Nuclear Terrorism: Assessment of U.S. Strategies to Prevent, Counter, and Respond to Weapons of Mass Destruction (2024)

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

9 Response and Recovery to Nuclear Incidents BOX 9-1 Summary Emergency preparedness, including preparations for a nuclear or radiological event, is almost entirely dependent on local, state, and regional authorities, who have the primary responsibility to protect the population within their jurisdiction. However, in a nuclear emergency key information, support, and rare expertise can come only from Federal resources. Governors and mayors are generally not adequately trained or equipped to respond to a nuclear or radiological event. Additionally, they are confronted with competing priorities that make it difficult to devote the attention required to prepare for this kind of low-probability/high-consequence threat. The coronavirus pandemic exposed the disparate capabilities that exist across the nation’s local and state jurisdictions as well as significant shortcomings in coordination among federal, state, local and tribal authorities in an extended public health emergency. Emergency management, like the U.S. public health system, operates primarily under the purview of governors, county commissioners, and mayors for which the federal government plays a support role. For a nuclear incident, consequence management and recovery have the added burden of trying to manage an incident in the face of widespread fear. This is compounded by the dangers associated with traditional media potentially broadcasting inaccurate information in its early reporting, alongside social media providing channels for pervasive disinformation and misinformation. An adequate response to a nuclear or radiological incident requires enhanced coordination of emergency management response protocols across all levels of government and strengthened information dissemination tools for providing trusted, accurate, science-based information and techniques. Nuclear response starts with the all-hazard building blocks but has scenario-specific nuances that require specialized capabilities and training. Significant new investments in resources will have to be made to develop and sustain adequate nuclear incident response and recovery capabilities at the local and state levels. Highlights • Renewed focus needs to be applied to preparing for nuclear incidents, domestically and internationally, to include updated protocols and technologies. • A general lack of understanding of radiation and health aspects of nuclear and radiological events, especially when combined with misinformation, disinformation, and mal-information, will significantly complicate response and recovery efforts. • There are continued shortfalls in local, state, and regional emergency management capabilities, particularly in trained and experienced personnel, for responding to and recovering from nuclear and radiological events. • Given these limited capabilities, the private sector (including social media companies), non- profit organizations, and civil society should be more deeply integrated into plans and exercises for responding to and recovering from nuclear and radiological incidents. 9.1 CURRENT RESPONSE CAPABILITIES FINDING 9-1: Over the past decade, training capacity and response capabilities have stagnated due to insufficient funding and planning resources. Prepublication Copy 104 

Response and Recovery to Nuclear Incidents For a government to be resilient in the face of the nuclear terrorism threat against the homeland, or after a nuclear terrorist attack, preparation and planning measures must be regularly updated. Government officials at all Federal, State, local, tribal and territorial levels (FSLTT) must be continuously educated about the threat landscape and their responsibilities for providing the necessary emergency management resources and capabilities. In the wake of the 9/11 attacks, the potential for a terrorist attack involving detonation of a nuclear or radiological device without prior warning commanded a great deal of attention and concern. While state and local planning capacity for a nuclear incident after 9/11 was increased, that capacity has since deteriorated due to significant reductions in funding and planning resources (Bentz 2022). Even where there are plans in place, the number and level of exercises to test those plans and bolster local response capabilities has decreased. In the limited instances where local exercises include a radiological/nuclear scenario, the central focus tends to be on development of individual responder skills (equipment maintenance, calibration, interpretation of readings, and other technical responsibilities) rather than on how all the various parts of the response system would operate together. This translates into state and local authorities with limited exposure to the kinds of issues that large-scale exercises would facilitate such as discussions of mitigation measures, plans for cleanup, and large-scale mapping of contamination zones. It is also rare for radiological emergency exercises to incorporate the likely follow-on disruptions expected in a real emergency nor do they consider the myriad challenges associated with recovery. For a society to be resilient in these circumstances, government readiness