INFORMATION TRANSMISSION UNDER CONDITIONS OF SENSORY SHIELDING

by Harold E. Puthoff, Ph.D., and Russell Targ, Stanford Research Institute, Menlo Park, California.

Harold E. Puthoff is a senior research engineer at the Stanford Research Institute and a specialist in laser physics. He holds patents in the areas of lasers and optical devices, and is co- author of Fundamentals of Quantum Electronics, a text bridging quantum mechanics, engineering, and applied physics.

Russell Targ is a senior research physicist at the Stanford Research Institute and an expert in the field of plasma physics. He is the inventor of the tunable plasma oscillator at microwave frequencies, the FM laser, and the high-power gas-transport laser. His publications include more than two dozen articles on lasers, plasma physics, and psychic research.

Published in Nature, VOL 252, No. 5476, Oct. 18, 1974, pp. 602-607.
For completeness, all of the investigations conducted at SRI on Geller and on other subjects are presented here.

WE PRESENT results of experiments suggesting the existence of one or more perceptual modalities through which individuals obtain information about their environment, although this information is not presented to any known sense. The literatures and our observations lead us to conclude that such abilities can be studied under laboratory conditions. We have investigated the ability of certain people to describe graphic material or remote scenes shielded against ordinary perception. In addition, we performed pilot studies to determine if electroencephalographic (EEG) recordings might indicate perception of remote happenings even in the absence of correct overt responses.

We concentrated on what we consider to be our primary responsibility – to resolve under conditions as unambiguous as possible the basic issue of whether a certain class of paranormal perception phenomena exists. So we conducted our experiments with sufficient control, utilizing visual, acoustic, and electrical shielding, to ensure that all conventional paths of sensory input were blocked. At all times we took measures to prevent sensory leakage and to prevent deception, whether intentional or unintentional.

Our goal is not just to catalogue interesting events, but to uncover patterns of cause-effect relationships that lend themselves to analysis and hypothesis in the forms with which we are familiar in scientific study. The results presented here constitute a first step toward that goal; we have established under known conditions a data base from which departures as a function of physical and psychological variables can be studied in future work.

Remote Perception of Graphic Material

First, we conducted experiments with Mr. Uri Geller in which we examined his ability, while located in an electrically shielded room, to reproduce target pictures drawn by experimenters located at remote locations. Second, we conducted double-blind experiments with Mr. Pat Price, in which we measured his ability to describe remote outdoor scenes many miles from his physical location Finally, we conducted preliminary tests, using EEGs, in which subjects were asked to perceive whether a remote light was flashing, and to determine whether a subject could perceive the presence the light, even if only at a non-cognitive level of awareness.
In preliminary testing Geller apparently demonstrated an ability to reproduce simple pictures (line drawings) that had been drawn and placed in opaque sealed envelopes he was not permitted to handle. But since each of the targets was known to at least one experimenter in the room with Geller, it was not possible on the basis of the preliminary testing to discriminate between Geller’s direct perception of envelope contents and perception through some mechanism involving the experimenters, whether paranormal or subliminal.
So we examined the phenomenon under conditions designed to eliminate all conventional information channels, overt or subliminal. Geller was separated from both the target material and anyone knowledgeable of the material, as in the experiments of Reference 4.
In the first part of the study a series of thirteen separate drawing experiments was carried out over seven days. No experiments were deleted from the results presented here. (For all target drawings and Geller’s responses see Plates 1 and 2.)
At the beginning of the experiment either Geller or the experimenters entered a shielded room, so that from that time forward Geller was at all times visually, acoustically, and electrically shielded from personnel and material at the target location. Only following Geller’s isolation from the experimenters was a target chosen and drawn, a procedure designed to eliminate pre-experiment cueing. Furthermore, to eliminate the possibility of pre-experiment target forcing, Geller was kept ignorant as to the identity of the person selecting the target and as to the method of target selection. This was accomplished by the use of three different techniques: (1) pseudorandom technique of opening a dictionary arbitrarily and choosing the first word that could be drawn (Experiments 1-4); (2) targets, blind to experimenters and subject, prepared independently by SRI scientists outside the experimental group (following Geller’s isolation) and provided to the experimenters during the course of the experiment (Experiments 5-7, 11-13); and (3) arbitrary selection from a target pool decided upon in advance of daily experimentation and designed to provide data concerning information content for use in testing specific hypotheses (Experiments 8-10). Geller’s task was to reproduce with pen on paper the line drawing generated at the target location. Following a period of effort ranging from a few minutes to half an hour, Geller either passed feel confident) or indicated he was ready to submit a drawing to the experimenters,in which case the drawing was collected before Geller was permitted to see the target.
Table 1. Summary: Remote perception of graphic material
Experiment Date Geller location Target location Target Figure
1 8/4/73 Shielded room #1a Adjacent room(4.1 m)b Firecracker 1a
2 814/73 Shielded room #l Adjacent room(4.1 m) Grapes 1b
3 8/5173 Shielded room #l Office (475 m) Devil lc
4 8/5/73 Room adjacent to Shielded room#l Solar system 1d
shielded room #l (3.2 m)
5 8/6/73 Room adjacent to Shielded room#l Rabbit No drawing
shielded room #l (3.2 m)
6 8/7/73 Shielded room #l Adjacent room(4.1 m) Tree No drawing
7 8/7173 Shielded room #l Adjacent room(4.1 m) Envelope No drawing
8 818/73 Shielded room #l Remote room (6.75m) Camel 1e
9 818173 Shielded room #l Adjacent room(4.1 m) Bridge 1f
10 8/8/73 Shielded room #l Adjacent room(4.1 m) Seagull 1g
11 8/9173 Shielded room #2c Computer (54 m) Kite (computer 2a
CRT)
12 8110173 Shielded room #2 Computer (54 m) ChurchBR (computer 2b
memory)
13 8/10173 Shielded room #2 Computer (54 m) Arrow through 2c
heart (computer
CRT, zero inten-
sity)
(a)EEG Facility shielded room (see text).
(b)Perceiver-target distances measured in meters.
(c)SRI Radio Systems Laboratory shielded room (see text).

