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OCR for page 381
The Medical Implications of Nuclear War, Institute of
Medicine. ~ 1986 by the National Academy of Sciences.
National Academy Press, Washington, D.C.
The Consequences of Nuclear War:
An Economic and Social Perspective
HAL COCHRANE, PH.D., and DENNIS MILETI, PH.D.
Colorado State University, Fort Collins, Colorado
INTRODUCTION
The original purpose of this paper was to assess the systemic effects of
a limited nuclear war and offer some thoughts regarding the potential
health care complications that might result. As work progressed, it became
increasingly apparent that research into the direct and immediate impact
of war has been, and continues to be, the subject of considerable effort.
However, a review of the literature on the consequences of nuclear war
revealed few references to social science research. The citations that were
uncovered appeared to be confined almost entirely to the application of
economic theory to problems of reconstruction. Much of the work was
performed in the mid-1960s to mid-1970s and is therefore dated. To our
knowledge, little has been done on such subjects as social response to a
warning of nuclear attack; willingness of health care organizations to
administer aid under postattack conditions; ability of a moneyless economy
to rebuild without the aid of other nations and without a heavy reliance
on fuel oils. There is, on the other hand, no shortage of assumptions
regarding the nation's institutions, individual behavior, and the likelihood
of social change, none of which have been seriously questioned. As a
result, published projections that implicitly adopt current economic and
social arrangements should be questioned as well.
In such a short paper, we cannot pretend to cover the subject of socio-
economic consequences in any depth. However, we do not apologize for
raising a wide variety of issues that may frustrate even the most patient
381
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382
MEDICAL RESOURCE NEEDS AND AVAILABILITY
reader. We view this as an opportunity to question, speculate, and entertain
possibilities that may not have been previously considered.
WARNINGS OF WAR
Mutual assured destruction (MAD) is founded on the condition that
each side's offensive weaponry surpasses the defensive capability of the
other. Deterrence is thought by some to be stable so long as populations
and industry remain vulnerable to the destructive capacity of the other
side. If one subscribes to MAD, then it must follow that any movement
to reduce vulnerability or enhance offensive capacity heightens the risk
of war. Accordingly civil defense could play a dual role. Under ideal
circumstances it might reduce casualties, but if thought to be too effective
it could also destabilize the arms race, and under certain conditions heighten
the potential for misinterpreting intentions.
It is well known that the Soviet Union has invested considerable effort
to develop an effective civil defense system. The Central Intelligence
Agency (CIA) notes that there is sufficient blast-resistant shelter space for
the Soviet leadership at all levels (Weinstein, 19811. The Federal Emer-
gency Management Agency (FEMA) assumes that the Soviet Union would
not launch a preemptive strike without first protecting its own citizens (or
at least reducing the number of anticipated casualties to tolerable levels),
by evacuating the larger cities and population centers proximate to major
industrial plants. It is estimated that it would take from 3 to 5 days to
complete the process. Such large-scale population movements would be
readily detected by U.S. intelligence sources interpreted as a warning of
an impending nuclear strike. One response to this message, albeit an
unlikely one, would be for the U.S. to launch a first strike directed at the
highly vulnerable evacuees. A second, which was favored for some time
by FEMA, would take advantage of the lead time afforded by the observed
movements to relocate 145 million of our own citizens.
This so-called crisis relocation strategy has been roundly criticized for
its lack of realism and the fact that only meager resources were devoted
to its preplanning. Despite the apparent lack of support at the federal level
for crisis relocation, unplanned evacuations may still be an important factor
in determining the number and types of casualties that might be sustained
as a direct result of war or indirectly as a product of the evacuation itself.
It is interesting to note that the debate over crisis relocation presumes that
evacuations are orchestrated primarily by FEMA. However, a spontaneous
flight from areas thought to be targeted cannot be precluded, in the event
of a sudden escalation in tension between the world's superpowers. It is
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AN ECONOMIC AND SOCIAL PERSPECTIVE
383
highly unlikely, for example, that Soviet population movements, of the
scale indicated above, would escape the attention of the news media. The
question which then must be answered is how will U.S. citizens react?
This is an area where lessons learned as a result of studying societal
response to natural hazards and warnings, particularly earthquake predic-
tion, may provide insights.
How people in general and people with disaster response roles respond
to information about impending catastrophe has been the target of research
for three decades. The findings have been summarized (cf. Mileti, 1975;
Williams, 1964) and suggest several principles that would affect the vul-
nerability of medical and health care systems to nuclear war.
People respond to situations of impending danger on the basis of their
situationally defined perceptions of risk, and what they then believe to be
appropriate response to those perceptions. Even without official govern-
ment evacuation plans or sanctioned warnings of an impending nuclear
exchange, news regarding related events could lead some people to per-
ceive risk and evacuate to areas thought to be safe. Persons who are
responsible for providing postimpact aid, such as health care professionals,
might be motivated to evacuate personnel and supporting materiel in order
to preserve their ability to provide assistance after the attack (cf. Mileti
et al., 1981~. Given Abrams' (1984) estimates of medical requirements,
it is doubtful whether such behavior would alter the outcome.
