environments. Coleman et. al. concluded that the "thematic frame made readers more

supportive of public policy changes and encouraged them to improve their own health

behaviors."86 As public health management involves population groups as the patient, it

makes intuitive sense that health information should also be framed in thematic frames to

maximize behavior changes for population groups.

The way in which health knowledge diffuses to the population has been enhanced

and facilitated by internet-based technologies. Health care researchers have documented

the transition from “physician-directed management to patient self-management,” where

the promise of Web 2.0 will further enhance this transition.87 Others have suggested that

new media offer a unique and under-used solution to overcome challenging barriers for

better medical outcomes, given that the United States spends the most, among many

(Coleman, Thorson, & Wilkins, 2011), 942. 84

(Coleman, Thorson, & Wilkins, 2011), 942-943. 85

(Coleman, Thorson, & Wilkins, 2011), 943. 86

(Coleman, Thorson, & Wilkins, 2011), 941. 87

(Roblin, 2011), 60.

western nations, on both clinical and public health care services.88 Termed

“dissemination 2.0”, Bernhardt et al. suggests four strategies in providing the bridge for

getting evidence-based research knowledge to end-user application more rapidly and

seamlessly. These four are strategies are noted as: increasing dissemination efforts,

assembling inventories of effective programs, partnership building, and increasing

demand for evidence-based knowledge.89

Health researchers suggest that tailored health communications could prove

integral to life-style behavior changes.90 Lifestyle changes promote health maintenance

and reversal of certain conditions. For example, weight loss among obese patients

reduces the risk of many chronic diseases such as hypertension, cardiovascular disease,

diabetes and osteoarthritis. Public health professionals understand that individual health

is as much about life-style is it is about genetics. Although it is easier said than done, a

major tenet of risk communications is to maximize credibility and compassion that

acknowledges the insecurities of the target audience in the post 9/11 world.91

Pulling of health information via SN/SM has become a dominant social trend

exercised by more and more people every year.92 Health risk communicators can exploit

this trend in the SN/SM sphere in unorthodox and app-centric ways that were not

technologically possible a decade ago. Such “pre-communicating” about emergency

preparedness through SN/SM channels will likely help society prepare for WMD events.

Conventional limitations, such as the physical page for print media and event

linearity of one-to-many transmission of broadcast media, do not exist for the medium of

(Bernhardt, Mays, & Kreuter, 2011). 89

(Bernhardt, Mays, & Kreuter, 2011), 36. 90

(Noar, Grant-Harrington, Van Stee, & Shemanski-Aldrich, 2011). 91

(Covello, 2003). 92

(Lober & Flowers, 2011).

SN/SM. One expert on information technology (IT), John Bielec, Drexel University’s

CIO, suggests that “enterprise-wide learning management systems (LMSs) will

undoubtedly disintegrate into a framework to access cloud-based distributed learning

objects creating a Personal Learning Environment (PLE). Facebook, YouTube, Survey

Monkey, Twitter, Google Apps, Drupal, and many others (some not even invented yet)

will fill the growing need for content and the widening quest for collaboration.”93 The

platform for collaboration, the one-to many-to-one paradigm, as suggested by many IT

professionals, is the promise of Web 2.0.

If a WMD event does take place, much can be done to protect the health of

populations through rapid dissemination of protective self-help instructions. Without

credible information, the likelihood of mass confusion and mob behavior is made more

likely. With credible health information filling the news vacuum through SN/SM in crisis

situations, consequence management would be made easier for public health and

preparedness officials.

Cyberspace and New Media in the Context of National Security

One can think of the new media as a type of battle space, a new type of warzone

in the framework of national defense. In the post-modern vernacular, it has been

generalized as cyber-warfare. Cyber-warfare lends itself to be framed in terms of

governments developing resources and infrastructure to attack or defend against cyber-

assaults from another hostile government or well-resourced criminal organizations. The

basic idea is that these attacks occur with the expressed purpose disrupting automated

(Bielec, 2011).

processes while hiding the identity of the perpetrator and the specific reasons behind it.

The target for this type of attacks are other computers and computer programming codes

designed to infiltrate, disrupt, and exploit the enemy’s digital systems. Successful cyber

warriors seek to remain hidden and never be identified by their intended targets.

This was the case in the “Stuxnet” attack by unknown assailants targeting the

computer systems of Iranian WMD nuclear weapons research site in June of 2010. The

International Atomic Energy Commission (IAEA) substantiated the success of the attack,

reporting that the IAEA identified significant reductions in uranium centrifuge operations

in the preceding year.94 Because of the sophistication and complexity for this type cyber-

attacks, government-level resources would be required, and stateless terrorists are likely

unable to use cyber-attacks in their terror strategy.95

In contrast to cyber-warriors, terrorists seek media attention. The main goal of

their attacks is to instill visceral and disproportionate fear in their target communities.

This strategy is similar to that of organized criminals where victimization is central to

their societal power,96 but the terrorist’s goal is not wealth or commercial gain. The goal

for terrorists is political speech and leveraging societal influences that may change

governmental behavior. The terrorists thus need access to all forms of media to further

their agenda and facilitate their grand design. Without this modern means of publicity,

terrorism could not thrive.

As technology further flattens the access points for terrorists to develop more

sophisticated messaging on the world-wide-web, the possibility exists where

governments will have to be vigilant in countering these messages. Some of these efforts

(Weinberger, 2011), 143. 95

(Weinberger, 2011), 144. 96

(Altheide, 206), 417.

currently include “limiting terrorists’ access to conventional mass media, reducing and

censoring news coverage of terrorist acts, and their perpetrators, and minimizing the

terrorists’ capacity for manipulating the media.”97

When a WMD crisis occurs, the terrorists are likely to follow up with Web 2.0

tactics using narratives designed to go viral and further increase the anxiety and suffering

among the victims of the targeted community. Through software, content, and hardware,

governments would be obligated to manage and match such hostile messaging and

actively countering it with appropriate messages to alleviate the negative impact on the

affected populace. This type of SN warfare was reported in the recent terrorist attacks in

Kabul, Afghanistan where the NATO forces are actively engaging and counter-posting

the NATO narrative.98

If such plans for strategic communications are not pre-planned, mitigation efforts

would be placed at risk and possibly reduce the people’s faith in their government.

Another more extreme outcome is that citizens would panic and compound mitigation

and recovery efforts by the authorities, especially if contagious infectious

microorganisms are involved. This could trigger martial law and imposition of quarantine

violations requiring exercising lethal police powers. A solution to such scenarios is to

increase the communications channels between the people and their government through

as many channels and platforms as possible.

(Weimann, 2008), 70. 98

(Farmer, 2011).

WMD Disasters: Can Social Networks Help?

One of the more common reasons for poor disaster recovery efforts immediately

following the disaster is the lack of reliable communications platforms that remain after

the devastation. Whether it is hurricanes, earthquakes or WMD events, the common

bottleneck for disaster and crisis managers is the limits on their communications capacity

within and external to the affected geographic area and its population. For this reason,

rapid recovery efforts may be hampered and first responders and officials find themselves

frustrated until communications are restored. If this problem persists, additional lives

may be at risk and recovery efforts will be disorganized, redundant, and inefficient.

Political attribution may follow, and significant resources may be wasted.

The field of disaster management continues to emerge as a critical discipline as

an aftermath of this nation’s experiences after 9/11 and Hurricane Katrina.99 Both

disasters were of horrific proportions, one man-made and the other nature-made, that

changed the way Americans viewed their sense of national security and sense of

individual vulnerability. Both disasters also occurred in the midst of a communications

revolution of sorts where technology promoted and exposed increased vulnerabilities in

the form of Web 1.0, social media, and wireless telephony. Journalists and private

individuals were able to record and transmit real-time news and imagery that served to

galvanize this nation. However, government officials were unable to communicate

effectively in a timely fashion that met the demand for credible and reliable information.

This unpreparedness resulted in FEMA’s director, Michael Brown’s resignation100 The

media coverage of Katrina compounded mitigation efforts using language to portray

(Garnett & Kouzmin, 2009), 385. 100

(Allbaugh, 2005).

government leaders as ineffective managers, thus abdicating the journalist’s “role of

objective observer to assume a privileged position of pointing blame toward legitimate

authorities.”101

For Katrina, the damage occurred rapidly in a 24-hour period, where a

combination of winds, flooding, storm surge, and later the levee breach resulted in

recovery costs in excess of $200B.102 In this disaster, the events that followed revealed

the limitations of civil government, technology and its antecedent failures of

telecommunications infrastructure. It is asserted that for period of many days, anarchy

prevailed, where looting, lawlessness, and general mayhem persisted until federal

resources and institutions of civil governance were restored.103

Louisiana’s officials reported 1464 deaths as a direct effect of Katrina,104 but the

socio-political aftermath still lingers as disaster managers recognized that the

government’s initial ineffectiveness was attributable to the lack of pro-active

communications platforms available to the heterogeneous group of emergency first

responders working in the area.105 Cellular networks were damaged or destroyed and

non-indigenous rescuers and emergency workers did not have the homogeneity of radio

equipment and frequencies that were compatible with each other. Coordination between

the different agencies was initially rendered unavailable. Restoration of basic emergency

communications systems required more than two weeks before the city had a reliable first

responder communications system.106

101

(Littlefield & Quenette, 2007), 28. 102

(Banipal, 2009), 485. 103

(Banipal, 2009), 486. 104

(Louisiana Department of Health and Hospitals, 2006). 105

(Silberman, 2005). 106

(Banipal, 2009), 488.

In WMD scenarios, use of nuclear or high explosives would likely render multiple

communications systems inoperable. This effect is less likely in chemical or biological

WMD's since such weapons do not result in high energy explosions or high radiation

pulses. Over time however, as large fractions of exposed workers are incapacitated by

radiation, neurotoxins or infectious organisms, the communications workforce may not

be able to sustain the operability of the communications infrastructure over the long term.

The limitations of conventional mass communications platforms are repeatedly

exposed when publics are confronted with large-scale public safety concerns. Normally,

the daily news cycle allows citizens to exercise their routines and habits for news

consumption based on the uses and gratification concept.107 In contrast, through Rogers’

DOI theory, communications behavior follows where “[e]arlier adopters have greater

exposure to mass media communications channels than to later adopters.”108 From the

perspective of the governmental entities, this study assesses the organizational

adaptations that communicators within these agencies have evaluated the SN/SM

mediums as possible channels to communicate with the public in abnormal crisis

situations. The level of adoption would be measured to the degree in which Web 1.0 and

2.0 platforms are integrated into their communications plan for WMD crises, with the

intent of this study measuring their “adoptive-ness” to leverage communications

technologies in large-scale disasters.