should not be the only metric. A society needs an educated and informed citizenry who can prepare themselves in advance, in order to be more resilient after such an attack. This is best guided by a concerted education campaign that presents a pragmatic explanation of the risks and helps the general population to understand what they must do after an attack to safeguard themselves and their families. Domestic education programs for these two primary audiences (FSLTT officials and the general population) must be complementary to maximize the nation’s readiness and resilience. Further, it is important to consider pre- and post-attack education as distinct topics. FINDING 9-2: Updated protocols and technologies, including forensics, are needed to support pre-event warning and to respond to an announced or threatened use of a nuclear device. Current protocols and technologies are not keeping up with emerging technologies. The response capabilities following a pre-event warning of a nuclear attack on the U.S. homeland, U.S. interests overseas, and treaty allies do not yet take advantage of various emerging technologies, including smart technologies enhanced by Artificial Intelligence (AI) and Machine Learning that could be harnessed to upgrade the existing indicators and warning systems (PANO 2022). Countermeasures includes diagnostics/forensics to support attribution in the event of the threat of a nuclear attack (e.g. blackmail) or in the aftermath of an attack. A capable and “advertised” nuclear forensics program can play a deterrent role. The federal post-detonation nuclear forensics program collects data and samples and contributes to weapon or device attribution. Recently a National Academies of Sciences committee reviewed the forensics program and made a number of recommendations to strengthen it (National Academies of Sciences 2021). This committee concurs with those recommendations. Prepublication Copy 105 

Nuclear Terrorism: Strategies to Prevent, Counter, & Respond to Weapons of Mass Destruction Preparing to respond to terrorist’s announced/threatened use of a nuclear weapon or device has been a significant component of the NNSA’ Nuclear Emergency Support Team (NEST)’s Joint Technical Operations Team (JTOT) program since its inception (Tilden and Boyd 2023). NNSA has developed a variety of tools and techniques to search for, diagnose, assess, defeat, transport, dismantle, and attribute nuclear devices while retaining chain-of- custody control to facilitate subsequent legal action. The formal pre-detonation forensics program contributes to weapon attribution facilitated by intelligence-informed databases of weapon characteristics. The NNSA laboratories have expanded their efforts to understand how an Improvised Nuclear Device (IND) could be designed using non-traditional materials in order to develop appropriate countermeasures. In the event of the actual employment/use of a weapon, the United States maintains a capability to respond to a nuclear weapon or RDD detonation. These capabilities include NNSA’s NEST and programs developed by DOD, FEMA and CDC. Efforts have been made to establish a whole-of-government (i.e. federal, state, local) approach to addressing public health concerns and providing population movement recommendations in the detonation zone and adjacent areas. 9.2 MESSAGING DURING NUCLEAR INCIDENT FINDING 9-3: A general lack of understanding of radiation and health aspects of nuclear and radiological events, especially when combined with misinformation and disinformation (MDM), could significantly complicate response and recovery efforts. Maintaining a sufficient number of well-trained, trusted nuclear experts at the State and local levels will be essential to manage public communications during the response and recovery efforts of an impacted community. There are significant challenges to informing and instructing the impacted and wider populace in the immediate aftermath of a nuclear event. Efforts to provide warning and lifesaving information for a nuclear incident have not kept pace with emergency information systems that have been developed for other disasters. For example, National Oceanographic Atmospheric Administration (NOAA) maintains separate warning systems for tsunamis, tornados, and hurricanes and the U.S. Geological Survey (USGS) is developing embryonic early warning system for earthquakes. Natural disasters happen with such frequency they are the primary focus of exercises and allow crisis managers to gain familiarity with what they should do when these disasters occur. This is not the case with nuclear/radiological events where the absence of a previous attack, and its low probability, makes preparing, exercising, and communicating in ways that will save lives and facilitate recovery very difficult. In the event of a nuclear or radiological attack, government officials and the public are likely to be unfamiliar with where they can go to get reliable information to include even the most rudimentary guidance such as whether to shelter in place or to evacuate. Those living near an attack site are likely to have severely disrupted communications capabilities, adding another challenge to information dissemination. This is fertile ground for the kind of harmful consequences associated with MDM that could be spread over social media, as was evident during the COVID-19 pandemic. Countering any MDM will take a substantial investment to develop a prophylactic “counter disinformation” capability to ensure a coordinated response that nimbly provides authoritative/trusted information. During the Fukushima Daiichi Accident and Prepublication Copy 106 