THE DIRECT AND IMMEDIATE IMPACT OF WAR
The immediate effects of nuclear war, the completeness of the devas-
tation it brings, and the detailed accounting of the expected human suf-
fering have all been the subject of numerous studies. We begin with a
war scenario which provides the basis for estimating the demands placed
on the medical system, and sets the parameters for determining the direct
and indirect economic impacts. The results are then reexamined in the
context of what is known about organizational behavior and transforma-
tion.
Damage to Cities
Other papers in this volume have touched on many of the direct effects
of a limited nuclear war. In order to avoid repetition we will briefly
describe the scenario which is used as a point of departure for the issues
raised in this paper. The following calculations are based on the Federal
Emergency Management Agency's CRP-2B scenario which assumes that
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MEDICAL RESOURCE NEEDS AND AVAILABILITY
the United States is exposed to 6,559 megatons (Mt) of nuclear explosives
targeted primarily at military installations and 250 centers of population
exceeding 50,000.
In the absence of warning and any subsequent evacuation, about 125
million people would be caught within the 2-psi circles (geographic areas
which sustain a blast overpressure of 2 pounds per square inch); nearly
58 million would be inside the 15-psi region (Haaland et al., 1976; p.
201. In preparing the scenario, defense planners anticipated the delivery
of 843 1-Mt warheads. It is estimated that each ground burst would leave
a crater 1,000 feet (about 305 m) in diameter and 200 feet (about 61 m)
deep. All structures from the point of detonation to a distance of 0.6 miles
(about 1 km) would be leveled. Within the band between 1.7 and 2.7
miles (about 2.7 and 4.3 km) (5 psi) only skeletal remains of commercial
and residential multistory structures would be observed. The 2-psi circle,
characterized by moderately damaged structures (cracked load-bearing
walls, windowless, contents blown into the streets), would reach 4.7 miles
(about 7.6 km) (Office of Technology Assessment, 1979; pp. 27-31~.
Damage to Electronic Systems:
Effects of Electromagnetic Pulse
In contrast to the effects of blast and fire, the electromagnetic pulses
(EMP), generated as a result of airbursts, leave no visible signs. None-
theless, in theory such pulses could be highly damaging to microcircuitry.
Because of the partial test ban treaty (1963) and the highly sensitive nature
of EMP to national security, there is little hard evidence to conclude just
how much damage might be incurred. However, recent military interest
in new communications technology, such as the $10 billion MILSTAR
project, to protect against the effects of EMP suggests how serious the
problem may prove to be. Although much of what is known about EMP
either is classified as secret information or is highly speculative, the danger
the phenomenon poses is very real. Telecommunications networks, in-
formation processing equipment, and highly sophisticated medical tech-
nology would be vulnerable and could be irreparably harmed by such a
blast. ~ The problems this pulse poses for electronic equipment are twofold.
Electrical power grids would pick up the EMP and transmit a transient
spike in voltage to equipment drawing power at the time of the detonation.
The rapid rise in voltage would damage microprocessors in a way similar
to that resulting from lightning strikes. However, the rise in voltage would
be typically 100 times faster, thereby rendering common surge protectors
ineffective. Second, the electronic component itself could pick up the
1
OCR for page 385
AN ECONOMIC AND SOCIAL PERSPECTIVE
, ~, _ _ ~
385
pulse and generate internally induced currents. The result could produce
nhv~ical damage to the equipment.
High-altitude bursts (above 21 km) produce EMP, which could blanket
hundreds of thousands of square kilometers (Office of Technology As-
sessment, 1979; p. 22~. A high-yield weapon detonated 200 miles (about
322 km) above Kansas would generate a pulse which would affect the
entire country plus parts of Canada and Mexico. Furthermore, the entire
region would be blacked out simultaneously, since the radiation produced
by the explosion travels at the speed of light (p. 5194. The economic and
social ramifications of disrupting a highly developed electronic network
would be staggering. Not a single facet of the economy would escape the
effects of an interruption to the normal flow of communications, data
retrieval, and the accompanying capacity to process vast amounts of in-
formation. Concern about the potential effects of EMP is new, and as a
result little is yet known about the social and economic consequences
which might be triggered.
Most large corporations have taken at least minimal steps to prepare
disaster plans permitting them to carry on data processing functions in the
event of sabotage or fire. Such plans normally involve securing the rights
to utilize an alternative facility (e.g., sharing systems) and duplicating
records on magnetic tape. Of course, this strategy will succeed only if
the backup system is spared, an assumption which may be appropriate in
the event of fire but less so given a nuclear exchange. Few corporations
and governmental agencies, however, have actually taken steps to protect
sensitive data processing equipment. These exceptions appear to be con-
centrated primarily in the financial sector and are prompted by consid-
erations of liability as much as concern about social and economic impacts.2
Such protection is likely to fail, however, even in cases where an extreme
amount of caution is exercised. For example, the Federal Reserve System,
charged with the important task of tracking and controlling the nation's
money supply, maintains a bombproof backup facility. However, this is
the strongest link in the network. Few other banks or their corporate clients
can boast of such a capability. Hence, despite the fact that the Federal
Reserve's computers would most likely survive the war, little data would
be available for them to process. The viability of the nation's electronic
funds transfer and recordkeeping system turns on the degree of protection
afforded by all its participants.