Because today’s social participation increasingly involves virtual means, the DOI

theory supports the method in which citizens communicate in crisis situations. One

argument proposed is that public information seeking behavior transitions to a “push-pull”

107

(Rosengren, Wenner, & Palmgren, 1985). 108

(Rogers E. M., 2003) (Rogers E. M., 2003), 291.

paradigm where individuals seek rapid updates (pull) of useable information when

official emergency broadcast communications (push) channels fill the airwaves. When

people feel threatened for their personal safety is at stake, their information seeking

behavior tend to migrate rapidly toward newer technologies such as SN/SM on the “pull”

side, as exemplified by the Virginia Tech shootings in 2007.109 Due to the lack of usable

real-time information during the crisis, students on campus relied upon Facebook as the

primary means of finding out who was safe and who was not, as previously noted.110

Recent history in the California fires noted another inadequacy of the traditional

emergency management system’s reliance on broadcast mediums. Broadcasters,

representing the “push” side of media channels, tended to select their reporting of news to

gain audience novelty rather than focusing on distributive information models designed

to inform the widest audiences in the effected danger areas. Thus emergency

management information about the specific locations of the fires was relegated to non-

primary airtime when compared to concentrating information mostly on the Malibu area,

where celebrities’ homes were threatened. Although the fires affected a much larger area

in southern California, from Santa Barbara to San Diego, the commercial broadcast news

channels failed to report the events proportionally to the actual risks to the general

public.111

In contrast to natural disasters, man-made disasters do not impact infrastructure to

the degree as it does civil institutions and the public’s faith in governance. In the 9/11

attack, the initial success of destroying the Twin Towers and attacking the Pentagon

resulted in severe damage and sense of safety in the psyche of local affected areas, but

109

(Winerman, 2009), 376. 110

(Winerman, 2009). 376. 111

(Winerman, 2009), 376.

served to galvanize a nation with a common goal to take the fight to the enemy. For

natural disasters such as the Japanese Tsunami of the Katrina disaster, the public’s

reaction seemed to affect the public’s faith in their government as large geographical

areas were affected and official statements were slow and contradictory. By contrasting

the cause of the disaster, three distinct differences can be pointed out.

Firstly, by intent, terrorists design their attacks to maximize disruptions in the

“normal flow of business” and the sense of societal security and faith in their

government.112 The psycho-social effects of terror are by design, the end point for the act

itself. The terrorist designs the attack as a message to a larger and geopolitical audience

that may not be the victim themselves, but to communities or societies who share the

victims’ identity or allegiance.113 Part of the disruptive process is to sabotage their

confidence in their government about national security and safety through the

communications. This wedging strategy focuses on dissolving, especially on the initial

stages of a WMD attack, the people’s faith in their system of relationships with their

leaders.

Secondly, the degree of the long term psychological effects is one of the primary

goals of terrorists use of WMD’s to civil societies. The purpose of terrorism can be

considered a form of political speech in that communication is taking place between the

terrorists and their adversarial government. The terrorist’s message may be that a

government must change a certain foreign policy under the threat of an act of terror.

When terrorists succeed in their attack, the success provokes friction between the victim

nation's leaders, national policies, and their government’s ability to manage international

112

(Canel & Sanders, 2010), 450. 113

(Weimann, 2008), 69.

relationships and economic alliances that may have been the status quo for many years.

In this aspect, the attack's success can place a psychological wedge between the

government and its traditional allies. Causing political divergence between nations with

similar historical interests is a key target of terrorists, as exemplified by the effects of the

Madrid bombings and how the Spanish government (and its people) viewed the risks of

supporting American policies in Iraq.

In applied terms, terrorism is a method of “leveling the political playing field”

between governments and stateless actors with transnational ideological agendas.

Terrorists understand that they do not possess the traditional or “hard power” war making

capacity to challenge governments directly. However, through various limited but violent

and lethal means, terrorists design their attack for maximum psychological impact. Their

primary weapon is the media. Through this medium, they can leverage modern

technologies in clever and lethal ways to instill fear and insecurity to much larger

vulnerable groups. Because terrorists are not constrained by limits of the law, their lack

of hard power is compensated by the openness of their target societies.

Thirdly, scholars have noted that since the 1970’s, terrorists developed expertise

in manipulating mass media for their political gain. With the goal of amplifying their

legitimacy on the world stage, modern terrorists learned from their predecessors while

recognizing and applying the powers of persuasion through choreographing compelling

narratives after gaining the media’s attention.114

The purpose of this study is not to review and develop new crisis communications

modalities in biological WMD events. Rather, the study researches how the presence and

functionality of SN/SM are identified by public health and safety institutional 114

(Weimann, 2008), 71.

communicators, and how their strategy seeks to leverage the use of SN/SM in WMD

events requiring mass public health resource mobilizations.

Biology in Post-modern War

Public health professionals know that biological agents are well suited for

“weaponization” for mass destruction in developed countries in urban settings.115 The

desired attributes of a weaponized microorganism include their ability to cause mass

terror, public anxiety, communicability of disease, high morbidity and mortality rates,

decrease confidence in government, provoke a collapse of regional health care systems,

and require exorbitant costs for recovery efforts. Given these criteria, public health

officials have identified six pathological organisms to be of the highest concern for

WMD applications.116 Known as class “A” agents, these six are:

 Anthrax (Bacillus anthracis)

 Smallpox (variola major)

 Plague (Yersinia pestis)

 Viral hemorrhagic fevers

o Ebola & Marburg (filoviruses)

o Lassa & Machupo (arenaviruses)

 Botulism (Clostridium botulinum toxin)

 Tularemia (Francisella tularenisis).

115

(Fischer III, 1999), 28. 116

(Center for Disease Control and Prevention (CDC)).

Infection by any of these microorganisms is likely to be lethal without prolonged

and intensive advanced hospital treatment, and theoretically, a single organism is

necessary for morbidity and death.

Biology in Pandemics

Public health professionals know that the potential for microbiology-mediated

catastrophes is very serious. The profound power and lethality of microorganisms have

been observed occurring naturally and in cycles. The last great flu pandemic of 1918

claimed an estimated 100 million lives worldwide, which eclipses the total death count

from the Great War that ended that year.117

Because of the possibility that the pandemic of 1918 could be repeated, in 2009,

the World Health Organization (WHO) declared the Stage VI Flu pandemic. An

estimated 61 million people were infected world-wide, but only about 13 thousand deaths

occurred.118 Because the H1N1 flu strain was very contagious, the infection rates fulfilled

expectations. Fortunately, the death-rate predictions did not materialize, because the

H1N1 strain turned out to be not as lethal as the 1918 strain.

Earlier in 2003, concern about a non-flu pandemic was aroused when the Center

for Disease Control (CDC) initiated an emergency surveillance requirement for a new

respiratory infection that had a high mortality and transmission rates.119 Over a twenty-

week period, from a single American index case of SARS (severe acute respiratory

syndrome), the CDC estimated that over 1400 unexplained cases arose in the US.120

117

(Center for Disease Control and Prevention, 2009). 118

(Center for Disease Control and Prevention, 2009). 119

(Schrag, Brooks, Van Beneden, Parashar, & Griffin, 2004), 188. 120

(Schrag, Brooks, Van Beneden, Parashar, & Griffin, 2004), 185.

Given that few SARS patients seem to be surviving the infection in Southeast Asia

(believed to be originating from Guangdong, China), 121 US public health officials were

bracing for the worst. With Western level of medical care, and rapid isolation of

suspected patients, all of the SARS patients survived,122 but many knew that we had

dodged another lethal pandemic.

Politics of WMD

The threat of biological weapons (BW) for political gain emerged concurrently

with the 9/11 attacks. The anthrax attacks in Washington D.C. and other cities occurred

when, a week later on 9/18, four postal letters doused with weaponized anthrax spores

where mailed from Trenton, NJ.123 Although small in scale, this attack resulted in five

Americans dying while 17 suffered critically over the next three months.124 An important

fact of this event is that a single point source mailed in New Jersey affected a much wider

area to include Florida, Connecticut, New York and as far west as Texas.125 The FBI

estimated the recovery costs as exceeding $1 billion when the cleanup was completed.126

Paradoxically, for the microbiology-trained terrorist, the cost of an anthrax weapon was

likely only several dollars (the cost of the mass mailings) and the possession of research

anthrax spores. The ratio of cost of the attack to the cost of mitigation is surreally lop-

sided; therefore, it is an ideal weapon for terrorists, and a daunting challenge for their

targeted governments.

121

(Schrag, Brooks, Van Beneden, Parashar, & Griffin, 2004), 185. 122

(Schrag, Brooks, Van Beneden, Parashar, & Griffin, 2004), 185. 123

(Frerichs, 2008). 124

(Frerichs, 2008). 125

(Frerichs, 2008). 126

(Lengel, 2005).

The cost of the cleanup was not based on anthrax’s true danger to the population.

Its enormous cost was the price paid for mitigating the public’s uninformed phobia about

the patho-physiology surrounding infectious diseases. The public demanded whole

buildings to be condemned or decontaminated, regardless of the actual risk to human

habitability. The public’s expectation was that that infectious disease risks could be

zeroed with sufficient efforts of wholesale clean-up, regardless of cause. The hysteria

surrounding this particular WMD event, in effect, drove the mitigation costs to

astronomical levels without proportionally reducing the true health risk for the general

population. Such irrationality will be repeated unnecessarily if the United States, as a

society, fails to educate its population about the limits and simple mitigation techniques

that can be used to reduce the risk to near zero, but never practically being zero.

On the other hand, the potential risk for unprepared population groups is

staggering. Less than a kilogram, engineered for optimal dispersion as desiccated anthrax

spores aerosolized over Chicago could kill over a hundred thousand unsuspecting

Americans, and would likely overwhelm Chicago’s and the region’s public health system

rapidly. This outcome can be reduced if public and private institutions disseminate health

information collaboratively prior to and during the attack. Strategic communications in

crisis management is effective and promotes societal resiliency when terrorist use

biological weapons.

