Reading Assignment Chapter 4.3: Response and Resilience, pp. 506-517, 518-533 Chapter 4.4: Unique Challenges of Responding to Bioterrorism Threats and Attacks, pp. 536-556

Unit Lesson Ever since the advent of the atomic bomb in the 1940s, there has been a growing concern over a possible nuclear attack here in the United States. The Cold War brought to light how tense issues could become in an instant, should an atomic blast occur. During the past several years, there has been progress in deterring the use and construction of nuclear weapons and the ability to disarm nuclear weapons with the superpower nations. As we have shown in previous lessons, there are some developing nations that feel much differently, support terrorist activities, and would use an atomic bomb or nuclear device in order to gain personal wealth within their own governments. The 2003 invasion of Iraq exposed the difficulty in accurately determining a nation’s progress towards manufacturing a nuclear weapon, and terrorist groups are even more difficult to adequately assess. How is the United States preparing for a possible nuclear attack? What would be some of the repercussions in the aftermath of such an event? There are no real steadfast answers regarding defense, preparedness, healthcare management, or the ability to sustain business continuity after such an event. A probable attack from terrorists would likely come in the form of one detonation, taking a designated city by surprise. The current thinking is that a nuclear fission weapon of about 10 kilotons, about the size of the ones used in WWII, in a major U.S. city would be likely. Although the terrorist group that detonated the weapon may only have one, they would invoke fear in the rest of the nation by stating there were more bombs set to be detonated in other locations. It is quite plausible that if a terrorist group could obtain one weapon, they could obtain other loose nukes, so the possibility of a subsequent bomb cannot be ignored (Howard & Forest, 2013).

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Response and Resilience and Developing Immunity

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It is likely that the detonation would be a ground burst in a city’s downtown area, and many buildings and city blocks in approximately a mile radius from the detonation would be leveled and devastated. In the region just outside that area there would be major damage, including fires and intense radiation, resulting in many additional casualties. Outside this radius, the major direction of the devastation would occur primarily along the axis of the wind-driven plume of radioactive material. Within a day, people within about 10 square miles of the blast and plume who did not find shelter would likely have received a lethal dose of radiation (Howard & Forest, 2013).

Emergency responders and federal emergency response teams might not be in place for at least another day, and communications coming from the downtown city disaster area would be interrupted, thus creating panic and riots, and the population beginning to question the authority of the U.S. government. The media would likely have the first and loudest voice as most media channels outside of the main blast area would not be influenced and would spread unsubstantiated stories and misrepresentations in the name of news. Hospitals located outside the immediate area would be filled with persons making their way to a safe location and seeking medical attention. The communication systems for disaster response and recovery would be overloaded due to the gravity of the situation, and contamination from patients presenting themselves to the hospital locations would become a greater issue as the days continued. In this scenario, it is wishful thinking that state

and local officials would be able to manage this disaster themselves. A national plan, which assumes a federal lead role, is required in all areas of response. All actions from federal agencies must be coordinated, including the necessary use of the Department of Defense. Resilience and contingency planning are some of the areas currently lacking in the United States. The government’s response plan should include an agreed- upon incident command structure and provide provisions to restore communications within the command structure as well as with Washington D.C. decision makers, the media, and the public. Preexisting plans for searching for multiple devices or anticipating the next device sent from another location need to be activated. At this tipping point, it is absolutely mandatory that all means be utilized to inform the public and provide timely updates in order to maintain trust, keep order, reduce panic, and communicate time- critical, potentially life-saving, emergency evacuation and sheltering actions (Howard & Forest, 2013). Retaliation is the norm during such events, but caution is urged in an effort to maintain peace by not spreading global panic, which could cause more attacks internationally. It is likely that the U.S. would insist on reserving the right to retaliate as necessary but would likely weigh the options of creating more havoc on the global horizon. One area that must continue during a nuclear attack is the U.S. government and its successors. Such plans were put in place during the Cold War and were updated in the early 1990s to reflect the growing risk of terrorist attacks on Washington D.C. These plans were modified again following 9/11. The contingency plans for successional leadership, should the president of the United States be killed in an attack, are imperative to the survival of the nation. Maintaining peace and should not be in doubt following a terrorist nuclear attack. It might be remembered that the vague location and physical security status of President George W. Bush during the 9/11 terrorist attack caused much anxiety among the population and led to speculation by some that the nation was under an all-out attack. The physical presence of White House officials, the Speaker of the House, and the next in line for leading the nation is already stipulated in the U.S. Constitution. However, few policies and procedures actually indicate the means of succession should an event occur. A consulting body representing the three branches of government should be put in place to advise the president, or whoever will be leading during this time of crisis, to ensure the rights given under the U.S. Constitution are not violated. Additionally, efforts should be initiated in obvious fact as well as appearance that extraordinary measures

Team of emergency responders simulating a scenario response (National Institute for Occupational Safety and Health, 2010)

