EM Forum Presentation — November 30, 2011

The Rad Resilient City Initiative
A Preparedness Checklist to Save Lives After a Nuclear Detonation

Monica Schoch-Spana, Ph.D.
Senior Associate, Center for Biosecurity
Assistant Professor, School of Medicine, Division of Infectious Diseases
University of Pittsburgh Medical Center (UPMC)

Amy Sebring
EIIP Moderator

This transcript contains references to slides which can be downloaded from http://www.emforum.org/vforum/UPMC/RadCity.pdf
A video recording of the live session is available at http://www.emforum.org/pub/eiip/lm111130.wmv
An audio podcast is available at http://www.emforum.org/pub/eiip/lm111130.mp3

[Welcome / Introduction]

Amy Sebring: Good morning/afternoon everyone and welcome once again to EMForum.org. I am Amy Sebring and will serve as your Moderator today. We are very glad you could join us.

Today we are going to learn about the Rad Resilient City initiative and the planning aid published by the University of Pittsburgh Medical Center’s Center for Biosecurity earlier this year, the Rad Resilient City Preparedness Checklist. Please see today’s Background Page for links to the document, and other related links.

[Slide 1]

Now it is my pleasure to introduce today’s guest: We are very happy to welcome back Dr. Monica Schoch-Spana, Director of the Rad Resilient City initiative and Senior Associate with UPMC’s Center for Biosecurity. She also serves as Assistant Professor in the School of Medicine Division of Infectious Diseases and on the faculty and steering committee for the National Consortium for the Study of Terrorism and Responses to Terrorism (START). Please see today’s Background Page for additional biographical information.

Welcome back Monica, and thank you very much for joining us today. I now turn the floor over to you to start us off please.


Monica Schoch-Spana: Thank you so much, Amy. It is a real pleasure to be back at EMForum. I appreciate this opportunity to brief you on a new initiative that the Center for Biosecurity has recently rolled out and is briefing throughout the country right now. The inspiration for the Rad Resilient City initiative is the fact that if prevention of nuclear terrorism fails then reducing exposure to radioactive fallout is the intervention that can save the greatest number of lives following a nuclear detonation.

For those of you who are familiar with the Center for Biosecurity, you’ll know that we focus on medical and public health preparedness for catastrophic health events. It was very illuminating for us to learn that minimizing exposure to radioactive fallout can save the most lives. This was a proposition we could not ignore and hence built the initiative around that finding.

[Slide 2]

The purpose of the Rad Resilient City initiative is to provide leaders from high terrorism risk localities with a checklist of preparedness actions to save tens of thousands of lives or more following a nuclear detonation. This is through adequate protection against radioactive fallout.

When we talk about providing a planning tool for leaders we mean all those people who hold sway and authority in a community. Elected and appointed officials certainly and chiefs of public health and safety agencies—but we are also talking about business executives, heads of volunteer and community based organizations and other grass roots opinion leaders.

This tool was meant to provide a common vision of community preparedness for an unthinkable event such as a nuclear terrorist attack and a way forward in terms of life saving objectives.

[Slide 3]

Here is just a quick overview of what I’m going to cover today. I want to talk with you about why we saw the checklist as needed today, the type of knowledge that is the background for the checklist on which it is grounded, the myths that the checklist dispels, the actions that the checklist recommends, some tools that help make the checklist doable for jurisdiction throughout the country, and where we see the value added for communities around the country.

[Slide 4]

Let’s start with the question of why the checklist is needed. There is of course the issue of nuclear terrorism, which is a real and urgent threat. This is an assessment by both the U.S. and other governments but also independent non-government experts such as the Nuclear Threat Initiative.

I’ve put up quotes from the last two years from key national leaders including the President, the Secretary of Defense and the Director of National Intelligence. President Obama declared at the Nuclear Security Summit, "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."

The fact that nuclear terrorism is a possibility in today’s modern political and technical context cannot be ignored.

[Slide 5]

The reason for that is that the raw materials exist in the world. Right now there is enough fissile material in the world to make more than 120,000 crude nuclear devices. At the same time that fissile material exists in the world, and should terrorist groups get their hands on it, there is information publicly available to help them make a nuclear weapon.

