Amanda Ripley Author of The Unthinkable

I’ll be giving a keynote address in September at the annual conference for the California Emergency Services Association. More details here!

We all know by now that President Obama declared H1N1 (swine flu) a national emergency the other day. But it may come as a surprise that Americans have been living under an almost continuous national emergency for many decades.

In fact, Congress has been throwing around emergency powers since at least 1792--when it called for the militia to suppress a whiskey-tax revolt in several states. These days, most “national emergencies” are actually global--the declarations are used to prohibit trade with foreign countries under the International Emergency Economic Powers Act (case in point: the October 27 continuation of the national emergency with respect to Sudan).

With the H1N1 declaration, the White House emphasized that it was more of a preemptive, administrative necessity, allowing the administration to waive federal requirements which could prevent or slow treatment measures. According to the Wall Street Journal, the declaration was ”aimed at clearing government red tape before it can become an obstacle for health-care providers.” OK, fine. Perhaps the more interesting point is that it takes a national emergency to trim back red tape…

A full list of declared national emergencies from 1976 to 2007 can be found here (PDF-warning!). 

Yesterday, I did an interview on NPR’s Talk of the Nation about the Northwest airline overflight. I was amazed, as I often am when listening to NPR, at the callers they got. In a half hour, we heard from two commercial pilots, one smoke jumper, one bus driver, a boat captain and a trucker--all of whom admitted that they struggle mightily with distraction. One of the most memorable recitations of typical distractions came from Paul the Bus Driver:

PAUL: “...[Y]ou’ve got a dispatcher who is a little perturbed that you’re 10 minutes behind schedule because somebody needed to make a potty break. I’ve got cell phones with wives, children and sick parents calling in and asking if, you know, they can find their meds. You know, I’ve got GPS systems that can be distracting in a dark night when you’re driving in rain. And then you’ve got some passengers on board who might have imbibed or are somehow in altered states and think they need to tell you all of their life’s problems.”

NEAL CONAN: “And there’s no armored door between you and your passengers.”

PAUL: “No. In fact, I’ve gotten hit by everything from vomitus to a used diaper.”

Many of the call-in drivers also confessed that boredom can be just as dangerous as distraction. One pilot admitted to having taken cat naps during the cruise portion of her flight--so that she would be more awake and engaged during the high-stress landing portion of the flight. In fact, some aviation safety advocates support formal policies allowing one pilot to take a short nap on long flights while the other stays awake. Sounds scary. But the overwhelming response of the drivers and pilots we heard from yesterday was that they are human. The sooner we treat them that way, the safer the rest of us will be.

Which is not to say pilots should be opening up their personal laptops in the cockpit. That’s indefensible. (It now appears that the pilots were out of radio contact for an hour and a half, which, if true, is appalling and reckless. The FAA revoked their licenses yesterday. You can see a copy of the revocation letter here.) But it is to say that the problem is probably bigger than the one freak incident we happened to hear about last week.

Yesterday, federal investigators interviewed the pilots of the Northwest plane that overshot its Minneapolis-St. Paul destination by 110 miles last week. So far, some people have been skeptical of the pilots’ vague explanation to date: that they got distracted during a heated discussion about airline policy and lost track of time.

But I don’t find that explanation hard to buy, personally. This problem is well-known to pilots. So well-known that they have a name for it--“task saturation”--as well as specialized training to try to avoid it.

The brain works on one thing at a time. This much we know. And pilots have gotten into terrible trouble before because they were absorbed in one thing to the exclusion of all others.

Cockpit myopia was a huge issue in the 1970s, when airplane pilots started to realize that the more stressed they got, the less they saw. As stress increased, they tended to become mentally obsessed with one data point to the exclusion of all others.

Consider the story of the green light. On the evening of December 29, 1972, an Eastern Air Lines jet coming from New York City began its final approach to Miami International Airport. The flight had been uneventful, and the weather in Miami was clear. The plane carried 163 passengers, most of them holiday travelers.

But when the pilots tried to lower the landing gear, they didn’t get a green light indicating that the gear was fully down.At 11:34 P.M, the captain, who had more than three decades of experience, called the Miami control tower to explain that he would have to circle while they worked on getting the green light. The plane climbed to two thousand feet and began a wide U-turn over the airport. For the next eight minutes, the flight crew tried to figure out what was wrong. Why wouldn’t the light go on? The captain ordered two different people to try to visually confirm that the gear was down, but they couldn’t see anything in the dark.

