Preparing to Save Lives and Recover
After a Nuclear Catastrophe: Implications for US Policy

Overview

"Two decades after the end of the Cold War, we face a cruel irony of history - the risk of a nuclear confrontation between nations has gone down, but the risk of nuclear attack has gone up."

President Barack Obama, Remarks at the Nuclear Security Summit, April 13, 2010

On April 29, 2010, the Center for Biosecurity of UPMC convened an invitational conference in Washington, DC, to examine critical issues associated with response to and recovery from a nuclear detonation and to consider the policy implications of those issues. The meeting was attended by more than 150 participants, who included federal, state, and local government officials, congressional staff, policy analysts, academics, members of the media, and experienced practitioners from the public health, medical, and emergency management communities. The conference was sponsored by the Alfred P. Sloan Foundation.

Among the day's presenters were Joan Rohlfing, President, NTI; Brooke Buddemeier, Global Security Directorate, Lawrence Livermore National Laboratory (LLNL); John Fortier, Executive Director, AEI/Brookings Continuity of Government Commission; and White House officials David Marcozzi and Tammy Taylor, both of whom spoke off-the-record. The meeting also featured 3 distinguished panels that explored some of the most difficult challenges that would face policymakers in the event of a nuclear detonation. Panelists discussed proposals for strengthening preparedness efforts. See the Conference Agenda for a complete list of speakers, panels, and presentations.

Suggested background reading:

• Mowatt-Larssen R. Nightmares of nuclear terrorism. Bulletin of the Atomic Scientists. 2010;66(2):37-45.
• Coleman CN, Hrdina C, Bader JL, Norwood A, Hayhurst R, Forsha J, Yeskey K, Knebel A. 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 Services. Annals of Emergency Medicine. February 2009;53(2):213-22.
• Courtney B, Toner E, Waldhorn R. Preparing the healthcare system for catastrophic emergencies. Biosecur Bioterror. 2009 Mar;7(1):33-4.
• Franco C, Toner E, Waldhorn R, Inglesby TV, O'Toole T. The national disaster medical system: Past, present, and suggestions for the future (Article Brief). Biosecur Bioterror. 2007;5(4):319-325.
• Florig HK, Fischhoff B. Individuals' decisions affecting radiation exposure after a nuclear explosion. Health Phys. 92(5):475-483, 2007.
• Becker SM. Emergency communication and information issues in terrorist events involving radioactive materials. Biosecur Bioterror. 2004;2(3):195-207.
• Sorensen J. Risk communication and terrorism. Biosecur Bioterror. 2004;2(3):229-31. Accessed April 15, 2010.
• Weinstock DM, Case C, Bader JL, Chao NJ, et al. Radiologic and nuclear events: Contingency planning for hematologists/oncologists. Blood. 2008;111(12).
• Hrdina CM, Coleman CN, Bogucki S, Bader JL, Hayhurst RE, Forsha JD, Marcozzi D, Yeskey K, Knebel AR. The "RTR" medical response system for nuclear and radiological mass-casualty incidents: A functional TRiage-TReatment-TRansport medical response model. Prehospital Disast Med. 2009;24(3):167-178.
• Graham R, Talent J, Larsen R. We all have a role: Working with your community to prepare for natural and man-made disasters. Washington, DC: Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism; 2010.

Agenda

Watch Videos

Welcoming and Opening Remarks
Tom Inglesby, Director and CEO, Center for Biosecurity of UPMC

Nuclear Dangers—"A Strange Turn of History"
Joan Rohlfing, President, Nuclear Threat Initiative

National Response to a Nuclear Detonation
David Marcozzi, Director, All-Hazards Medical Preparedness Policy, National Security Council Staff, The White House
Mr. Marcozzi's talk was off the record.

State and Local Roles in Response to a Nuclear Detonation
Tammy Taylor, Senior Policy Analyst, National Security and International Affairs Division, OSTP Policy, Executive Office of the President, The White House
Ms. Taylor's talk was off the record.

Brooke Buddemeier, Global Security Directorate, Lawrence Livermore National Laboratory
Video: Effects of a Nuclear Detonation in a Major City • Handout

Panel Discussion—What Are the Most Important Policies and Programs to Reduce Casualties from Nuclear Fallout?