To prevent sensory cueing of the target information, Experiments 1 through 10 were carried out using a shielded room in SRI’s facility for EEG research. The acoustic and visual isolation is provided by a double-walled steel room, locked by means of an inner and outer door, each of which is secured with a refrigerator-type locking mechanism. Following target selection when Geller was inside the room, a one-way audio monitor, operating only from the inside to the outside, was activated to monitor Geller during his efforts. The target picture was never discussed by the experimenters after the picture was drawn and brought near the shielded room. In our detailed examination of the shielded room and the protocol used in these experiments, no sensory leakage has been found.
The conditions and results for the ten experiments carried out in the shielded room are displayed in Table 1 and Plate 1. All experiments except 4 and 5 were conducted with Geller inside the shielded room. In Experiments 4 and 5, the procedure was reversed. For those experiments in which Geller was inside the shielded room, the target location was in an adjacent room at a distance of about 4 m, except for Experiments 3 and 8, in which the target locations were, respectively, an office at a distance of 475 m and a room at a distance of about 7 m.
A response was obtained in all experiments except Numbers 5-7. In Experiment 5, the person-to-person link was eliminated by arranging for a scientist outside the usual experimental group to draw a picture, lock it in the shielded room before Geller’s arrival at SRI, and leave the area. Geller was then led by the experimenters to the shielded room and asked to draw the picture located inside the room. He said that he got no clear impression and therefore did not submit a drawing. The elimination of the person-to-person link was examined further in the second series of experiments with this subject.
Experiments 6 and 7 were carried out while we attempted to record Geller’s EEC during his efforts to perceive the target pictures. The target pictures were, respectively, a tree and an envelope. He found it, difficult to hold adequately still for good EEG records, said that he experienced difficulty in getting impressions of the targets, and again submitted no drawings.
Experiments 11-13 were carried out in SRI’s Engineering Building, to make use of the computer facilities available there. For these experiments, Geller was secured in a double-walled, Copper-screen Faraday cage 54 m down the hall and around the corner from the computer room. The Faraday cage provides 120 dB attenuation for plane wave radio frequency radiation over a range of 15 kHz to 1 GHz. For magnetic fields the attenuation is 68 dB at 15 kHz and decreases to 3 dB at 60 Hz. Following Geller’s isolation, the targets for these experiments were chosen by computer laboratory personnel not otherwise associated with either the experiment or Geller, and the experimenters and subject were kept blind as to the contents of the target pool.
For Experiment 11, a picture of a kite was drawn on the face of cathode-ray tube display screen, driven by the computer’s graphics program. For Experiment 12, a picture of a church was drawn stored in the memory of the computer. In Experiment 13, target drawing, an arrow through a heart (see Plate 2(c)), was drawn on the face of the cathode-ray tube and then the display in was turned off so that no picture was visible.
To obtain an independent evaluation of the correlation between target and response data, the experimenters submitted the data for judging on a “blind” basis by two SRI scientists who were not otherwise associated with the research. For the ten cases in which Geller provided a response, the judges were asked to match the response data with the corresponding target data (without replacement). In those cases in which Geller made more than one drawing as his response to the target, all the drawings were combined as a set for judging. The two judges each matched the target data to the response data with no error. For either judge such a correspondence has an a priori probability, under the null hypothesis of no information channel, of P = 1/(10!) = 3 X 10-7.
A second series of experiments was carried out to determine whether direct perception of envelope contents was possible without some person knowing of the target picture.
One hundred target pictures of everyday objects were drawn by an SRI artist and sealed by other SRI personnel in double envelopes containing black cardboard. The hundred targets were divided randomly into groups of twenty for use in each of the three days’ experiments.
On each of the three days of these experiments, Geller passed. That is, he declined to associate any envelope with a drawing that he made, expressing dissatisfaction with the existence of such a large target pool. On each day he made approximately twelve recognizable drawings, which he felt were associated with the entire target pool of 100. On each of the three days, two of his drawings could reasonably be associated with two of the twenty daily targets. On the third day, two of his drawings were very close replications of two of that day’s target pictures. The drawings resulting from this experiment do not depart significantly from what would be expected by chance.
In a simpler experiment Geller was successful in obtaining information under conditions in which no persons were knowledgeable of the target. A double-blind experiment was performed in which a single 3/4-inch die was placed in a 3 x 4 x 5-inch steel box. The box was then vigorously shaken by one of the experimenters and placed on the table, a technique found in control runs to produce a distribution of die faces that does not differ significantly from chance distribution. The orientation of the die within the box was unknown to the experimenters at that time. Geller would then write down which die face was uppermost. The target pool was known, but the targets were individually prepared in a manner blind to all persons involved in the experiment. This experiment was performed ten times, with Geller passing twice and giving a response eight times. The eight times he gave a response, he was correct each time. The distribution of responses consisted of three twos, one four, two fives, and two sixes. The probability of this occurring by chance is approximately one in 10^6.
In certain situations significant information transmission can take place under shielded conditions. Factors that appear to be important and are therefore candidates for future investigation include whether the subject knows the set of targets in the target pool, the actual number of targets in the target pool at any given time, and whether the target is known by any of the experimenters.
It has been widely reported that Geller has demonstrated the ability to bend metal by paranormal means. Although metal bending by Geller has been observed in our laboratory, we have not been able to combine such observations with adequately controlled experiments to obtain data sufficient to support the paranormal hypothesis.
Remote Viewing of Natural Targets
A study by Osis (5) led us to determine whether a subject could describe randomly chosen geographical sites located several miles from the subject’s position and demarcated by some appropriate means (remote viewing). This experiment carried out with Price, a former California police commissioner and city councilman, consisted of a series of double-blind, demonstration-of-ability tests, involving local targets in the San Francisco Bay area, which could be documented by several independent judges. We planned the experiment believing that natural geographical, places or manmade sites that have existed for a long time are more potent targets, for paranormal perception experiments than are artificial targets prepared in the laboratory. This is based on subject opinions that the use of artificial targets involves a “trivialization of the ability” as compared with natural preexisting targets.
In each of nine experiments involving Price as subject and SRI experimenters as a target-demarcation team, a remote location was chosen in a double-blind protocol. Price, who remained at SRI, was asked to describe this remote location, as well as whatever activities might be going on there.
Several descriptions yielded significantly correct data pertaining to, and descriptive of, the target location.
In the experiments a set of twelve target locations clearly differentiated from each other and within thirty minutes’ driving time from SRI had been chosen from a target-rich environment (more than 100 targets of the type used in the experimental series) prior to the experimental series by an individual in SRI management, the director of the Information Science and Engineering Division, not otherwise associated with the experiment. Both the experimenters and the subject were kept blind as to the contents of the target pool, which were used without replacement.
An experimenter was closeted with Price at SRI to wait thirty minutes to begin the narrative description of the remote location. The SRI locations from which the subject viewed the remote locations consisted of an outdoor park (Experiments 1 and 2), the double-walled copper-screen Faraday cage discussed earlier (Experiments 3 and 4, and 6-9), and an office (Experiment 5). A second experimenter would then obtain a target location from the division director from a set of traveling orders previously prepared and randomized by the director and kept under his control. The target demarcation team (two to four SRI experimenters) then proceeded directly to the target by automobile without communicating with the subject or experimenter remaining behind. Since the experimenter remaining with the subject at SRI was in ignorance both as to the particular target and as to the target pool, he was free to question Price to clarify his descriptions. The demarcation team then remained at the target site for thirty minutes after the thirty minutes allotted for travel. During the observation period, the remote-viewing subject would describe his impressions of the target site into a tape recorder. A comparison was then made when the demarcation team returned.
Price’s ability to describe correctly buildings, docks, roads, gardens, and so on, including structural materials, color, ambiance, and activity, sometimes in great detail indicated the functioning of a remote perceptual ability. But the descriptions contained inaccuracies as well as correct statements. To obtain a numerical evaluation of the accuracy of the remote viewing experiment, the experimental results were subjected to independent judging on a blind basis by five SRI scientists who were not otherwise associated with the research. The judges were asked to match the nine locations, which they independently visited, against the typed manuscripts of the tape-recorded narratives of the remote viewer. The transcripts were unlabeled and presented in random order. The judges were asked to find a narrative that they would consider the best match for each of the places they visited. A given narrative could be assigned to more than one target location. A correct match required that the transcript of a given date be associated with the target of that date. Table 2 shows the distribution of the judges’ choices.
Table 2.
Distribution of correct selections by judges A,B,C,D, and E In remote viewing experiments
Descriptions chosen by judges Places visited by judges 1 2 3 4 5 6 7 8 9 Hoover Tower 1 ABCDE D
Baylands Nature Preserve 2 ABC E D D
Radio Telescope 3 ACD BE
Redwood City Marina 4 CD ABDE E
Bridge Toll Plaza 5 ABD DCE
Drive-in Theater 6 B A c E
Arts and Crafts Garden Plaza 7 ABCE
Church 8 c AB
Rinconada Park 9 CE AB

Of the 45 selections (5 judges, 9 choices), 24 were correct. Bold type indicates the description chosen most often for each place visited. Correct choices lie on the main diagonal. The number of correct matches by Judges A through E is 7, 6, 5, 3 and 3, respectively. The expected number of correct matches from the five judges was five; in the experiment 24 such matches were obtained. The a priori probability of such an occurrence by chance, conservatively assuming assignment without replacement on the part of the judges, is P = 8 x 10^-10.
Among all possible analyses, the most conservative is a permutation analysis of the plurality vote of the judges’ selections, assuming assignment without replacement, an approach independent of the number of judges. By plurality vote, six of the nine descriptions and locations were correctly matched. Under the null hypothesis (no remote viewing and a random selection of descriptions without replacement), this outcome has an a priori probability of P = 5.6 x 10^-4, since, among all possible permutations of the integers one through nine, the probability of six or more being in their natural position in the list has that value. Therefore, although Price’s descriptions contain inaccuracies, the descriptions are sufficiently accurate to permit the judges to differentiate among the various targets to the degree indicated.
EEG Experiments