Response and Recovery to Nuclear Incidents response, the spokespeople had backgrounds in food, epidemiology, health and medicine, and environmental expertise. They provided critical technical information to decision makers, responders, and the impacted communities alike. Such programs must be established, maintained, and exercised prior to a nuclear incident to avoid or minimize the MDM challenge. Countering disinformation will require utilizing all mechanisms (radio, TV, social media) to communicate authoritative/trusted messages and establish techniques to counter MDM. BOX 9-2 Immediate Messaging Joseph Pfeifer and James Schwartz were first responders on 9/11. Chief Pfeifer was the first fire battalion chief to arrive at the World Trade Center. Responding with members of Engine 7 and Ladder 1, he implemented a command center in the North Tower’s lobby. Under Chief Schwartz, the Arlington County Fire Department led the Unified Command effort to the attack at the Pentagon. When discussing the necessary and immediate messaging in response to a nuclear incident, they gave the committee this simple and meaningful advice.1 “In an active shooter incident we tell the public to run, hide, fight. Well, what are we going to tell the public to know for an IND (improvised nuclear device)? And what we thought about was again 3 words, and I throw this out […] to all of you […] well, what about, Hide? Help? Go? The first is hide, to go inside. Help each other, because the first responders aren’t coming, at least initially. And then, when directed, go, move out of the area. So Hide, Help, Go.” Radiological Operations Support Specialists (ROSS), are experts in radiological and emergency response who provide technical expertise to state, local, tribal, and territorial (SLTT) jurisdictions (Irwin 2022). This FEMA-led program, first piloted in nuclear detonation exercises in 2014, gathers and interprets data to assist decision making and provides information about available federal assets to the SLTT first responders, key leaders, and decision makers. FEMA provides public affairs and National Incident Management System (NIMS) training to these nuclear Subject Matter Experts (SME) so that they can operate effectively during an emergency. Maintaining a sufficient number of well-trained nuclear experts who can be readily available for 1 Written materials submitted to a study committee by external sources and public meeting recordings are listed in the project’s Public Access File and can be made available to the public upon request. Contact the Public Access Records Office (PARO) at the National Academies of Sciences, Engineering, and Medicine for a copy of the list and to obtain copies of the materials. E-mail: paro@nas.edu. Prepublication Copy 107 

Nuclear Terrorism: Strategies to Prevent, Counter, & Respond to Weapons of Mass Destruction SLTT organizations to draw upon will be key to getting timely and accurate information directly to an impacted community. 9.3 STATE, LOCAL, TRIBAL AND TERRITORIAL CAPABILITIES AND NEEDS FINDING 9-4: There are continued shortfalls in state, local, tribal, and territorial (SLTT) and regional emergency management capabilities for responding to and recovering from nuclear and radiological events. Given these limited capabilities, state and local authorities would benefit from more closely integrated efforts by the various federal departments and agencies, as well as a central repository to provide support before, during, and after a nuclear incident. Achieving this integration will require strong leadership at the White House level. Current and past strategies for managing a nuclear incident have focused almost exclusively on the immediate alert and preparing for just the first minutes of response. As this is clearly insufficient, efforts are underway to develop response capacity for at least the first 72 hours following an event. The updated Nuclear Detonation Planning Guide (Federal Emergency Management Agency 2022), provides 72-hour guidelines (Federal Emergency Management Agency 2023). There are also 100-Minute Guidelines (U.S. Department of Homeland Security 2021), and National Council on Radiation Protection and Measurements guidelines for volunteers and non-radiation workers.(National Council on Radiation Protection and Measurements 2022a)2 (National Council on Radiation Protection and Measurements 2022b).3 Additionally there are training videos that provide public and responder education (U.S. Center for Disease Control 2023),4 and a variety of public health training courses developed by the 2 The National Council on Radiation Protection and Measurements (NCRP) has recently issued two Statements addressing volunteers and non-radiation workers that have not been previously covered in other NCRP reports. NCRP Statement #14 provides recommendations for maintaining the readiness of radiation detection equipment retained by municipal, county, and state entities, including fire services, law enforcement, emergency management, public health agencies, and hospitals. A three-tiered, mission- oriented approach is described, which allows users to attain confidence in their equipment while working within available funding and personnel resources. It recognizes that a functional instrument, even if not formally calibrated, can still support certain missions during a large-scale emergency and is preferred to an absence of instrumentation. 