The sensitivity of the nation's credit system to computer failure was
demonstrated recently when Paul Volcker, Federal Reserve Board Chair-
man, revealed that "something in the nature of a computer glitch" left
the Bank of New York $30 billion overdrawn (November 20, 1985~. To
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MEDICAL RESOURCE NEEDS AND AVAILABILITY
quell fears, the Fed was forced to make an unprecedented loan of $22.6
billion to the New York bank, the interest on which amounted to more
than $5 million per day. The loan, according to Volcker, was made amid
"increasing evidence of potential problems at other institutions around
the country," all part of the computer network involved in the purchase
and sales of government securities. This is, of course, a rather mild event
in contrast to the prospects of disruption due to a nuclear exchange. It
does, however, underscore the sensitivity of these financial systems, in-
viting speculation as to how economic recovery might proceed in the event
of a total collapse.
Direct Consequences for Medical Care
Abrams (1984), in pulling together a plausible set of projections re-
garding the direct effects of such an attack, provides a sobering view of
the situation. Abrams' calculations are based on the assumption that the
attack is sudden, leaving the victims no time to take protective actions.
Furthermore, the need for health care assistance is based on preattack
medical procedures. Beginning with the fact that 73 percent of the nation's
populace resides in areas assumed to be attacked, along with 80 percent
of the country's medical supplies, it quickly becomes evident that the
need for care would far outpace the medical resources which survive the
attack. However, it is the extent of the imbalance which is so startling.
He concludes that of the 93 million survivors, 32 million would require
medical care.3
It is difficult to imagine how the estimated 48,000 physicians surviving
the attack could cope with a workload which would tax 1.3 million (Abrams,
1984; p. 6571. How long medical care organizations could continue to
function effectively under such conditions is open to question. There is,
however, a body of research regarding the sociology of organizations
which suggests that cohesiveness and the will to carry on in such an
overwhelmingly stressful environment would be a limiting factor in de-
livering care. This perspective is developed more fully below.
THE LINGERING EFFECTS OF NUCLEAR WAR
The longer-term effects of war would pose an altogether different set
of challenges for the medical care system. Maintenance of a reasonable
standard of health may be impossible without the rapid recovery of the
economy's critical industries: petroleum, petrochemicals, electronics, ag-
riculture, and pharmaceuticals. Without these it is difficult to imagine
how the potential for the transmission of disease could be controlled.
OCR for page 387
AN ECONOMIC AND SOCIAL PERSPECTIVE
387
Leaning (1983; p. 424) has forcefully argued that some of the greatest
risks to health lie in the postattack period. The prolonged period of crowd-
ing in makeshift fallout shelters, which are likely to be poorly ventilated
and ill equipped to treat or dispose of wastes, would create the conditions
for the rapid spread of disease. Providing that the survivors endure this
period, they would face similar difficulties outside. The lack of sanitary
systems, the absence of power for refrigeration, the presence of millions
of unburied dead, and a disturbed ecological balance fostering the rapid
growth in insect populations would combine to produce an environment
fertile for the contraction and transmission of disease. The complex in-
teractive effects of stress, malnutrition, and an immune system damaged
by radiation would tend to weaken the physiological defenses to a point
where people may succumb to diseases presently considered to be only
moderately virulent.4
It might not be unreasonable to anticipate postwar pandemics similar
to those just described. Survivors weakened by malnutrition could not
expect to be vaccinated nor would antibiotics be available in sufficient
quantities to prevent complications.
The focus of health care therefore shifts from the immediate problems
of administering postattack aid to the longer-term issues surrounding re-
construction. The number of casualties produced by hunger and exposure
would not be significantly altered by the availability of trained medical
personnel and pharmaceuticals. Access to food and energy would prove
to be the key to survival. The prospects for avoiding catastrophe are tied
inextricably to the prospects for reconstruction.
Prospects for a General Economic Recovery
The economic infrastructure which is left intact after the attack would
play a key role in determining the length of time during which such life-
threatening conditions might persist. The survivors would face the critical
task of rebuilding a viable economy capable of rapidly reallocating un-
damaged capital and distributing uncontaminated foodstuffs. The few stud-
ies which have dealt with the issue of economic recovery are sobering.
Potential Vulnerability Affecting National Survival (PVANS), a study
prepared in 1970 for the Office of Civil Defense by the Stanford Research
Institute (SRI) (Goen et al., 1970), estimated the fewest number of nuclear
detonations required to "prevent economic recovery." The attack which
SRI found to be most effective in achieving this end combined the de-
struction of the industrial capacity located in 71 of the nation's largest
standard metropolitan statistical areas, 5 and SRI concluded that a crippling
blow could be delivered by a combination of 500 1-Mt and 200 to 300
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388
MEDICAL RESOURCE NEEDS AND AVAILABIlll~Y
additional 100-kiloton (kt) weapons. This number is only 10 percent of
that posed by the formulators of the FEMA CRP-2B scenario. The direct
effects of the PVANS attack, in terms of health care delivery, would not
differ significantly from the projections sketched above. However, the
economic dislocations resulting from the attack may create a whole new
set of health issues.
