What are the risks of Bioterrorism?

We have trouble understanding risks that seem catastrophic and uncontrollable. We fear risks that are new to us and those that have a high "dread factor". We live with little fear of riding in automobiles despite the fact that 35,000 people die in accidents each year. We buckle seat belts, drive with care and avoid driving impaired or riding with an impaired driver, but the risks are still there and largely not under our control.

So it is clear that we can be comfortable with substantial risk. Many still smoke cigarettes, apparently without fear, although smoking kills 400,000 people each year. Contradictory approaches to personal risks are the rule rather than the exception.

Terrorism risks have been much lower than our everyday risks, even though each of the several thousand terrorism deaths is an individual tragedy. Quite likely if we could put all of the effort against domestic terrorism into reducing cigarette smoking we could save hundreds of thousands of lives. The anti-terror campaign is of course justified, but we need at the same time to keep it in perspective.

The underlying fear of terrorism is that a massive attack with an agent such as anthrax could cause a large number of casualties. This scenario is possible, but unlikely. These agents are hard to deliver and the casualties are largely preventable. The anthrax attacks in 2001 were dealt with quite efficiently even with an unprepared public health system and future attacks will evoke a faster and better response.

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