What if a Bioterrorist Attack Occurs?—A Survey on Citizen Preparedness in Aveiro, Portugal
, Maria de Lurdes Pinto 1,2,3, Luís Cardoso 1,2,3, Isilda Rodrigues 4 and Ana Cláudia Coelho 1,2,3,*
Tom Schafer
David Malet
Round 1
Reviewer 1 Report
Please see attached document - all comments are contained there.
Comments for author File: 
Comments.pdf
Author Response
REVIEWER # 1
Q.1 - General Impressions - I would consider that this paper represents a valuable contribution to the study of social knowledge of, and reaction to, bioterrorist attacks. After a brief flurry of understandable interest after 9/11, this topic has sadly fallen out of the public eye, while the need for such research was most certainly demonstrated by the uneven and sometimes panicked reaction by both the public and governmental authorities to Covid-19. The somewhat surprising focus on pets (see below) was particularly valuable, since this has proved to be a major weak point in the response of public authorities to disaster; I call this surprising, since pets and issues relating to them were not mentioned in the abstract, despite making up a large portion of the paper. That being said, this paper is a valuable contribution to the literature, despite, or perhaps because of, its rather discouraging findings.
A - Thank you for the constructive comments. The manuscript has been revised taking into consideration the reviewer’s comments.
Q.2 - Abstract - As noted above, the abstract could use some work. For example, at least half of the results section, and a majority of the discussion section, are devoted to pets and their care in the wake of a bioterrorist attack, but this is nowhere referred to in the abstract, nor are any references to pets included in the keywords. This will deprive the paper of a larger potential audience, and should be rectified.
A - Thanks for the suggestions. More information has been included in the abstract. The word “pets” was included in the keywords.
Q.3 - Introduction - The introduction did a good job of setting up the research, although there were a few minor wording errors, pointed out below in the section “Minor Linguistic Errors”.
A - Thank you for the constructive comments.
Q.4 - Materials and Methods - I found this paper generally methodologically valid, however, some questions were presented by the methodology of the researchers. In the “Materials and Methods” section, on line 52, the authors state that “A cross-sectional study about the knowledge of COVID-19 best practices was conducted from January to September 2020.” Is this the study referenced in the body of the paper? If so, there is no mention of bioterrorism here, only COVID, a far different matter. Was the survey over COVID or bioterrorism? We are left unsure.
A - We apologize for this mistake. The study is to assess the knowledge about bioterrorism, self-perceived preparation to act in case of bioterrorism and pet owners’ preparation. The sentence has been corrected as required.
Q.5 - Also, the paper states that the survey was administered via social media. Did this skew the survey towards younger persons, in a situation where the self-selection factor is already high? There is no breakdown by age with regard to the recipients, which might prove to be important.
A - Thanks for the comments. The information has been included in study limitations.
Q.6 - In addition, I am no expert on Portugal but from my brief research, I find that Aveiro is hardly typical of Portugal as a whole – might this prejudice the results, in one way or another? Also, a simple map showing the location of the study area would improve the overall utility of the paper.
A - Aveiro is similar to other Portuguese communities and has a lot of tourism as all Portuguese cities. We applied the questionnaire in this city because the first Author is from that city, and it was easier. We used the term “touristic” to international readers that do not know Aveiro (and all Portugal) are very touristic, and in this moment we have a lot of people everywhere. Text has been updated to read as: “similar to other Portuguese cities, which is a medium-sized country on the European scale.”
We have inserted a map showing the location of the study area, in order to improve the overall utility of the paper.
Q.7 - The data processing techniques used in this paper are appropriate and valid, in this reviewer’s opinion.
A - Thank you for the constructive comments.
Q.8 - Results - The results were, discouragingly, what one might have expected, although the almost two to one prevalence of women among the respondents was unexpected, and might have skewed the results, at least somewhat. There does seem to be a contradiction in the results section, where, in the body of the paper, 80.3% of respondents are said to not be able to name any potential bioterrorism agents, whereas in Table 1, 80.3% are said to “Know diseases/bioterrorism agents”. This contradiction needs to be resolved.
A - Many thanks for the correction. The contradiction has been resolved and the sentence corrected to “Do not know diseases/bioterrorism agents”. To comply with the other reviewer’s concerns, we have transformed tables in charts.
Q.9 - Discussion - The discussion section was interesting and informative, and the results and their possible implications were well laid out. The authors seemed unsure as whether to use “bioterrorist” or bioterrorism” attack in this section – I would recommend that “bioterrorist” be used, since it is bioterrorists who do the attacking, not the abstract concept of “bioterrorism”.
A - Many thanks for the corrections. Corrected as required.
Q.10 - Also, I am not sure of the relevance of citing Nofal et al with regard to Saudi Arabia – if this citation has any bearing on the results from Portugal, it is not brought forth.
A - Many thanks for the suggestion. The reference Nofal et al. has been deleted and replaced with another reference.
Q.11 - Conclusions - The conclusions were succinct and validated by the body of the paper. No changes were seen as necessary here.
A - Many thanks for the positive comments.
Q.12 - References - The references were recent, and were used in a manner that generally supported the research carried out, with a few exceptions noted above.