The technology is readily available. We know the Al-Qaeda and other terrorist groups have stated that they seek and have attempted to acquire nuclear weapons. It is the materials, the technology and the motivation that is compelling national leaders that we just quoted to worry about the possibility of a nuclear detonation.

[Slide 6]

Alongside the threat, we have the fact that most Americans don’t know how to protect themselves and their families in the event of a nuclear detonation. Currently I would say that most local emergency management structures are not necessarily well equipped to instill knowledge about minimizing fallout exposure either before the event in public education, or after the event in terms of post-incident public warning messages.

I’d love to us to talk more about what is going on in your respective jurisdictions. We have a threat but we have a population that does not know what action is going to help reduce casualties in the presence of that threat. There has been wonderful guidance emerging that has been supported by the federal government—emerging from the national laboratories.

We have great guidance coming out of radiological professional groups such as the National Council on Radiation Protection and Measurements, but in the face of all these hundreds of pages of helpful guidance on how states and locals can tackle nuclear preparedness and response, we didn’t until presently have a clear checklist that communities could follow and see themselves as gaining purchase on this complex problem.

Most local jurisdictions have been on their own to piece together recommendations and chart out a path forward. So we see the Rad Resilience City preparedness checklist as filling a critical planning gap at the local level.

[Slide 7]

I should point out that this project stands on the shoulders of other people. I want to underscore that. This project was never meant to reinvent the wheel. It was meant to take the emerging federal guidance and technical reports on improvised nuclear device response and produce a user friendly guide to community preparedness.

We rolled out the preparedness checklist at the end of September. In the prior year to that rollout, we had convened an expert advisory group—the Nuclear Resilience Expert Advisory Group—to help hold together those key elements of the federal guidance and technical reports. This group was a multi-disciplinary group that included top experts and leaders from across government, radiation science, communication science, emergency response, and the business, volunteer and community sectors.

We felt that this is such a complex problem—that is, preparing communities for the prospect of a nuclear detonation and exposure to fallout—that we had to hear from the best minds from a variety of fields. For example, we needed from the perspective of an emergency manager what logistical challenges would a phased-in mass evacuation provide after a period of sheltering.

We needed the perspective of behavioral and social scientists who know how people engage in behaviors during a period in the process of evacuation and we needed experts on public warnings on how one communicated in an effective way to people about whether they should shelter in place, and at one time they should evacuate the area.

We have had the emergency management talking to public warning expert, talking to the health physicist who knew what challenges are posed in terms of radiation levels and exposure to fallout. We brought all those people to the table.

We also reviewed a number of research studies on community preparedness to find out what were the system capabilities one needed in place regardless of hazard to support community preparedness. We also drilled down into a number of local radiation emergency plans.

There is an extensive practical and technical knowledge base that the checklist emerges from in addition to those multi-disciplinary conversations that we thought were absolutely essential to coming forth with good guidance for jurisdictions.

[Slide 8]

What the checklist does at the outset is dispel a number of myths. The fact is that much of what the U.S. public knows or imagines about nuclear detonations has been shaped in the cold war context. We grew up with movies such as "The Day After" and all the science fiction movies about gigantic ants and other creatures that were morphed by high radiation levels. What is important to notice is that most of our notions about cold war nuclear detonations do not apply to nuclear terrorism involving a crude device detonated at ground level and producing a low yield explosion.

The sense that death is certain for all after a detonation is a myth. We don’t have to be resolved to some pre-ordained number of casualties. We can actually reduce the number of casualties related to radioactive fallout exposure. Why it is that the nuclear detonation scenario does not map onto the nuclear terrorist scenario—I’ll give you some figures.

A nuclear scenario modeled in 1985 assumed 6,559,000 kilotons of explosives detonating at targets throughout the U.S.—a true Armageddon like scenario. Contrast that with the nuclear terrorist threat. Experts now estimate that ten kilotons would be the approximate yield of a successful entry level fission bomb made by a terrorist organization.

Contrast 6,500,000 kilotons as opposed to ten kilotons—which Brooke Buddemeier, who is an expert from the National Laboratories, says is comparable to 5,000 Oklahoma City truck bombs, just to give another type of comparison.

Ideas about what constitutes the best protective actions can also be based on false premises. This checklist dismantles three misconceptions that really inhibit people from taking action, or the correct protective action, in the context of a nuclear terrorist attack. We know that death is not certain for all after a detonation.