• Ann Norwood, Senior Associate, Center for Biosecurity of UPMC, Moderator
• Baruch Fischhoff, Howard Heinz University Professor, Department of Social and Decision Sciences and Department of Engineering and Public Policy, Carnegie Mellon University
• Tammy Taylor, Senior Policy Analyst, National Security and International Affairs Division, OSTP, Executive Office of the President, The White House
• Kathleen Kaufman, Director, Radiation Management Program, Los Angeles County Department of Public Health

Reconstitution of the Federal Government After an Attack: Gaps and Ways Forward
John Fortier, Executive Director, American Enterprise Institute-Brookings Continuity of Government Commission

Panel Discussion—Saving Lives After a Nuclear Detonation: Making the Best Use of Medical Resources

• Richard Waldhorn, Distinguished Scholar, Center for Biosecurity of UPMC, Moderator
• C. Norman Coleman, Office of the Assistant Secretary for Preparedness and Response, HHS
• David Weinstock, Department of Oncology, Dana-Farber Cancer Institute; Medical Advisor, Radiation Injury Treatment Network
• Irwin Redlener, Director, National Center for Disaster Preparedness, Columbia University
• Ann Knebel, Deputy Director, Preparedness Planning, Office of the Assistant Secretary for Preparedness and Response, HHS

Roundtable Discussion: What Is the Response and Role of the Press Following a Nuclear Terrorist Event?
Note: At the request of the panel, this discussion was off the record.

• Randall Larsen, Former Executive Director, Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism, Moderator
• Mimi Hall, Journalist, USA TODAY
• Jeanne Meserve, Correspondent, CNN

Panel Discussion—What Policies Could Enable Communities to Recover After a Nuclear Detonation?

• Monica Schoch-Spana, Senior Associate, Center for Biosecurity of UPMC, Moderator
• Ann-Margaret Esnard, Professor and Director, VPT Lab, Florida Atlantic University School of Urban and Regional Planning
• Louisa Vinton, Senior Programme Manager and Chernobyl Coordinator, Western CIS and Caucasus Countries, United Nations Development Programme
• Gavin Smith, Executive Director, Center for the Study of Natural Hazards and Disasters, UNC Chapel Hill; DHS Center of Excellence for the Study of Natural Disasters, Coastal Infrastructure and Emergency Management
• Brian Flynn, Former Assistant Surgeon General, Associate Director, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences

The Dead Hand—The Untold Story of the Cold War Arms Race and Its Dangerous Legacy
David Hoffman, 2010 Pulitzer Prize-winning author

Concluding Remarks
Thomas V. Inglesby, Director and CEO, Center for Biosecurity of UPMC

Speakers
 

Brooke Buddemeier, CHP

Global Security Directorate, Lawrence Livermore National Laboratory
 

C. Norman Coleman, MD

Office of the Assistant Secretary for Preparedness and Response, HHS
 

Ann-Margaret Esnard, PhD

Professor and Director, VPT Lab, Florida Atlantic University School of Urban and Regional Planning
 

Baruch Fischhoff, PhD

Howard Heinz University Professor, Department of Social and Decision Sciences and Department of Engineering and Public Policy, Carnegie Mellon University
 

Brian W. Flynn, EdD

Former Assistant Surgeon General, Associate Director, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences
 

John C. Fortier, PhD

Executive Director, American Enterprise Institute-Brookings Continuity of Government Commission
 

Mimi Hall

Journalist, USA TODAY
 

David Hoffman

2010 Pulitzer Prize-winning author of The Dead Hand: The Untold Story of the Cold War Arms Race and Its Dangerous Legacy
 

Thomas V. Inglesby, MD

Director and CEO, Center for Biosecurity of UPMC
 

Kathleen Kaufman

Director, Radiation Management Program, Los Angeles County Department of Public Health
 

Rear Admiral Ann R. Knebel

Deputy Director, Preparedness Planning, Office of the Assistant Secretary for Preparedness and Response, HHS
 

Col. Randall Larsen, USAF (Ret.)

Executive Director, Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism
 

David Marcozzi, MD

Director, All-Hazards Medical Preparedness Policy, National Security Council Staff, The White House
 

Jeanne Meserve

Correspondent, CNN
 

Ann Norwood, MD, COL, USA, MC (Ret.)

Senior Associate, Center for Biosecurity of UPMC
 

Irwin Redlener, MD

Director, National Center for Disaster Preparedness, Columbia University
 

Joan Rohlfing

President, Nuclear Threat Initiative
 

Monica Schoch-Spana, PhD

Senior Associate, Center for Biosecurity of UPMC
 

Gavin Smith, PhD

Executive Director, Center for the Study of Natural Hazards and Disasters, University of North Carolina at Chapel Hill, and Department of Homeland Security's Center of Excellence for the Study of Natural Disasters, Coastal Infrastructure and Emergency Management
 

Tammy Taylor, PhD

Senior Policy Analyst, National Security and International Affairs Division, Office of Science and Technology Policy, Executive Office of the President, The White House
 

Louisa Vinton, MA

Senior Programme Manager and Chernobyl Coordinator, Western CIS and Caucasus Countries, United Nations Development Programme
 

Richard Waldhorn, MD

Distinguished Scholar, Center for Biosecurity of UPMC
 

David Weinstock, MD

Department of Oncology, Dana-Farber Cancer Institute; Medical Advisor, Radiation Injury Treatment Network
 

Attendees