The overarching goal for such strategies is to communicate the survivability of

WMD attacks/events, and convey the fact that rapid recovery is likely when modern

medical and public health practices are integrated, taught, implemented, coordinated, and

exercised by the citizenry and their leaders. Such preparations would also have secondary

and tertiary benefits for society in that fear of the unknown would be greatly reduced. We

would feel empowered by our knowledge and will be able to unlearn the “learned

helplessness” that could result from another WMD attack.

Diffusion of Innovation Theory (DOI)

In 2003, Everett Rogers published an update to his seminal theory on Diffusion of

Innovations (DOI, Fifth Edition). His first edition was published in1962 as Rogers

described his research at the University of Iowa analyzing the socio-behavioral

determinants that prompted farmers to adopt innovations in new farming techniques.

With the 5th edition, he integrates the recent phenomenon of technology-driven changes,

specifically in communications platforms, that he observed as a result of the internet and

wireless cellular phones.127 Rogers also noted additional phenomenological effects of

“diffusion networks” and “critical mass” as his theory continues to be "derivatized" for

communications research.128

Orr continued with the theme and when he wrote that the “most striking feature of

diffusion theory is that, for most members of a social system, the innovation-decision

depends heavily on the innovation-decisions of the other members of the system,” thus

offering the applicability of DOI as an explanation of how innovations spread in

societies.129 Orr also introduces the concept of “utility” in his review of the DOI where

uncertainty in adoption decisions is mediated by the “cost-benefit” analysis that

individuals make routinely.

127

(Rogers E. M., 2003), xv. 128

(Rogers E. M., 2003), xviii. 129

(Orr, 2003).

As noted earlier, the SN/SM platforms obviate certain needs for multi-media

capacity and previously tethered access tools. Traditional broadcast media required

devices needing wall outlets, while home computers powerful enough process high-

density media content required a bulky desk-top. Miniaturization continues to challenge

the orthodoxy of hardware-based conventions in regards to portability and long-use

battery technology. Continued ubiquity of wireless broadband technology allows for

streaming video on demand, as well as all the Web 1.0 and Web 2.0 content to merge

seamlessly into the smart phones and tablets. The potential for growth is coupled with the

unrelenting diffusion of digital technology into modernity. Rogers noted that the internet

was a form of “critical mass” in his DOI theory, given its adaptation through the

1990’s.130 From this frame, the SN/SM medium may also have passed its critical mass

point, given the sheer number of its participants using SN/SM platforms today.

Since the advent of the Internet, digitization of content continues to transform

communications in developed countries along the mechanisms outlined by Professor

Rogers. He had updated the theory to reflect wireless telephony and internet as a

communications technology that diffuses innovations. Rogers defines communications as

"a process in which participants create and share information with one another in order to

reach a mutual understanding."131 He defines diffusion as "the process in which

innovation is communicated through certain channels over time among the members of a

social system."132 His theory suggests that individuals in a collective society interact in

130

(Rogers E. M., 2003), 346. 131

(Rogers E. M., 2003), 5. 132

(Rogers E. M., 2003), 5.

such a way that innovations are communicated, assessed, and adopted in a sequential five

step process, the five steps being:133

1. Awareness of the innovation (knowledge)

2. Formation of favorable or unfavorable attitude (persuasion)

3. Activity to make a choice to adopt or reject the innovation (decision)

4. Adoption and use of the innovation (decision)

5. Evaluation of expectations met or not met (confirmation)

Rogers’ theory categorizes individual behavior adaptations in five broad

observable patterns. They are innovators, early adopters, early majority, late majority,

laggards.134 From this foundation, Rogers’ 5th edition adds the corollaries that there is

interplay between media channels and interpersonal channels that affect these patterns in

different proportions. For example, Rogers writes, “Mass media channels are relatively

more important than interpersonal channels for earlier adopters than for later adopters.”135

Rogers suggests that in the extremes of adoptive behaviors (i.e. innovators verses

laggards), this interplay displays the inverse effect in relative proportions, where

interpersonal channels dominate adoptive behaviors among laggards while mass media

channels dominate among innovators. This difference in proportional channel influences

is maximally divergent in the persuasion phase of the innovation-decision process, which

is the most critical phase of the knowledge-persuasion-decision-confirmation spectrum of

adopting an innovative behavior. Innovators and early adopters are more susceptible (or

open) to media marketing while laggards are more susceptible to interpersonal

relationships.

133

(Orr, 2003). 134

(Furneaux, 2005). 135

(Rogers E. M., 2003), 211.

For decisions made by organizations, Rogers discusses organizational decision

making in terms of three types of innovation-decision categories. These three are termed

optional innovation-decision, collective innovation-decision, and authority innovation-

decision.136 In essence, these three types can be simply described as autonomous,

consensus oriented, and autocratic organizations. Rogers describes multiple factors that

influence how organizations make their decisions. These factors include their size, type

of business of the organization, governmental or private organizations, and civilian or

military organizations.

The DOI theory seems consistent with the digital revolution that began in the

1980’s and validate many milestones that punctuate communications paradigm shifts that

were experienced since then. From ARPANET (DoD’s precursor to the internet), to

internet, to emails and cellular technology, to Web 1.0 and Web 2.0, digital technology

has transformed the mediums of communications rapidly.137 Digital technology is

transforming the very essence of how society communicates within itself, mediated by

virtual communities linked as an information-rich collective. Its complete effects are

difficult to fathom, and its profound importance for society is gaining converts. As an

example, Twitter’s influence in politics is an interesting case-study.

In 2009, when asked about social media, one British Member of Parliament (MP)

Kerry McCarthy made an interesting (under) statement, noting that "Twitter has the

potential to transform politics, making it accessible to citizens in a new setting."138 She

was appointed Labour’s New Media spokesperson. A year later, shortly before Britain’s

national elections, the private email addresses of many Labour politicians were sent out

136

(Rogers E. M., 2003), 403. 137

(Rogers E. M., 2003), 346. 138

(Ramsay, 2009).

inadvertently by email. News of this error, and the addresses, were sent out also on

Twitter in a timeframe much faster than main stream media breaking the story.139 This

may have complicated the election process, given how close the elections were to the

news story.

In May 2, 2011, Sohaib Athar tweeted his observations of a helicopter assault on

Twitter from Abbottabad, Pakistan, starting at 1 AM.140 This turned out to be the Navy

SEALs’ attack on Osama Bin Laden’s compound. Later in the day, it was confirmed by

another Twitter participant that, indeed, Osama was killed by the US Special Forces.141

In the summer of 2011, the White house claimed that it has 2.25 million Twitter

followers.142 In July of this year, President Obama had a "town hall meeting" with his

Twitter followers on July 6, 2011, hosted by Twitter.143 From these examples over time,

it seems clear that the politics and Twitter have become complementary and synergistic

in engaging constituents of political leaders and other stakeholders. This phenomenon is

not limited to the western societies either. On September 22, 2011, Social Media Week

released the "Top 10 Social Media Events that Shook the World", listing the Arab Spring

and the Japanese Tsunami as number #1 and #2 in the SN/SM context, complementing

mainstream news in world events.144

These observations are consistent with Rogers’ theory that ties adoptive behaviors

to two sub-categories in DOI’s communications: media channels and interpersonal

channels.145 These two channels has been an accepted as the Bass diffusion model among

139

(Dunn, 2010). 140

(Butcher, 2011). 141

(Sandoval, 2011). 142

(James, 2011). 143

(James, 2011). 144

(Social Media Week, 2011). 145

(Rogers E. M., 2003), 211.

marketing scholars; it is the two primary channels used by potential adopters of an

innovation.146 An example of using the media channel is the 2008 presidential elections.

The Obama Campaign used the social media channels as both a grass-roots political

organizing tool and a communications channel that some characterized as a social

movement for its participants.147 In contrast, an example of interpersonal channel use is

the day-to-day campaigning that took place with town hall meetings and shaking of hands

at campaign stops.

Although Rogers discusses this point in qualitative terms initially for farmers in

Iowa, its theory can be applied to consumers transitioning to the Web 2.0 paradigm. In

other words, as media channels become more pervasive in the post-modern world, the

need for interpersonal channels, as Rogers originally envisioned, becomes far less

influential for adoptive behaviors to take place in the DOI spectrum of innovators to

laggards. This perspective in some respects, would emulate a type of compression (in

time) of the adoptive range since SN/SM tends to fuse media with interpersonal (i.e.

social) channels of communications. In other words, it is suggested that the distribution

curve that Rogers formulated would be positively skewed to the left. In aggregate, the

adoption takes place earlier for the whole population (see below).

146

(Rogers E. M., 2003), 208. 147

(Smith, 2009).

Figure 1:

148

Figure 2:

149

Suggested Skewing of Roger’s Categorizations in Social Networked Systems

148

(Rogers & Shoemaker, 2008). 149

(Purestone Partners Analytics LLC, 2010).

In Web 2.0, the media channels developed rapidly as a hybridized fusion of the

read-only media (Web 1.0) and social interactivity allowed by real time multimodal

wireless “conversations”. In chapter 8 of his Diffusion of Innovation (5th Edition),

Rogers discusses the concept of "Diffusion Networks", which addresses the notion of

opinion leaders and their influence on adopters of innovation. Rogers writes that

"interpersonal communication drives the diffusion process by creating a critical mass of

adopters."150 Today, SN/SM platforms allow interpersonal communications to take place

more easily and expand geometrically. Consistent with the DOI theory, the SN/SM

platforms may act as an accelerant to personal communications network formation. The

resulting effect is innovation being adopted in the qualitative trajectory as Rogers' theory

suggests between the continuum of early adopters through laggards, but at a faster rate

when compared to old media.

As Moore’s law continues to fulfill expectations on the hardware side, where

computer's processing power doubles every 18 months, Rogers’ DOI theory finds

consistency in current societal communications trends. It offers a lens to which one can

view and attempt to understand the communications processes currently in transformation.

This phenomenon of hardware innovations (i.e. smart phones and tablets) potentiate

communications and sharing of ideas through sophisticated and elegant content enabled

by more hardware power. Although Rogers has not addressed Web 2.0 in his 5th Edition,

it would not be unreasonable to posit that his DOI theory supports the diffusion of new

ideas and penetration of applied health information in routine and crisis situations using

Web 2.0 platforms.

150

(Rogers E. M., 2003), 300.