New federal modeling, for example, of a ten kiloton ground burst in Los Angeles suggests that if everyone at risk of exposure to dangerous fallout quickly went into a shallow basement or equally protective place, 280,000 lives could be saved. It is a myth that death is certain for all after a detonation.

The second myth is that fleeing is the best way to avoid radiation exposure. In theory getting away from the destroyed area sounds like a good idea. In actuality, fleeing as quickly as possible will result in lives lost. Immediately finding and staying in the most robust shelter will reduce radiation exposure and save lives. Fleeing is the last thing one should be doing post nuclear detonation.

The third myth that the checklist dispels at the beginning is that people must rely on first responders for protection. In fact, people can’t wait to be told what to do to protect themselves. The reasons are that fallout is the most dangerous in the first few hours after detonation and secondly, degraded communications will prevent officials from warning people in the areas that need the information the most.

Therefore pre-educated citizens are what we need to strive for. They can protect themselves. They don’t need to wait to be told what to do. They can rely on being told what to do because of the timeliness of the advice and there could be degraded communication infrastructure.

[Slide 9]

What actions does the checklist recommend? The checklist sets for seven clear actions for communities to build an integrated fallout preparedness program. When we were putting together the checklist and the various implementation tasks, the expert advisory group made it very clear that we needed to provide a path forward in which priorities were clear to people.

Certainly no city or region is capable of immediate success so what we strove to do was put actions in order of what should be tackled first and foremost. In that way the checklist tries to balance the practical and the perfect.

[Slide 10]

The first action which won’t come as a surprise to all of you is the need to obtain broad community backing for nuclear event preparedness. Fallout preparedness is a broad community concern. There is no single entity that can provide this public service. Sound emergency management structures and strategies are absolutely essential.

In addition, we also need efforts by businesses, schools, non-profits, and average citizens around this issue. Also important to remember is that a diverse coalition can help overcome any reticence to plan for an unthinkable event like a nuclear detonation.

Going back to the earlier issue about myths people tend to hold in their minds around a nuclear terrorist attack—the general reticence to plan for any type of disaster is a problem that we all have to face on a regular basis but it is complicated by the fact that people think there is absolutely nothing you can do to reduce casualties after a detonation. That fatalism gets in the way.

It is absolutely important to have a diverse set of stakeholders backing up the importance of nuclear event preparedness.

[Slide 11]

The second main action is conducting pre-event public education to inform people about the effects of a nuclear detonation and how they can protect themselves. In a "no notice" nuclear detonation, the public needs to be empowered beforehand with the knowledge that the most effective action they can take is to find adequate shelter immediately.

As we mentioned, following a detonation it is going to be difficult or impossible to issue fallout warnings in the areas that most need them due to the destruction and disruption of the communication infrastructure. Pre-event public education is a top priority in the checklist.

[Slide 12]

The third action is enabling building owners and operators to assess shelter attributes and teach others. When we say "building owners and operators" we are talking about everybody from skyscraper managers down to individual householders. Studies in the U.S. show that people spend almost 90% of their time in enclosed buildings.

Six percent is spent in enclosed in some form of transportation vehicle. People have a very strong relationship with their built environment. It makes up most of their day. We believe it is important to raise people’s consciousness about the built environment around them.

There are already institutions at play in our communities that have a focus on the buildings in which we live, play and work. Homeowners associations, commercial building owner and manager associations—and we need to work through those institutions and people who have responsibilities for overseeing buildings that they function as key educators in their communities—that they promulgate shelter rating guides so that tenants of all kinds learn which places provide the most safety.

[Slide 13]

The fourth action is strengthening the ability to deliver public warning post incident. Jurisdictions really need to be creative in terms of thinking through how they are going to deliver fallout warnings after detonation assuming a degraded communication infrastructure. By creative, we are talking about mixing both radio broadcasts with text based messaging and the like, and also low tech technologies as well.

It is also critical to have pre-scripted scientifically based public messages about protective actions. Communities should not wait until after an incident to decide who should authorize the release of a fallout warning and what it should say. Time delays can result in preventable deaths.

[Slide 14]

Action five is establishing a rapid system for mapping and monitoring the dangerous fallout zone. There will be plume models available from federal sources within fifteen minutes after a nuclear detonation. That is the current planning assumption. Plume models are not going to give you the most accurate reading about radiation levels and its distribution throughout a community.

