TORONTO -- Ontarians' reactions to an emergency alert stating there had been an incident at the Pickering Nuclear Generating Station ran the gamut from fear to confusion to – eventually – outrage.

Ted Gruetzner's first instinct was a little different. He was puzzled, yes, but he also had a strong suspicion that there was no cause for alarm.

"I have the luxury of knowing how these things work, and it struck me as something that [was] a little bit off," Gruetzner said Sunday on CTV News Channel.

As a former vice-president of Ontario Power Generation – which operates the power plant in Pickering, Ont. – and someone still heavily focused on the energy sector through his work with the Global Public Affairs consulting firm, Gruetzner felt that the message didn't ring true.

Few of those who received the alert have Gruetzner's background and expertise, though. And for that group, Gruetzner says, it's not at all surprising that the message caused panic.

"You're going to want to make sure that you're getting your message very clear, giving clear direction on what people should worry about and what they should do – and I think that message wasn't very clear this morning," he said.

"It created a lot of uncertainty and unease."

Pickering Mayor Dave Ryan also spoke of the mental health impacts of the false alarm Sunday morning.

"This has a huge impact on our community as a whole – the obvious anxiety that is uncalled for," he said in an interview with CP24.

Anxiety, sometimes rising to the level of post-traumatic stress disorder, has been shown to increase following false alarms of imminent danger. One of the most notable such mishaps occurred almost exactly two years before Sunday's alert.

On Jan. 13, 2018, an emergency alert was automatically transmitted over every radio and TV signal in Hawaii, and sent to every phone in the state. The alert advised recipients to seek shelter and included an all-caps message declaring "NOT A DRILL."

It took 38 minutes for authorities to send a follow-up message stating that the initial alert was a false alarm.

That 38-minute gap was more than enough for Hawaiians' panic levels to shoot through the roof, according to a 2019 paper in the American Psychologist journal.

Researchers from the University of California scraped data from Twitter, examining more than 1.2 million tweets from 14,830 accounts believed to be based in Hawaii over a two-month span including the day of the false alarm.

By searching for keywords such as "worried" and "afraid," they found "a marked increase in anxiety among likely Hawaii residents that lingered well after the missile threat was dispelled," as Nickolas M. Jones and Roxane Cohen Silver wrote.

The anxiety levels climbed from the moment the alert was issued until Hawaiians received the follow-up false alarm message – even though the state's emergency management office and local politicians tweeted during that period that there was no real emergency. As one Twitter user put it, "who knows who's right?"

Days after it became clear there never had been a threat, the Twitter users who had been expressing the least anxiety before the alert continued to show a big increase in their anxiety levels. Those who had already displayed signs of anxiety, conversely, had stopped doing so – which Jones and Silver say could be a sign of "near-miss relief" or may mean that they had re-evaluated the things which caused them anxiety before the alert.

"Users in the high prealert anxiety group may have recognized how much worse things could have been had the missile threat been real," they wrote.

The researchers note that there are limitations to their findings: Twitter skews younger and more urban than the general population, word use is a very generalized way to track anxiety, and there is no guarantee every tweet they logged came from Hawaii.

Still, much of their study reads as if it could be a warning for the Ontario government in the wake of Sunday's erroneous alert, which the Ontario government has blamed on an accident during a "routine training exercise." Researchers warn that false alarms can erode the credibility of an organization and make people less inclined to believe future warnings. For example, a 2009 study found that residents of American areas with significant histories of false tornado alarms are less likely to trust the U.S. National Weather Service – and more likely to die when tornadoes do strike.

"When officials charged with disseminating information about impending threats falter, this might lead to a disaster … and there may be a number of unintended consequences," they wrote.

Jones and Silver did find some reasons for hope. They note that after a public trauma, anxiety levels tend to decrease as authorities and media explain exactly what has happened and what is being done to stop it from happening again.

"When emergency systems falter, research shows that credibility loss can be mitigated by a clear explanation of why the false alarm occurred in the first place," they wrote.

In Hawaii, that took the form of the state creating new safeguards to prevent one person from sending an emergency alert without approval. Media reports about past issues involving the employee who sent the alert "may have assured the public that the entire affair was a fluke," Jones and Silver wrote.

Gruetzner said he hoped to see similar public communications efforts in Ontario as the investigation into Sunday's false alarm unfolds.

"You don't want to create more questions than you answer with your communications," he said.

"People have to have faith in the system, and I think they're going to do what they can to address the problem."