An experiment was undertaken to determine whether a physiological measure such as EEG activity could be used as an indicator of information transmission between an isolated subject and a remote stimulus. We hypothesized that perception could be indicated by such a measure even in the absence of verbal or other overt indicators. (6,7)
It was assumed that the application of remote stimuli would result in responses similar to those obtained under conditions of direct stimulation. For example, when a normal subject is stimulated with a flashing light, his EEG typically shows a decrease in the amplitude of the resting rhythm and a driving of the brain waves at the frequency of the flashes. (8) We hypothesized that if we stimulated one subject (a sender) in this manner, the EEG of another subject (a receiver) in a remote room with no flash present, might show changes in alpha (9-11 Hz) activity, and possibly EEG driving similar to that of the sender.
We informed our subject that at certain times a light was to he flashed in a sender’s eyes in a distant room, and if the subject perceived that event, consciously or unconsciously, it might be evident from changes in his EEG output. The receiver was seated in the visually opaque, acoustically and electrically shielded double walled steel room previously described. The sender was seated in a room about 7 m from the receiver.
To find subjects who were responsive to such a remote stimulus, we initially worked with four female and two male volunteer subjects, all of whom believed that success in the experimental situation might be possible. These were designated “receivers.” The senders were either other subjects or the experimenters. We decided beforehand to run one or two sessions of thirty-six trials each with each subject in this selection procedure, and to do a more extensive study with any subject whose results were positive.
A Grass PS-2 photostimulator placed about 1 m in front of the sender was used to present flash trains of ten-seconds’ duration. The receiver’s EEG activity from the occipital region (Oz), referenced to linked mastoids, was amplified with a Grass 5P-1 preamplifier and associated driver amplifier with a band pass of 1-120 Hz. The EEG data were recorded on magnetic tape with an Ampex SP 300 recorder.
On each trial, a tone burst of fixed frequency was presented to both sender and receiver and was followed in one second by either a ten-second train of flashes or a null flash interval presented to the sender. Thirty-six such trials were given in an experimental session, consisting of twelve null trials – no flashes following the tone – twelve trials of flashes at six flashes per second and twelve trials of flashes at sixteen flashes per second, all randomly intermixed, determined by entries from a table of random numbers. Each of the trials generated an eleven-second EEG epoch. The last four seconds of the epoch were selected for analysis to minimize the desynchronizing action of the warning cue. This four-second segment was subjected to Fourier analysis on a LINC 8 computer.
Spectrum analyses gave no evidence of EEG driving in any receiver, although in control runs the receivers did exhibit driving when physically stimulated with the flashes. But of the six subjects studied initially, one subject (H.H.) showed a consistent alpha blocking effect. We therefore undertook further study with this subject.
Data from seven sets of thirty-six trials each were collected from this subject on three separate days. This is all the data collected to date with this subject under the test conditions described above. The alpha band was identified from average spectra; then scores of average power and peak power were obtained from individual trials and subjected to statistical analysis.
Table 3. EEG data for H. H. showing average power and peak power in the 9-11 Hz band, as a function of flash frequency and sender Flash
Frequency 0 6 16 0 6 16
Sender Average power Peak power
J.L 94.8 84.1 76,8 357.7 329.2 289.6
R.T. 41.3 45.5 37.0 160.7 161.0 125.0
No sender
(subject
informed) 25.1 35.7 28.2 87.5 95.7 81.7
J.L. 54.2 55.3 44.8 191.4 170.5 149.3
J.L. 56.8 50.9 32,8 240.6 178.0 104.6
R.T. 39.8 24.9 30.3 145.2 74.2 122.1
No sender
(subject not
informed) 86.0 53.0 52.1 318.1 180.6 202.3
Averages 56.8 49.9 43.1 214.5 169.8 153.5
-12% -24%(P0.04) -21% -28%(P0.03)
Each entry is an average over 12 trials

Of our six subjects, H.H. had by far the most monochromatic EEG spectrum. Plate 3 shows an overlay of the three averaged spectra from one of this subject’s thirty-six-trial runs, displaying changes in her alpha activity for the three stimulus conditions. (See Plate 3.)
Mean values for the average power and peak power for each of the seven experimental sets are given in Table 3. The power measures were less in the sixteen-flashes-per-second case than in the zero-flashes-per-second in all seven peak power measures and in six out of seven average power measures. Note also the reduced effect in the case in which the subject was informed that no sender was present (Run 3). It seems that overall alpha production was reduced for this run in conjunction with the subject’s expressed apprehension about conducting the experiment without a sender. This is in contrast to the case (Run 7) in which the subject was not informed.
Siegel’s two-tailed t approximation to the nonparametric randomization test (9) was applied to the data from all sets, which included two sessions in which the sender was removed. Average power on trials associated with the occurrence of sixteen flashes per second was significantly less than when there were no flashes (t= 2.09, d.f. = 118, P 0.04). The second measure, peak power, was also significantly less in the sixteen-flashes-per-second conditions than in the null condition (t = 2.16, d.f. = 118, P 0.03). The average response in the six-flashes-per-second condition was in the same direction as that associated with sixteen flashes per second, but the effect was not statistically significant.
Spectrum analyses of control recordings made from saline with a 12 k ohm resistance in place of the subject with and without the addition of a 10 Hz, 50 micro volt test signal applied to the saline solution, revealed no indications of flash frequencies, nor perturbations of the 10 Hz signal. These controls suggest that the results were not due to system artifacts. Further tests also gave no evidence of radio frequency energy associated with the stimulus.
Subjects were asked to indicate their conscious assessment for each trial as to which stimulus was generated. They made their guesses known to the experimenter via one-way telegraphic communication. An analysis of these guesses has shown them to be at chance, indicating the absence of any supraliminal cuing, so arousal as evidenced by significant alpha blocking occurred only at the noncognitive level of awareness.
We hypothesize that the protocol described here may prove to be useful as a screening procedure for latent remote perceptual ability in the general population.
Conclusion

From these experiments we conclude that:
1. A channel exists whereby information about a remote location can be obtained by means of an as yet unidentified perceptual modality.
2. As with all biological systems, the information channel appears to be imperfect, containing noise along with the signal.
3. While a quantitative signal-to-noise ratio in the information theoretical sense cannot as yet be determined, the results of our experiments indicate that the functioning is at the level of useful information transfer.
It may be that remote perceptual ability is widely distributed in the general population, but because the perception is generally below an individual’s level of awareness, it is repressed or not noticed. For example, two of our subjects (H.H. and P.P.) had not considered themselves to have unusual perceptual ability before their participation in these experiments.
Our observation of the phenomena leads us to conclude that experiments in the area of so-called paranormal phenomena can be scientifically conducted, and it is our hope that other laboratories will initiate additional research to attempt to replicate these findings.
REFERENCES
1. Pratt, J., J. B. Rhine, C. Stuart, and J. Greenwood, Extrasensory Perception after Sixty Years (New York: Henry Holt, 1940).
2. Soal, S. and F. Bateman, Modern Experiments in Telepathy (London: Faber and Faber, 1954).
3. Vasiliev, L. L., Experiments in Mental Suggestion (Hampshire, England: ISMI Publications, 1963).
4. Musso, J. R. and M. Granero, Journal of Parapsychology, 37, 13-37, 1973.
5. Osis, K., ASPR Newsletter, No. 14, 1972.
6. Tart, C. T., “Physiological Correlates of Psi Cognition.” International Journal of Parapsychology, V, No. 4, 1963.
7. Dean, E. D., International Journal of Neuropsychiatry, 2, 1966.
8. Hill, D. and C. Parr, Electroencephalography: A Symposium on Its Various Aspects (New York: Macmillan, 1963).
9. Siegel, S., Nonparametric Statistics for the Behavioral Sciences (New York: McGraw-Hill, 1956), pp. 152-56.

However, I think of observation abilities as a form of intelligence, falling under the heading of what Gardner called the “personal intelligences.” However, I don’t feel that Gardner gave observational intelligence its just due. While it is true that it is an important type of intelligence for someone such as a detective or counselor, observational intelligence can serve everyone in their daily lives. Observational intelligence can lead to good problem solving – for example, noticing things that others don’t notice. That of course can be helpful in nearly any position.
And we shouldn’t fail to realize just how key observational intelligence plays a role in the greater domain of personal intelligence. The ability to “read people” and to understand their motivations can be an extremely valuable type of intelligence in a workplace setting and personal relationships. While it is true that it is an invaluable “skill” for a psychologist or counselor to have, rarely has it been talked about as a sought after type of intelligence for anyone to have in order to succeed in their career and in their personal relationships.

A workplace example: one afternoon I was setting up a training webinar on the 4th floor of the office building where I’ve worked now for 3+ years. I regularly work on the 5th floor, but at some time or another find myself on all 5 floors for various work-related activities. I was only minutes away from beginning my training class, many attendees had already began to come into the training room when an employee from the 4th floor burst into the training room. “Can I help you?” I asked as he stood in front of me. “I just didn’t know what you were doing in here, and thought you might have been one of the new guys from our section. I didn’t recognize you.” I replied, “I’ve worked here for over 3 years and you never recognized me before?” He said “No!” firmly. I laughed, and he walked out of the room.

Okay, a couple interesting points about this: One, I had seen this fellow numerous times not only on the 4th floor hallways and bathrooms, but also on the 5th floor where I work in the break room getting coffee. We had never spoken before, but had nodded heads to acknowledge each other a few times. Plus, I’m a rather large guy, about 6′ 2″ and 210lbs so not so easily overlooked. The only conclusion I could come to is that this was a good example of someone who is what I would say has low observational intelligence.

A quick Google search of the term succinct revealed a definition, but no mention of why being succinct is important or good, or if it indeed is. And a search of the American Psychological Association (APA) database also returned nothing on succinctness. However, when I did the Google search I noticed several articles that came up under the term “artificial intelligence” that mentioned the necessity of a succinct programming language.