To know the true fallout footprint you have to rely on on the ground monitoring. Knowing the fallout footprint is going to vastly improve guidance on which residents need to evacuate, how soon, and which routes present the lowest possible dose.

A key point I really want to underscore is that mapping and communicating where fallout is not a threat is just as important as communicating to the people who are in the dangerous fallout zone. Unnecessary evacuation will strain resources for people in high-risk areas, so we need people to stay put if they are not at risk.

[Slide 15]

Action six is to develop capabilities to support a large-scale phased evacuation. At a certain point in time, some people are going to need to transition from their protective shelter to a place of greater safety to minimize radiation dose. A large-scale phased evacuation is a very complex undertaking that calls for intense advanced planning. That is because some groups are going to need to leave an area sooner than others and roads could be obstructed.

[Slide 16]

The seventh action, again, speaking more broadly about community preparedness in general, is to integrate tests and conduct training on all the above elements. What we see is a comprehensive preparedness and public warning system relative to fallout. Unless people have a chance to train and practice they’ll be less likely to perform well when it really matters, which I know all of you are already familiar with.

[Slide 17]

I mentioned earlier that the expert advisory group tried to create a list in such as way that it balanced the practical and the perfect. The judgment of the group was that when implementing the checklist jurisdictions should put their early emphasis and fallout preparedness on pre-event public education.

This is a challenging task, but in comparison to some technological challenges related to radiation monitoring, this is more straightforward and the reward is immense. The end results of successful pre-event public education would be an informed population capable of acting on its own.

What we want people to do is seek adequate shelter and stay there at least 24 hours, by which time the dangerous exposure levels will have dropped off significantly. When we spoke as a group about a pre-event public education campaign, we thought about its various components.

Certainly one would need a mass education campaign around key lessons such as how you judge adequate shelter, why stockpiling for at least several days, if not more, is important to support sheltering in place, and why it is safe to take in evacuees from a stricken region. There are key messages that need to be delivered by a mass education campaign.

The group also underscored the importance of a more neighborhood based training and education program to help seed grassroots conversations about fallout. Certainly there are already people who are primed in a community who have taken on preparedness as a core objective. These persons can be spokespersons about the importance of preparedness for something as unthinkable as nuclear terrorism.

Lastly, going back to the issue of building owners and operators being key educators, a successful pre-event public education campaign would broadly distribute a shelter rating guide to both private and public building owners and operators so they can work with their various constituents to raise the level of awareness about what constitutes adequate shelter in the context of nuclear fallout.

[Slide 18]

On the issues of what tools make the checklist doable—as Amy pointed out, all of these materials are available at no cost online. The accompanying workbook to the checklist—there were a number of resources to help communities make quick progress on the checklist. These included a phased implementation plan that breaks down preparedness into manageable and prioritized steps.

Secondly there is a compilation of critical topics that communities can incorporate when designing their own public education campaigns around fallout preparedness, trying to anticipate the topics people want and need to know in relation to minimizing radiation exposure.

A third type of resource is tips on how you write an effective post-detonation fallout warning message drawing on the communication science about what actually motivates people to take protective action. There is a strong empirical basis about how one communicates in such a way that people take the protective action that you intend.

Also included are sample fallout warning messages that put these tips into action and also model the public health information that is needed in the minutes, hours, and days following a nuclear detonation. The jurisdictions can take both the sample fallout warning messages and the various public health information scenarios to prepare their own materials.

Lastly, there is a listing of frequently asked questions that are targeted to building owners and operators and safety officers for businesses and schools and neighborhood associations on the best buildings and spaces in which to shelter.

[Slide 19]

I want to conclude with a few words on what we see are the benefits to communities that adopt the Rad Resilience City Checklist building on the systems they already have in place. Sheltering is fundamental to fallout preparedness. The ability to shelter in place for at least 24 hours and over a period of several days, perhaps, is absolutely key.

It resonates with other hazards that are familiar to you in your own jurisdictions. We see fallout preparedness not as far-fetched idea—given the protective behavior being sheltering in place. Fallout preparedness helps extend an "all hazards" framework until it becomes truly comprehensive in the ability to address nuclear terrorism.

By using the Rad Resilience City Checklist to see how your current systems measure up for handling fallout preparedness, we believe people are achieving a more comprehensive approach in a truly "all hazards" framework.