At 11:40, a half-second alarm tone went off in the cockpit, indicating that the plane had deviated from its altitude. The transcript from the cockpit voice recorder shows that no one said anything about the alarm. It was as if they hadn’t heard it at all. The crew continued to speculate about possible reasons for the light problem. But then, two minutes later, the first officer noticed another problem.

“We did something to the altitude,” he said. “What?” the captain said.

The first officer backtracked: “We’re still at 2,000, right?”

Then the captain said, “Hey, what’s happening here?”

Another warning sound began to beep, more insistently this time. Two seconds later, the plane crashed into the Everglades, 19 miles from the airport.

Investigators would find that the plane had been in fine working order—except for the lightbulbs in the landing-gear indicator, which had burned out. While the flight crew worried about the light, the plane had dipped toward the earth. When it sliced into the soggy marshland,it disintegrated on impact. The wreckage was scattered over an area 1,600 feet long and 330 feet wide. A total of 101 people died.

The crash, and several other unnervingly similar accidents, convinced aviation researchers that pilots needed to be trained to avoid task saturation.“This happens to everybody under stress,” Rogers V. Shaw II, who trains pilots for the FAA, told me when I was working on my book. “If there’s not enough training, you get channelized on one thing, and you forget the whole big picture.”

Today, Shaw trains pilots to proactively scan their instrument panels, over and over again, to counteract the tendency to fixate on one problem. He also teaches pilots to make sure one member of the flight crew remains focused on flying the plane at all times.

It’s too soon to say if task saturation was the cause of the Northwest incident. But the prospect that it might be reminds me of the power of the green-light story--a lesson not just for pilots but for anyone who drives anything. Your brain wants to work on one thing at a time. And no, you are not different, and no, that email you feel you absolutely must read while on the highway is not actually very important. 

So far, the biggest problem with the swine flu vaccine seems to be that it is hard to find. This may not be a bad thing, at least not from a public-health perspective. If the vaccine were easy to find, fewer people would want it. It’s perverse but true. Long lines can be good for your health.

When humans are faced with a shortage of a commodity, they tend to want more. In a bar, the research shows, men and women tend to view each other as increasingly attractive the closer it gets to closing time. Same thing goes for vaccines. From a 2008 paper, “Short on Shots,” out of the Univ. of California, Berkeley:

“[P]erceptions of scarcity can induce a sharp increase in demand due to rising salience of the scarce good, worsening whatever true shortage there might be. Some of the great famines in history like those in Bengal in 1943, Ethiopia in 1973, and Bangladesh in 1974 in fact occurred without any disruption in supply (Sen, 1981). The “Great Toilet Paper Shortage’’ caused in zest by Johnny Carson in 1973 also occurred without any change in supply.”

The rest of this study is even more interesting. The researchers took advantage of the 2004 flu-vaccine shortage to see how changes in supply--and rhetoric--can influence demand.

Here’s how they did it: At one university campus, the researchers sent one group of departments an email warning of shortages in the vaccine supply and setting out a schedule for vaccinations. Then the researchers sent another email to another group with the same information plus a request (much like the one made nationally by the Centers for Disease Control and Prevention at the time) that people outside the high-risk groups hold off on getting vaccinated.

Well, a few interesting things happened. First, there was an overall increase in demand for the vaccine, now that there was a shortage. This was true all over the nation that year, by the way. Many people who had not been vaccinated before suddenly wanted the vaccine, now that it was hard to get.

But something even more suprising happened at this particular campus clinic. The request for non-high-risk people to show restraint seemed to backfire--leading to exactly the opposite result! Among the group that received that appeal for benevolence, more people came out to be vaccinated. Most perversely of all, the increase was due entirely to people in the non-priority groups. People in the high-risk groups? Well, they seemed to listen to the call for restraint and stay home…

A nice example of how very complex it can be to try to engineer human behavior during a pandemic.

So far, the best advice I have seen for how to improve the long lines came from one of the people waiting in such a line: “Letting some coffee vendors know about us here would...be a nice thing,” Dan Orbach told a Washington Post reporter, outside of a Montgomery County, MD, clinic yesterday.