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were being taken to find any additional nuclear devices and prevent follow-on detonations (Howard & Forest, 2013). Although planning and preparedness will not change the entire dimension of a catastrophe, thousands of lives and perhaps millions or even billions of dollars could be saved by the proper implementation of planning, preparation, and practicing for such an event. The national level nuclear detonation emergency response plan should include periodic education of the public, not unlike the Cold War Civil Defense model, on portions of the plan where public understanding and knowledge is essential if the public is to follow the government leader’s emergency action directions willingly. This would include a basic understanding of evacuation and sheltering in case of a nuclear detonation event, decontamination practices, and the characteristics of a nuclear detonation (Howard & Forest, 2013). Understanding how citizens may react to a nuclear attack, or any emergency, calls for coordination among the emergency response personnel in the field. A multi-agency approach to the event should be designated immediately after determining the nature of the event and amounts of injuries. One line of thinking is that community representatives and emergency responders are typically responding to an event that is lacking communication, organization, and creating panic in the community being impacted. Most citizens and emergency responders will respond in an organized manner in an effort to assist others who are injured. There are many myths regarding the effectiveness of response. These may include antisocial behavior, projection of multiple injuries and not wishing to respond, or the lack of dissemination of information causing panic. In most cases, this is not factual. Following a disaster, there are often reports of those in the impacted area experiencing feelings of shock, disorientation, and having an overall insensitivity to the event. Panic is another popular myth related to catastrophic events. Panic is defined as an acute loss of self-control followed by nonsocial behavior, which occurs after the person reaches safety. The response to the emergency is often considered to be an active response to the event and the desire to seek a safer environment. If panic flight does arise in a crowd, it usually appears only in a small number of people who are impacted by the incident (Howard & Forest, 2013). Some experience the shock, trauma, and psychological impacts of such events immediately, while others might not have signs and symptoms of trauma until much later. It may be a month or even a year, but the implications would eventually arise. In essence, authorities who are responding to and managing an incident should expect community members to feel frightened. For the most part, people who are within those confines of the disaster are looking for authority and direction towards a safer environment. It is important to plan ahead for crowd control and mass fear from citizens. If a biological attack or disaster were to occur, the United States is prepared to handle these events and is capable of vaccinating millions of people effectively. An example includes the use of a biological agent, such as smallpox. If this type of terrorist event would take place, the Supreme Court would likely uphold a religious or otherwise non-health-related exemption to vaccinations at the local point of distribution (POD). Religious exemptions are a consideration during this time, not a necessity, due to the imminent danger to life and public health in general. Although this may infringe upon certain liberties and rights, the goal is to maintain safety in the community. Public well-being is imperative to continuing normalcy in those communities impacted immediately by the event. The federal government stands a better chance in dealing with the religious issues, liberties, and freedoms after the safety and health-related issues within the communities have been addressed. The federal government should take the lead in dealing with the severity of the situation, coordinate with lead agencies that are responding, and be able to communicate any updates to the public regarding safe locations, points of distribution centers, shelters, and any other pro-visionary items necessary for the incident. Finally, the government must be willing to take action against those citizens who are noncompliant and unwilling to follow orders intended for the well-being of the community. The government may have to designate times, locations, and other areas of reference for vaccinations. The communities will have to abide by the communications given from local authorities. Regardless of the consequences, there is a need for order, structures for vaccinations, obedience of any federal mandates that may be issued, and willingness to work alongside many other agencies. This will help to maintain crowd control and the safety of those emergency personnel arriving on the scene.

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Any form of advanced preparation will save the government, communities, and emergency planning agencies time and money if the event should occur. The lack of preparation, planning, development, and communication can lead to catastrophic failure during a nuclear or biological attack or a disaster. Those who are impacted by disasters at times feel compelled to become martyrs and not follow the rules during crisis situations, but it does not grant them the freedom to work outside the parameters established by the federal government for the protection of those involved in the incident. The mandatory vaccinations are established to protect not only the individuals themselves, but their neighbors and the entire community. Compliance and preparation are the keys to successful implementation.

References Howard, R. D., & Forest, J. (2013). Weapons of mass destruction and terrorism (2nd ed.). New York, NY:

McGraw-Hill. National Institute for Occupational Safety and Health. (2010). Emergency responders (8743399305).jpg

[Photograph]. Retrieved from https://commons.wikimedia.org/wiki/File:Emergency_Responders_(8743399305).jpg

Suggested Reading In order to access the following resource, click the link below. The following article discusses the efforts of the U.S. Department of Defense (DoD) to incorporate with the Homeland Response Force (HRF) for the establishment of capabilities and readiness measures for chemical, biological, radiological, and nuclear (CBRN) response. You are encouraged to review it. Kirschbaum, J. W. (2016). Defense civil support DOD has made progress incorporating the Homeland

Response Force into the chemical, biological, radiological, and nuclear response enterprise. GAO Reports, 1-44. Retrieved from https://libraryresources.columbiasouthern.edu/login?auth=CAS&url=https://libraryresources.columbia southern.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=tsh&AN=116503342 &site=ehost-live&scope=site

Learning Activities (Nongraded) Nongraded Learning Activities are provided to aid students in their course of study. You do not have to submit them. If you have questions, contact your instructor for further guidance and information. You are assigned as a news team reporter to cover a CBRN incident in a nearby city. You will be interviewing the Federal Emergency Management Agency (FEMA) or Emergency Operations Center (EOC) director to present a special report to the local population and surrounding area. Prepare a one- or two-page news feed to cover key questions to ask the director on steps being taken to handle this incident and inform the population on actions by the government to provide emergency services such as food, shelter, and healthcare.