Another benefit is that there are certain activities that are fundamental for nuclear terrorism readiness such as the development of public warning protocols and who is authorized to release a warning and also the cross section of collaboration that is fundamental to this issue—all of these can have spillover effects in planning for other complex disasters.

Given that nuclear terrorism is a hazard that is often put in the "too hard to do" list, we see that steady implementation of the checklist with clear milestones, so people can measure their success in moving forward, can help create momentum for tackling other nuclear response and recovery issues—like the surge in demand for medical services and sheltering of mass displaced populations.

It goes without saying that lastly in the event of an actual nuclear detonation tens of thousands of lives could be saved.

[Slide 20]

Let me include a quick postscript before we turn to the Q&A section of today’s forum. I’ve had questions from a number of people about what the status is of the project. We are currently speaking at a variety of national meetings across the country over the next 12-18 months, briefing people on the checklist and the supporting materials available and the workbook.

We have already spoken at the Big Cities Emergency Manager’s meeting, the National League of Cities Congress and Expo—we were just in Las Vegas at the International Association of Emergency Managers Annual Meeting and Expo. We spoke recently at the National Association for Radiation Readiness.

We are going to a variety of other meetings in the future—the Public Health Preparedness Summit. We are going to the annual meeting of the Building Owners and Managers Association. We’ll be addressing the Fire Chiefs when they are here in Baltimore.

We are trying to get on the agenda of the U.S. Conference of Mayors and the National Governors’ Association meetings. We will be speaking at the annual meeting of the National Council on Radiation Protection and Measurements.

The point I want to make is that we are trying to move out knowledge of the checklist to a variety of practitioners in addition to elected and appointed officials. Actually, this comes up from reactions we have gotten with regard to the checklist. People see the checklist as an important guide and help to them.

We have heard from a number of people that nuclear preparedness and response is a politically taboo issue and it has been very difficult to raise in some communities. This topic is one that people don’t want to address unless they be seen as fear-mongering or lest they appear to know something the public does not know—that there is some kind of imminent threat.

So we have had two kinds of reactions to the checklist—one is gratitude that we are willing to talk about a taboo issue and at least chart a path forward. The second is that the checklist is great but in some context it is difficult to press nuclear preparedness and response as a legitimate concern for any community.

We have also heard that jurisdictions could benefit greatly from the federal government taking a more proactive lead on the public communication challenges around this very difficult topic—that it may not make sense for jurisdiction to do their own pre-event publication initiatives on their own one at a time without some clear national level message coming out of the federal government.

The next step for the initiative is continued dissemination through various national meetings and through wonderful communication tools such as the EM Forum. We are in conversation with several entities who are interested in adopting the checklist. We are talking about how the Center for Biosecurity can assist them both on a strategic and operational level.

Thank you for your attention and I look forward to you questions and learning about what is going on in your jurisdiction around this issue, whether you find that it is a politically taboo issue or one that is difficult to move in a period of economic duress and major cutbacks in public institutions and emergency management budgets.

Thank you again for your attention and it is a real pleasure to be here today.

Amy Sebring: Thank you very much, Monica. Now we will proceed to our Q&A and audience comments.

[Audience Questions & Answers]

William R. Cumming: Should individual citizens and residents possess KI [potassium iodide] tablets and dosimetry? A NUDET with an actual weapon device or RDD is not the same as a core-melt accident at a nuclear power station but last week on the 24th both NRC and FEMA released updated guidance on the REP (radiological preparedness program)!

Monica Schoch-Spana: I think it is important to point out, and thanks to Bill for bringing this up—the different radiological and nuclear incidents that are possible. An accident or attack on an nuclear power plant, a radiological dispersal device or dirty bomb, or an improvised nuclear device or a detonation of a crude nuclear weapon. A fourth incident could be a nuclear attack with a weapon that had been developed under a state based program—likely to be larger than ten kilotons.

There is a spectrum of incidents that would involve radiological and nuclear aspects to it and they have different challenges. The reason why we focus particularly on improvised nuclear detonation scenarios (IND) is because it is a catastrophic health event.

A dirty bomb would have profound economic and social impacts. Health impacts would be minimal. We prioritized the IND scenario in terms of needing to get information out to community leaders and the wider public about what is the most important intervention in terms of reducing casualties.