3 NCRP Statement #15 recommends a tiered approach for respiratory protection for a subgroup of emergency workers, including public health and mass care workers and volunteers, who may be at risk of an inhalation or incidental ingestion hazard generated by arrival and movement of potentially contaminated people. Workers and volunteers will be involved in assisting the displaced population with evacuation, screening and decontamination at community reception centers (CRCs), mass care at public shelters, and referrals for medical, relocation, and other services outside the affected area. Respiratory protection standards and guidelines that are suitable for occupational exposure scenarios will be difficult to implement for all workers who will be interacting with and providing services to potentially contaminated people. Unlike the medical response to mass casualties or crises, there is currently no equivalent provision for “crisis standards of care” when it comes to addressing the health and safety needs of this group of emergency workers. Lack of guidance and potential confusion about acceptable approaches to protect their health and safety can impede emergency response operations. 4 An example of this is the efforts CDC has put into creating animated videos[5] to address 1) shelter in place during a radiation emergency that highlights how shelter in place would be different for a radiation Prepublication Copy 108 

Response and Recovery to Nuclear Incidents Center for Disease Control and Prevention (Center for Disease Control and Prevention 2022)5 that are available to the SLTT response community. These training efforts are commendable but would be more useful if they were incorporated into a central repository where the full range of information needed by SLTT responders and authorities could be accessed. A central repository would have to be managed initially at the White House level by a designated individual or interagency group but should eventually be turned over to a lead federal agency such as FEMA or the CDC. HHS maintains Radiation Emergency Medical Management (REMM), but REMM does not have an overall strategy for creation of information and capabilities. A commitment to long-term funding will be needed to train responders/receivers in these integrated protocols. In addition, there needs to be a sustained, focused examination on roles and responsibilities connected with transitioning from response to recovery. This has yet to be done in any systematic way. The United States has been through enough large-scale catastrophes to develop an understanding of what is involved in crisis response and what is required to have a successful post-disaster recovery. Capturing this knowledge would provide the basis to update national strategies for radiological or nuclear emergency response and recovery. Following an attack, prompt post-event actions are necessary to communicate risk information, save lives, support forensics, and guide recovery. These actions include: • Partnerships. A response to a nuclear or radiological emergency places a premium on effective coordination and collaboration among local and state authorities and federal and regional-based partners.6 National planning scenarios, and the development of matrices and annexes that outline national CBRN response capabilities are foundational to identifying the roles and responsibilities of each partner. Enhanced preparedness requires moving from planning scenarios to conducting major exercises, and analyzing the outcomes to identify any gaps in capabilities, tools, training, and organization. The actual decision makers for a real event, i.e., governors, county commissioners, mayors and other state and local officials with delegated authorities, should participate in these exercises. This will provide a basis for determining which entities are best suited to perform which critical functions within a state, county and municipality. Importantly, managing a nuclear emergency should draw on extant capabilities that are used in more commonly-occurring disasters; e.g., floods, wildfires, hurricanes, etc. Additionally, the knowledge derived from radiological and nuclear preparedness planning, particularly with respect to informing regional and national collaborative efforts, can emergency compared with shelter in place instructions during COVID, 2) exposure versus contamination in the radiation world that explains the difference between exposure and contamination and highlights the differences with COVID, and 3) understanding Potassium Iodide, clearing some of the misconceptions about its use (specifically those arising from the conflict in Ukraine). animated videos can be found at https://www.cdc.gov/nceh/radiation/emergencies/protectiveactions.htm. 5 CDC is piloting a new training course titled “Applied Course for Public Health Decision Making in a Radiation Emergency” specifically designed for the public health community that uses a holistic approach to emergency preparedness and response. 6 These partners can include the Federal Bureau of Investigation (FBI) Stabilization Teams, the FBI WMD coordinator, Department of Homeland Security field partners, Department of Energy (DOE) Radiological Assistance Program teams, DOE national labs, state Radiation Safety Offices, state and regional hazmat teams, state-level law enforcement, and others. Prepublication Copy 109 