The five categories, innovators, early adopters, early majority, late majority,

laggards, are functions of observable behavior patterns that occur over time. It is

suggested that Rogers’ DOI theory has the additional utility of allowing the

communications researcher to view organizations through this lens. Adopting this

approach in applying the DOI theory, this research proposal attempts to qualitatively

assess and categorize how well public health and preparedness have adopted two Web 2.0

platforms in effecting their WMD strategic communications plans. The degree of

adaptation among the various agencies can also be analyzed through a comparative lens

that may allow for qualitative analysis if any differences are found between federal, state,

and local agencies.

Chapter 3 Research Methodology and Design

For public health professionals, the concern for WMD consequence management

is well founded, given the national security policies established by our nation’s leaders. A

feature of successful management of WMD’s is the rapid and credible pushing forward of

information needed for mitigation efforts. The messages also have to encompass

credibility and transparency. Whether a disaster is natural or created by humans, effective

strategic communications can assist in the successful management of mass casualty

situations. Twitter and Facebook is ubiquitous in the technological platforms that define

of social networks and social media. Using these platforms as a framework for analysis,

this study interviewed a sample of public health and emergency preparedness

governmental agencies with the intent of answering the following research question:

RQ: How well prepared are local, state and federal public health & preparedness

institutions in leveraging their websites (Web 1.0) with social network (SN) and social

media (SM) platforms (Web 2.0), specifically Facebook and Twitter, to manage crisis

communications in a WMD attack from biological weapons in the pre-event to the first

48 hours after the attack (Phase I and II)?

Sub-RQ1: How are these agencies using Facebook and Twitter technology to

engage the public and affected stakeholders in preparation for WMD’s?

Sub-RQ 2: In what ways have the agencies leveraged Facebook and Twitter for

optimization to engage Web 2.0 virtual communities requiring health information in

national disasters impacting health and well-being?

Sub-RQ 3: Do these agencies have preferences in how they use the Internet, their

web pages, and social network/media technologies to engage their target audiences while

overcoming barriers, if present?

The Institutional Review Board (IRB) of the University of Missouri-Columbia

reviewed the scope and methodology of this study and approved the method under the

standard IRB exempt protocol, accepting its “minimal risk level” status (IRB Project

Number 1200144). Data collection took place by using commercially available internet

search engines to review the web pages of the targeted institutions of public health and

emergency preparedness. Telephone numbers were obtained using the contact numbers

posted on the official web site of the health and preparedness agencies. Concurrently,

emails were sent requesting interviews through the various email addresses posted for

institutional queries.

First assessment of this research consisted of a qualitative review of web sites of

various public health and preparedness agencies at the federal, state, and local levels. The

first goal was to assess consistencies and contrasts in how different levels of public health

and preparedness agencies approached their strategic communications strategies through

the Web 1.0 medium for potential WMD events. The author studied the web-content in

the subjective categories of ease of use, coordination with other echelons of government,

and consistency of macro-messaging about the biological WMD threat. By reviewing the

various Web 1.0 tools to deliver information about biological attacks, the analysis was

designed to investigate if the agencies identified biological WMD as a potential threat to

its stakeholders. If it was identified as a threat, instructive and amplifying information

was reviewed for ease of access and relevancy to biological WMDs. An effort was made

to identify novel or unique content presence to communicate the threat of the WMD, in

general, and biological warfare specifically. When Facebook and Twitter icons were

present, they were clicked and the content and tweets were read for context and

references to WMDs.

This study’s first assessment of the Web 1.0 design focuses on government

agencies in a vertically tiered three level model. This approach supported the meeting the

second goal of the qualitative review, which was to identify any trends, overlaps, and

gaps that may be exist. Such assessment would be of interest to communicators,

emergency planners, journalists, the military, and health professionals in the WMD

consequence management profession as they interact with the colleagues in the other

echelons of government.

The second assessment of this research consisted of contacting the target agencies

for phone interviews. The interviews consisted of asking open ended questions about how

their various local, state and federal public health and preparedness agencies are

preparing to use SN/SM as a communications platform with the publics in WMD events,

focusing on the platforms of Twitter and Facebook. This approach allowed for

discussions of context, priorities, and the integration of Web 1.0 and new media resources

from the perspective of WMD consequence management. The scale of WMDs, itself,

would likely involve the whole of government at all three tiers, and the perceptions of

these mass casualty practitioners would provide valuable insights to enrich the

understanding of consequence management philosophies inherent in the three levels of

our governance.

The interview discussions were limited to the pre-event preparation phase (phase

1) and the first 48 hours after a WMD event (phase 2). The study established these

temporal constraints for three reasons. First, this study was designed to begin a study

framed to be consistent with federal strategic planning guidance for national emergencies,

as defined by the President under the Homeland Security Presidential Directive (HSPD)-5.

This directive establishes the planning authority to Department of Homeland Security (DHS)

under the National Response Framework (NRF) guidance provided by DHS.

Another directive, HSPS-18 addresses the requirement for protecting the

homeland specifically against WMD threats, using a two tiered approach. Both HSPD-5

and HSPD-18 are the executive authority for the whole of government to prepare for

WMD events. Under DHS, FEMA has published the national planning guidance for

declared national emergencies, titled National Incident Management System (NIMS).151

The Department of Defense, in domestic emergencies support NIMS through the Joint

Operations Planning Doctrine (JP 5-0).152 NIMS and JP 5-0 operationalize the two

presidential directives.

Second, given the scope of preparing for and managing WMD events to be likely

massive and multidisciplinary that can easily consume a professional career, this self-

imposed research limitation to the first two phases provides a launch point concerning the

strategic communication paradigm in the novel environment of biological WMDs.

Follow-on studies could address the other phases of NIMS and JP-5 as time and

journalistic interest allow. This scope embraces a scholarly point of demarcation to begin

an intellectual dialog in the field of strategic communications specifically addressing the

151

(Department of Homeland Security, 2008), i. 152

(Department of Defense, 2011).

challenges of WMD environments and our national leaders’ directives on organizing the

management of its consequences.

Third, social networking and social media are emerging phenomena that do not

easily lend themselves to partitioned study among the traditional academic disciplines.

The approach of this study hopes to view the phenomena using cross-disciplinary lenses

of psychology, strategic communications, public health, sociology, mass casualty

management, and military science. Because of the scale at which WMD’s will affect

societies of nations, such a multi-disciplined approach seemed appropriate and reasonable

to better assess the complexity and dynamism of SN/SM in the context of WMD

consequence management.

This study examined three tiers of governmental organizations. At the federal

level, representatives of three agencies were contacted. All three accepted the interviews.

They are Center for Disease Control (CDC), Federal Emergency Management Agency

(FEMA), and Defense Threat Reduction Agency (DTRA). These three agencies represent

three major cabinet level departments of Health and Human Services (HHS), Department

of Homeland Security (DHS), and the Department of Defense (DOD) respectively. These

agencies were chosen because of the nature of their mandates in protecting United States

against mass casualty events, inclusive of WMDs.

At the state level, nine state health departments participated in the study.

Although more states were contacted, nine states eventually returned the phone and email

solicitations for interview within the time frame of this study. State public health officials

have traditionally been the most engaged in managing routine public health functions

because public health and infectious diseases management, such as childhood vaccination

programs and sexually transmitted diseases. It was not surprising that this cohort

represented the majority of the participant in this study, since public health and

preparedness usually fall in the daily operational purview of state health departments.

At the local and municipal level, four public health and preparedness departments

completed the phone interview within the time frame of the study. Several interview

participants recommended additional points of contact to include an associate dean of

medicine at a teaching medical center, a state cabinet level health secretary, and former

state health secretary. All were contacted for follow-up and interviewed.

All of the institutions who participated in the phone interviews had active

websites concerning public health and emergency preparedness (ninst=16). Three

additional phone interviews took place with individuals as subject matter experts (nSME=3)

upon the recommendations of some of the institutional participants. The minimum

desired sample size of 15 institutions was exceeded by 4 additional participants. This

sample size provided a cross-section of the public health management hierarchy, from

federal to local levels.

The instrument of assessment chosen was phone interviews. The researcher was

confident that this level of personal interaction is consistent with established qualitative

research methodology where language and conversation allow for collegial information

exchange and candor preserving interpretive accuracy.153 The interview technique

permitted a level of subjective assessment in revealing possible perceptive SN/SM trends

among public health and preparedness professionals when addressing WMD challenges

from a strategic communications framework. One specific goal of this study was to seek

opinions on the viability of the Twitter and Facebook platforms in the professional nexus 153

(Jensen, 1991), 32.

of journalism, public health and crisis communications. Given a biological WMD event,

participants were asked on how they perceive the benefits and challenges that they may

face in the first two phases (i.e. pre-event and first 48 hours) when using Twitter and

Facebook, and whether these two platforms are important or not in mass casualty

situations.

This qualitative methodology included open-ended questions on identifying some

of the perceived barriers or constraints faced by the participating agencies. Participants

were asked to comment on their perceptions of similarities and differences in how the

different echelons of government would likely approach the strategic communications

terrain.

The theory of DOI was used as the framework in which the innovation of the Web

1.0 and Web 2.0 were discussed. Interviews were conducted as a peer-to-peer query,

facilitated by the researcher’s credentials as a student of journalism, public health

professional and mass casualty clinician. Given that the respondents were well educated

as communicators, the DOI theory allowed for a common framework for their agencies to

be evaluated. The participants were asked open-ended questions about how they manage

their organizations toward SN/SM use in strategic communications with the publics. The

discussions included queries concerning organizational homophily and heterophily

among their professional groups and institutions.

The following table categorizes the echelons and number of participants.

Table 1: Survey Participants

Echelon Federal State Local SME

Participants 3 9 4 3

Chapter 4 Results

Web 1.0 Assessment: Survey of Websites

Federal:

Reviews of the institutional websites showed differences among the tiers of

government (i.e. federal vs. state vs. local). Within the three federal agencies (CDC,

FEMA, DTRA), each agency’s website offered information founded on national policy,

consistent with the nature of their institutional mandates as identified by their website and

Homeland Security Presidential Directive (HSPD) 5 and 18 , and the National Response

Framework (NRF). In a national emergency, DHS through FEMA would provide the

management leadership and coordination for on-scene response. DTRA and CDC would

provide supporting roles for biological WMD attacks. This framework was searchable on

the FEMA website. FEMA’s website provided links to CDC and DTRA, when more

technical detail was desired.