To answer my own question of whether or not being succinct is a type of intelligence, I would say that yes it certainly is. As to what domain it falls under, I tend to think of it as a blend of logical & linguistic types of intelligences. Now, another interesting question is does our current intelligence testing measure succinctness? I don’t know the answer to that, but I’m planning to follow-up on it with my own research and I’ll post back to this blog after I learn more about it. I’m surprised however that I didn’t find more information on this on the APA website. In fact, I found none! But I have a collection of APA journals at my home that I’m also planning on reviewing and look for information on this topic. It could be that the idea of whether or not “succinctness” is a type of an intelligence, and one that is accounted for already by current IQ testing has already been asked and answered, and if that is the case, I’ll be happy to update my blog entry with the information that I find out. However, if it has been asked and answered, it certainly is not well-documented.

On the other hand, infectious diseases like influenza for example (the common flu) really don’t have so much to do with your lifestyle choices, at least not significantly. You can do “all the right things” and still get the flu. Infectious diseases are more determined by biology than psychology, you can’t always control whether or not you will be exposed to a virus (an infectious disease) but you can control lifestyle choices that lead to chronic diseases.

**NOTE (you can click on the above photos to blow them up to full size)**

Udon Thani is approximately 560 km northeast of Bangkok and is considered Isaan’s “gateway city” to Laos. It is located about an hours drive from the Laotian border and has a population of approximately 225,000. During the Vietnam War, the city catered to the nearby Royal Thai Air Force Base and the American military. Yearly training events among the American military and the Thai military are still held here, so the city has developed a sort of “GI feel” with a lot of bars and massage parlors. However, the city has other historical and cultural attractions that are often overlooked. About 47km east of Udon Thani is Ban Chiang, a Bronze Age archaeological site. And amongst the city’s impressive wats are Wat Pho (a replicated design of the more famous “Wat Pho” in Bangkok) and Wat Ard Su Ra Vi Han – an often overlooked wat by tourists.

Wat Pho is quite impressive in terms of the size of the grounds and the numerous buildings. Many young Thai men perform their required monk “internships” at this wat. From the Charoensri Grand Royal Hotel (renamed the Centara Hotel & Convention Centre in 2009), and the adjacent main shopping plaza, it is about a 50 baht tuk tuk ride. Even more impressive is Wat Ard Su Ra Vi Han, which is located near one of the city’s 2 lakes – on the other side of the lake is a Chinese temple known as Sala Poo Ya which is worth a visit since you are in the area. You can walk around the concrete park path with some nice views of the lake, check out the Chinese temple (there’s a Chinese restaurant there as well), and then make your way over to the Thai temple. A tuk tuk ride from the Centara Hotel round trip, including wait time for the tuk tuk driver while you walk around the park and visit the Thai temple (allow about 1-2 hours), should run you about 300 baht.

Udon Thani also has a sizable night market, which is located about a 10-minute walk from the main shopping plaza (adjacent to the Centara Hotel). And there are many eateries located within walking distance or a short tuk tuk ride from here as well. The large shopping plaza is about 5 floors high and has a food court, movie theater, and KFC amongst other options. The city also has two city parks, one which is located across from Wat Ard Su Ra Vi Han and the other named Nong Prachak is located near Wat Pho and is quite impressive in size and is a favorite spot for locals to spend a lazy afternoon on the well-maintained grass.

Commuting to Udon Thani from Bangkok:

From Bangkok you have three flight options to Udon Thani. Yes, there are other travel options by bus or train, but these will all take 8 hours or more. You will save a few thousand baht perhaps, but loose a few hours in the process. I did take a VIP bus from Bangkok to Khon Kaen on two occassions and though it was comfortable enough, I really prefer to explore the highways and countryside on my own via car – maybe you feel differently.

THAI Airways flies three times daily from Suvarnabhumi (BKK) to Udon Thani – a mid-morning flight, afternoon flight and evening flight. Check their website for exact travel times. The fees will vary from about 3,500 baht to 5,000 baht (round trip) depending upon whether you are travelling during a peak season or holiday like Songkran (mid April).

Air Asia flies twice daily from Suvarnabhumi (BKK) to Udon Thani – an early morning flight and a late night flight. Again check the website for exact travel times. Sometimes you will find an Air Asia flight to be a little cheaper than THAI Airways, but in my experience they are often about the same and if I have an option, I like the afternoon flight better – Air Asia doesn’t offer one.

Nok Air flies twice daily from Don Mueang to Udon Thani – an early morning flight and an afternoon flight, no evening flights. Nok Air is perhaps good if you are flying domestically, but if you arrive on an international flight, you will arrive to what is often referred to as “the new airport” which is Suvarnabhumi (BKK). This means that you will need to take a metered taxi (about 650 baht and 45 minutes) to reach the old airport, Don Mueang. Although Nok Air is sometimes as much as 50% cheaper than either THAI Airways or Air Asia, when you factor in the taxi ride, the time lost, and the inconvenience I don’t feel it is a viable option if you are arriving on an international flight.

Abstract

In August of 2005, Hurricane Katrina struck the Gulf Coast killing nearly 2,000 people and causing approximately 100 billion dollars in damage. The disaster was ranked as one of the deadliest in United States history, with New Orleans suffering a great bulk of the damage. Eventually about 80% of the city became flooded which caused a series of public health issues. The damage of this natural disaster was shocking but even more shocking was how the response from local, state and federal public health and emergency response agencies was mishandled. Not only was the public health response criticized but it seems that New Orleans was not adequately prepared to handle such an event. Three areas will be discussed in this paper: the roles and responsibilities of the local, state and federal public health authorities and how these roles were unmet; how these agencies should have worked together before and after the disaster; and how these agencies could have better handled the problems that arose during and after the event. This paper will target specifically how to improve leadership among public health authorities during a disaster such as Hurricane Katrina, recommendations for timely decision making during such a disaster, and how to make improvements to infrastructure and preparedness before a disaster.

The mishandling of the Hurricane Katrina disaster

Hurricane Katrina struck the Gulf Coast in August of 2005 and with it brought devastating damage to the region. The city of New Orleans was hit particularly hard and was the result of much of the monetary damage as well as human loss of life. Katrina exposed serious flaws in the United States’ disaster response capabilities (Howitt et al., 2006).

In the American disaster response schema, the initial responsibility for disaster response rests with local authorities (Howitt et al., 2006). This “bottom-up” approach makes sense in most emergencies because local governments are closer to disaster sites and therefore can provide quicker response as well as intimate knowledge of the area (Howitt et al., 2006). Aid from state or federal sources is generally provided in such instances where localized resources have been exhausted (Howitt et al., 2006). There are generally more specialized resources at the state and federal levels, but these resources are further away and their response time is longer, which is decidedly important in disaster response (Howitt et al., 2006).

Some of the other criticisms of the mishandling of Hurricane Katrina were cited as unqualified crisis managers and weak elected officials, inadequate preparedness plans, failure to make investments into infrastructure (particularly in the case of New Orleans) and poor and/or late decision making (Howitt et al., 2006).

“Crisis” emergencies like Hurricane Katrina are distinguished from routine emergencies by their novelty (Howitt et al., 2006). In other words, the “crisis” emergency presents something that the planners have not adequately planned for. According to Howitt et al., (2006), it is inevitable that at some point a community will be presented with this type of crisis disaster. These crisis disasters require different capabilities, for example: responders must identify the novel elements of the disaster. In the Hurricane Katrina disaster these novelties were: the need for assistance in the evacuation of people from their homes and from the city of New Orleans, the failing of the levees which resulted in significant flooding to the city, the unexpected use of the city’s convention center for sheltering refugees (which included providing food and law and order), and restoring water and power (Howitt et al., 2006).

Even though Hurricane Katrina was a local disaster, federal disaster relief was needed because of the magnitude of the disaster. No local municipality or state can afford to keep all the assets that are necessary in an emergency like Katrina in reserves, so turning to federal assistance was necessary (Howitt et al., 2006). As Howitt et al., (2006, p. 219) points out, the coordination of federal, state, and local agencies “demands skillful coordination of aid workers, equipment, and organizations across professions, agencies, jurisdictions, levels of government, and the public and private sectors.” No easy task. And many or most of the public health officials and organizations that were part of the post-Katrina response had little or no prior experience working together (Howitt et al., 2006).

This fact was at the center of the debacle of the post-recovery response from Hurricane Katrina; and illustrates the point quite clearly the need for such training to occur in disaster preparedness whereby individuals at the local, state, and federal levels that may be called to work together in the event of a large scale disaster need to have real-life training as such.