Nuclear Terrorism: Strategies to Prevent, Counter, & Respond to Weapons of Mass Destruction enhance integrated response capabilities and recovery efforts for major natural disasters. Establishing ongoing and productive partnerships centered on an all-hazard approach is a crucial element in achieving effective preparedness. • Procurement and Supply Chain. Maintaining large inventories of nuclear response equipment (e.g. monitoring equipment, personal protective equipment (PPE), medical supplies, and dosimeters) in every community is not practical. As such, repositories of these resources maintained at the national and regional levels is more practical, but places a premium on rapid distribution to impacted areas when they are needed. Supply chain management would be an important element of establishing and managing such repositories. As the COVID-19 pandemic highlighted, many supply chains depend on foreign or single-source suppliers and are susceptible to disruption. Supply chain management to include the identification of vulnerabilities and implementing approaches to addressing them, (e.g. preserve PPE, accelerate distribution, and pivot to allocation) is critical to ensuring an effective nuclear incident response.7 The relevant government agencies who procure the equipment must make their requirements clear and provide for emergency suspension or waiver of any rules or statutes, e.g., the Jones Act. Risk matrixes to help decision makers deal with supply chain disruptions, without generating unintended consequences, will be needed as will effective information sharing protocols. • New medical diagnostics and countermeasures. The combination of innovative medical diagnostics and treatments for radiation exposure can save many lives that would be at risk even when excellent preparedness efforts lead to timely rescue from an area impacted by a nuclear detonation. Given the large number of casualties, an integrated clinical diagnostics system to enhance surge capacity is needed. One example would be to apply basic hematology techniques and lymphocyte depletion kinetics alongside dicentric assessments and other novel dosimetry methods in a tiered triage approach so limited resources and time-consuming analysis can be focused on those in most dire need of treatment. Similarly, a combination of existing medical countermeasures and advanced treatments such as nucleic acid amplification and cell therapy for radiation injuries should be used in a tiered approach given the potential for large number of patients, the time-sensitive nature of the treatment, and the limited number of trained medical providers (Coleman et al., 2013). These diagnostic and therapeutic elements should serve as the foundation of a national concept of operations (CONOPs) to integrate and sustain capabilities across the government and private sector (U.S. Department of Health and Human Services 2023). 9.4 COMMUNICATIONS AFTER A NUCLEAR INCIDENT FINDING 9-5: Existing approaches for managing and disseminating trusted, accurate, science-based information in response to nuclear and radiological incidents are not adequate. 7 A negative element within every response is the subset of citizens who cash in on the vulnerability of the public during a disaster. Updated strategies should address the need to combat various forms of profiteering when there is a sudden surge in demand and the legitimate supply chain cannot quickly ramp up. The public is particularly vulnerable to a shortage of needed supplies, such as personal protective equipment, that can be misrepresented or counterfeited. During a crisis, monitoring and prosecuting such cases becomes difficult to prioritize. Prepublication Copy 110 

Response and Recovery to Nuclear Incidents The erosion in public trust in government could hamper the effective communication of public health and safety guidance in times of crisis. There are nascent steps in considering social media and other alternative information pathways when advising the public on what to do during a nuclear or radiological incident, but these are not as engrained in the public’s mind as long-standing approaches. Moreover, weapons of mass destruction (WMD) policies and operational planning for the federal government date back many decades and are exercised with state and local counterparts only in a limited way. These policies and plans were not designed to counter misinformation, disinformation, and mal- information (MDM), endemic in today’s environment. Overall, the individual citizen has not factored into response planning since civil defense measures were abandoned in the mid-20th century. In the aftermath of a nuclear incident, however, individual citizens must determine: (1) whether they shelter in place or evacuate, and by what route, when they receive warning of an imminent attack; (2) which sources of information they will listen to for guidance; and (3) how comfortable they are about returning to an area that they had to leave because of radiation exposure. Waiting until there is incident to provide lifesaving information to the public is a prescription for disaster. The appropriate planning approach is to embrace the tenet that only an “informed public” will be in a position to make sound decisions following a nuclear incident. Preparedness efforts should place an emphasis on public awareness and education efforts. This will require taking response plans off the shelf and getting them into the hands of local decision makers and the general public. One model for such an approach is to replicate on a much wider scale the kind of guidance, testing and exercises that are done with residents and local officials who are located in the vicinity of nuclear power plants. Communicating public health threats and harm mitigation strategies must take into account cultural, language and technical barriers that may interfere with the ability of vulnerable populations to understand and act on that information. For instance, these populations may have limited access to broadband, which limits the reach of digital-based sources of emergency preparedness, response, and recovery information. Analyzing and addressing the barriers for diverse populations to comprehend and effectively use information is a prerequisite to any sound community engagement effort for advancing nuclear and radiological preparedness. In the absence of readily available federal guidance, states and local leaders will make their own decisions. This underscores the need for a flexible response framework that enables states to make wise independent decisions while working alongside federal planning and response efforts. Since the State Radiation Safety Control Program is typically responsible for managing radiological emergencies in most states, it is essential to integrate these offices into federal planning activities. The State Radiation Control Program operates under the umbrella organization known as the Conference of Radiation Control Program Directors (CRCPD) (Conference of Radiation Control Program Directors 2023), which serves as a convenient centralized resource to access state programs and their experts. While the Environmental Protection Agency (EPA), Centers for Disease Control and Prevention (CDC), and Department of Energy (DOE) routinely provide funding for various advisory and technical initiatives, the current collaboration with CRCPD, often ad hoc, relies on relationships rather than a programmatic structure. Prepublication Copy 111 

Nuclear Terrorism: Strategies to Prevent, Counter, & Respond to Weapons of Mass Destruction 9.5 RECOVERY FROM A NUCLEAR INCIDENT FINDING 9-6: Medium- and long-term plans for any impacted areas are inadequate to recover from nuclear and radiological attacks on the U.S. homeland and abroad. Prior to a crisis, nuclear and radiological hazards must be understood to prioritize response and recovery actions, particularly those requiring time-sensitive decisions. To date, there is no consensus among federal, state, and local authorities on standards for radiation cleanup and area rehabilitation, possibly impeding a “return to normal” for an affected community Beyond preparing for the immediate response, there must also be plans and capabilities to manage the transition from response to long-term recovery to contain and restore an impacted area after a nuclear or radiological attack. Prior to a crisis, state and county officials and responders must understand nuclear and radiological hazards to prioritize response and recovery actions, particularly those requiring time-sensitive decisions. The goal should be to ensure that local and state leaders have a sound framework for decision-making. Disadvantaged populations need particularly attention as the vulnerabilities and the need for external support will be greater. An effective whole-of-community approach to preparedness should include the trusted interlocutors, such as community non-profit organizations and faith leaders, for marginalized groups. Internationally, while the United States consistently offers its assistance, such as during the Fukushima incident, there are not adequate plans to guide how an impacted state or municipality could accept and utilize assistance from international partners. Part of the challenge is the lack of knowledge regarding the specific nature of the assistance and the difficulty of planning for its integration into local and state responses. The International Atomic Energy Agency (IAEA) Response and Assistance Network (RANET) is a well-organized resource that could help address this significant challenge. There are plans and capabilities in place to support a U.S. response to a nuclear incident overseas. This includes the International CBRN Response Protocol that spells out the roles and responsibilities of the relevant federal departments and agencies for nuclear or radiological response overseas. Long-term support to allies for recovery will be managed through the established mechanisms within the relevant federal departments and agencies, particularly the U.S. Departments of State and Commerce. Within the national borders of the United States, there have been many lessons learned from the February 2023 East Palestine, Ohio rail