The recent false alarm in Hawaii underscores the threat from nuclear devices. While there has been media attention placed on how the United States is taking military and diplomatic action against North Korea from launching a nuclear strike, there is little media attention given to how well the United States is medically prepared for a nuclear attack. According to a recent report in the Bulletin of the Atomic Scientists, U.S. cities are not medically prepared for a nuclear detonation. This report, written by Dr. Jerome Hauer, who was the former assistant secretary for the Office of Public Health Emergency Preparedness at the U.S. Department of Health and Human Services, asserts that the United States is completely unprepared to manage the aftermath of a nuclear detonation. We are at a moment in history where nuclear terrorism is an unfortunate reality. North Korea and Iran have established nuclear capabilities, and Pakistan has stockpiles of highly enriched uranium.
These countries have a history of supporting terrorist groups. It has been acknowledged by our government that highly enriched uranium can be smuggled into this country to build a 10-kiliton improvised nuclear bomb, like that dropped on Hiroshima in 1945. A nuclear threat would even include a dirty bomb that combines a conventional explosive with radioactive isotopes, which could contaminate an area and leave a residual radioactive “hot zone” that is too dangerous for even first responders to enter. Also, radioactive particles can disperse into the air and create a “plume” that could extend hundreds of miles away from ground zero and create a contamination area that would last for years.
A nuclear blast would instantly release a massive pressure wave and heat that would incinerate everything within half a mile and kill an estimated 75,000 to 100,000 people. Another 100,000 to 200,000 would suffer complexed radiation burns, while others would be exposed to high doses of radiation that would cause acute radiation syndrome that is characterized by bone marrow failure and gastrointestinal, cardiac, neurological and pulmonary toxicity. The starkest fact about a nuclear bomb attack is that it destroys the capacity to respond from a medical and civil service perspective. There will be a loss of local government services from firefighters, police and hospitals, along with loss of water, sewage and utilities. There will be a loss of communication systems to direct survivors where to evacuate for treatment.
The management of mass casualties from nuclear detonation is far more complex than for natural disasters. Hot zones are too dangerous for first responders to enter to render medical assistance to casualties. Yet, victims would still need to be evacuated somehow. According to the report, most U.S. cities lack medical preparedness to manage the aftermath of a nuclear explosion. FEMA has not devoted enough attention to address this issue. This makes it important for cities and states to develop plans for the worse case scenarios. Each state should have a plan of preparedness that includes special medical triage centers; coordinated schemes from state military and local police to provide mobile communication assets and protection against civil unrest; and specialized trained hospitals that can medical manage the injuries associated with a nuclear bomb. There needs to be a statewide plan from the governor’s office from each state, along with each state’s department of public health, to ensure there is sufficient medical preparedness.
Several government officials stated they were unable to take steps forward out of being accused of inciting fearmongering. However, developing a comprehensive preparedness program against nuclear threats should not just stop with military action but should include a medical preparation program regardless of how politically undesirable the subject may be. Preparedness should be mandated at every local and state government level.
• Alan Moy is CEO of Cellular Engineering Technologies and scientific director of the John Paul II Medical Research Institute.