In fact, one could argue the point that the disaster response for Hurricane Katrina put NIMS – the National Incident Management System – that was created in 2002, to the test. Unfortunately, it was a failed effort which further points to the need for additional training on the management of this type of disaster. The purpose of NIMS, ideally, is to establish a clear division of labor and assignment of functional responsibility; and to clearly define the chain-of-command (Howitt et al., 2006). But in the disaster response post-Hurricane Katrina, the NIMS system was not effective in any of these areas. It is this writer’s opinion that the problem is one of management-style. The NIMS style opts for a “military-type” command system; even the terminology of “command system” and “chain-of-command” give the whole federal disaster response system a military feel. The military is quite capable in war-time efforts, but is not the most effective of systems in peace-keeping efforts. With NIMS on showcase in post-Katrina response we got a military-style effort; what we needed was a peace-keeping or humanitarian effort.

In the case of Katrina, there was noticeable friction between local and state officials, with the city officials and mayor on one side, and the state and governor on the other side. And both local and state officials criticized the federal response, most notably FEMA (Howitt et al., 2006).

Rosenbaum (2006, p. 437) writes: “(Katrina) exposed every public policy failure essential to community and population health. After the levees broke, we watched every single system associated with the life of a city fail: the electric grid, the water system, the sewer system, the transportation system, the telephone system, the police force, the fire department, the hospitals, even the system for disposing of corpses.” In fact, the devastation to New Orleans (and other areas) infrastructure was so great that more than one million people were homeless even as of December 2005, four months after the disaster struck (Rosenbaum, 2006).

When Hurricane Katrina struck, first responders were as unprepared for the disaster as they had been on 9/11 (Shughart, 2006). But why, and who was to blame? Why was FEMA delayed in their arrival? Why were no police or National Guard units in place to prevent looting (Shughart, 2006)? According to Shughart (2006, p. 32), “the fiasco was predictable because politicians and bureaucrats have relatively weak incentives to prepare for emergencies and to promptly mobilize the resources necessary to alleviate hardship when catastrophe strikes.”

While I agree with Shughart in that Government is certainly full of shortcomings, I’m not sure we can simply say “oh well, that’s Government for you” and forget about it. When a disaster the size of Katrina occurs and the response is as impotent as it was, I think we must address why it occurred and look for some solutions. It may not make the next big disaster go perfectly, but hopefully we can make some improvements when the inevitable occurs again.

And it isn’t as if public officials didn’t have ample warning about Katrina. On August 27, 2005 – two days before Hurricane Katrina struck the Gulf Coast – Louisiana State University’s Center for the Study of the Public Health Impacts of Hurricanes predicted that New Orleans would flood as the result of Hurricane Katrina (Shughart, 2006). With this warning in hand, city officials should have evacuated the city, but they did not. In fact, another study two years prior to Hurricane Katrina found that a category 3 hurricane, which Katrina was, would flood the city (Shughart, 2006). So there was enough evidence to suggest that city officials should have put the city on alert and began evacuation procedures, but they did not.

The Army Corps of Engineers, who were responsible for both building and monitoring the levees around New Orleans, warned state and local officials that soil erosion had caused some stretches of the flood barrier to sink as much as three feet, and these areas must be repaired (Shughart, 2006). However, the levees were not repaired. Why did city or state officials not address the levees, knowing it was simply a matter of time before a category 3 storm would hit the city? When the storm reached New Orleans, the levees failed as predicted, and about 80% of the city was under water, 20 feet deep in some places (Shughart, 2006).

The best answer for why the levees were not repaired was because citizens of New Orleans did not voice their concerns loudly enough to politicians. That is not to say that it is the residents of New Orleans fault, but rather politicians will typically only address those issues that are likely to get them reelected (Shughart, 2006). Since citizens were not talking about levee repairs for the most part, city officials and politicians ignored it, choosing to spend money in other areas (Shughart, 2006). For politicians, money spent on infrastructure and repair is wasted money, because no one really sees it, it deteriorates over time, and the public isn’t generally aware of it (Shughart, 2006). So politicians generally ignore these types of infrastructure necessities, hoping that when a problem occurs, it will “happen on someone else’s watch” (Shughart, 2006).

Another issue regarding the levees was that they were overseen by four different governing boards, made up of gubernatorial and local political appointees, each with their own autonomy to some extent (Shughart, 2006). And in the city of New Orleans, there are independent water and sewer boards that run and maintain the pumps and canals needed for draining low-lying areas (Shughart, 2006). This fragmentation clearly had foreseeable consequences, for it seems that though the Army Corps of Engineers recommended repairs to the levees, it was unclear exactly who was responsible for the repairs (Shughart, 2006). The city thought the repairs should come from the governing boards responsible for the levees, and those boards thought the cost should be footed by the city of New Orleans. And it seems that past repairs to the levee system had been done rather haphazardly – repaired well in some areas using appropriate materials, repaired poorly in other areas using cheap or ineffective materials or erecting levees that were not sufficiently high enough (Shughart, 2006).

The Orleans Levee District (one such governing board) focused more on developing its prominence in the region and acquiring more political power in order to build parks, marinas, walking paths, and a commuter airport near Lake Pontchartrain in an order to make considerable profits (Shughart, 2006). And during this development of the area, very little money was put into levee repair by this governing board, instead opting for money-making developments. Lake Pontchartrain area was one of the hardest hit by Hurricane Katrina. Most of these developments by the Orleans Levee District board were destroyed (Shughart, 2006).

To address the fragmentation of government that we saw in the Hurricane Katrina example, it is essential that in situations such as these that one governing board be over the entire flood levee system. Or at least have a governing board that has the power and authority to enforce the “local” boards with regards to repairs. And this governing board should not be compromised by having real estate development interests and money-making schemes as its first priority.

But the failures of the Katrina response were not merely inadequate preparations. Both the mayor of New Orleans and the governor of Louisiana were heavily criticized regarding their actions or rather inactions for the first few days when Hurricane Katrina hit (Shughart, 2006). Mayor Nagin chose to “wait-out” the disaster in a local high-end hotel rather than being at Louisiana’s emergency operations facility in Baton Rouge (Shughart, 2006). Shughart (2006) also criticizes Governor Kathleen Babineaux Blanco for allowing the mayor to determine whether or not New Orleans should be under mandatory evacuation. It would seem that perhaps Governor Blanco was not confident enough to make such a decision, perhaps fearing the move would hurt the local and/or state’s economy. But she had ample evidence that Katrina was a severe enough hurricane that significant damage was likely to be done to the area, especially in light of New Orleans’ inadequate levee protection. Though the mayor should have called for the evacuation of the city, so should have the governor stepped in and done so when the mayor failed to do so. Both are to blame for the inadequate response in my opinion.

Once Hurricane Katrina struck New Orleans, communications between the mayor and the governor and between the governor and other public health officials were cut-off (Shughart, 2006). The governor was able to notify the president of the need for additional assistance the day that Katrina struck the city, but did not give a detailed list of what was needed until three days later (Shughart, 2006). Apparently this was due to her lack of communications with the mayor and other public health officials in the city. And then it was several days later before President Bush actually sent any aid (Shughart, 2006). So from the time the storm hit New Orleans to the time that aid actually arrived, about 5 days had passed (Shughart, 2006).

One way that this could have been avoided was to have all of the necessary players, the mayor, the governor, and other city and state officials at the command center, rather than having them separated in different parts of the city and state. In fact, this one of the main tenets of the NIMS system: the Incident Command Post (ICD). So why the ICD was not used in this case by officials is still unclear.

President Bush was also criticized for his lackluster response (Shughart, 2006). The President kept speaking engagements and continued his vacation even after learning of what was happening in New Orleans (Shughart, 2006). Looting and rioting were problems in the flooded streets of New Orleans, particularly since a significant portion of the police force had deserted the city (Shughart, 2006). It wasn’t until several days later that President Bush suggested to the governor that she allow federal National Guard units to impose martial law on the city. However, the governor refused (Shughart, 2006). Many accused the president of racism since the majority of those left behind and homeless in New Orleans were poor and black. But Shughart (2006) contends that the lackluster response from President Bush more likely had to do with motivation. President Bush was already in his second term with no re-election to worry about, and in an area of the country that is loyal to the Republican Party (Shughart, 2006).

I agree with Shughart’s contention about President Bush to some extent. But to say that a sitting president could care less about what happens during his second term because there is no re-election value I think it a bit off. Someone doesn’t reach the level of president without being an ego-maniac to some extent, and presidents always care about their legacy. This writer’s opinion is that President Bush waited to respond because both the mayor and the governor were democrats. President Bush wanted to see them fail and struggle to some extent so he could rush in and “save the city” from the inept democratic leadership. Unfortunately for President Bush, his own response along with his FEMA appointee, Michael Brown, were equally inept.