disaster, the COVID-19 pandemic, civil unrest, and climate-related catastrophes of mega wildfires, hurricanes, floods, and tornadoes. While Americans are typically good at managing the life and safety issues associated with disaster, recovery efforts are too often developed on the fly and as a result, are poorly conceived and executed. Plans and protocols to transition from disaster response to recovery should be improved or developed where they do not exist. For instance, there are often plans in place for evacuating neighborhoods or a region, but no formal planning for returning residents to impacted areas. The transition from an emergency to “normal” conditions requires considerable time and effort and needs ongoing public communications. A nuclear or radiological incident will involve particularly challenging and largely unsettled issues associated with post-event cleanup. Today there is still no consensus among federal, state, and local authorities on standards for radiation cleanup and area rehabilitation. This will likely serve as a major impediment to a “return to normal” for areas affected by contamination. Prepublication Copy 112 

Response and Recovery to Nuclear Incidents 9.6 AN ALL-OF-SOCIETY APPROACH FINDING 9-7: Significant roles exist for the private sector (including social media companies), non-profit and faith-based organizations, and civil society, in responding to and recovering from nuclear and radiological incidents. All have incentives to speed up the recovery process by providing assistance. The value that volunteers from the community, the surrounding region, and the country can provide should not be underestimated. For a major disaster, there are never enough available professionals to meet all the needs of the impacted populations. Plans that anticipate and embrace volunteers throughout the disaster cycle are instrumental for successful response and recovery. Operational planning needs to account for the role of volunteers and factor in what assistance they can provide. Community associations, faith-based organizations, and other local volunteer organizations should be part of the planning process. Additionally, representatives from these groups should be invited to participate in exercises and professional conferences to bolster an understanding of the role and capabilities they can bring to bear. Nongovernmental organizations and private sector leaders should be consulted during planning and exercises and throughout a nuclear/radiological emergency. The National Alliance for Radiation Readiness (NARR) is an important organization representing practitioners in the field of radiation readiness including state and local public health practitioners, elected officials at the state and local level, and first-responder/first-receiver groups. Inevitably, there will not be enough highly skilled and equipped teams like DOE’s Radiological Assistance Program (RAP) team, EPA’s Radiological Emergency Response Team (RERT), and the National Guard Weapons of Mass Destruction Civil Support Teams (CSTs). Thus, plans that incorporate volunteers are essential for a successful response and recovery. RECOMMENDATION 9-1: FEMA should reinvigorate a dynamic, comprehensive, and inclusive exercise regimen, in coordination with the Federal Radiological Preparedness Coordinating Committee (FRPCC) and with guidance and oversight from the NSM-19-established council of leadership. This should include fully utilizing the FRPCC (Federal Emergency Management Agency 1996; Nuclear Regulatory Commission 1973) in its capacity as a national-level forum to develop and coordinate radiological prevention and preparedness policies and procedures. Planners need to insert unscheduled crises into the normal exercise cycle that challenge senior decision makers to grapple with multiple emergencies at once while responding to a radiological emergency. Training protocols can be designed to assist practitioners in dealing with dynamic situations where there is considerable uncertainty about outcomes. Exercises can include identifying gaps in available capabilities for which decision makers will need to develop potential workarounds. Businesses with advanced supply chain capabilities could provide helpful insights and should be included in exercises and training. Online tools and local websites have been developed by many state emergency management agencies and regional preventive radiation and nuclear detection focus groups. These tools and websites should be used and assessed during exercises along with training that incorporates lessons learned to improve crisis response. Each exercise is also an opportunity to educate the participating leaders and the local community and should include a strong public affairs component. By thoughtfully engaging traditional and social media this public affairs Prepublication Copy 113 

