This Is What You Should Do During a Nuclear Alert
There were two basic reactions people in Hawaii had after receiving the Jan. 13 text message advising the public that a ballistic missile was headed their way. On the one hand, TV coverage suggested that "panic" may have been rampant with video images of people running, driving and diving for shelter in what seemed to be manholes and basements. And who could blame those people who feared the worst and had little prior information about where to go or what to do? Especially with the state's proximity to North Korea, which says its ballistic missiles can carry nuclear warheads. On the other hand, while it didn't make for good TV, many people  including a friend of mine vacationing in Maui  got the warning message, but brushed it off as "probably a mistake," as indeed it was. I also spoke to the chief admitting clerk in one of Hawaii's busiest hospitals. She was on duty when the alert appeared on her cell phone, but she stayed at work. She says she didn't feel panicked or seek shelter, explaining to me, "Well, I just thought there wasn't anything that could be done, so why worry about it?", Those two reactions  panic-driven chaos and fatalistic complacency  show the utter failure to educate the public about what to do in the event that a nuclear detonation has occurred or is imminent. Maybe now, while the 38-minute scare in Hawaii still has our attention, we have a teachable moment, an opportunity to provide usable information in what I would call the second era of global nuclear threat the first being the Cold War. Now, in this second era of threat we have rogue nuclear states like North Korea and regional nuclear stand-offs, such as the persistent tension between India and Pakistan, both of which possess at least 100 nuclear warheads ready to launch should the situation boil out of control. India just, for the first time, successfully test-fired its first nuclear-capable intercontinental ballistic missile., It is also not impossible for a terrorist organization to steal, buy or build a nuclear device that could be detonated in a major city. So, what do we as individuals need to do?, First, there are some basic facts the public should know about the nuclear threat. In the event of a nuclear detonation, there is an enormously bright flash that could temporarily blind a person staring at the flash followed by an extremely loud explosion and hurricane-force winds. A device the size of the atomic bomb we dropped on Hiroshima would obliterate all structures and almost everyone within a half mile of the point of detonation. But being at a distance from ground zero and inside a protective structure greatly improves chances of surviving the blast, fires and acute radiation exposure. Outside is the worst scenario, followed by being in a car, then a wooden structure  and the best is a building made of solid concrete or brick, without windows., After the initial blast  and the winds have stopped  the next big concern is radioactive fallout. In general you have about 15 to 20 minutes to locate and enter a good shelter before radioactive particles begin hitting the ground from the mushroom cloud of debris. That means being in a basement or preferably the core of a building made of bricks or concrete, away from windows and at least 15 feet from the roof. If you've been outside and exposed to radioactive particles, it would be advisable to brush out your hair, remove and get rid of your outer layer of clothing and, if possible, shower. Then  and this is key  in order to avoid significant radioactive fallout exposure, you must stay in that shelter for at least 12 to 24 hours, or until officials say it is safe to leave and in which direction you should travel. If everyone followed this guidance, hundreds of thousands of lives might be saved in a major urban environment that experienced a nuclear blast. The important mantra here is "Get inside, stay inside, stay tuned!", But what about cities? What should they do to get prepared for such a terrible catastrophe? How do they maximize survival? There are four key strategies. First, go public with the message outlined above. Let people know that following basic guidelines will save lives. Trying to deliver that message when a detonation is imminent or has already occurred is too late. Also, remind people that our society can and would survive a single bomb from a rogue nation or a terrorist organization, even though that would certainly be an overwhelming, unprecedented tragedy. The fact is that we are not facing an apocalyptic obliteration of "life as we know it," as was the case during the Cold War stand-off between mighty nuclear powers. Second, make sure there is a sound and well-planned way to provide medical care to survivors. Anticipate destruction or the disabling of large portions of the pre-attack health care system. Work with state and federal resources to have a feasible plan in place to provide essential medical services outside the immediate impact area. Third, think hard about evacuation. Even though public health officials and virtually all citizens would like to get as far as possible for radiation-contaminated rubble in the aftermath of a nuclear attack from any source, the reality of actually evacuating would be a monumental challenge. Think of rush hour on a Friday night of a holiday weekend then multiply the situation by 500. Think of the accidents and the medical crises along the way. Consider where and how people would get fuel, food and water. And consider how to make sure that destination sites receiving and caring for sick, terrified and traumatized evacuees are ready for potentially years of absorbing thousands of new residents into their communities. Fourth, plan now for recovery  a concept even more challenging than evacuation. Radioactive contamination, building and infrastructure destruction and massive disruption of human services, schools, employment and the economy in general may make recovery a decades-long process in the best-case scenario. There is no doubt that a nuclear detonation would be an unspeakable and complex tragedy. That fact should not be sugarcoated to the public or officials. Sadly, there are just too many nuclear weapons on the planet to ever rule out the possibility of one or more being used by nations at war or a terror group bent on destruction. Hawaii reminded us that we live in a dangerous world made more dangerous by our being unprepared for it. We need to plan for the worst, even as we hope for the best. Let's hope that the false alarm in Hawaii is a wake-up call and that when the drama of the moment passes that we don't act as if it was nothing more than a snooze alarm where we "hit the button" and drift back into complacency.