Fear is still the thing to fear

Dr. Kenneth Litwack is a highly respected specialist in infectious

diseases who works out of Hoag Hospital in Newport Beach. He is also

a good friend who -- with his wife, Louise -- had dinner in our home

last week.

Because I never get far from my journalistic roots, I broke one of

the cardinal rules that kicks in when a physician is a guest in your

home. I talked shop. His shop.

I wanted to hear his expertise on the smallpox shots being pushed

on a reluctant society by our government.

Did he plan to get one? No. Did he think it was a good idea for

the rest of us? No. Did he think smallpox was a weapon that

terrorists could use effectively against us? No. Actually the greater

threat, he said, was the use we might make of it ourselves.

So we were off and running.

The only way smallpox can be transmitted, he said, is by a person

with the disease. There is no data on spreading it in any other way.

Putting it into a missile and releasing it in the air, for example,

is highly unlikely to be dangerous because the virus is extremely

fragile.

So to use it as a weapon, the terrorists would almost certainly

have to infect one of their agents and send him or her to this

country. If he could pass the infection along to a handful of

Americans, he might be able to start a mini-epidemic. But the

barriers in his way are formidable. The most important is his

appearance. When the disease surfaces, he will be an unsightly bed of

sores. And the disease is communicable only when it is obvious. So to

pass the disease along , he would first have to get into the country

and then move among us while he was marked with multiple sores on his

face and extremities, a scenario that reads like a bad “B” movie.

On the other hand, Litwack said, the wholesale inoculation of our

citizens against smallpox carries much greater likelihood of danger

than its use as a weapon by terrorists. And not from the one or two

in a million chance that the inoculation will kill the recipient or

even the much greater chance that there may be severe side effects

but rather because those who are vaccinated can unwittingly pass the

vaccine virus along -- with possibly fatal results -- to others whose

immune systems have been weakened for a multitude of reasons. Thus,

in a bizarre sort of way, the terrorists might more likely achieve

their goals through the protections we put up against them.

I asked Litwack if most physicians shared this view, and -- if so

-- why it hasn’t been passed along strongly to the public? He said

that anyone educated in medicine would understand these reservations

and that a good many doctors have appeared on panel talk shows to say

so.

The problem, he said, is that these voices are drowned out by the

party line -- centered in government health agencies -- that smallpox

shots are an important weapon against terrorists rather than an

expensive and counterproductive insurance policy against an

exceedingly remote danger.

What about the other so-called “biological weapons of mass

destruction?” Do they need to be better understood by the lay public?

He said there are six possible biological weapons. In addition to

smallpox, he named anthrax, botulism, plague, viral hemorrhagic fever

and tularemia.

“It would take great expertise to weaponize any of these

substances,” he said, “and they would be extremely difficult to

deliver. They would also be detected quickly if they ever were

delivered. The system is in place for a quick response if an unusual

case appears, and we would have plenty of time to immunize the

victims.

“Smallpox is in a class apart,” he continued, “because there is no

immunization for these other threatened substances. Nor is there an

immunization for fear. ‘Biological weapons for mass destruction’ are

buzz words that strike fear. We should respond to fear with accurate

information.”

Franklin Roosevelt, when he told America the only thing it had to

fear was fear itself, made the same point. He was right.

Roosevelt assuaged our fears and dealt to our strengths. The

present leaders of this country feed our fears and deal to our

vulnerabilities.

Bio-terrorism clearly isn’t the only threat to our homeland.

Chemical weapons -- particularly nerve gas and nuclear devices --

also threaten us. But they also need to be dealt with intelligently

and not with emotional buzz words.

Their availability, accuracy, method of delivery, pattern and

degree of destruction, and modes of defense need to be understood --

as much as possible free of bias -- as far as the information is

accessible. A good place to start is the Web site of the Centers for

Disease Control at www.bt.cdc.gov.

It has become clear that our own government is not going to

provide information that doesn’t support immediate policy needs. So

we have to dig it out ourselves. Fear has become a potent player on

the war team. Information is an antidote for fear with a great deal

more effectiveness than smallpox shots.

Ken Litwack is an expert in a field where disseminating accurate

information is a considerable public service. To deal with the chaos

in which we all find ourselves these days, we need to listen to cool

and unbiased expertise wherever we can find it to provide the balance

we need to keep our own heads straight. We’re lucky he’s in our

neighborhood to help.

* JOSEPH N. BELL is a resident of Santa Ana Heights. His column

appears Thursdays.