With regards to the technical facilitation of WMDs, DTRA provided most of the

information in the activities that the agency is currently engaged in to reduce the strategic

threat of WMDs. DTRA emphasized their partnerships with in the whole of the federal

government, inclusive of the Departments of Homeland Security, State, and Health and

Human Services. These three cabinet departments are the three primary federal

institutions responsible for establishing policies and doctrines to defend this nation

against WMD according to the National Response Framework (NRF).

The NRF is FEMA’s strategy written for senior elected and appointed leaders (i.e.

governors, agency heads, federal government department secretaries) to coordinate the

national response in emergencies regardless of scale, inclusive of a WMD attack. It is a

layered framework where the concepts of operation and the roles and responsibilities of

government are clearly delineated to maximize effective response while minimizing

redundancy and overlap.

In contrast to DTRA and its international perspective, the Department of

Homeland Security (DHS) website provided the most guidance on the architecture of

operationalizing national responses to domestic security and consequence management

issues. The information available included specific WMD threats to a detail where the

public can pull actionable information about CBRNE (chemical, biological, radiological,

nuclear and high yield explosives) threats. The dedicated WMD webpage discusses first

the biological threat, followed by the nuclear/radionuclide threat and the chemical

weapons threat.

For consequence management efforts, the DHS website links to the FEMA

website, where further homeland security issues transition to informational content

necessary for preparation and mitigation of the WMD events. FEMA dedicated a website

branch to the subject of biological WMDs. In accordance with the National Incident

Management Systems (NIMS) framework, FEMA divides the nation in to ten regions for

disaster coordination.154 The FEMA regional coordination centers establish the nerve

center for disaster management and coordination for the three tiers of government.

154

(FEMA, 2010).

Figure 3: Ten Regional Coordination Centers of FEMA

After a review of the CDC website, it was observed that the CDC’s website has

tailored practical public health information, both in quantity and quality, for both the

general public and medical professionals. Archival information is also available from

previous pandemics and health bulletins. The CDC’s bioterrorism website tailors its

webpage access algorithm through two audience-specific portals, one for the general

public and the other for medical professionals. The general public information focused on

the highest threat class “A” biological agents. Through hypertext links, the bioterrorism

agents are explained in laymen’s terms through a Q&A format to include self-help

guidance on what to do if exposure or infection is suspected. A useful feature found in

the CDC web site is that the information can be printed or emailed with a single click at

the icons available at bottom of each informational webpage. Also, every page had a “1-

800-CDC-INFO” phone contact number and a hearing impaired TTY phone number.

Although the phone service is only available Monday through Friday, it is a 12 hour

extended phone service (8AM-8PM) that allows for coverage during business hours

across all four US time zones.

The CDC bioterrorism website offers another option for medical professionals.

This access option offers detailed public health and scientific information that would be

important to health professionals concerned about a bioterrorism attack. It includes other

than Class “A” bioterrorism agents. The information is easy to access, thorough, and

succinct. CDC’s approach is well thought out and user-friendly where critical information

was usually three clicks or less away from the content desired.

When compared, the relative level of technology adopted by the three federal

institutions seems variable. DTRA, as a DoD agency, offers thematic information on the

national policies that govern US treaty relationships with other nations concerning WMD

non-proliferation agreements. This involves Strategic Arms Reduction Treaty (START II)

with Russia that president Obama signed last year. As a combat support DoD agency,

DTRA operates more in the international arena and inter-departmental federal levels with

less interaction with the general public. Their web site has significant archival

information that traces back the legacy of the Cold War years, and the international

struggles to reduce nuclear, chemical, and biological weapons. As the federal

government's executive agency that administers the SALT II compliance, their website

does not reveal day to day operations of their agency. A conspicuous absence of SN/SM

was noted. Their support of other military institutions is robust with heavy emphasis on

technical reach-back capability of their operations center. The operations center is a 24-7

center. When contacted on a weekend, a person answered the phone and offered guidance

and help in answering my questions. Follow-up was also offered.

The FEMA website was found to be very active in current information. At the

time of this review, FEMA was handing 96 active disaster declarations for the 2011

calendar year. This included snow-storm related massive power outages in New England,

the large wildfires in Texas, and flood recovery in plain states. FEMA website hosts

active blogs as an agency, and offers both Twitter and Facebook icons for following

FEMA's activities. Both SN/SM sites were active with multiple daily posts. Additional

SN/SM services linked were FEMA's own You Tube Channel, FEMA Widgets, SMS

service by state, and apps (both Android and Apple devices) for mariners, travelers, and

weather information. All links were active, and none resulted in internet dead ends.

FEMA's preparedness website has its own web address (www.ready.gov).

The CDC website was also robust in information density, broadness, and detail.

When compared to the other two federal sites, the CDC website seemed to have a good

balance between archival information and cataloging current health issues for the health

care professional. Their availability and use of Twitter and Facebook were up to date and

active on a daily basis. At the time of this review, the CDC had its annual campaign to

promote seasonal flu vaccine compliance. Other SN/SM channels available were CDC-

TV, SMS, Mobile Website, Podcasts, Widgets & Gadgets. A common note that

accompanied the CDC's Mobile Website is the phrase, “Your Mobile Source for Credible

Health Information". CDC is the only agency that emphasizes the credibility of the

information available on their web pages.

Of the three federal websites reviewed, all offered complementary information, in

their Web 1.0 and Web 2.0 channels. With the exception of DTRA, it appears that the

federal public health and preparedness agencies have incorporated Twitter and Facebook

into their communications strategy, as well as other SN/SM applications. Both FEMA

and CDC leveraged the SN/SM platforms while maintaining these channels actively. In

contrast, DTRA does not use SN/SM as its public communications channels. However,

their operations center operates their phones 24/7. The reasons for this contrast may lie in

the fact that DTRA is an externally looking agency directly supporting the military

mission of our armed forces. The DoD does not have a direct mission impact internal to

the United States except as a supporting role to the civil authorities of DHS and DHHS.

State:

Review of the survey of state websites revealed multiple approaches to offer

stakeholders information concerning the WMD threat. Despite the heterogeneity of

website information tree design the survey revealed significant content homogeneity on

the subject of WMDs. This finding seems to be based on the fact that the source of WMD

information usually from the same federal agencies supporting the national defense

against WMDs.

DHS is the primary federal department that is responsible for protecting the

homeland. WMD events will likely use federal resources, and DHS would be in charge.

DoD and DHHS will provide support under the authority of DHS. For information about

WMDs, the various states' websites hyperlink detailed information residing at the CDC or

FEMA websites. This approach reduces the redundancy of information and the possibility

of conflicting information about biological WMD preparedness. The websites conformed

to the HSPD 5 and 18 directives.

Many states recognized the bioterrorism threat, although not all states developed

dedicated web pages for it. The states that had dedicated web pages had large military

bases active within the state. These states were Florida, Kansas, Maryland, and Texas.

Most states approached the WMD threat more as a national threat rather than a state-

specific threat by the way the states presented the threat and referring to the CDC or

FEMA for further elaboration. Several states were exceptions to this rule and displayed

WMD web pages with substantial preparedness content (Florida, Kansas, Maryland and

Texas). Some were dedicated to the biological WMD with detailed preparedness with

discussions about national medical countermeasures stockpiles and unique technical/bio-

scientific content. The least amount of WMD information was on the Nebraska

Department of Health and Human Services website.

Local/Municipal Websites:

Review of the four local and municipal public health websites showed that none

offered a dedicated WMD information webpage. Two offered hyperlinks back to the

CDC bioterrorism website. The primary focus of the local and municipal health

department websites were the classic public health issues such as sexually transmitted

diseases (STD), flu season preparations, communicable diseases, and senior health

services. Other significant content was dedicated to mental health, suicide prevention and

environmental health services (i.e. air and water quality, lead abatement). Additional

review of local emergency preparedness sub-websites revealed that one of the four local

municipalities had a web site dedicated to terrorism through the National Terrorism

Advisory System (NTAS) with searchable content form the FEMA. Of note, the NTAS

system replaced the color coding of the obsolete Homeland Security Advisory System

(HSAS). The NTAS allows for automated Facebook and Twitter alert tie-ins.

As an overview of the websites surveyed (federal, state, local), all the agencies,

except three, provided Twitter feeds. Of the three exceptions, one was a federal agency

and two were state agencies. Half of the 16 agencies sampled offered Facebook option in

their institutional website, and only three of nine states offered a Facebook feed for their

websites. All four local health departments offered Twitter feeds and three of four offered

Facebook option. Where available, the author used the Twitter and Facebook-linked

pages from the websites offered by local jurisdictions. Most of the postings and tweets

were local in character and content, (i.e. helpful health reminders for the winter season).

Table 2: Sampled echelon’s use of Twitter and Facebook

Echelon Federal (n=3) State (n=9) Local (n=4)

Twitter 2/3 7/9 4/4

Facebook 2/3 3/9 3/4

Web 2.0 Assessment: Interviews

A total of 16 agencies and 3 subject matter experts (SME) agreed to be

interviewed. Some of the participants requested that the questions be emailed first for

review prior to conducting the interview. The interviews lasted between 20-50 minutes

and all interviews were contiguous. The conversations among the representatives of the

three echelons and the SMEs were enriching and collaborative. All agreed that this

subject matter was relevant to their professional public health and preparedness offices.

Overall, the participants recognized and shared the need to support

interdepartmental and interdisciplinary nature of managing crisis communications that

would be required after biological terrorist attack. All participants felt that the strategic

communications challenge lie first in the coordination, especially in the first 48 hours of

an attack, given the enormity of the scale that WMDs can have on population groups. The

need to speak in one voice would be an arduous challenge given the lack of verifiable

scientific evidence that would be available in the first few days of an attack.

Another challenging risk would be posed by the possibility that the

microorganism may have been weaponized so that conventional public health disease

models may not be sufficient to make reliable recommendations to the general public for

many days or weeks. Understanding that effective crisis communications would require

rapid, credible, and reliable information, the WMD scenario would pose significant

difficulties for the public health communicators. Some of these known unknowns would

be lethality, incubation periods, infectivity, transmission kinetics, pathogenicity,

morbidity, best treatment protocols, and mortality rates.

Most participants felt that FEMA’s ten coordination centers are the keys in

preparing for and managing a WMD event. Some suggested that the regional intelligence

fusion centers will also play a key role especially in the pre-event (phase 1) of an

imminent biological WMD attack, or immediately following the attack. The participants

understood that the work of these intelligence fusion centers is usually classified, and

therefore not available to the public. However, one state participant suggested that they

may have the capability to monitor SN/SM activity in such a way to find ways to help

public health offices increase awareness for potential biological WMDs.