The SRI results have been subjected to refinements by Katz (1982; p.
115) and others (Sassen and Willis, 19741. These studies suggest that an
even lower exchange threshold (100 to 300 Mt) would result in unac-
ceptable economic disruptions and bottlenecks.
Reasons for Doubting Economic Projections
The picture, grim as it is, may understate the impacts. The tools avail-
able to researchers are based on historic patterns of production and insti-
tutional arrangements. However, these are likely to change during the
period of reconstruction. It is highly unlikely that the social order, for
example, would remain static. There are a number of other reasons for
doubting the economic projections. The methodology should be ques-
tioned. There may be insufficient reserves of domestic oil and gas to meet
the needs of both reconstruction and production of essential consumer
items. Trading patterns may not return to their prewar state. The destruc-
tion of data processing and retrieval facilities would make it difficult to
conduct monetary reform or reestablish property rights, both of which
have, in past wars, been instrumental preconditions for a rapid recovery.
Naturally, there are a large number of other issues which could have
been addressed. The few we have chosen to include offer a perspective
which is somewhat different from that of previously published works.
They also reflect some highly speculative thoughts regarding the extent
to which recent trends in the economy might affect the speed and nature
of recovery.
Methodological Concerns
Input-output models, which are the foundation for many of the economic
recovery studies, utilize a static matrix of technical coefficients.6 The fact
that these coefficients are computed based on statistics collected while the
economy is in a balanced state leads one to wonder about the reliability
of the approach when applied to the analysis of catastrophic shocks.
As an alternative to this static model, Cochrane (1984) simulated a
market economy which permitted industries to substitute labor for capital
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AN ECONOMIC AND SOCIAL PERSPECTIVE
389
and consumers to substitute more abundant commodities for those in
limited supply. It was found that the destruction of a portion of an econ-
omy's capital stock results in a new matrix of trade flows and hence in a
new set of input-output coefficients which adjust throughout the recon-
struction period. In addition the model produced
1. new price ratios:
2. new mix of consumer and producer goods;
3. new import-export balance;
4. a pattern of recovery which depends on the elasticity of substitution
(labor for capital), the competitiveness of producers in other regions, and
the amount of external aid flowing to the victims;
5. new government budget deficit.
Most noteworthy for the issue of postwar reconstruction, the model shows
that under certain conditions7 the economy would never reattain its prewar
prominence. It appears that the conditions which led the Japanese and
German economies to rapidly rebound from World War II bombing raids
are not likely to be repeated.
Systems models (Pugh-Roberts Associates, Inc., 1981) have been con-
ceived as a means of assessing the combined effects of environmental and
climatic change on the survivor's health and material well-being. How-
ever, here too, the functions (in this case differential equations) are drawn
from past experiences which reflect a unique pattern of prices, capital and
labor productivity, health, and legal and political institutions. Once again,
the accuracy of these dynamic models in portraying the consequences of
an event, which is likely to alter the very foundation of man's relationship
to nature as well as to his fellow man, should be seriously questioned.
Perhaps the most serious shortcoming we have found in the works cited
above is the lack of social science input. Except for Katz (1982), economic
projections are made without even a passing reference to behavioral and
institutional considerations. One thing is clear. A nuclear exchange of the
magnitude reported in these studies would cause a rapid collapse of the
nation's social and economic infrastructure. The speed with which a new
system could be erected is an open question, and one which may never
be answered. However, there are a number of issues worth noting that
have been skirted thus far and to which we now turn our attention.
The Social Aspects of Recovery
The results of sociological research suggest that a CRP-2B level of
nuclear weapon exchange would alter the social order and, consequently,
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390
MEDICAL RESOURCE NEEDS AND AVAILABILITY
human behavior in ways which may not have been captured by the analyses
just cited. What might the postwar social order look like and what would
contribute to its formation?
Conceptual Framework The social "glue" that holds complex in-
dustrialized societies together is efficient but impersonal. In the course of
a typical day, an individual is expected to play a variety of highly seg-
mented roles. Adherence to these roles creates an image which often masks
the underlying personality. It is only rarely that the true persona, the whole
person, is revealed to others. When this happens it is normally to a close
intimate. Most human interaction in complex industrialized nations is
impersonal and limited role playing. This impersonal social glue serves
an important function in that differentiation and objectification are essential
to efficiently carrying out the task of provisioning society and caring for
unmet needs. For example, once the role of customer is learned, a person
can buy almost anything in almost any store in the nation without going
through the more personal but time-consuming task of getting to know
the salesclerk. Role playing is of lesser importance to small rural com-
munities, agrarian societies, and tradition-bound cultures which are bonded
instead by personal relationships. In such a setting, individuals are more
apt to get to know each other and interact personally (cf. Tonnies, 1957;
pp. 31-102~.
