Thinking the Unthinkable - Preparing for nuclear attack*

Zachary Coile, Chronicle Washington Bureau

Friday, June 27, 2008

(06-27) 04:00 PDT Washington --It is a grim, almost unthinkable
scenario: a 10-kiloton nuclear weapon, smuggled into the United States,
is detonated in a major U.S. city, perhaps even the Bay Area.

Top federal officia ls and medical experts gathered in Washington on
Thursday to consider this nightmare vision. Their conclusion: Cities and
states are frightfully ill-prepared for dealing with an attack using a
small nuclear bomb.

"Few of them have coordinated response plans for the aftermath of
nuclear terrorism," said Brooke Buddemeier, a specialist in the
radiological and nuclear counter-measures division at the Lawrence
Livermore National Laboratory. "There is a general lack of understanding
of the response needs and uncertainty over federal, state and local
roles and responsibilities."

Federal officials are worried enough to have convened a National Academy
of Sciences committee on medical preparedness for a nuclear attack by
terrorists. The panel is holding its first two-day meeting in Washington
this week.

"The risk is there - it's not zero," said the committee's chairman,
Georges Benjamin, executive director of the American Public Health
Association. "We don't know where all the suitcase nukes are. They are
out there, and we know the bad guys are trying to get their hands on
them. ... If there is a catastrophic event, there are things we can do
to prepare for it and to mitigate the effects if it happens."

The panel is specifically looking at six metropolitan areas seen as at
risk of a nuclear attack: New York City-northern New Jersey, Washington,
Houston, Chicago, Los Angeles and the San Francisco Bay Area. New York
and Washington are often seen as the highest-risk targets, but San
Francisco ranks high because of its status as an iconic city with
landmarks ranging from the Golden Gate Bridge to the Transamerica Pyramid.

The committee began its first session with a ghastly overview of what a
10-kiloton nuclear blast would look like: If detonated at the White
House, it could destroy virtually every building within 1,500 yards.
People in an area out to 1.55 miles could suffer second-degree burns,
while others would be injured by flying debris and shattered windows.
Those 4.5 to 7.5 miles away could suffer momentary "flash" blindness,
causing traffic accidents.

A lethal plume of radioactive material would, depending on winds,
stretch as far as 9 miles, affecting up to 300,000 people, although
injuries would depend on a person's exposure to radiation.

"It's not just about radiation exposure," Buddemeier said. Many of the
injured would have shards of glass in their eyes, ruptured eardrums and
other impact injuries from the blast's shock waves.

In San Francisco, the forecast would be equally bleak. Cham Dallas,
director of the Institute for Health Management and Mass Destruction
Defense, conservatively estimates that a nuclear blast in the city would
injure at least 25,000 people - not counting those killed instantly.

The injured would have few outlets for medical care. Local hospitals
could empty their beds of nonemergency cases, but they still would have
only about 2,500 beds available four hours after the attack. Those
hospitals would likely be the only option until the National Guard or
Army arrived to set up field units.

"It will be very difficult to get to those beds," Dallas said. "The
roads will be clogged. Access to helicopters will be very limited. The
federal response is not likely to be significant in the first 48 hours,
as we saw with Hurricane Katrina."
Similar to Hiroshima

Health experts say the immediate aftermath could be similar to
Hiroshima, the Japanese city where the United States dropped a roughly
15-kiloton nuclear bomb in 1945. In a city of 250,000 people, 64,000
were killed, half of those on the first day. An additional 72,000 were
injured.

The blast destroyed all but three of Hiroshima's 45 hospitals. John
Mercier, director of military medical operations for the Armed Forces
Radiobiology Research Institute in Bethesda, Md., said 10,000 people
showed up the first day at the damaged Red Cross Hospital, which had
just 600 beds.

Mercier said U.S. hospitals could be in a similar position. The blast
could knock out power and some hospitals would lack any water pressure,
meaning they may have to rely on fire trucks or other means to
decontaminate victims of radiation exposure. The number of victims is
likely to be so high that doctors and nurses will have to make decisions
about who could be saved.

"Physicians are going to have to have moral courage," he said. "They are
going to have to decide there are not enough resources for this person
or that person."

The U.S. government has started to alert the public about the
possibility of such an attack, with Web sites like www.ready.gov, which
urge families to make a plan in the event of a terrorist attack.
No consensus

However, there is still no consensus on how the public should respond to
a nuclear blast. Ready.gov urges people to "Take cover immediately, as
far below ground as possible." The private Rand Corp., though, urges the
opposite: "Avoid radioactive fallout: evacuate the fallout zone quickly."

Dallas said the best response is somewhere in between: If you're in the
path of a lethal plume of radioactive matter and can get out in time,
evacuate. If not, seek shelter in a heavily reinforced building or
basement to limit radiation exposure.
What can you do during a nuclear attack?

-- If there is any warning, take cover - in a basement or heavily
reinforced building.

-- Lie flat on the ground and cover your head. If the explosion is some
distance away, it could take 30 seconds or more for the shock wave to hit.

-- Do not look at the flash or fireball, which can blind you.

-- Avoid windows, which can shatter and injure.

-- Listen to official instructions. If authorities say it is safe to
evacuate, do so quickly.

-- Otherwise, remain sheltered in place - even if you are many miles
from the blast site, because wind can carry radioactive fallout for
hundreds of miles.

-- If you are exposed to radiation, remove outer layer of clothing and
shower if possible. Seek medical help.

Source: Federal Emergency Management Agency; Chronicle staff report