Perhaps no one, not even the mayor or governor or president took more blame than did FEMA (Shughart, 2006). According to Shughart (2006) the cause of FEMA’s inept response to Hurricane Katrina was the result of their reorganization after 9-11 into the newly formed Department of Homeland Security, where their role in disaster preparedness was diminished and they were forced to utilize their resources to “prevent another 9-11-style attack.” This left them ill-prepared to handle a natural disaster the size of Hurricane Katrina.

But it wasn’t only that FEMA was not accustomed to the role that it was cast into during the Katrina recovery, other criticisms were leveled at the then FEMA director, Michael Brown, who by his own acknowledgement was probably not the man for the job, despite President Bush’s infamous supportive statement of “Brownie you are doing a heck of a job!” (Hsu and Glasser, 2005). President Bush’s transparent self-interest statement of Brown aside, it was quite clear that as FEMA director, Brown, a lawyer with no real background in disaster management or public health, was in over his head; some even calling him “clueless” (Hsu and Glasser, 2005 & CNN, 2006). Brown resigned his post shortly after Katrina (Hsu and Glasser, 2005).

Despite the poor leadership of FEMA, a more central issue is at hand in my opinion. We can replace all the FEMA directors we want, but the real issue is the role that FEMA has been cast into as part of the Department of Homeland Security. Acts of terrorism in this country, both foreign and domestic, have been quite rare. The amount of money that is being allocated to combat terrorism are funds that are misappropriated in my opinion. Perhaps even some republicans agreed for one of their recommendations to the Department of Homeland Security was to increase FEMA’s budget by 10% in 2007 (CNN, 2006). Additionally, an organization like FEMA must be allowed to do what it does best, disaster preparedness, not trying to thwart terror attacks – that is what the CIA and or/FBI should be doing.

What is perhaps most interesting about the ineptness of the local, state, and federal government responses was how well by comparison private companies like Wal Mart were able to offer assistance to victims of Katrina (Shughart, 2006). According to Shughart (2006, p. 42), “Wal Mart frequently beat FEMA by days in getting trucks filled with emergency supplies to relief workers and citizens.” Both Home Depot and Fed Ex also leant support in similar efficient style in the aftermath of the disaster (Shughart, 2006).

So what does this say about our Governmental preparedness to handle disasters when private companies are able to outperform them? Is it simply inevitable that the more talented of individuals will find themselves employed in the private sector because their talents are better appreciated and more rewarded there? Government would need to increase salary amounts or provide other types of incentives such as easy-qualifying home loans or student loan repayment in order to attract more talented individuals into the Government positions. Or is it less of a reflection of government personnel and more a reflection of poor infrastructure? Private sector tends to shoot for top performance due to profitability, whereas government wants standardization, control, and an acceptable level of performance.

Recommendations

In summary, there were several factors that led to the mishandling of the Katrina response, both in terms of pre-event planning and post-recovery response. First, it is conceivable that if the necessary infrastructure repairs had been put into place, most notably in the levee repairs and they had been performed to an adequate level, that the devastation of Hurricane Katrina and the havoc it brought about on New Orleans would have been much less severe. In my opinion, despite the poor leadership of the mayor, the governor, the president, and FEMA, those repairs alone may have saved countless lives and dollars. But the disaster did shed light on other issues of leadership and governmental structure that are lessons that we can learn from and hopefully use to prepare for the next inevitable disaster.

Second, fragmentation of government will always likely be an issue, but we must work to ensure that in situations such as infrastructure repair to something so important as levees, that only one governing body has the ultimate authority and responsibility for maintenance.

Third, I believe we need to restructure our disaster response into something less “military-style” as NIMS is, and opt for something that is more focused on a humanitarian effort. Perhaps lessons can be learned from how Wal Mart and other private sector businesses outperformed the military-styled NIMS system. And fourth, FEMA must be removed from the Department of Homeland Security and given back its primary role of disaster preparedness.

References:

CNN. (2006, February 14). Report: Katrina response a ‘failure of leadership.’ Retrieved from

http://www.cnn.com/2006/POLITICS/02/13/katrina.congress/index.html

Howitt, A & Leonard, H. (2005). Katrina and the Core Challenges of Disaster Response.
The Fletcher Forum of World Affairs, 30(1), 215-221.

Hsu, S. & Glasser, S. (2005, September 6). FEMA Director Singled Out by Response
Critics. Washington Post. Retrieved from

http://www.washingtonpost.com/wp-dyn/content/article/2005/09/05/AR2005090501590.html

Rosenbaum, S. (2006). US Health Policy in the Aftermath of Hurricane Katrina. American
Medical Association, 295(4), 437-440.

Shughart II, W. (2006). Katrinanomics: The politics and economics of Disaster Relief.
Public Choice, 127(1), 31-53.

Outbreak Scenario

On October 12th, 2009 at 9:32am, a group calling themselves “The Movement” contacted members of the local media in Phoenix to tell them that a bioterrorism “bomb” had been released at the Arizona Cardinals stadium in Glendale during a football game on October 11th, which had several thousand fans in attendance. The group claimed that it had released anthrax (a category A agent) in an aerosolized manner. The group expressed that they are an anti-immigration group that is angered by Phoenix’s lax immigration standards. The media then immediately contacted the Phoenix Police Department and notified both the Maricopa County Health Department and the Arizona (state) Department of Health.

On October 12th at 10:04am, officials at the state and county health departments held a teleconference call where it was determined that the local hospitals should be contacted to notify physicians and epidemiologists to be on the look-out for cases of inhalation anthrax. Physicians were asked to confirm their diagnosis of anthrax via a blood culture test and to submit the blood culture to the state lab for confirmation. Physicians would then be notified by the state lab if there was a confirmation of the diagnosis. However, since inhalation anthrax is a fast progressing disease, physicians were instructed to begin administering antibiotics for any suspected cases of anthrax even before blood test confirmation. The public health officials also contacted the National Pharmaceutical Stockpile and asked that shipments of ciprofloxacin and Biothrax be readied in the event that there was a shortage of needed antibiotics.

The police were also contacted and notified that a HAZMAT team was assembled and was being sent to the stadium for decontamination. The HAZMAT team arrived to the stadium at 12:12pm on October 12th and decontamination procedures were initiated. The clean-up of the stadium and the surrounding area took approximately 10 hours, and some residents surrounding the stadium were evacuated during the decontamination process to protect them from possible exposure. The Arizona Cardinals stadium is a dome, but has an open roof, so it was not initially clear if the aerosolized spores of anthrax were contained within the stadium or had traveled to the surrounding areas outside of the stadium.

The HAZMAT team worked in cooperation with the local police department, fire department, and the Federal Bureau of Investigation who had also been called-in due to the terrorist nature of this event.

Residents were allowed to return to their homes after the HAZMAT team determined that there were no exposure risks outside of the stadium. However, the stadium remained closed for a week to ensure that all areas of the very large stadium had been thoroughly decontaminated and to allow the local police department and the FBI to conduct investigations.

At 12:30pm on October 12th the county health department received a call from Dr. Marquez at Phoenix Baptist Hospital indicating that a patient had reported to their ER room with symptoms that are suspicious for inhalation anthrax and the patient notified hospital staff that he had been at the game on the 11th. Dr. Marquez ordered a blood test and confirmation was confirmed on October 14th at the state lab. This patient was the first index case.

Shortly thereafter, at 12:44pm on October 12th, the county health department received another call, this time from Dr. Wongduan at St. Joseph’s Medical Center indicating that he had heard about the news report regarding the possible bioterrorist attack yesterday at the Cardinals game, and he had a patient that has symptoms that are concerning for inhalation anthrax. He wanted to report the case to the health department before lab confirmation. This case was also lab confirmed via a blood culture on October 14th.

The health departments received a total of 8 calls on October 12th from hospitals and dozens of calls from concerned citizens that had attended the game. The public health officials told those concerned citizens to report to an ER room at a local hospital and await instructions from hospital staff. The hospitals were instructed to begin administering antibiotics for any patients that presented with symptoms concerning for inhalation anthrax. A total of 10 patients that presented with symptoms on October 12th were confirmed via blood test on October 14th.

After learning of the advisement from the public health officials, some hospitals recalled patients that were initially diagnosed on the evening of the 11th and early morning on the 12th that presented to the hospital with flu-like symptoms. It is felt that these patients may have been misdiagnosed and were possibly exposed to the inhalation anthrax. However, none of these patients were confirmed as having anthrax.