The impersonal social glue dissolves quickly under the stress of national
or community emergency. Disasters that result in significant loss of life
and property will serve to transform the order which bonds social life (cf.
Mileti et al., 1975; Dynes, 1970; Barton, 1969), eliciting an intense
identification with the community (Barton, 1969), guilt over being a sur-
vivor (Lifton, 1967), an energetic response to provide help to those who
need it (Dynes, 1970), and the development of an emergency consensus
(Barton, 1969) which focuses human attention on the few acts directed
toward the sole values of preserving life and helping others. A disaster-
induced shift in social order and behavior triggers a temporary suspension
of providing aid and comfort to the disaster victims. This pattern has been
observed time and again (cf. Mileti et al., 1975; Dynes, 19701. However,
these findings are drawn from experiences where communities were ca-
pable of rebuilding both their physical capital and social relationships in
a form which reflect their predisaster states. In almost every instance.
ample resources, information, and relief personnel were funneled from
unaffected regions to the disaster-stricken community (cf. Fritz, 1961),
making it possible for it to return to the predisaster form of social orga-
nization. Localized, community-wide disasters, therefore, would undoubt-
edly see the social order change, albeit temporarily, to enhance the ability
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AN ECONOMIC AND SOCIAL PERSPECTIVE
391
and stamina of medical and health care system personnel to perform their
work.
The first order of routine social life is thus impersonal but efficient.
The second order of social life is personal and typifies life and behavior
in both communities impacted by localized disasters and life in agrarian
and traditional societies; it, too, is efficient for it focuses attention on
disaster relief goals, temporarily abandoning less-important priorities. The
second order soon reverts back to the first as immediate emergency needs
are met.
Application to CRP-2B The finding that disasters experienced see the
first order of social life replaced temporarily with a second order that
reverts back to the first order when emergency needs are met and after
outside assistance converges on the stricken area is not likely to hold given
the magnitude of disruption and depravation accompanying a nuclear ex-
change. In this case the second order would give rise to a new third order
rather than revert back to the first order; in other words, nuclear exchange
would produce changes leading to a permanent social reorganization rather
than a temporary change as characterizes most other disasters.
- Sociological research has documented the emergence of second orders
replacing first orders in hundreds of studied disasters (cf. Mileti et al.,
1975; Dynes, 1970; Barton, 1969~. These second orders contain the seeds
of new third social orders including new group leadership (e.g., Dynes,
1970), new bases for the distribution and use of power (e.g., Quarantelli,
1970), less complex systems of social stratification and status (e.g., Bar-
ton, 1969), and the abandonment of traditional societal priorities (cf. Mileti
et al., 1975~. These changes have been detected in cataclysms of all types
ranging from snow storms (Frtiz et al., 1958) and mine disasters (Lucas,
1969) to natural and technological emergencies in general (cf., Mileti et
al., 1975; Quarantelli, 1970; Form and Loomis, 19561. These seeds and
the second order are only abandoned when the inevitable demise of the
second order is triggered by the convergence of outside help and when
the goals of meeting emergency impact needs and the restoration of that
which was destroyed are met.
It is unlikely that the two factors that trigger the demise of second orders
would occur after nuclear exchange; the seeds of a new social order
contained in second orders would not be blocked from emerging into a
new and permanent third order. The first of these factors is the convergence
of nonvictims on the affected area. It is unlikely that outside assistance
would reach the surviving victims of destroyed cities in the CRP-2B
scenario for months, if at all. The second of these factors is meeting
impact needs and the restoration of that which was destroyed. It is also
OCR for page 400
400
l.o
of
0.8
0.7
0.6
0.5
IL
c: 0.4
UJ
MEDICAL RESOURCE NEEDS AND AVAILABILITY
- /! ~
/ ~
0.3
0.2
0.1
o
~or _
,
o
~r T
4 6
2
YEAR
-:. 1. ~. ~i:
8 10
o 50 + 65 O 75 ~ 85 x 95 v 100
PERCENT REDUCTION FROM PREWAR LEVELS OF CONSUMPTION
FIGURE 2 Percent of capital stock rebuilt as a percentage of prewar oil con-
sumption.
anct economic considerations, reducing the likelihood that such simplifying
assumptions would significantly alter the conclusions.
Agriculture A point which seems self-evident but has not been the
subject of systematic research is the effect of the postattack weather on
the economy. Without question, the combination of colder temperatures,
envisioned by Sagan (Ehrlich et al., 1985), and radiation would reduce
agricultural yields. One might also expect that increased variance in rainfall
accompanying the new environmental conditions would induce surviving
farmers to abandon specialized crops. Diversification might be the only
option available for coping with fluctuating temperature and moisture. It
is clear that abandoning specialization would depress production. Lastly,
the effects of nuclear winter on soil losses have yet to be addressed. It is
not implausible to expect significant amounts of wind erosion for several
years after the war. The magnitude of such losses and their subsequent
impact on agriculture have not yet been established.
