From Irwin Redlener’s Americans at Risk:

Even if the nation’s intelligence capacity is substantially strengthened and homeland security better assured, these systems will never be perfect. An American city could conceivably experience the nightmare of a nuclear detonation. The essential point is that the quality and extent of survival and recovery, even from a nuclear bomb, are affected by the success of our preparedness and mitigation programs.

The current presidential administration is, of course, now well-known for its argument that it “didn’t want the smoking gun to become a mushroom cloud.” Implicit – by omission – was that the strategy of pre-empting the (hypothetical or fictional) threat of nuclear attack by Iraq would so likely to succeed that it wasn’t necessary to take steps to mitigate or prepare for the effects of a nuclear attack.

Redlener’s point is that it’s folly to bet we’ll always be able to deter, incapacitate, or otherwise prevent attacks, in this case nuclear. If there’s a risk of a given outcome – we need to make worst-case planning assumptions (we may suffer one or more nuclear attacks) at the same time that we make efforts to prevent an attack.

In fact, preparation itself may be a deterrent to an attack. Knowing that America is poorly prepared to respond to a nuclear attack increases the effects of any given attack, making it a more attractive option to attackers. This is especially true if attacks are launched in the hope that America will be too demoralized or incapacitated to fight back.

More from Dr. Redlener:

Our future is anything but hopeless and we are not helpless. We are a nation of 300 million. In spide of wide ideological and political diversity, we have a vast reservoir of talented problem-solvers who share a common desire to examine what puts the nation at risk and determine how best to reduce its vulnerability.

– snip –

…. the United States a great deal of “unfinished business” that has challenged and plagued the nation for many decades – long before we were jolted by 9/11 and horrified by the response to Hurricane Katrina. Intractable poverty in many segments of American society, a deteriorating and ever more costly health-care system, concerns about immigration policy, massive problems in public education in many parts of the country, and struggles to keep up with the new realities of global economic competition are among the many issues that will not conveniently fade away while we focus our attention on terrorism and disaster response. We have to be able to deal with all of these issues simultaneously.

Let’s put this another way:

• If you live in a constant state of economic hardship – worried, for instance, about today’s food – the notion of preparation for an anticipated emergency doesn’t make much sense. If you’re poor, you’re already living in a state of emergency.
• To the extent that a disaster or emergency results in injuries – are we going to continue or discard our distinction between the insured and uninsured?
• If we think that – in a natural or accidental disaster, or crisis caused by terrorism – that we’d provide health care for everyone – why don’t we make sure everyone has access to health care the rest of the time?

(We’ve been doing some reading comparing underground shelter systems in the United States and other countries – it’s hard to imagine how we could set up a large-scale shelter system which, if used, wouldn’t end up housing people who normally wouldn’t be in the same room. Mixes of people from different races, economic classes and religions in the same shelters).

The most important thing to take away from Redlener here is not that we’re at risk – but that we have the resources – the will and the resourcefulness – to make ourselves a lot safer.

What’s missing, then? Discussions – especially local discussions – about communities taking charge of their own safety and health – and using the political process to fill in the gaps of expertise, funding, training and coordination that will make it work on a larger scale. But since it appears that support for citizen involvement from national political leaders is mostly hot air – the decision to be prepared has to start with families and neighbors.