Nuclear Terrorism: Strategies to Prevent, Counter, & Respond to Weapons of Mass Destruction outreach can provide subject matter familiarization and important information and guidance to local community members that will be lifesaving during an actual event. It can also provide reassurance to the public that their elected leaders are engaged along with pre-identified and well-trained local subject matter experts who can build trust with the public on radiation-related issues. RECOMMENDATION 9-2: FEMA with CDC, EPA, DOE, and NIH should empower local response, by making available simple and accessible real-time information through application development that will facilitate standardized actions and guide an appropriate public response. To assist, the White House should clarify the agency that serves as overall lead for providing federal interagency coordination and oversight of developing response tools to include educating state. local, tribal and territorial officials as well as the general public on their availability and utility, and strive to establish itself as a trusted agent. User-friendly data visualization products such as graphs, maps, and infographics will be essential tools in a radiological emergency. As with many low probability/high consequence events, there is no single platform or network to connect the non-governmental radiological/nuclear community to media or public officials. It will be important to develop such a mechanism to share resources and tools, including technical methods and information. RECOMMENDATION 9-3: President should request and Congress should support adequate resources for consequence management (CoM) programs that are key to a nuclear incident response. This should recognize the important role states, localities, tribal nations and territories play in saving lives. More resources are needed because these programs have insufficient budgets, staffs, and capabilities, and yet are foundational to any successful response to a nuclear or radiological event.” References Bentz, Julie. 2022. “Learning From Catastrophe: Lessons from the COVID-19 Pandemic for Preparing for and Responding to a Domestic Radiation Emergency.” NTI Paper. https://www.nti.org/analysis/articles/learning-from-catastrophe-lessons-from-the-covid- 19-pandemic-for-preparing-for-and-responding-to-a-domestic-radiation-emergency/. Center for Disease Control and Prevention. 2022. “Radiation Emergency Training, Education, and Tools.” Last Modified October 20, 2022. https://www.cdc.gov/nceh/radiation/ emergencies/training.htm. Coleman, C. N., D. J. Blumenthal, C. A. Casto, M. Alfant, S. L. Simon, A. L. Remick, H. J. Gepford, T. Bowman, J. L. Telfer, P. M. Blumenthal, and M. A. Noska. 2013. “Recovery and resilience after a nuclear power plant disaster: a medical decision model for managing an effective, timely, and balanced response.” Disaster Med Public Health Prep 7 (2): 136-45. https://doi.org/10.1017/dmp.2013.5. Conference of Radiation Control Program Directors. 2023. “CRCPD A Partnership Dedicated to Radiation Protection.” https://www.crcpd.org/. Federal Emergency Management Agency. 1996. Emergency Management and Assistance. Washington: U.S. Government Publishing Office. Prepublication Copy 114 

Response and Recovery to Nuclear Incidents ---. 2022. Planning Guidance for Response to a Nuclear Detonation Third Edition. edited by Biological Chemical, Radiological, and Nuclear (CBRN) Office ---. 2023. Nuclear Detonation Response Guidance: Planning for the First 72 Hours. Irwin, William. 2022. “The Radiological Operations Support Specialist (ROSS).” National Radiological Emergency Preparedness Conference, Nashville, Tennessee, April 11, 2022. http://www.nationalrep.org/2022Presentations/Session1_ROSS_Presentation.Final.pdf. National Academies of Sciences, Engineering, Medicine,. 2021. Restoring and Improving Nuclear Forensics to Support Attribution and Deterrence: Public Summary. Washington, DC: The National Academies Press. National Council on Radiation Protection and Measurements. 2022a. NCRP Statement No. 14 - Instrument Response Verification and Calibration for Use in Radiation Emergencies. National Council on Radiation Protection and Measurements (National Council on Radiation Protection and Measurements). https://ncrponline.org/wp-content/themes/ ncrp/PDFs/2022/Statement_14.pdf. ---. 2022b. NCRP Statement No. 15 - Respiratory Protection Recommendations for Workers and Volunteers Responding to a Nuclear Incident Outside the Affected Area. National Council on Radiation Protection and Measurements (National Council on Radiation Protection and Measurements). https://ncrponline.org/wp-content/themes/ncrp/PDFs/2022/Statement _15.pdf. Nuclear Regulatory Commission. 1973. 10 CFR Part 73—Physical Protection of Plants and Materials. PANO. 2022. “Introducing Pano Actionable Intelligence for Wildfire Management.” https://www.pano.ai/. Tilden, Jay A., and Dallas Boyd. 2023. “Nerds, ninjas, and neutrons: The story of the Nuclear Emergency Support Team.” Bulletin of the Atomic Scientists 79 (2): 87-94. https://doi.org/10.1080/00963402.2023.2178179. https://doi.org/10.1080/00963402. 2023.2178179. U.S. Center for Disease Control. 2023. “Radiation Emergencies - Resource Library.” https://www.cdc.gov/nceh/radiation/emergencies/resourcelibrary/videos.htm. U.S. Department of Health and Human Services. 2023. “MedicalCountermeasures.gov CBRN Radiological and Nuclear Medical Program.” https://medicalcountermeasures.gov/barda/ cbrn/radiological-and-nuclear-countermeasures/. U.S. Department of Homeland Security. 2021. “Radiological Dispersal Device (RDD) Response Guidance Planning for the First 100 Minutes Report and Video.” Last Modified January 12, 2023. https://www.dhs.gov/publication/st-frg-rdd-response-guidance-planning-first- 100-minutes. Prepublication Copy 115