Since inhalation anthrax is a fast-developing disease, it was necessary to start confirmed cases of inhalation anthrax on ciprofloxacin, along with another antibiotic such as penicillin or doxycycline given intravenously. Public health officials decided to recommend to doctors not to use the Biothrax vaccine, due to its controversial nature, unless they felt it necessary in a particular case and then the physician should discuss the possible side-effects with the patient before administering it. Exposed individuals also underwent decontamination procedures at hospitals to include removing any contaminated clothing from the patient and to have the patient shower with soap and water for about 20 minutes. Bleach solution was not recommended unless the exposed individual could not be decontaminated with soap and water for some reason, and then if necessary, the diluted bleach solution to be used after the soap and water shower, and then rinsed off after a 10 to 15-minute period. Isolation or quarantine was deemed unnecessary since anthrax is non-communicable, so only standard precautions applied.

Over the course of one week, from the exposure date of October 11th, a total of 112 people were confirmed via blood culture as having inhalation anthrax. Public health authorities had feared that there might be considerably higher numbers given the aerosolized manner of the substance. It is unclear as to why more people were not infected, perhaps when the police investigation is concluded more will be understood about how the terrorists released the substance. However, police and FBI investigations revealed that all of the infected individuals were seated in one section of the stadium, so other areas of the stadium were apparently not affected. It is unclear at this time if this was intentional by the terrorists or if the aerosolized spores somehow deviated from the planned attack area.

Of the 112 laboratory confirmed cases, 10 of them reached second stage development of inhalation anthrax, which was confirmed by a chest x-ray, presumably because these individuals did not report to a hospital ER room in a timely manner. Of these 10 individuals, 9 died of inhalation anthrax. This resulted in a total mortality rate of 8%, however, of the victims that reached the second stage of symptoms for inhalation anthrax there was a 90% mortality rate. All exposed patients are currently receiving treatment and will continue to receive treatment for up to 60 days. Currently all other patients are responding well to the treatment.

Conclusion

On October 12th, 2009 a terrorist group calling themselves “The Movement” contacted local media in Phoenix, Arizona to notify them that aerosolized anthrax had been released at the Arizona Cardinals football stadium in Glendale on October 11th. The media immediately contacted public health officials and the Phoenix Police Department. Public health officials then contacted local hospitals to notify them to be on the look-out for suspected cases of inhalation anthrax and to test all suspicious patients with a blood test. Infected patients were decontaminated and started on antibiotics which included a combination of ciprofloxacin and either penicillin or doxycycline. A HAZMAT team was also sent to the Arizona Cardinals stadium to close down and decontaminate the entire area. The decontamination of the surrounding neighborhoods was completed within 10 hours and residents were allowed to return to their homes. The stadium and adjacent facilities were closed for one week to ensure a thorough decontamination of the area.

Laboratory confirmed cases of inhalation anthrax were totaled at 112. Public health officials expected this number to be much higher, but it was determined by the Phoenix Police Department along with the FBI that only one section of the stadium was exposed to the aerosolized anthrax. Of the 112 confirmed laboratory cases of inhalation anthrax, 10 of them reached “second stage” symptoms, which resulted in a total of 9 deaths from this terrorist action. There have been no further cases identified since October 18th, 7 days after the exposure date. However, public health officials will continue to provide surveillance for up to 60 days. The Phoenix Police Department’s investigation into the terrorist actions is ongoing as is that of the Federal Bureau of Investigation.

Background

Anthrax is a naturally-occurring bacterium which lives in soil and can remain alive for years as a spore, which can then be passed to humans that handle infected livestock or eat contaminated, undercooked meat (Null, 2003). Anthrax occurs in three forms: pulmonary, cutaneous, and gastrointestinal (Heymann, 2008). Cutaneous anthrax is the most common, accounting for greater than 95% of cases affecting humans (Heymann, 2008).

Symptoms of cutaneous anthrax typically begin with itching of the affected site, followed by a lesion developing into a depressed black eschar, this last phase taking approximately 2 to 6 days (Heymann, 2008). The eschar is then surrounded by moderate to severe edema, which is quite extensive; there is usually little to no pain (Heymann, 2008). However, there is often considerable swelling around the site of the sore and bouts of shivering and chills in the affected individual are common (Null, 2003).

Common sites of infection include the hands, forearms, head and neck; this is because these are exposed parts of the body and cutaneous anthrax requires a pre-existing cut or break in the skin for it to enter into the body (Heymann, 2008). If left untreated, the disease may spread to the lymph nodes and into the bloodstream, though this is fairly rare (Heymann, 2008; Null, 2003). The fatality rate for cutaneous anthrax is between 5 to 20% if untreated, however, with treatment fatality is rare (Heymann, 2008).

If anthrax were to be used as a bioweapon, it would most likely be aerosolized which would result in inhalation anthrax (Null, 2003).  Early symptoms of inhalation (also known as pulmonary anthrax) are a mild cough, headache, fever, and general malaise, which makes them virtually indistinguishable from symptoms of influenza, unless a blood test is done (Null, 2003). However, within 3 to 4 days, symptoms progress to respiratory distress, enlargement of the mediastinum, immune system failure, shock, and death within 48 hours after the release of the toxin (Heymann, 2008; Moore, 2001). For untreated cases, fatality is 100% and may occur in as many as 95% of treated cases if therapy is begun more than 48 hours after the onset of symptoms (Cieslak et al., 1999).

Gastrointestinal anthrax is not common in developed countries, but is seen in poor or developing countries, usually by way of eating contaminated meat (Heymann, 2008). The consumption of tainted meat usually takes the form of gastrointestinal anthrax, though oropharyngeal may also develop (Heymann, 2008). With oropharyngeal anthrax the lesion is in the mouth cavity, on the tongue, mucosa, tonsils, or pharynx wall (Heymann, 2008). Early symptoms of oropharyngeal anthrax include sore throat and extensive edema in the throat that may lead to blockage of the trachea (Heymann, 2008). The lesion of gastrointestinal anthrax is typically found in the intestinal tract and is ulcerative and massively edematous, which leads to hemorrhaging and obstruction of the gastrointestinal tract (Heymann, 2008). The incubation period for both gastrointestinal and oropharyngeal anthrax is approximately 3 to 7 days (Heymann, 2008). It is not always fatal, but even with treatment, this form of anthrax has a high fatality rate (Heymann, 2008).

Naturally occurring cases of anthrax may come about from environmental disasters, like tsunamis or floods which can cause erosion of burial sites of infected animals, which in turn can lead to contact of the disease by humans (Null, 2003). Any contact with an infected animal, including touching the hair or skin of the animal as well as handling bones of a deceased animal that was infected can result in a human becoming infected with anthrax (Cieslak et al., 1999). Biting flies that have bitten a diseased animal and then bite a human can also infect the human, as well as touching contaminated soil (Heymann, 2008). Inhalation anthrax occurs primarily in industrial or factory settings where animal hides are processed and there is poor ventilation, which results in ingestion of the anthrax spores (Heymann, 2008).

The incubation period for anthrax is generally 1 to 7 days, though incubation periods of up to 60 days is possible (Heymann, 2008). Person to person transmission is exceptionally rare and has only been documented with cutaneous anthrax (Heymann, 2008).

Anthrax has also been both used and studied as part of some countries bioweapons programs, perhaps most notoriously by the Japanese Imperial Army during the 1930’s and 1940’s, through the infamous Unit 731; and by the Soviets during the cold war era (Miller et al., 2001).  Anthrax has also been used as a bioweapon by domestic terrorists, most recently and perhaps most notably in October of 2001, which infected and killed a number of Americans (Null, 2003). According to military and counterterrorism experts anthrax is near or at the top of any list of most likely bioweapon (Cieslak et al., 1999; Moore, 2001). Given the relatively short incubation period, and rapid progression of disease, identification of the exposed population within 24 to 48 hours and employment of therapeutic and prophylactic strategies are likely to present a challenge (Cieslak et al., 1999).

There is a vaccine for anthrax, Biothrax (also known as AVA, which stands for Anthrax Vaccine Adsorbed), though it is not made available to the general public, it is recommended for lab workers and workers that handle potentially contaminated raw materials who may come into contact with anthrax through their job duties (Heymann, 2008). The vaccine was also administered to American military troops prior to their campaign in Iraq, as a precautionary measure against Saddam Hussein’s army which it was feared might use anthrax as a bioweapon against American soldiers (Null, 2003).

The vaccine is effective in preventing cutaneous and inhalation anthrax and is designed for preventing exposure to anthrax, though it can be administered as an “after-the-event” treatment in the case of a biological weapons attack, for example, and would be combined with antibiotic therapy, of which ciprofloxacin is considered the first line treatment though doxycycline or amoxicillin maybe used in some cases (Heymann, 2008). However, ciprofloxacin and doxycycline have side effects which may be more severe than other antibiotics which also may work against anthrax, like penicillin (Null, 2003).