That is why we focused on that particular event—and because, again, it is a taboo issue. It was easier for a non-governmental organization such as us to go out on a limb and talk about this issue. We don’t get elected and we don’t have to protect our emergency management budgets.

On the issue of potassium iodide—in the IND scenario where there is a variety of radionuclides, potassium iodide is not going to be protective. It has a very limited value even in terms of the types of events we saw in Fukushima. I’ll stop there because I would have to defer to my medical colleagues on the pros and cons of potassium iodide in particular scenarios.

I do know that it is not protective across the variety of radionuclides that would be released in a nuclear detonation. Certainly in a power plant radiological release that we saw in Fukushima, it has limited application. It has to be taken within a particular amount of time. It has a more protective benefit for children than adults.

I do want to be clear about the limits to my own knowledge about those scenarios but I feel comfortable making those general statements. Amy and Bill, I think there was a third component to the question that I can’t recall, but I did want to touch those.

I think the dosimetry question is a good one. I think Bill was asking if individual citizens should invest in that kind of equipment for themselves. Certainly that is a personal decision. We have seen some interesting grassroots radiation monitoring being carried out in Japan in the context of people’s distrust about what the central government was producing in terms of data about radiation levels.

I think many of you are familiar with the USGS program "Did You Feel Something" (I can’t remember what it is called) and it is an interesting proposition to think about a subgroup of the population who is equipped with dosimetry capabilities that could help fill in the monitoring picture.

Amy Sebring: Toward the end of your slides, there was a feedback comment about a clear federal message on this. Is this going up the food chain? Have you contacted Congress or the Administration?

Monica Schoch-Spana: Yes on both counts—we have briefed members of FEMA on the project and have gotten positive feedback from them on it. We have also carried out a Congressional seminar very specifically on the impacts of a nuclear detonation and interventions that communities could take to save lives.

It was a very well attended Congressional seminar with a number of staffers present. Certainly there are members of Congress who have a particular interest in nuclear non-proliferation, we had those represent, in addition to those who have an interest in homeland security issues.

It is a period of economic austerity. There are some people who want this issue to advance. I think the issue of whether it is a legitimate issue to pursue has not been settled for some people. The assessments are that this is a real threat. We have briefed various staff to members of Congress and we have reached out to FEMA. We will continue to brief people within the administration as well as the practitioners out in the country.

Amy Sebring: Do you think that Citizen Corps is a potential outlet for you?

Monica Schoch-Spana: Absolutely. I think the CERT training has some elements of nuclear preparedness already incorporated into it, as does ready.gov. I think there is some additional information that could be expanded to augment that training.

The Council on Radiation Control program directors has put together a great resource that I would point people in the direction of, which is a guide to how one would recruit, train and mobilize volunteers to assist in a radiological or nuclear event.

There is a scarcity of individuals who are adept at communicating around radiological issues and there are ways of growing one’s preparedness and response work force by involving volunteers from different radiological professional groups—through the Health Physics Society, the various medical groups that have a radiological dimension to them.

The Council on Radiation Control Program Directors (CRCPD) has put together this great resource about how one can incorporate volunteer radiological professionals into emergency management structures, a key platform being of course the Medical Reserve Corps. I’m sure a number of you have units in your jurisdiction.

I would point people in the direction of that resource. It just came out about nine months ago and it is available online. [See http://www.crcpd.org/Homeland_Security/RRVC_FinalReport.pdf]

Avagene Moore: We recently had REAC/T staff on and heard about their work in Japan. Have you looked into the need for education on radiation within the medical community? If so, what did you find? I ask because the REAC/T folks spent a lot of time on this point.

Monica Schoch-Spana: I would say that everyone, in and out of government and the medical field, needs a basic introduction to or a refresher course on radiological matters. Some of you may be familiar with Steve Becker who is a social behavioral scientist who has done work on radiation incidents and following public reactions and the like.

He was part of rapid response team that was deployed to Japan after the Fukushima Daiichi crisis to, in fact, provide refresher training courses for healthcare workers around issues of safety of interacting with people.

I defer to my colleagues with the REAC/Ts groups. Healthcare workers of all stripes need basic training or refresher courses on aspects related to radiation safety. Radiation is a fear-inducing topic even among healthcare workers. Training is absolutely essential, even for them.