Among the state participants, all agreed on the importance of approaching the

WMD threat holistically. They felt that the FEMA regional model is the best way to

coordinate multi-jurisdictional efforts in preparing for and mitigating the consequences of

biological WMDs. The states felt that the coordination infrastructure offered by FEMA

and CDC through their regional model is robust, effective, and necessary to ensure that

all echelons of government will function in a coordinated fashion, including the use of

SN/SM as an adjunct for the overall strategic communications plan.

All the participants recognized the potential of SN/SM in mass casualty crisis

situations. At the federal level, FEMA considers Web 2.0 a medium that can be

beneficially exploited to facilitate consequence management of WMDs. Communicators

at DTRA felt that as a support agency, its need for developing their own Web 2.0

infrastructure would be redundant and unnecessary. The emergency communicators at

CDC, unlike DTRA, felt that SN/SM technologies are key commercial infrastructures,

especially in the pre-event phase. Coupled with their robust and detailed Web 1.0

platform and content, the synergy offered by digital mass communications media is an

invaluable resource for the nation and lower echelons of public health and preparedness.

Their sense of importance is accentuated by the fact that about a year ago, CDC

reorganized the separate web and SN/SM management teams into one organization.

The majority of the participants agreed that the dual use (send and receive content)

of the technology of Web 2.0 was viable for emergency communications needs. They all

held favorable opinions of Twitter and Facebook being the two most popular and useable

platforms. One state official felt that You Tube is also part of his top three SN/SM

resources.

One county preparedness director was the exception to this opinion, because of

funding limitations where he could not support both Twitter and Facebook platforms. He

had chosen Twitter over Facebook as his primary SN/SM platform during county

emergencies. He noted that Twitter is the planned strategic communications doctrine for

his county for emergency communications, due to its reliability and reduced need of

broadband wireless services. He shared an anecdote of how his agency used the Twitter

feed to notify the public about sheltering in place during hurricane and immediate actions

to take during an earthquake. He noted that Twitter never was saturated nor buckled

under maximum usage load. His agency received accolades from their county executive

as well as the local media for his innovative use of Twitter during those public

emergencies. He considered broadband wireless infrastructure vulnerable to saturation

during crisis situations, and he wanted to rely on a medium that will tax least that

vulnerability. Although he was not against Facebook, he felt that for his county’s needs,

it was redundant.

In contrast, one state preparedness director preferred Facebook over Twitter,

although his state maintains both platforms. He responded that although Twitter is the

least data-intensive medium of the Web 2.0 technologies, it is also the least capable of all

the SN/SM platforms. Because he has currently the resources to fund multiple platforms,

both in manpower and contracted services, his state maintains Facebook, Twitter, and

You Tube capacities. He noted that for emergency situations, especially in the early

phases of consequence management, his department had plans to augment his SN/SM

staff because of the expected sharp increase in Twitter, Facebook, and You Tube

participation by the public. He felt that his "surge" capacity could be sustained for about a

week before he would have to find alternative medium and long term augmentation of

staffing. He felt that these three platforms offer complementary technologies while

offering a certain level of redundancy and flexibility, even in crisis situations. Other

states seem to perceive Facebook as a useful tool for long-term strategic communications,

especially in the pre-event phase, but maintain Twitter capability as a hedge for

continuous community contact especially for the first hours following a major disaster.

In terms of national coordination, training, and standardization of operations, the

participants recognized the value and importance of NIMS and NRF in coordinating

preparations for WMDs. However, NIMS and NRF does not directly address the

application of SN/SM for strategic communications guidance. Some felt that the NIMS

should be updated to reflect this gap.

Within the organizational model of FEMA’s ten regions, it must be noted that the

SN/SM is not currently integrated with the individual state systems. Each state has stand-

alone Facebook and Twitter management systems and control. One state official

suggested that this may be a gap that requires attention by FEMA, especially in managing

biological WMD events. He felt that federal fiscal resources are more robust, compared

to state public health budgets, and would be a better long-term funding stream to enable a

more integrated SN/SM system.

Other barriers to leveraging SN/SM during crisis events were noted. One

participant noted that, at least at the state level, federal grant funding was the primary

source for her state’s funding of innovative strategic communications initiatives,

including SN/SM ventures. She stated that this has been true for the past five years.

However, grant funding for homeland security has dried up and many of her SN/SM

initiatives now have to be mothballed because of the lack of federal grant funding that

state budgets cannot replace. Another participant recounted how she is unable to fund any

new emergency preparedness initiatives because her state government is faced with

significant budget reductions.

Most interview participants stated that they do not officially permit their

employees to represent their agencies independently in Twitter and Facebook platforms.

All have policies in place where their agency’s SN/SM presence is through official

channels only using their official logos. When their agencies participate in Twitter and

Facebook, all have in place administrative vetting processes to ensure that tweets and

Facebook postings are credible and properly vetted through official internal channels.

However, federal participants perceived increased frustrations in ensuring the timely

placement of their Twitter and Facebook content because of the length of their vetting

processes. Lower governmental agencies enjoyed a higher level of autonomy when

posting on their Twitter and Facebook sites.

Another major barrier for communicators in the surveyed agencies is the lack of

resources and manpower available in their organizations to monitor and manage SN/SM

platforms. This limitation prevents active monitoring of their Twitter and Facebook

“walls”. Many state and local participants would like to monitor more closely their

SN/SM sites, but are unable to do so because of manpower limitations within their

agencies. If there are technologies available to use artificial intelligence (AI) to perform

this function, most felt that it would be very useful.

Another major barrier noted by several states is the rapidity of staff turnover

within their public health and preparedness departments. One state noted that because of

personnel turnover, he does not have any experienced staff. Those who handled his

state’s H1N1 activities in 2009 all had moved to new positions in and out of his

organization. He also noted that experienced personnel were hard to find, even when he is

able to hire additional staff within his division.

Some participants provided anecdotal evidence that Twitter and Facebook were

critical platforms to the mitigation efforts in their jurisdictions as local natural disasters

temporarily distressed their old media channels. This came about as electrical power was

disrupted for days in highly populated urban areas where home media equipment

designed for accessing old media, such as televisions and computers, had no power. They

felt that in the first few days of a WMD event, wireless devices accessing emergency

information through Twitter and Facebook are viable alternatives, and may be the only

alternatives available if the power grid is disrupted.

All interviewed agencies note that Twitter and Facebook are currently adjunctive

communications tools and not their primary platforms. None has plans to leverage

SN/SM as the primary strategic communications tool. However, all agree that credibility

and reliability of their SN/SM content is of paramount importance.

Chapter 5 Discussion and Conclusions

Discussion

These interviews provided a cross-sectional sampling of institutions that would be

at the forefront of preparation and mitigation efforts for biological WMDs. All the

participants were very supportive of the design and mechanics of this study. They felt

that the interview method provided a desirable forum that allowed their perspectives and

thoughts to be documented for leveraging SN/SM for mass communications needs. All of

the participants recognized the strategic and tactical value of Facebook and Twitter for

WMD applications. They agreed on the common goal of studying the ways in which

SN/SM can be used to manage the consequences of WMDs was a worthy area of research.

Some participants felt that it is unfortunate that only now are their institutions

embracing SN/SM’s high value for effective communications in abnormal macro-

environments. Currently all governments are facing fiscal challenges. Lackluster growth

and high unemployment rates portend reductions in public infrastructural outlays,

regardless of their perceived benefits. For the medium and long term, the fiscal outlook

appears dim. Many participants, being in supervisory or higher positions are faced with

hiring freezes and lay-offs of their valuable employees. Their institutions were managing

reductions in their workforce instead of considering new initiatives in better meeting their

public health and preparedness mandates. Such reductions will inevitably reduce services

and capabilities to include active Twitter and Facebook support and stakeholder

engagements. This perspective seems to most resonate among state institutions and less

so with local and federal agencies.

In the evaluation of the websites, certain trends were identified. For state and

local agencies, their websites provided easy to use access points to find usable

information about local and regional public health issues. For detailed information about

the WMD threat, almost all of the websites provided hyperlinks to the CDC website. This

cascading information hierarchy suggests that information is well integrated vertically in

the different echelons of government. As a result, redundancy and overlapping of health

information was minimal.

Another trend noted was the separate informational access point with one

information icon branched to the lay-person, and another branched to the health care

professional. This approach seems to have been championed by the CDC. It allows

efficient consumption of web-based health information for both of stakeholders while

reducing the potential for frustration for its users seeking rapid and relevant information

without being confused by too much or too little detail, respectively. The general rule of

“three clicks or less” seems to be valid in majority of the website informational searches

experienced in this study.

As with the CDC website, FEMA’s website featured easy and convenient access

to the searched information. Because of the nature of FEMA’s mandate, their webpage

focuses on the preparedness aspect of disasters. Their emphasis on disaster management

organization and architecture of authority, as defined by NIMS and NRF, provided up-to-

date perspectives for WMD and consequence management plans for the nation. FEMA

also believes in the validity of SN/SM as a viable and strategic communications

technology that they embrace for WMD management. Although not directly addressed in

the NIMS and NRF doctrine, the organizational latitude is given to the ten FEMA

regional coordination centers for deploying of Twitter and Facebook as adjunctive

communications platforms.

From the perspective of state public health and preparedness officials, the regional

FEMA’s regional system is the foundation in which federal, state, and local resources are

organized and deployed in a coordinated fashion. State agencies were particularly

positive about the way in which FEMA organizes disaster management postures for large

geographic areas. Many state agencies agreed that individual states would not have

sufficient resources to mitigate the consequences of biological WMD independent of

FEMA regional offices. It is interesting to note that the CDC has organized its ten regions

around the FEMA model as well.

All agreed that the overarching goal is to begin a rational and objective

assessment of this nation’s ability to prepare for and mitigate the consequences of a

WMD event. The vertically integrated design, sampling all the echelons of government,

from federal down to local levels, seemed to be a reasonable lens at which to look at the

early impacts of SN/SM both as a technology and sociological phenomenon. It was not

clear to the participants on the perceived trajectory of the SN/SM as a potential key

adjunct to the communications needs during a mass casualty CBRNE event. However, all

agreed that this study provided a unique framework to begin to assess this nation’s

readiness to manage a biological WMD event.

The sample size may not have been robust in numerical terms, but the quality of

the participants offered significant engagement of the institutions that they represented.