Prevention control for naturally acquired anthrax includes vaccinating livestock, properly disposing of dead livestock by burning them, ensuring proper ventilation systems in factories and labs, and educating employees that might come into contact with anthrax about safe practices such as wearing protective masks and clothing (Heymann, 2008).
Anthrax is essentially non-contagious, so quarantine of humans is unnecessary and standard preventive measures when handling the patient such as wearing disposable gloves, changing bedding soiled with lesion fluid, disinfecting clothing, and washing hands regularly would be applicable (Heymann, 2008).

Assumptions

On October 12th, 2009 a group calling themselves “The Movement” contacted members of the local media in Phoenix to tell them that a bioterrorism “bomb” had been released at the Arizona Cardinals stadium in Glendale during a football game on October 11th, which had several thousand fans in attendance. The group claimed that it had released  anthrax (a category A agent) in an aerosolized manner, though this has yet to be confirmed.

Of great concern to the county and state health departments is the high number of citizens in Phoenix that might be affected due to the amount of residents potentially exposed at the football game. Shortly after receiving the call from The Movement, physicians at hospitals in Phoenix began reporting patients that were beginning to show early symptoms of what might be inhalation anthrax. The disease progression is expected to have a normalized progression and those patients reporting to local hospitals are being tested for inhalation anthrax and will receive “after-the-event” vaccinations and antibiotic therapy as well as decontamination if the tests are positive. The local and state health departments are currently working with the media to release a message to those in attendance at the game to report immediately to an ER room at a hospital to get tested for possible inhalation anthrax exposure.

References:

Cieslak et al., T.J. & Eitzen, E.M. (1999). Clinical and Epidemiologic Principles of Anthrax.  Emerging Infectious Diseases, 5(4), 552-555.

Heymann, D.L. (2008). Control of Communicable Diseases Manual (19th ed.). Baltimore: United Book Press.

Miller et al., J., Engelberg, S., and Broad, W. (2001). Germs: Biological Weapons and America’s Secret War. New York: Simon & Schuster.

Moore, P. (2001). Killer Germs: Rogue Diseases of the Twenty-First Century. London: Carlton Books.

Null, G. (2003). Germs, Biological Warfare, Vaccinations: What You Need to Know. New York: Seven Stories Press.

I first heard about the concept of generational differences in the workplace about 2 years ago while I was studying for my first Master’s degree with Roosevelt University. I suppose I already knew about generational differences, but I had never really observed them in my own life until I started working in my current Government job in public health.

It seems the topic is getting a lot of discussion, at least online, because there are 4 different generations in the workplace now for I guess the first time in history. Though the numbers of “Eisenhower’s” are dwindling as they are at or past the traditional retirement age, and now the older end of the Baby Boomers are retiring and Generation X, my generation, is starting to take on more leadership roles in the workplace as we now move into midlife. Generation Y is of course coming up behind us. For myself, I think I’m a pretty prototypical Gen X. I was born in 1969, so it puts me at the slightly older end of the range, but I was in high school during the 80′s and I  grew-up in the 80′s which is what I think really makes someone “Gen X.”

However, I don’t notice myself having too many conflicts with Gen Y. I seem to fit in with them very easily. But I like the techno gadgets and social networking sites and texting and writing blogs (obviously) and twittering too! So maybe I’m more of a young Gen X at heart.

Anyway, I have noticed a real difference, a “generational gap” if you will, to use an overused term one more time, amongst Gen X and Boomers and Eisenhower’s. There aren’t many Eisenhower’s generation left in the workplace now since they are basically at or past retirement age. But the Boomers and the Eisenhower’s have a lot of the same ideologies and work habits I think.

The following is a collection of observations I’ve made, along with some things that I’ve read through various sources.

Let’s start with an example:

I have a coworker, who is a young Baby Boomer, he is actually only about 7 years older than me. But you would think we were 20 years apart. He is very conservative and believes that what you do at your job doesn’t really matter. What is more important is to be seen working late, even if you aren’t really working. He likes to call it “face time.” So he will stay around the office later than most, but his work quality is horrible, he makes a lot of mistakes. But in his way of thinking, and I think a lot of Boomers think this way, getting the job done or done right matters less than having people think you are working hard and giving more of yourself.

For me, and I think this is pretty typical of Gen X, I’m not so concerned about people thinking of me as someone who is always willing to working overtime. But I like to be known as someone that when he is at the office does a good job. I get the job done, and my work that I put in is quality work. However, when the 8 hours is up, now it’s my time and I’m off to pursue other personal interests. WE call that “work/life balance.” Our total weekly working hours is probably less, but the quality of both our work and our personal life is probably more.

Another big difference that I’ve noticed is communication style. Boomers almost without exception prefer face-to-face contact or using the telephone. With Gen X, it is variable, but many Gen X like to use email for communication. WE find it more efficient and I think we like having the written documentation.

Many of the Boomers at the office prefer the phone over email to the point that some of them won’t even use email to communicate. We have one coworker who brags that he never even reads his emails. I think he thinks he is “cool in an old-school” kind of way, but most of us just think of him as unprofessional.

The advantage of email I think is that it is less intrusive. If I call you on the telephone, maybe I’m interrupting you. But if I email you, you can read it at your leisure and get back to me. Hopefully!

Another difference I’ve noticed is in terms of education. I think Boomers view education as a means to an end. In other words, you get the degree to get a job. If the degree doesn’t make you any money, then it is worthless. Whereas I feel that the education itself is its own reward. Yes, I would like to make more money with the degree, but if I don’t, that’s okay too. Education for its own sake and lifelong learning are cornerstones of Gen X beliefs.

And Boomers like their predecessors, the Eisenhower’s, prefer a rigid top-down approach to management. Boomers grew up in an era where they embraced ideas about equality, especially in the workplace, but when they hit midlife they sold out on those beliefs and cashed in on BMWs and stock portfolios. For Gen X, I think we prefer a more collegial atmosphere, realizing that responsible people can “self-manage.” Boomers on the other hand seem to like to lead or be led.

Of course there are always exceptions and individual personalities sometimes “win-out” over generational tendencies, but these have been my observations.

From LAX (Los Angeles) to BKK (Bangkok), you have several options. On my first trip I flew Cathay Pacific, which is a Hong Kong based airlines. The service was good, food was excellent for airline food, and the plane was new with above average leg room in the economy section. However, I wouldn’t necessarily recommend them if you are travelling on a budget as they are usually quite pricey. Sometimes their tickets are $2 to $3 thousand dollars – more than triple the price of other carriers. But they do have specials sometimes and you can find tickets to BKK in the $1,000 – $1,500 range. On the downside, Cathay Pacific does not at this time offer a direct flight to BKK, so you have to change planes in Hong Kong.

EVA Airways is based out of Taiwan, and is more of a long-distance budget carrier. The planes are so-so, the airline food is so-so to pretty good, and the in-flight service is very good. They also have individual monitors and on-demand movies for every seat in the economy section. And a decent selection of movies, usually 4 or 5 new release titles. My ticket price range with them has been about $750 – $900. If you are looking to save some money, EVA is a nice choice and much better than any American based airline.

EVA used to have a good frequent flier program a few years back, but with recent budget cuts in the industry in an effort to make more money they have discontinued use of the LAX  VIP lounge for Silver card carriers. EVA also does not offer a direct flight to BKK, so you will need to change planes in Tai Pei, Taiwan – but this is probably the most efficient airport I’ve ever been to for connecting flights. It’s about a 3-hour flight from Tai Pei onto BKK.

The last time I flew EVA was about 2 years ago – I had a bad customer service experience with them in the VIP lounge at the Tai Pei Airport, and have not flown them since. But overall, I would still recommend them as a nice choice if you are on a budget.

I think your best flight option to BKK is Thai Airways. They DO offer a direct flight from LAX to BKK, and if you book far enough in advance and aren’t travelling at a holiday time, you can usually get the ticket for $1,300 – $1,500. Thai Airways is a nice airline, but the service, food, and seating is all average in my opinion – nothing really special and above EVA other than the option of the direct flight from LAX. So you may prefer to save the extra $500 and go with EVA Airways. However, you should always do a price comparison and see what you can find. If I could get the Thai Airways flight for only a couple of hundred above the EVA price, I’d jump on it! Also Thai Airways offers some pretty good hotel voucher deals for stays in top hotels throughout Thailand. So after only one trip internationally you are likely to accrue enough airline miles to quality for a hotel voucher worth about $100 for your next trip. So keep that in mind too when price comparison shopping.

A lot of people like to use those cheap ticket sites, but sometimes you can find even better deals directly on the airline’s website. Plus, I like to accrue the airline mileage  and if you fly the same airlines you can move up in their frequent flier program and get to use the VIP lounge.

*last updated July, 2010