Similarities Between a Nuclear Disaster and a Pandemic In both incidents, uncertainty (a key risk assessment confounder) was pervasive. Both incidents were expected but neither were predicted precisely, nor were initial response actions made rapidly enough to gain meaning- ful prevention momentum. The characteriza- tion of the threat to human health from radia- tion and COVID-19 is also incomplete, which contributes to the consideration of widely avail- able inexpert information and misinformation by the public. The evidence about the health eects of radiation—at small and large doses to environmental health, and including flora, fauna, agriculture, and wildlife—is equivocal in the literature and influenced by political and energy industry-driven economic interests. The uncertainties of a novel pandemic pathogen, even though almost 3 years after the WHO declaration of a pandemic, may be deepening rather than clarifying as SARS COV-2 Omicron variants continue to arise and the severity of infection varies. Further, more variants likely will present in the future. Many other factors influenced uncertainty and unpredicted outcomes: the ecacy and use of personal protective equipment (PPE) and social distancing practices; multisystem inflammatory syndrome; neurological and other acute and chronic medical sequelae, including long COVID (Cutler, 2022; Huang et al., 2022); vulnerabilities and suscepti- bilities of immunocompromised individuals; coinfected and comorbid populations; and the ecacy and durability of vaccines chal- lenged with potential evasion by new variants and subvariants. International Health Regulations: Global Health Security The striking similarity between the two cri- ses is clarified further in terms of emergency management prevention and mitigation strategy performance. The breach of con- tainment resulted from the global commu- nity’s failure to adequately expect and prevent the release of hazards presented by rapidly expanding threats, as well as its poor adjust- ment to the escalating crisis. The Fukushima nuclear disaster was characterized by the loss of coolant event that resulted in the melt- ing of nuclear fuel and the failure of radia- tion containment. The fuel inventory should have been the primary point of preparedness
emphasis but was inadequately addressed in a disaster planning process that emphasized the probability and magnitude of natural disaster trigger events. The COVID-19 pan- demic can be characterized as the loss of international epidemic containment, which potentially could have been preventable due to reporting obligations required by the Inter- national Health Regulations (IHR) under a Public Health Emergency of International Concern declaration (WHO, 2022). The state of Missouri sued the People’s Republic of China for loss of life, human suf- fering, and economic turmoil resulting from the COVID-19 pandemic. The court case states that the Chinese government had a duty to report “all events which may constitute a public health emergency of international con- cern within its territory within 24 hr under Article 6.1 of the International Health Regula- tions, yet it failed to do so” ( State of Missouri v. People’s Republic of China , 2020). Estimated costs for the resulting consequences of the two disasters are staggering: in U.S. dollars, $13.8 trillion for the COVID-19 pandemic and $700–800 billion for the Fukushima nuclear disaster, although the Fukushima cost is likely to increase due to the decade-spanning length of the projected mitigation schedule (Agarwal et al., 2022; NPR, 2021). The IHR is the primary global public health security framework and the U.S. Depart- ment of Health and Human Services (HHS) National Health Security Strategy is the pri- mary driver of U.S. national public health security. Both organizations address all-haz- ards readiness, public health emergencies, and radiological and infectious disease threat containment irrespective of natural, acciden- tal, or intentional causes (U.S. Department of Health and Human Services [HHS], 2019a; WHO, 2022). Additionally, the HHS National Health Security Strategy and the IHR follow a multisectoral, One Health approach (Nuttall et al., 2014; Sinclair, 2019). Updated in 2005, the IHR was based on lessons learned from the 2003 severe acute respiratory syndrome (SARS) global outbreak and was designed specifically to prevent the expansion of a novel epidemic across juris- dictional and national borders (WHO, 2022). The hazards associated with the Fukushima nuclear disaster and the COVID-19 pandemic are both specifically targeted by the IHR. Fur- thermore, the IHR demarcates both radiation
and epidemic disease as requiring immedi- ate and combined international attention by member states. Although the necessity to bridge One Health and all-hazards preparedness is established in the literature, the Fukushima nuclear disaster and the COVID-19 pandemic reveal practical reasons for its establishment on the ground at local, state, federal, and ter- ritorial levels. For example, the 2004 SARS- CoV-1 and 2019 SARS-CoV-2, regardless of lacking definitive source confirmation (e.g., natural, accidental, or intentional), cause zoonotic diseases and are linked directly or indirectly to animals in the wild, at markets for human consumption, or used in research activities. Future surveillance and emergency preparedness response solutions require cross-sectoral collaboration among animal and veterinary, medical, and environmental health professionals. Additionally, the acute threat to human health by radiological acci- dents or attacks must be addressed by the immediate availability and accessibility of medical countermeasures. Long-term envi- ronmental health contamination caused by nuclear accidents requires cross-sectoral and integrated prevention strategies that consider the potentially irreversible nature of envi- ronmental contamination in animals, plants, and humans. It is essential to clarify terminologies used during emergency management planning processes. The terms disaster, emergency, and crisis have been addressed in the literature. It is accepted that crises are acute and dif- ficult to manage, and disasters have already occurred (e.g., extreme weather events). As such, modern U.S. federal doctrine is invested in all-hazards emergency preparedness guid- ance that eectively bypasses the need to make categorical distinguishments between terms, aside from legal proclamation. The term crisis, however, is used in the health- care industry, specifically in association with emergency management, including the utilization of various forms of the National Incident Management System (NIMS)-based, unified incident command system (ICS) to protect hospital surge capacity and assure quality of service when resources are scarce (Sase & Eddy, 2021). Redesigning the Emergency Management Cycle
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