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AN ECONOMIC AND SOCIAL PERSPECTIVE
401
Money, Credit, and Banking The wholesale destruction of physical
capital envisioned by the formulators of the CRP-2B scenario would result
in a sudden and dramatic flight from money to real assets. To the extent
that a postwar voluntary exchange economy is permitted to function, a
rapid acceleration in the price of essential goods could be anticipated.
Based on the experience of German monetary reform after World War II,
it may be possible to quickly reissue currency in amounts which are tied
to the reduced scale of economic activity (Stanford Research Institute,
19691. However, the fact that modern banking is highly dependent on
electronic funds transfer systems, which have been pointed out above to
be highly vulnerable to EMP, may complicate matters. Money is no longer
a tangible commodity but is a complex combination of bits stored in
electronic memory banks. Who will step forward to conduct monetary
reform, and how it would be accomplished in an equitable fashion, is
without question one of the most important aspects of economic recovery.
Without a means of exchange, the survivors would be forced to resort to
barter or simply implement a command economy where production and
o.e
0.7
0.6
0.1
o
~100
+tt
_
XX
how ' I 1 ~-_
i
~5 -
_~__
0 20 40 60
YEAR
lo 50 + 65 O 75
~85 x 95 v 1 Do
PERCENT REDUCTION FROM PREWAR LEVELS OF CONSUMPTION
FIGURE 3 Gas for consumption.
OCR for page 402
402
1.0
0.9
0.8
0.7
0.6
us 0.5
CC
LU
CL
MEDICAL RESOURCE NEEDS AND AVAILABILITY
/~'
0.4
0.3,
0.2
0.1
- //// ~
0 2
4 6
YEAR
lo 50 + 65 ~75 O 85
8 10
x 95 v 100
PERCENT REDUCTION FROM PREWAR LEVELS OF CONSUMPTION
FIGURE 4 Percent of capital stock rebuilt as a percentage of prewar gas con-
sumption.
resource allocation is dictated. In any case, it is clear that the projected
period of economic recovery reported in the literature takes no account
of this important consideration, and we believe, therefore, that the resultant
estimates are overly optimistic. The postwar economy would be more
inefficient and grow slower than might appear to be the case given current
statistics.
Trade Relationships International trade would suffer for similar rea-
sons. It is unlikely that our current trading partners would be willing to
sustain the balance of payments deficits which have been recorded in
recent years. Such has been made possible by the fact that many other
areas of the world are politically less stable than the United States. As a
result the U.S. dollar has served as a hedge against a sudden reevaluation
of other currencies (due to revolutions or monetary mismanagement).
Nuclear war would not only wipe out foreign claims on U.S. assets but
would eliminate the very reason for the dollar's prominence as an inter
OCR for page 403
AN ECONOMIC AND SOCIAL PERSPECTIVE
403
national medium of exchange. Postwar international trading would most
likely be conducted on a quid pro quo basis. Both U.S. and foreign
economic recovery would suffer as a result.
Treatment of Surviving Capital One can only wonder how the own-
ership of property will be settled and what ingenious mechanisms survivors
might invent to distribute that which is still economically viable. Records
would be difficult to retrieve. In some cases capital would be rendered
useless as a result of raw material shortages. At the other extreme, the
owners of uncontaminated land located in more favorable climatic zones
could reap substantial gains, providing of course that property rights are
respected. An unprecedented reduction and transfer of wealth could take
place within a relatively short time period. How would the legal and
political systems respond?
Why Would the U.S. Experience Differ from
that of Germany arid Japan?
A recovery period lasting a decade or more contrasts sharply with the
recorded postwar economic performance of both Germany and Japan. Each
sustained heavy losses but were able to reestablish viable economies within
5 years after the cessation of hostilities. What forces led both of these
nations to their current economic prominence? Could such factors be
repeated to produce a rapid economic recovery in the United States?
The factors which coalesced to create a favorable climate for both the
Japanese and German economies are unlikely to reoccur. Fossil fuels
during the postwar period were both plentiful and inexpensive. Contrary
to popular belief, Germany sustained relatively minor damage to its pro-
ductive capital. "It must be emphasized that bomb damage to industry,
as opposed to transport and housing, was relatively negligible. Germany's
. . . post-war industrial potential was roughly equivalent to that which
had existed in 1938." (Owen-Smith, 1983; p. 13~. Reconstruction during
the war with technically more advanced equipment meant that Germany
emerged from fighting with a superior industrial base. Bomber raids simply
obliterated housing and commercial establishments in the cities' centers,
leaving the industrial plants situated in the outskirts virtually untouched.
It has been estimated that industrial losses amounted to between 10 and
20 percent for metallurgical, chemical, engineering, and textile firms.
Japan's losses were more telling. Its index of industrial production
dropped from a prewar high 149 (in 1940) to 31 in 1946 (Allen, 1963,
pp. 200-2091. The previous high was not reachieved until 1953, although
it grew steadily throughout the intervening period.