All the participants were at least supervisors, and most were senior managers of their

institutions with consistent longevity within their professions. Due to the caliber,

education, and professional training of the participants, this qualitative methodology

came about successfully in allowing certain conclusions in the trends perceived by the

institutions interviewed.

The survey respondents were asked to discuss why they viewed SN/SM in such

positive terms. Most of the respondents had at least 10 years of experience in the

emergency preparedness profession. All felt comfortable with the platforms of Facebook

and Twitter. This comfort level is another way of noting the concept of indigenous

knowledge systems in the DOI theory.155 Because the participants were already using

Twitter and Facebook personally, their resistance to adaptation was reduced when their

departments deployed them.

Many felt that, compared to SMS, Facebook offered much more for their

organizations, both in terms of internal communications and external communications

with the publics. However, they felt that the dependence of SN/SM operability with the

cell phone infrastructure was a key vulnerability for the platforms. Regardless of 3G or

4G as a technology, wireless broadband cannot be relied upon for disaster management if

the cell tower "grid system” is damaged or destroyed in large swaths of their jurisdictions.

Thus, many participants agreed that the complementary aspects of SN/SM with

traditional media were exceptional and should be exploited. All felt that the SN/SM

technology should not replace old media technologies.

Some felt that the digital to analog mass communications infrastructure should be

reversed engineered sufficiently preserve the full spectrum of options available to

communicators in WMD environments. This included standardization of emergency

radio systems between jurisdictions, although it would be very expensive. Some 155

(Rogers & Shoemaker, 2008), 254.

participants suggested that the value of SN/SM is more in the pre-event phase of the

WMD consequence management of the continuum, because of this infrastructural

vulnerability of cell towers and the dependence of these digital wireless devices to the

cellular network.

In the area of information compatibility of emergency preparedness, many of the

respondents felt that their rate of adopting their STRATCOM content to Twitter and

Facebook was driven by how the technology was being used by the public. In other

words, they were following the times of how people were already using the platforms

(DOI’s critical mass concept). Knowing how pervasive Facebook and Twitter’s presence

is in modernity, many states chose to use these two platforms to engage the public.

Some pointed out that they studied the events of the Virginia Tech shootings.

They noted how SN/SM technologies were adopted as a "I’m OK, Are you Ok?”" social

checking system that emerged in that shooting event. They noted that this was a lesson

learned for their departments. This is the DOI attribute of compatibility with needs

concept for adaptations to take place more urgently.156 The participants felt that in the

first hours after a mass casualty event, SN/SM would be critical but also susceptible to

signal saturation. Some of the agencies in Washington DC experienced network

saturation during the recent earthquake that occurred on August 23 of this year as one

federal participant noted.

In terms of DOI's sense of complexity, all respondents felt that the Facebook and

Twitter processes were not too complex in the operability of the medium. In the

complexity and simplicity spectrum that Rogers described, most felt that the medium of

SN/SM, in general, is not complex. However, many surveyed felt that the complexity of 156

(Rogers E. M., 2003), 246.

SN/SM systems lie in obtaining the funding mechanisms for their agencies to integrate

and sustain SN/SM to their strategic communications plan with additional staff. Many

desired to hire additional full time staff to monitor and respond to Facebook and Twitter

traffic as appropriate. This challenge was mostly voiced in the state and local levels.

In the area of DOI's trialability, many state and local respondents determined that

using SN/SM revealed a limitation in their operation of it. They wanted to find ways to

monitor and interact with their audiences. Most viewed this effort as a manual process

that should not be automated to maximize the one-to-many-to-one interactivity allowed

by SN/SM platforms. As public servants, this desire seems to resonate among the

surveyed. Current lack of manpower within their departments precluded implementing

such interactive processes, however. This limitation in their trialability of engaging their

audiences interactively in Facebook and Twitter was a consistent remark from all three

levels of government.

Most respondents are themselves networked professionally with others in their

profession (DOI’s interconnectedness). This networking preceded their initial

commitment to SN/SM for their agencies. One state participant stated that his

organization's desire to integrate SN/SM to his home state emergency preparedness was

"mentored" by the military adjutant general of his state. Another state respondent stated

his organization's motivation was due to his recognition of other state programs that he

found on line over a period of time. None of the participants felt that they considered

themselves as particularly skeptical or traditional when it comes to technology

adaptations.

From the sampled participants, it seems that they fell into the first three categories

of the adopter spectrum of innovators, early adopters and late adopters. This adoptive

behavior was enabled by mostly the interpersonal channel (Bass Model) where

participants felt that SN/SM allow their peers to influence their attitudes toward SN/SM.

In terms of DOI’s organizational models of decision making, the collective

innovation-decision model seems to be the model in which their organizations made

decisions. This made sense because the respondents first developed consensus within

their organizations prior to their organization's decision to spend public money for their

establishment of their SN/SM platforms. The participants spoke of discussing extensively

within their organizations to justify the expenditures for initiating and sustaining their

Twitter and Facebook presence. Many noted that the funding was primarily through

federal DHS and FEMA grants.

Like the discursive approach, this methodology lend itself to contextual points of

enumeration while hinting at inductive insights to isomorphic perceptions about a

technology that may not be sufficiently mature enough for accurate academic judgments.

However, by analyzing the degree of communications technology embedded in the

interviewed agency’s strategic outlook for Facebook and Twitter as a communications

platform, some ecological assessment is allowed for early conclusions to be suggested.

The use of DOI theory as a lens provided a workable architecture to view how

WMD strategic communications needs were met by organizational adaptation of SN/SM.

It was reassuring that the interviewed agencies were so forward-thinking in leveraging

Twitter and Facebook as a viable communications medium in crisis environments. It is a

reasonable conclusion that the public health and preparedness profession has integrated

the SN/SM innovation to their communications operational plan well. The diffusion of

innovation theory suggests that even the laggards, if such characterization of institutions

is allowed, are in transition to using SN/SM for crisis communications. However, the

delayed adoptive behavior of the lagging institutions is not rooted in psychology, but

rather in the fiscal constraints imposed by the current long-term realities of our national

economic outlook.

Limitations of Study Methodology

There are several methodological limitations of this research design. One

limitation is that its focus was the information source of the medium (government

agencies), and not the medium itself. Because the technology of SN/SM is changing so

rapidly, it is possible that public health and preparedness agencies may not possess the

organizational nimbleness or metrics to measure success or failure of their SN/SM

activities. Further, this research did not capture this intra-organizational dynamism, and

was blind to deterministic elements that drive the complex inter-relationships inherent in

large bureaucratic organizations.

Secondly, the technology of SN/SM is as novel as it is unproven in true social

utility in large scale disasters. The way in which the public uses SN/SM two years from

now may be very different from institutional perceptions of it today. It is not clear today

how the publics will ultimately use SN/SM during mass casualty situations brought about

by biological WMDs. If one was to examine the market viability of previous SN/SM like

MySpace, its drive to irrelevancy was a shock to technology market watchers. Neither the

researcher nor the participants can really predict where Twitter and Facebook will be a

few years from now. Potential disruptive technologies like tablets may introduce still-to-

be-invented applications that negate the relevancy of Twitter and Facebook, or further

potentiate its relevancy.

A third limitation of this approach is the lack of ability to interview senior leaders

in the targeted organizations. This limitation prevents more complete understanding of

how public communications decisions are made by the organization. Although review of

established policy decisions is within the scope of this research method, the process in

which those policies were made was beyond its scope.

A fourth limitation of this methodology is that this study does not evaluate the

hardware necessary for the SN/SM platforms to operate. This study assumes that the

infrastructure enabling SN/SM is available in WMD events. It is known that in nuclear

WMDs, electronic devices will not be able to withstand the electromagnetic pulse (EMP)

of a nuclear detonation. If biological WMD succeeds in its intent, the technicians who

maintain the SN/SM infrastructure may become incapacitated in sufficient numbers to

risk whole system failure over time, and their skills not be easily replaced.

A fifth methodological limitation was the limited sample size. As a qualitative

study, this study was not designed to offer generalizability to the current state of

readiness of the whole of government, nor all the stakeholders for WMD response. The

study does offer, however, the feasibility experienced by the survey participants while

their efforts to facilitate institutional SN/SM participation seemed to provide innovative

leadership to their organizations.

Finally, the agencies studied are all funded through different entities of the local,

state, and federal governments. Participants noted that until recently, federal grant money

was the primary source of funding SN/SM strategic communications initiatives at the

state and local levels. The changes or loss of these funding streams may have hidden or

unintended consequences. Perhaps for future research projects, analyzing ways to

preserve these funding streams may be of value.

Theoretical Limitations

In terms of theoretical limitations, one weakness of using the DOI framework is

that the intended audience is ignored in this research design. Reception theories, thus,

was not be engaged, and a potential for not recognizing critical observations about the

intended audience would not be known. Once can consider reception analysis as a

possibility for future research efforts in how the audience would use SN/SM during

WMD events.

Another weakness of using DOI theory is its inherent variability in their social

systems. Because three of the targeted agencies are large bureaucratic organizations

under three different cabinet level departments, they being DHS, DOD, and DHHS

respectively, with tens of thousands of employees, organizational compartmentalized

dynamics (stove-piping) may preclude a easy qualitative comparison among the three

agencies. In other words, qualitative analysis in adoptability may introduce confounders

when compared to smaller state and municipal organizations.

Local, state and federal agencies have widely varying constraints on operating

budgets relative to each other. Because technology-based hardware requires capital

expenditures, training and equipment, financial limits of smaller health departments and

safety agencies may not have the financial resources readily available to fund innovations

on the hardware side compared to their federal counterparts. Such limitations make

simple qualitative asssessments between the groups less intuitive and more susceptable to

misinterpretations of the survey answers.

Conclusions

By surveying how institutions of public health and preparedness view SN/SM as a

possible solution to biological WMDs, it was hoped that the analysis revealed certain

trends that benefit its participants. Further, such as qualitative survey suggests that the

DOI theory is a workable adoption model for the institutions surveyed. Because this

study’s design focuses on government agencies in a vertically tiered three level model,

this approach found evidence of adoptive behavioral trends among its surveyed

institutions, but not at the expense of redundancy or ignorance of known communications

gaps. The lessons learned from 9/11, Washington anthrax attacks, Katrina, and now

Fukushima enabled rapid institutional adoption of SN/SM technology because of its

unequivocal ubiquity and commercial existence. Such assessment, it is hoped, would be

of interest to crisis communicators, emergency planners, journalists and the public health

professionals.