A - Many thanks for the comments.
Q.13 - Minor Linguistic Errors - Some minor linguistic points follow.
A - Many thanks for the corrections. Corrected as required.
Q.14 - On line 8 of the paper, there is reference to “Aveiro, coast Centre of Portugal” and this recurs several times further down. Is this the way to which this city and its location are customarily referred? This needs to be checked.
A - The correct way to which this city and its location are customarily referred is Aveiro, Centre of Portugal. It is a city on Atlantic Ocean coastline. The term “coast” was deleted from the text.
Q.15 - On line 33, the word “are” should be inserted, so that the sentence reads “among which are the enrichment of public health”.
A - Corrected as required.
Q.16 - Line 35, the word “conduct” is incorrect – possibly “conduce”?
A - Corrected as required.
Q.17 - In line 38, the word “on” should be changed to “to”, and the “s” can be left off the word “damages”.
A - Corrected as required.
Q.18 - In line 39, insert the word “the” before the words “general public”.
A - Corrected as required.
Q.19 - In line 55, the “coast Centre of Portugal” recurs – does nor sound correct.
A - Corrected as required.
Q.20 - The caption for Table 1 needs reworking – the words “knowledge, attitudes and practices” need only be used once.
A - Thanks for the correction. To comply with other the reviewer’s concerns, we have transformed tables in charts.
Q.21 - In line 211, the word “unables” should be replaced with “disables”, or something similar.
A - Corrected as required.
Q.22 - Line 218, not sure if “hierarchical” is the word you want there.
The word is deleted and replaced by “governmental organizations”.
Q.23 - Line 220, the word “its” should be replaced with “their” for clarity.
A - Corrected as required.
Q.24 - In line 253, use the word “tool” since weapons are not usually associated with saving people.
A - Corrected as required.
Q.25 - Line 265, “a” microchip.
A - Corrected as required.
Q.25 - Line 269 “microchipping”.
A - Corrected as required.
Q.25 - Line 299, use “high”.
A - Corrected as required.
Author Response File: Author Response.pdf
Reviewer 2 Report
I was interested to read this article because I previously conducted a similar study, and also and because I was working in one of the offices that received the anthrax bioterrorism letters in 2001. I believe the article is publishable, but some revisions would strengthen it.
First, and as a bioterrorist attack survivor, I have to ask why the general public should care or be better trained. about a threat they are unlikely to ever face and that occurs only extremely rarely. Explaining why it is imperative to do more to educate the public would be helpful.
It is not imperative to cite my own work (Malet and Korbitz, 2014 and 2015) but it would be helpful to cite other research on public viewsabotu bioterrorism and not just emergency preparedness in general. Is Aveiro unique or is it similar to other communities? This matters for significance.
Is the focus on pets relevant to bioterrorism or just a more general facet of emergency management.
The data would be more easily digestible in charts.
Author Response
REVIEWER # 2
Q.1 - I was interested to read this article because I previously conducted a similar study, and also and because I was working in one of the offices that received the anthrax bioterrorism letters in 2001. I believe the article is publishable, but some revisions would strengthen it.
A - Thank you for the constructive comments. The manuscript has been revised taking into consideration the reviewer’s comments.
Q.2 - First, and as a bioterrorist attack survivor, I have to ask why the general public should care or be better trained. about a threat they are unlikely to ever face and that occurs only extremely rarely. Explaining why it is imperative to do more to educate the public would be helpful.
A - Thanks for the suggestions. It is an honour to have a paper revised by an expert in bioterrorim. We have included the pertinent information.
Q.3 - It is not imperative to cite my own work (Malet and Korbitz, 2014 and 2015) but it would be helpful to cite other research on public views about bioterrorism and not just emergency preparedness in general.
A - we have now added the following two references:
Malet, David; Korbitz, Mark (2014). Accountability between Experts and the Public in Times of Risk. Australian Journal of Public Administration, 73(4), 491–500. doi:10.1111/1467-8500.12112
Malet, David; Korbitz, Mark (2015). Bioterrorism and Local Agency Preparedness: Results from an Experimental Study in Risk Communication. Journal of Homeland Security and Emergency Management, 12(4), –. doi:10.1515/jhsem-2014-0107
Q.4 - Is Aveiro unique or is it similar to other communities? This matters for significance.
A - Aveiro is similar to other Portuguese communities. Text has been updated to read as (line 59): “similar to other Portuguese cities, which is a medium-sized country on the European scale.”
Q.5 - Is the focus on pets relevant to bioterrorism or just a more general facet of emergency management.
A - This study aimed to strengthen the message of include pets in bioterrorism preparedness by promoting awareness among tutors and the general public. A sentence has been included to reinforce the importance of pets in bioterrorism preparedness: Concerning preparedness of pet owners, their lack of preparation is an identified risk factor associated with failure to manage emergencies or disasters. To comply with the other reviewer’s concerns, we have also inserted information about pets in the abstract.
Q.6 - The data would be more easily digestible in charts.
A - Performed as required. Tables have been transformed in charts.
Author Response File: Author Response.pdf