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MEDICAL RESOURCE NEEDS AND AVAILABILITY
Both Japan and Germany benefited greatly from external aid, primarily
from the United States. Assistance to Germany alone amounted to $3.6
billion between 1946 and 1953, a sizable amount, especially when mea-
sured in current dollars. Approximately half the aid was in the form of
Government and Relief in Occupied Areas (GARIOA), an emergency
program to alleviate starvation (Owen-Smith, 1983; p. 29~. The foodstuffs
provided by both the GARIOA and the Marshall Plan, which succeeded
it, permitted Germany to economize on scarce foreign exchange so it
could afford to import ingredients essential to its manufacturing operations.
Japan's economy benefited equally from the aid it received. The Korean
War served to stimulate demand for Japanese products at a point when
U.S. aid was dwindling. That, plus a postwar economic boom which
fueled demand for vessels fabricated in Japanese shipyards, all provided
a sound platform for recovery.
Even though a plentiful supply of cheap energy throughout the 1950s
and 1960s provided both countries the opportunity to maintain a sound
long-term growth path, energy shortages which materialized immediately
after the war were a source of hardship and suffering. Germany was forced
to relinquish territories amounting to 25 percent of the Third Reich's land
area. The expulsion of German nationals from these areas caused a rapid
rise in population which resulted in a homeless rate of nearly one family
in three. The loss of 17 percent of Germany's coal-producing capacity to
Poland and the imposition of mandatory coal exports as part of reparations
contributed to an energy crisis. In the particularly bad 1946-1947 winter
deaths per 1,000 of the population were 10 percent higher than in the
following years (Owen-Smith, 1983; p. 29~.
Despite the short-term hardships both countries benefited greatly from
a fortuitous combination of factors which are unlikely to be repeated. No
nation would have the resources or possibly the will to come to the aid
of a United States devastated by a nuclear exchange. Foodstuffs would
be hoarded rather than shared. No worldwide economic boom would
ensue. Without an external source of demand for its products, the U.S.
economy would languish.
CONCLUSIONS
The medical consequences of nuclear war have proven more elusive
than first thought. The number of immediate casualties anticipated and
the potential for the spread of disease over the long term hinge on more
than the number of warheads targeted at American cities. How the pop-
ulace responds to the warnings of war cannot be ignored. It is difficult to
believe that an attack would occur without foreknowledge, either provided
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AN ECONOMIC AND SOCIAL PERSPECTIVE
405
by FEMA or otherwise. Nonetheless, it is safe to say that the medical
consequences of an attack depend on whether warnings/rumors of war
produce an orderly exodus from cities to rural host communities (as FEMA
may have planned it), trigger a spontaneous flight from areas thought to
be vulnerable, or are ignored altogether. To our knowledge the required
research to answer this question has yet to be initiated.
Abrams (1984) has shown that the administration of aid to the survivors
of a CRP-2B attack (assuming minimal evacuation) would be an enormous
task, far exceeding available manpower and stockpiles of pharmaceuticals.
How health care organizations might respond to the challenge is open to
debate, since even the lessons learned from Nagasaki and Hiroshima may
not apply to attacks of the CRP-2B magnitude. The totality of the de-
struction would make it virtually impossible for local health care units to
receive external assistance within a reasonable time span.
The longer-term prospects for maintaining the health of the survivors
are just as grim. Malnutrition, an immune system weakened by the effects
of radiation, and poor sanitary conditions would combine to boost the
death toll. Contrary to first impressions, the availability of pharmaceuticals
may not be as important a factor as initially expected. The fact that
manufacturing facilities located abroad contribute an increasing proportion
of world drug supplies should alleviate concern about persistent shortages.
One might even expect a relatively rapid rebound of domestic production.
U.S. pharmaceutical research, on the other hand, might never reattain its
prewar status.
How long survivors must endure such deprivation depends on the speed
with which a viable economy can be rebuilt. Without an adequate means
of mobilizing manpower to distribute food and other necessities, the health
of the survivors would remain in jeopardy. There is sufficient reason to
believe that the period of reconstruction would far exceed the 3 to 5 years
often reported by economic analysts. The vast quantities of fossil fuel
required to reconstitute the nation's destroyed stock of shelter and indus-
trial capital may be the single most important limiting factor. The United
States should expect little in the way of international assistance, and trade
would most certainly be conducted on a quid pro quo basis. Aid on the
scale of that provided to Japan and Germany at the conclusion of World
War II would amount to only a minuscule fraction of the estimated $3
trillion to $5 trillion in losses resulting from a CRP-2B exchange.
The pace of rebuilding would also be inhibited by the destruction of
the nation's data banks and information processing centers. No one seems
to know at this point how electronic networks and equipment may function
as a result of EMP. Nor has anyone asked the more general questions
regarding information processing failures how records would be recre
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MEDICAL RESOURCE NEEDS AND AVAILABILITY
ated, how money and credit would be tracked, how economic sectors
would be coordinated, and how essential information regarding prices and
production would be generated and transmitted to the surviving firms.
Research into the role that telecommunications and information processing
plays in the economy seems vital.
