Study: Hospitals would be 'overloaded' by nuclear attack on U.S. - USATODAY.

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nuclear attack on U.S.

The specter of nuclear annihilation haunts the modern mind. With North Korea testing nukes last year, Iran
apparently bent on developing a weapon and Pakistan in possession of a dozen bombs already, hopes have
faded that the world will one day be free of the threat of nuclear weapons.

In March, the Council on Foreign Relations warned the "probability of a nuclear attack by terrorists has
increased," citing the efforts of Iran and Pakistan. And a USA TODAY/CNN/Gallup poll last year found 80% of
respondents thought it very or somewhat likely that Iran would give a nuclear weapon to terrorists .

On top of this concern, the conflicting safety advice issued in the wake of the Sept. 11, 2001 destruction of the
World Trade Center buildings and the 2001 mailing of anthrax-filled letters has public health and weapons
experts asking some hard-to-answer questions about nuclear terrorism. Examining the likely toll of such an
attack on large U.S. cities, one pair of public health experts question in a recent International Journal of Health
Geographics study how well hospitals could handle the casualties. Their conclusions are not reassuring.

If terrorists detonated a nuclear weapon in a city, "it is reasonable to expect that the health care system would
be overloaded with massive numbers of patients requiring an array of professionals with specialized training,"
write the study authors, William Bell and Cham Dallas of the Center for Mass Destruction Defense at the
University of Georgia in Athens. "If this already stretched medical community was also severely impacted by the
very attack that requires its response, the effects would be even more devastating," they argue.

Acknowledging that hundreds of thousands of people would die in such an attack, almost too awful to
contemplate by itself, the pair looked at how hospitals in New York, Chicago, Atlanta and Washington D.C.
would respond after the detonation of a relatively small nuclear weapon, 20 kilotons (about the size of the 1945
Hiroshima bomb), and a large one, 550 kilotons, the most common size in Russia's arsenal. The study charts
and tables, available online for free, make for grim reading.

Blasting and burning are how nuclear explosions kill at first. "The entire U.S. has specialized facilities to treat
roughly 1,500 burn victims, which is far less than the burn casualties produced by one single small nuclear
explosion. Additionally, most of these beds are already occupied," the study authors note. Just the small
explosion in the study would produce from 3,132 cases of third-degree burns (in Washington D.C.) to 20,660
cases (New York), they conclude, with the numbers growing about 10 times higher for the larger blast. Third
degree burns are the most serious ones. "Even a small nuclear event will totally overwhelm our hospitals' ability
to take care of resulting burn casualties," the authors conclude.

Radiation and radioactive fallout plumes would kill more people and create more patients for hospitals. "In a
nuclear explosion, over 400 radioactive isotopes are released into the biosphere," the study authors note. Just
the small 20 kiloton explosion would produce from 46,579 cases of deadly radiation poisoning (in Atlanta) to
429,172 cases (in New York), they conclude, adding that 90% would die.

A large blast would destroy or make unsafe 50% to 56% of all hospital beds within 20 miles, the researchers say. Atlanta, with more suburban
hospitals, fares slightly better than other cities in the event of the smaller blast. But overall, "the nationwide trend of locating a majority of the
major urban health care institutions in downtown areas would result in a staggering loss of the total institutional health care delivery following
nuclear weapon use," they conclude.

Finally, the study authors call for more training and resources for hospitals in the age of terrorism. The state of Georgia, for example, recently
purchased 11,000 temporary hospital beds in case of a massive emergency. "Obviously, the most important resources in medical response
are the trained health care personnel and it is in this area that the most dramatic impact of a nuclear detonation is seen on overall health care

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response," they add. "Losing at least half of your health care responders in the first minute of the attack is all the more damaging because so
many of the thermal and trauma injuries require immediate care and cannot wait for the time-consuming importation of replacement medical
workers."

"There are a variety of scenarios in which a nuclear warhead or improvised nuclear device could be smuggled into the United States and
detonated," says Charles Thornton of the University of Maryland's Center for International and Security Studies, who was not part of the study.
"This is a real-life threat, and one for which our consequence management system is not prepared to handle. Moscow and European metro
areas are even less prepared."

The best defense against nuclear terrorism isn't more hospital beds for after an attack, Thornton suggests, but trying to shut down avenues for
a smuggled weapon to arrive in the United States. "Having a layered policy – from non-proliferation to counterproliferation to export and import
controls to law enforcement and all the way through post attack response – is an ideal for which we should strive. But, in a world of finite
resources I believe that the scarce money, time, resources, political capital, and diplomatic clout should be directed primarily towards
preventive action at the sources of the threat."

Each week, USA TODAY's Dan Vergano combs scholarly journals to present the Science Snapshot, a brief summary of some of the latest
findings in scientific research. For past articles, visit this index page.

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