Most public health professionals think that WMD attacks/events are survivable,

and recovery is probable when modern medical and public health practices are integrated,

taught, implemented, coordinated, and exercised. To this end a certain national

consciousness and awareness about WMD’s has been nurtured through traditional as well

as emerging online platforms for public health and preparedness communicators. This

includes leveraging SN/SM platforms for mitigation plans for the WMD threat. Twitter

and Facebook are commercial enterprises that seem to be well suited for crisis

communications functions because of their ability to establish virtual and reliable

communities for critical information exchange in emergent environments. All three levels

of government recognize the capability and capacity of Twitter and Facebook as crisis

communications platforms.

With the steady and rapid rollout of the smart phone and tablet technologies, and

FCC’s efforts to narrow the digital divide, the economic barrier to broadband access will

continue to be lowered. Content for these new devices will likely rise geometrically, and

the connected and wired world will likely become more of the connected and wireless

world.

The varieties of content will be used to educate, enrich, create wealth, and

enhance security for the collective. If or when a WMD event occurs, the mitigation

efforts will be made easier because more public health and preparedness institutional

leaders are aware of the necessary actions to communicate reliably and credibly with

their stakeholders. Biological WMD attacks are manageable. The collective has a better

chance of solving associated problems when their ideas and innovations are connected

rather than isolated. Although not a panacea to all the problems we face with WMDs,

solving the problems will easier when teams of minds are engaged rather than

individuals.

It is ironic that the same diffusion of life-science innovations that allowed

Americans to double their life expectances from a hundred years ago can be used by

terrorists to harm so many so easily. Our nation’s leaders have identified the WMD threat

as both real and possible inevitable. Americans coped with and adapted to the 9/11 attack

and the Katrina disaster. With experience gained in this and other crises, journalists and

crisis communicators can play critical roles of thought leaders in how well this nation

handles and overcomes the next disaster, regardless of it being sourced by nature or by

mankind. This study was designed to begin that conversation among health

communications professionals to self-evaluate their readiness for WMDs with their

fellow Americans.

"I think by far the most important bill in our whole code is that for the diffusion of knowledge among the people. No other sure foundation can be devised, for the preservation of freedom and happiness...Preach, my dear Sir, a crusade against ignorance; establish & improve the law for educating the common people. Let our countrymen know that the people alone can protect us against these evils [tyranny, oppression, etc.] and that the tax which will be paid for this purpose is not more than the thousandth part of what will be paid to kings, priests and nobles who will rise up among us if we leave the people in ignorance." - Thomas Jefferson157

157

(Jefferson, 1786).

Appendix

Definitions

Biological Weapons: Microbiological organisms used to infect, incapacitate, and kill

human beings.

Inductive Theory: Qualitative research theory based on interpretive social sciences

where inferences are made from observations of human behaviors that offer a perspective

of probable truth.

Media Relations: A process in which organizations and institutions interact with the

media and its institutions in such a way to offer an institutional point of view that is

positive or least negative.

New Media: online platforms that enable members to produce, share, or

collaborate on content across social networks (i.e. Web 2.0).

Node: In a virtual community, the Web 2.0 user who behaves as a “micro-broadcast”

relay point for many other users in that community.

Public Relations: A process in which organizations and institutions interact with the

general public in such a way to offer an institutional point of view that is positive or least

negative.

Publicity: A process of attracting media attention for the purposes of gaining

commercial or community notoriety.

Social Media: Technology-based medium that offers participatory communications

modality for building relationships.

Social Responsibility: The obligation of the journalist as recommended in the Hutchins

Commission Report of 1947 to report fair, complete, balanced, and intelligent stories of

events relevant to the society.

Social Networking: Any process in which multiple digital technology-centered mediums

are used to facilitate and organize communities and their agendas.

Strategic Communications: Subset of journalism that deals with organizational

strategies and plans to provide internal and external stakeholders perspectives of and

from the organization.

WMD crisis-mediated Strategic Communications: The deliberate process of strategic

communications before, during and after a WMD event requiring national coordination

and facilitation of policy, strategic and tactical information to be disseminated widely to

organizations, institutions, subordinate governments, and citizens. This information flow

would be multilateral and managed to maximize legitimacy and resiliency of affected

civil society.

Weapons of Mass Destruction (WMD): Any man-made chemical, biological, nuclear,

radiological, and high explosive (CBRNE) device designed for use in conflict, war, or

terrorism.

Web 1.0: Any first generation communications technology that allows for unilateral one-

way transfer of data and content from its creator to the consumer/receiver.

Web 2.0: Any second generation communications technology that allows for multi-nodal

and multilateral real-time wired/wireless transfer and sharing of data and content to

collaborate in a virtual community that allows any member to participate.

Interview Script and Questions

Script for Phone Survey/Interview Questions

For Participating Agencies

Please refer any questions to:

Andrew (Andy) Kim, ,DO, MPH, MS (eq.)

Principle Investigator

[email protected]

Cell: 443-878-9172

mailto:[email protected]

(To be read over the phone to pre-arranged participating agencies and their reps)

Research Scope

“I thank you and your agency for volunteering to be interviewed. You

can stop the interview at any time. The interview is designed to be a

conversation, and not an interrogation. Not all questions have to be answered,

and if you want to take a break, it is not a problem. There are no time limits.

Do I have your consent to start the interview? ____(yes), _____(no)

(If the participant declines, terminate interview, thank the person, ask if

any questions arose, answer questions, and go to next agency).

May I start now?

(pause)

The scope of this research is to review the current state and vision of

how your agency is considering the use of social networking (SN) and social

media (SM) to communicate with your target audiences in the context of a

biological weapon of mass destruction (WMD) attack. The questions are

open ended to give your agency an opportunity to share, in an academic

setting, any plans and innovations for facilitating communications in WMD

events.

Your agency’s opinions on how best to approach the communications

environment in a WMD environment is worthy of research. The policies and

strategies of the whole of government is not the subject of this study. It is

understood that your agency’s answers to these questions do not represent

the policies of the US, state or local governments or official positions. The

intent of this research is to provide a forum for discussing and identifying

possible applications of the “new media”, enabled by existing modern

communications technology in a WMD-related event. Your participation will

serve to provide a forum for academic discussions for the benefit of the

participants seeking to bridge the communications need in the nexus of a

biological WMD scenario and public health.

Social Networks/Social Media

One of these unique communications platforms is the social networks

(SN) / social media (SM) paradigm that exist today. SN/SM has become

ubiquitous in our society. It is efficient and effective for both visual and text

messaging in a band-width independent manner. It has proven to be durable

and near-universal in its ubiquity among American consumers. The

technology transcends socio-economic status (SES) and class. Given these

attributes for a communications medium, social media/networking

technology has the potential to moderate and facilitate the communications

needs of a nation prior to and during national crisis situations provoked by

WMD attacks.

In mass casualty situations, experts in health departments can also

function in critical communications roles, given the trust that public health

professionals enjoy in state and local governments. Major media outlets also

employ medical journalists, assuming the role of information intermediaries

in reporting the complexities of health information, but the credibility of

broadcast mediums will be limited in the first few days due to their nature as

being intermediaries. 158

Given these overlapping roles, public health

officials (as primary sources), reporters and journalists (as secondary sources)

will be able to leverage their experiences in moderating errors, falsities and

uncertainties in Facebook, and Twitter.”

Interview Questions

“Please answer the following questions in the context of WMD’s. All

questions do not require answers, and activities and ideas in

consideration may be used to address these questions.”

1) What are the public health or community security responsibilities of

your agency in regards to WMD’s?

Pre-Event:

First 48 hours after WMD:

2) Does your office have designated spokespersons for WMD crisis

situations? Does your office require any special qualifications for this

responsibility?

Pre-Event:

First 48 hours after WMD:

158

(Johnson, 2006).

4) Does your agency feel that Web 1.0 as a communications platform is

important to your stakeholders and community during WMD events or

other disasters? How and why?

Pre-Event:

First 48 hours after WMD:

5) Does your agency use/plan to use Web 2.0 as a communications

platform? Is it part of the communications plan for WMD events or

other disasters? Please describe how you use this platform.

Pre-Event:

First 48 hours after WMD:

6) Does your agency have a preference on which Web 1.0/2.0 platforms

to use or not use in WMD events or other disasters? And why?

Pre-Event:

First 48 hours after WMD:

7) When using the Web 2.0 platform, do you have guidance or standard

operating procedure (SOP) for Facebook engagement with the public

in WMD events or other disasters? How is Facebook currently being

used?

Pre-Event:

First 48 hours after WMD:

8) When using the Web 2.0 platform, do you have guidance or standard

operating procedure (SOP) for Twitter engagement with the public in

WMD events or other disasters? How is Twitter currently being used?

Pre-Event:

First 48 hours after WMD:

9) Does your agency allow or encourage its employees to use Facebook

for interacting with the public on a routine basis? Does your agency

have a policy for employees using Facebook to engage the public?

Does this policy change during a national emergency?

10) Does your agency allow its employees to use Twitter for interacting

with the public on a routine basis? Does your agency have a policy for

employees using Twitter to engage the public? Does this policy

change during a national emergency?

“We’re about half-way through. Would you like to take a break?

(pause)

If not, may I continue?”

11) Does Facebook represent a primary, secondary, tertiary, or unofficial

platform for agency communications?

Pre-Event:

First 48 hours after WMD:

12) Does Twitter represent a primary, secondary, tertiary, or unofficial

platform for agency communications?

13) Does your agency perceive any challenges in working other

governmental institutions? Please describe the issues in your own

words and your suggestions to overcome them.

14) Does you agency have a crisis communications protocol with other

agencies? Is it specific for WMD’s? How about Biological WMD’s?

Please describe it in your own words.

15) Does your agency perceive of any barriers or challenges in using

Facebook as a communications platform in WMD environments?

Pre-Event:

First 48 hours after WMD:

16) Does your agency perceive of any barriers or challenges in using

Twitter as a communications platform in WMD environments?

Pre-Event:

First 48 hours after WMD:

17) Do you have any additional comments that reflect your agency’s

preparations for crisis communications as a result of a biological

WMD attack? Feel free to add any information you feel appropriate in

this subject

“This concludes the interview. Thank you and your agency for your participation.

Are there any questions you would like to ask?

(pause)

Thank you again, and have a good day.”

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