Finally, much of what has been written regarding nuclear war inad-
vertently assumes that institutions and behavioral norms would remain
unaltered. It is not uncommon, for example, to read economists' assess-
ments of reconstruction which assume that property rights would be re-
spected or Cat government fiscal and monetary policy would be implemented
to alleviate the effects of war on the economy. These, of course, are
foolish bases upon which to build realistic projections. The tools currently
available to economists and sociologists tend to paint a picture which is
overly optimistic. Experience gained from the study of past disasters
provides little insight as to how society may cope with the aftermath of
nuclear war. Certainly snowstorms, floods, and even earthquakes pose
sufficiently different problems than those upon which the papers in this
volume have centered, and the social response to natural hazards may be
an unsound basis for extrapolation.
It is clear that knowledge about the physical and biological aspects of
nuclear war have advanced significantly in recent years. Even the cli-
matological and environmental issues have attained greater focus, despite
the controversy surrounding the prospects of nuclear winter. The same
cannot be said about the state of socioeconomic knowledge. We know
that nuclear war will change the foundation of man's relationship to man
and to nature, but we are either unwilling or unable to imagine what forms
these new social arrangements will take and how they relate to the well-
being of the surviving population. A significant change in the extent and
direction of socioeconomic research appears warranted.
ACKNOWLEDGMENTS
The authors acknowledge the assistance of Laurie Walters, Jung Soo
Kim, and Marjorie Muench, who assisted in the preparation of this paper.
NOTES
iAt high altitudes, gamma rays are produced in the first nanoseconds of a nuclear ex-
plosion, which can travel hundreds of kilometers before encountering electrons in atmos-
pheric molecules. After being knocked out of their original molecular configuration, these
electrons would be deflected toward Earth in a downward rotating motion along the Earth's
magnetic field lines. These high-energy electrons would be picked up by any metal object.
The resultant pulse would peak rapidly (within 10 nanoseconds) to a level of 50,000 to
100,000 V/m. The greater the surface area, the greater the amount of EMP absorbed.
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AN ECONOMIC AND SOCIAL PERSPECTIVE
407
2In passing the Electronic Funds Transfer Act (1978), Congress attempted to assign
liabilities, rights, and responsibilities to both the consumer and the financial institutions.
Interest in backup facilities was spurred by the requirement that transactions be processed
within a reasonable length of time. The legal consequences of not fulfilling this obligation
were felt to be more than sufficient reason to take protective measures.
3The scale would change with the attack scenario, however; even given a very limited
war involving 10 major cities, the imbalances Abrams points out would still prevail, albeit
to a lesser extent. The approach may in fact understate the effects, since no account is
taken of the location of surviving resources relative to where they are needed. Nor is any
consideration given to the mix of resources available. The ratios Abrams utilizes are based
on normal conditions, wherein personnel, equipment, and pharmaceuticals are available in
desired proportions. How effective will a medical staff be in the event that equipment is
rendered inoperable?
4Contrary to what one might first think, cholera, typhoid, plague, and small pox con-
tributed in only a minor way to the world's morbidity and mortality rate this century.
Surprisingly, the influenza virus proved to be the most lethal. Over the 2-year period
between 1918 and 1919 flu resulted in nearly 21.6 million deaths worldwide. In the United
States alone nearly 20 percent of the population was infected, producing nearly 400,000
deaths in a single month (Ayres, 1965; p. 411). Most of the fatalities were the result of
complications such as pneumonia.
sThe attack was assumed to reduce industrial output to less than 3 percent of the preattack
level. The industries considered critical are (1) petroleum refining; (2) iron and steel works;
(3) primary smelting and refining of zinc, copper, lead, and aluminum; (4) engines;
(5) electrical distribution products; (6) drugs; (7) office mechanisms; and (8) mechanical
. .
measuring ~ .evlces.
6This methodology establishes a normalized pattern of trade which weaves the industrial
sectors together. A technical coefficient is simply the percentage of one industry's output
that another industry comprises.
7The most important is that the disaster-stricken region exhibits a cost of production equal
to or in excess of its competitors.
These trends can be explained in part by the following: (a) U.S. Food and Drug Ad-
ministration regulations which impose significantly greater costs and delays on U.S. research
efforts; (b) liability regimes for consumer product claims which are more cumbersome and
risky in the United States than in competitor nations; (c) antitrust legislation which prevents
the achievement of scale economies in terms of pharmaceutical research and development;
(d) foreign nontariff trade barriers such as discriminatory safety regulations and pricing.
9An average of 60 new drugs were subjected to clinical trials in the mid 1960s. The
number has declined to 25 per year in 1982. In contrast, the number of trials conducted
by foreign-owned companies has remained constant (at 20 per year).
i°Statistical Abstract of the United States, 1985. The total comprises the following: $1.4
trillion (nonresidential equipment); $1.6 trillion (nonresidential structures); $2.8 trillion
(residential structures); $2.0 (government); and $1.2 trillion (household durables).
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Representative terms from entire chapter:
social perspective
