Our nation’s major metropolitan areas have detailed community response plans for hurricanes, forest fires, and other natural disasters. But in my decades in the field, I have noticed a worrisome gap: pre-disaster community planning for a nuclear event such as a terrorist plot.
In 2010, President Barack Obama told the 47-country 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.” A May 17, 2026, UN News article by Conor Lennon concurs, stating that the threat of nuclear terrorism is higher than ever.
The theft of 133 commercial-grade, uranium dioxide tablets in Tajikistan in 2021 remains unsolved. Some believe terrorists are planning a radioactive dirty bomb. That’s the low-tech scenario, which would be bad. But the higher tech scenario is the greater threat: terrorists detonating a compact tactical nuclear bomb in a U.S. city.
Imagine you and your family are home, and a flash of light floods the room. Your vision is temporarily blurred. Your home starts shaking as if a major earthquake just struck. Next, a giant sonic boom ruptures your eardrums, leaving you in pain and with the sound of Niagara Falls persisting in your ears.
Everything in the house that can fall does. Every dish and glass in the kitchen cabinets flies out. You duck and cover under the dining room table. Car alarms go off outside. People everywhere are screaming for help. After the rumbling ceases, you work your way across broken glass to a shattered window. You see a massive mushroom cloud rising in the distance.
Panicked, you try calling 911, but your fingers barely cooperate. No matter, you’ve already lost wi-fi and cell service, which also means you can’t go on the internet to ask for help or get advice.
You recall public health experts on TV recommending everyone stay indoors, preferably in a basement, until radiation dissipates. But you don’t have a basement. Or a bomb shelter. Fearful of the spreading radiation, you hastily decide to flee.
The experts say to have a go bag ready in case of disaster. But you never got around to it. You toss some saltine crackers and a few bottles of water into a shopping bag. Two gallons of water per person per day for a week is recommended. But you don’t have that on hand, and your faucets are spitting air.
You and your family are not sure which way to drive. Or how far to drive. It seems like everyone is doing what you are doing. You notice your fuel tank is low. You head for the nearest gas station, but the pumps are down. No power. You drive on, but you don’t know which highway is best. There are no signs for evacuation routes like the signage seen along the west coast for tsunamis. No zone assignments for forest fires. And your radio is all static.
Soon, you are stuck in gridlock. After three exasperating hours — no gas and maybe five miles covered — your family abandons the car and heads home. You are walking home through radioactive dust. And mayhem. You may be robbed. You will likely be seriously sick in a few days.
Now, rewind the tape. What if you and your community had made suitable preparations? You have plenty of bottled water. You quickly tape up your windows. You and your family stay put in an interior room. You try not to panic. You and your neighbors have some disaster training and have plans to help each other. You communicate via walkie-talkies. You have a first-aid kit and key medicines on hand, like prescription antibiotics and pain pills.
Staying put has its problems, but mayhem, heightened radiation exposure, dehydration, and starvation on the clogged highways are surely worse. Two days or so later, you learn that radiation levels have dropped to safe levels. Your city government is well prepared, the feds are coming, and local radio stations begin broadcasting life-saving recommendations for obtaining food, water, and emergency medical care.
Note, this is ideal. You must be patient. Depending on the extent of the terrorist attack, some supplies could take weeks. But if you and your community are well prepared, many additional lives will be saved. Perhaps yours.
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To fill several gaps in our current level of readiness, the federal government’s old civil defense plans, terminated in 1994, need to be resurrected and modernized. Community Emergency Response Teams classes, overseen by the Federal Emergency Management Agency, need to be mandatory in schools. Depending on the community, voluntary participation is not nearly enough.
First step: Visit ready.gov and prepare a go bag.
Geoffrey Simmons, MD, is a novelist and CERT Trainer of Trainers, a former FEMA RAC X member, and boarded in internal medicine and disaster medicine. He is the author of Common Sense and Disaster Preparedness and his latest novel, the nuclear terrorism thriller Oppenheimer’s Demon.