Exploring Medical and Public Health Preparedness for a Nuclear Incident Proceedings of a Workshop (2019) / Chapter Skim
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4 Updating Planning Assumptions of Nuclear Preparedness
4 Updating Planning Assumptions of Nuclear Preparedness
Pages 47-60
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From page 47... ...
(Young) Nuclear preparedness planning has been under way for decades, par ticularly in the past 20 years, but the reemergence of state actors has changed the threat calculus.
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From page 48... ...
MAGNITUDE OF EMERGING NUCLEAR THREATS Dallas reiterated concerns that thermonuclear weapons are once again an emerging threat after having faded following the Cold War, not only because of current geopolitical tensions with North Korea but because of threats from other countries as well. He compared fatalities, casualties, and other impacts of three different nuclear weapon yield, all modeled based on what would happen if the detonations were to occur in Seoul, South Korea:
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From page 49... ...
For a 25 kt bomb, there would be 67,000 casualties; for a 100 kt bomb, 229,000 casualties; and for a 475 kt bomb, 809,000 casualties. TABLE 4-1 Comparison of Predicted Casualty Distributions for 25, 100, and 475 kt Nuclear Weapon Detonations in Seoul, South Korea 25 kt 100 kt 475 kt Fatalities (50% fatality; blast 8.1 psi)
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From page 50... ...
A typical hospital has three or four medical care per sonnel tending to a single burn patient. In a nuclear detonation situation, there would be an overwhelmingly large number of thermal burn patients and only a small number of qualified medical care personnel who would have survived to help, and he emphasized the importance of thermal burn care for the likely millions of patients who would require support in such a scenario.
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From page 51... ...
Hundreds of small weapons tests were conducted there. In contrast, the yield of the more than 60 tests of large thermonuclear weapons conducted in the Pacific Proving Grounds2 in the Marshall Islands totaled more than 108 Mt.
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From page 52... ...
To build resil iency, Whitcomb called for extensive communication networks nationally, regionally, and locally to encourage communities to recognize a statesponsored nuclear event as a threat. He also noted that a nuclear event should activate Emergency Support Function #8 functions and encouraged leveraging lessons from recent disasters in preparedness and response plan ning.
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From page 53... ...
Phillip Maytubby, director, public health protection, Oklahoma CityCounty Public Health Department, commented on the often competing messages and situational instructions from different federal entities. For example, during the Oklahoma City bombing, law enforcement officers nearly exchanged gunfire due to mixed messages received from federal leadership.
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From page 54... ...
However, Young noted, when considering a potential state actor attack in North Carolina, other potential targets could include the state's three military bases: Fort Bragg, which is the largest Army base in the United States; Camp Lejeune, a Marine Corps base on the coast and the only operational Marine Corps base in North Carolina (i.e., with actual war fighters, not just training and education commands) ; and Seymour Johnson Airforce Base.
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From page 55... ...
A Shift in Reliance on Mutual Aid North Carolina's emergency management community has an active and effective mutual aid program, Young said. In the past 2 years, the state has sent teams to support Puerto Rico's response to Hurricane aria, helicopters M and swift water boats to Houston to help evacuate people during Hurricane Harvey, and an incident management team to Hawaii to support the response to the Kilauea Volcano eruption.
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From page 56... ...
Young echoed McClendon's and Williams's calls for a directive from the federal government -- or, Young added, from senior elected leaders in the state, law enforcement, or the intelligence communities -- that a nuclear incident is more likely to occur than previously believed. REGIONAL RESPONSE: OPPORTUNITIES AND CHALLENGES Building on Yeskey's description of ASPR's Regional Disaster Health Response System, Dallas asked the panelists how the regional planning process would be useful and what obstacles to its implementation exist.
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From page 57... ...
Department of Homeland S ecurity, voiced concern about the logistical problems of moving materials into and around an impacted site and simultaneously moving patients out of an impact zone to receive treatment at a regional or national health care facility. These problems would be especially challenging in the event of a state agent nuclear detonation, in which case all of the U.S.
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From page 58... ...
However, during audience discussion, Paul Eder, senior medical diagnos tics analyst with Tunnell Consulting and a contractor with the diagnostics division of BARDA, clarified that the diagnostic tools are not yet procured for the SNS, although discussions are under way to consider that action. In addition, he clarified that the medical countermeasures mentioned by Dallas are for inhalation radiation.
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From page 59... ...
FEAR OF RADIATION: IMPLICATIONS FOR PLANNING Workforce Incentives Dallas echoed Hawkins's earlier concerns about the fear of radiation events and lack of willingness among medical care and public health per sonnel to respond in the event of a nuclear disaster. He wondered what guidance, moral appeals, or other incentives would encourage medical and public health personnel to show up to work at various response levels.
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From page 60... ...
Whitcomb said that in addition to monetary incentives, there is a need to convince state and local preparedness and public health partners that the nuclear threat is a true risk. This applies even outside of major metropoli tan areas or other target areas, he argued, stressing the regional nature of such an event.
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