Is it true that a nuclear attack on one American city would completely overwhelm the nation’s healthcare system? Would it even be feasible to transport large numbers of injured and radiation sickness victims for treatment? Would they just be allowed to die to conserve resources?
Well, it would certainly overwhelm all health care in the region. It wouldn’t do so nationwide simply because there is no way we could mobilize enough transportation to move that many casualties all over the country. Look how much trouble we had moving non-injured people out of a non-destroyed New Orleans.
Although I should add that resources for the hospitals all over the country would be in short supply because they would be diverted to care for casualties of the attack.
Bear in mind this is for a single attack. Multiple attacks would exponentially exaggerate the problems.
Something you are not considering as well, many counties have disaster plans that do things like turn places like walk in clinics and small urgent care clinics into care for walking wounded and activate things like national guard and millitary base medical facilities for recieving civillian casualties.
The biggest difficulty is stabilization and transport for seriously injured folks. If seriously injured people can not be transported to a hospital capable of helping them they will often not last more than a few hours.
Depending on the size and scope of things, those that cannot get to treatment in time are no longer a problem. In my home county for example there are around 60 ambulances on duty at any given time. Calling for extra help from neighboring counties and calling in off duty personell could bump that to around 100, unfortunately it would take several hours to get people into town, breifed on the situation, given appropriate radio instructions for base hospital contact, etc, etc.
So its not a matter of letting them die to conserve resources, its letting them die because the resources that exist are insufficent to handle the number of patients involved. An airliner going down can easily generate enough casualties in minutes to exceed the patient load seen in a full day of even a large citys emergency services.
I am not a doctor, but in the aforementioned scenario, a large city being devastated by a nuke, the city healthcare system would be overwhelmed. You must remember, doctors, hospitals etc will be among the casualties.
Surely, because of fallout/residual radiation, by no other choice, the military would seal off the city, and not allow other medical personnel to come in. Depending on wind patterns, the “forbidden” zone could extend maybe 50/100 miles outside of the city itself, if not more. Believe me, they would not let people in to treat the injured.
So, that leaves us with the survivors on their own. Very few people will likely even make it to a functioning hospital/clinic., and those that do will likely be turned away, what with thousands of sick (radiation) people out in the street waiting. Not to mention the anarchy thing, guns and crazy shit going on.
The docs and nurses and techs left alive (who didn’t haul ass to be with their loved ones, can’t blame them) will be busy treating trauma/burns, much less radiation sickness, which would quickly be triaged. If you are obviously dying, too bad. Many people would die of rad doses alone in the days/weeks following the attack.
So in short, it would not overwhelm the national healthcare system because the city will be sealed off and live or die on it’s own.
Sounds cruel, but you would NOT be allowed to just drive into a nuked city to render aid, nor would they just ship people off to other places.
It would depend on several things, such as what is meant “one nuclear attack” (one missile? one warhead?), whether air burst or ground burst, warhead size (20 kilotons? 20 megatons?), and target (Boise Idaho? New York City?). Also depends on what is meant by healthcare system being “overwhelmed” – ceases functioning on a national level, or everyone must wait longer for Dr. appointment, or somewhere in between?
Either way it would be bad, but we must place the healthcare burden in the context of other past disasters. The influenza epidemic of 1918 killed about 700,000 just in the U.S., and about 20 million world wide. In the U.S. about 40,000 die each year from auto accidents, very roughly 500,000 per year from cancer and 500,000 per year from heart disease. Our healthcare system copes with that.
A 20 kiloton airburst H bomb wouldn’t contaminate the countryside – most of the destruction would be from blast and heat, not radiation. Rescue workers could move in very quickly. It would be bad, but possibly about equal to a year’s worth of auto fatalities and injuries, just all at once.
Historically, we have other similar wartime scenarios to examine: the WWII firebombing of Tokyo killed about 100,000 and destroyed most of the city, yet the Japanese healthcare system, economy and war effort continued.
OTOH a 24 megaton warhead (carried by the Russian SS-18 missile) detonated in a surface burst would be very “dirty” radioactively and the crater itself would be maybe 1 mile in diameter. The radius of total destruction would be about 4 miles. IOW there would be no city and few survivors needing care. There would be a large radioactive fallout “footprint” downwind. Would that totally collapse the entire national healthcare system? It would obviously be a catastrophe of historic proportions, and cause vast social and economic upheaval. However in general I think the healthcare system would survive (in some form), even in that case.
Obviously there is a tipping point whereby everything would disintegrate into anarchy, but it’s probably somewhere above a single city attack, bad as that would be. Previous historical examples seem to indicate that.
However the missiles from a single nuclear submarine could almost certainly destroy a country (and healthcare system), no matter what preparatory civil defense or contingency measures. E.g, a U.S. Trident submarine has 24 Trident DII Mk 5 missiles, each with eight 475 kiloton warheads, for a total of 192 independently targetable warheads per submarine.
Depending upon the type of warhead used, and the altitude at which it was detonated, electromagnetic pulse (EMP) would wreak havoc with electronics and computer systems. High-tech medical devices, databases and communications would all be badly affected.
I suspect that if, God forbid, an American city is subjected to a nuclear attack in the foreseeable future, it’s going to be through the detonation of a smuggled-in bomb at or near ground level, not by a missile.
I don’t see why rescue workers wouldn’t be allowed in. First off, there’s no such thing as “residual radiation”. Any radiation from the blast itself is going to be deep into interplanetary space before rescue workers can get to the scene. There is fallout, but that’s ordinary material (dust, etc.) that’s rendered airborne and possibly made slightly radioactive. It’s only a serious health problem if it’s ingested, and a simple dust mask will take care of that problem (you probably wouldn’t even need a full gas mask). And even if the rescuers were not adequately prepared, they’re not risking anyone other than themselves. Radiation sickness isn’t a contagious disease like plague or smallpox; even if the rescuers do succumb to the fallout and go back to their home cities, their neighbors will still be just fine.
You underestimate the effect of fallout. Fission product activity alone is around 3E10 curies/KT. For the BRAVO test at Bikini Atoll, it was calculated that anyone in a 35 x 170 mile area downwind would have received a fatal dose within 96 hours.
There might be more burn units today then back then, however reports like these are still easy to find:
The degree to which fallout is a problem varies widely based on bomb type and detonation altitude. The normal strategy for “soft” targets like cities is using an “air burst”, where the bomb detonates several thousand feet up. That maximizes damage per unit bomb energy. In this case blast and heat (not radiation) is the main damage mechanism. A terrorist device might not be air-deliverable, but rather a surface detonation.
A surface burst has much more fallout. See the below page for radiation intensity fallout charts for a 200 kt and 1 MT surface burst given 15 mph winds. You could be 15 miles downwind of a 200 kt surface burst and you’d absorb a lethal radiation dose from fallout within about 1 hr. How long you’d have to avoid that area depends on the half lives of the induced radiation, which varies based on bomb type.