By Peggy O'Farrell
The Cincinnati Enquirer

Knowledge is good.

Panic is deadly.

And stockpiling duct tape and gas masks probably won't help much in the event of a terrorist attack.

That's the prognosis from Dr. Angelo Acquista, an internist and medical director of the New York City Mayor's Office of Emergency Management. He also specializes in pulmonary medicine and tropical diseases.

Acquista covers everything from anthrax to unidentified chemical agents in his new book, The Survival Guide: What to Do in a Biological Chemical, or Nuclear Emergency (Random House; $12.95).

He discussed the risks and realities of preparing for and responding to terrorist attacks in a telephone interview.

Question: What made you decide to write The Survival Guide?

Answer: I felt the need to do something to fight terrorism. This was one for way for me to take away the terrorists' weapon of fear. The common denominator for fear is ignorance. People fear what they don't understand.

I put together the book to make people understand that despite the fact that we call biological agents weapons of mass destruction, people should know that there are treatments and therapies for most of them, and once the initial cluster of victims is finished, the damage is usually very limited.

In my opinion, I do not think that biological weapons are weapons of mass destruction. The only true weapon of mass destruction is a nuclear explosion.

Q: In your opinion, which scenario should Americans be the most worried about - biological, chemical or nuclear attack?

A: The answer is, what can terrorists get their hands on the easiest. Certainly there is a technological threshold which is quite high for a terrorist to manufacture a nuclear weapon. The threshold is quite high for a terrorist to be able to weaponize a biological agent, such as anthrax. But chemical weapons are available from industry... We know them as insecticides and pesticides. And since they are available, they're the one thing terrorists can get their hands on easily.

But there are significant environmental factors that interfere with chemical weapons. In cold weather, chemical weapons are useless because they can't vaporize. In hot or windy weather, they disperse too rapidly to cause mass casualties. Understanding these limitations, people should be able to walk outside without worrying that a chemical cloud is going to envelop them.

Q: But chemical weapons have been used, as in the nerve gas incident in Japan.

A: In the best case scenario that occurred in Japan in the 1990s, in the most optimum environment, a closed subway train, only 10 percent of the victims became symptomatic, and only 1 percent, which was 12 people, died. In that light, they are not weapons of mass destruction. Certainly they are lethal.

We all have this image of a crop plane spraying a crowd with some chemical agent, and that's not going to happen.

People should now understand the onus is on the terrorist to be able to deliver significant casualties in limited areas because of the environmental limitations of chemical weapons and the significant technological thresholds that they have to cross for biological and nuclear weapons.

Q: How should people use your book?

A: I organized it to put the threats into perspective so that people are empowered with a certain fund of knowledge, so that they know the facts and, more than that, know they can take steps to minimize the threat. Once you know how to do something, that will contribute to you being less frightened.

Q: How frightened should Americans be by the prospect of a biological attack involving smallpox or anthrax or another disease?

A: People should not be frightened, because there are multiple effective antibiotics for each of the diseases that are mentioned in the book that would be available ...

From a realistic point of view, you're more likely to injure yourself by crossing the street and being hit by a car than you are to be injured by a biological weapon or a nuclear attack.

Q: Do we need to go out and buy duct tape and plastic sheeting to protect ourselves?

A: My recommendation is, if you have duct tape, that's fine. If you don't have it, don't panic. The reason why you should have duct tape and plastic sheeting is in case there is a need to "shelter in place."

More important than duct tape and plastic sheeting are why you have it, how you use it and when you should use it. If something happens and you need "shelter in place" because of a chemical attack, you'd better remember to shut off the ventilation system or you're wasting your time. You should cover your vents, but also take precautions to let air come in to your shelter lest you suffocate.

E-mail pofarrell@enquirer.com