Amy Sebring: You touched on the need for resilient communications. Are there recommendations on that included in your checklist?

Monica Schoch-Spana: Yes. There are several kinds of resources included in the workbook that are specifically about communications both before and incident and after an incident. We have the content of key topics that need to be part of any pre-event public education campaign written in plain language that people can incorporate.

As I mentioned we have templates for public warning messages related to fallout and protective behaviors afterwards that people can adopt for use in their own communities. Another resource I want to draw people’s attention to is the production of a guide of messages relevant to the first 72 hours following a nuclear detonation. Communication messages relevant to the first 72 hours following a detonation.

This was produced by a federal interagency group. It was meant to prime people, practitioners, and officials for the types of questions that were likely going to emerge among the public after such an incident and that included information they needed to know even if they didn’t raise the issue themselves.

That is also available and we should provide a link to it. The Center for Disease Control and Prevention Support (CDC) has been testing these messages in focus groups to also get feedback on them and improve that resource. That is something people should take a look at.

[See Nuclear Detonation Preparedness: Communicating in the Immediate Aftermath]

Amy Sebring: As a follow, up my question was meant more toward communication infrastructure resilience.

Monica Schoch-Spana: There is some guidance in the checklist about ways in which one can harden information infrastructure against the EMP (electro-magnetic pulse) problem. I should point out that there is currently a lack of consensus among experts about the extent of damage that is possible though EMP.

Some believe it could take out things in a two to five mile radius and have cascading impacts on the electrical grid and impact a very large geographic area. Others think EMP will be a very limited event and that communication infrastructure will be able to be preserved outside of the heavy damage zone.

I would recommend that people return to the checklist for very specific ways to harden communication structure. More work needs to be done on this and it actually turns a lot on basic research on what type of impact one can expect with EMP. That question has still not been answered adequately.

There is a high degree of uncertainty, but yes the checklist does have some advice about hardening information infrastructure, and something about social media.

William R. Cumming: FEMA produced two versions of Guidance to Response to a NUDET and wondering if these are useful in supplementing the checklists. I believe the issue dates were January and June 2009.

Amy Sebring: We actually had a program on that guidance and I am assuming that is something you reviewed while putting the checklist together. [See 1/12/11 EMForum program.]

Monica Schoch-Spana: In fact, several of the principals who were responsible—and Bill was right, there was a second edition of First Responder Guidance that came out—several of the principals that were involved in the creation of that response guidance were members of our expert advisory group.

Many aspects of those documents were woven into the checklist. As I mentioned earlier, this checklist was meant to synthesize and distill from a variety of current guidances and technical reports to chart a clear path forward for people.

But yes, from our point of view they were excellent resources and they definitely were woven into the checklist, and principals involved with their creation were part of the creation of this checklist.

Joseph Parish: You mentioned that 285,000 lives could be saved by shelters in LA. With almost a 4 million population in 2010 those odds do not appear to be very encouraging. Can you expand on this or should the citizen's in our second largest city be concerned?

Monica Schoch-Spana: The 280,000 number—this is out of the number of people included in the dangerous fallout zone. It does not take into account the entire population of the city, if I understood his question correctly.

Amy Sebring: I think what you’re saying is an additional 285,000 lives could be saved by these actions that would be lost in the absence of these actions. Is that correct?

Monica Schoch-Spana: That is correct. Thank you for phrasing it that way.


Amy Sebring: Time to wrap for today. Once again Monica thank you so much on behalf of Avagene and myself and all our participants today. We appreciate your taking the time to be with us and educate us on this issue, and we wish you continued success with your initiative in the future.

Monica Schoch-Spana: Thanks Amy. It is always a pleasure to work with you guys. And best wishes to everybody out there in the field. I hope everyone had a good Thanksgiving.

Amy Sebring: Thank you so much. This is a tough one and I commend you all for taking it on.

Folks before you go, PLEASE take a moment to do the rating/review! Note: We are asking you to rate the relevance of the information, and this will assist us in our future programming.

Our next program will take place Wednesday, December 14th and will be our last program of 2011. Please watch for our announcement and plan to be with us then.

Don’t forget you can now earn CEUs for attending our programs. Details are linked from our home page.

Until next time, thanks to everyone for participating today. Have a great week. We are adjourned.