Thinking the Unthinkable

Abstract

There have been many initiatives to advance the state of national disaster preparedness since the attacks of September 11, 2001. Expenditures in preparedness exceed tens of billions of dollars, and a new cabinet-level agency, the Department of Homeland Security, emerged in one of the most sweeping examples of governmental restructuring ever. The Federal Emergency Management Agency was placed under the Department of Homeland Security, and part of its mission refocused on technologic disasters, including terrorist attacks. To support the pressing need for national preparedness, other federal agencies created new offices, directorates, or commands or reinvigorated old ones. One of these, the Office of the Assistant Secretary for Preparedness and Response, replaced the former Office of Public Health Emergency Preparedness. Besides acting as the Secretary of Health and Human Service's principal advisor on matters related to bioterrorism and other public health emergencies, the Office of the Assistant Secretary for Preparedness and Response also “coordinates interagency activities between HHS, other Federal departments, agencies, and offices, and State and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies.” 1 Office of the Assistant Secretary for Preparedness and ResponseUS Department of Health and Human Services http://www.hhs.gov/aspr/ Google Scholar Medical Response to a Radiologic/Nuclear Event: Integrated Plan From the Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human ServicesAnnals of Emergency MedicineVol. 53Issue 2PreviewThe end of the Cold War led to a reduced concern for a major nuclear event. However, the current threats from terrorism make a radiologic (dispersal or use of radioactive material) or nuclear (improvised nuclear device) event a possibility. The specter and enormousness of the catastrophe resulting from a state-sponsored nuclear attack and a sense of nihilism about the effectiveness of a response were such that there had been limited civilian medical response planning. Although the consequences of a radiologic dispersal device are substantial, and the detonation of a modest-sized (10 kiloton) improvised nuclear device is catastrophic, it is both possible and imperative that a medical response be planned. Full-Text PDF