These forecasts, like those for Iranian cities, are difficult even for experts to assess. "Obviously, accurate predictions of casualty and fatality estimates are next to impossible to obtain," says Dr. Glen Reeves, a longtime consultant on the medical effects of radiation for the Defense Department's Defense Threat Reduction Agency, who was not involved in the research. "I think their estimates are probably high but not impossibly so."
According to Paul Carroll of the Ploughshares Fund, a San Francisco-based foundation that advocates for nuclear disarmament, "the results would be catastrophic" if major Iranian cities were attacked with modern nuclear weapons. "I don't see 75% [fatality rates as] being out of the question," says Carroll, after factoring in the longer-term effects of radiation sickness, burns, and a devastated medical infrastructure.
According to Dallas and his colleagues, the marked disparity between estimated fatalities in Israel and Iran can be explained by a number of factors. As a start, Israel is presumed to have extremely powerful nuclear weapons and sophisticated delivery capabilities including long-range Jericho missiles, land-based cruise missiles, submarine-launched missiles, and advanced aircraft with precision targeting technology.
The nature of Iranian cities also makes them exceptionally vulnerable to nuclear attack, according to the Conflict & Health study. Tehran, for instance, is home to 50% of Iran's industry, 30% of its public sector workers, and 50 colleges and universities. As a result, 12 million people live in or near the capital, most of them clustered in its core. Like most Iranian cities, Tehran has little urban sprawl, meaning residents tend to live and work in areas that would be subject to maximum devastation and would suffer high percentages of fatalities due to trauma as well as thermal burns caused by the flash of heat from an explosion.
Iran's topography, specifically mountains around cities, would obstruct the dissipation of the blast and heat from a nuclear explosion, intensifying the effects. Climatic conditions, especially high concentrations of airborne dust, would likely exacerbate thermal and radiation casualties as well as wound infections.
Nuclear Horror: Then and Now
The first nuclear attack on a civilian population center, the U.S. strike on Hiroshima, left that city "uniformly and extensively devastated," according to a study carried out in the wake of the attacks by the U.S. Strategic Bombing Survey. "Practically the entire densely or moderately built-up portion of the city was leveled by blast and swept by fire... The surprise, the collapse of many buildings, and the conflagration contributed to an unprecedented casualty rate." At the time, local health authorities reported that 60% of immediate deaths were due to flash or flame burns and medical investigators estimated that 15%-20% of the deaths were caused by radiation.
Witnesses "stated that people who were in the open directly under the explosion of the bomb were so severely burned that the skin was charred dark brown or black and that they died within a few minutes or hours," according to the 1946 report. "Among the survivors, the burned areas of the skin showed evidence of burns almost immediately after the explosion. At first there was marked redness, and other evidence of thermal burns appeared within the next few minutes or hours."
Many victims kept their arms outstretched because it was too painful to allow them to hang at their sides and rub against their bodies. One survivor recalled seeing victims "with both arms so severely burned that all the skin was hanging from their arms down to their nails, and others having faces swollen like bread, losing their eyesight. It was like ghosts walking in procession" Some jumped into a river because of their serious burns. The river was filled with the wounded and blood."
The number of fatalities at Hiroshima has been estimated at 140,000. A nuclear attack on Nagasaki three days later is thought to have killed 70,000. Today, according to Dallas, 15-kiloton nuclear weapons of the type used on Japan are referred to by experts as "firecracker nukes" due to their relative weakness.
In addition to killing more than 5.5 million people, a strike on Tehran involving five 250-kiloton weapons -- each of them 16 times more powerful than the bomb dropped on Hiroshima -- would result in an estimated 803,000 third-degree burn victims, with close to 300,000 others suffering second degree burns, and 750,000 to 880,000 people severely exposed to radiation. "Those people with thermal burns over most of their bodies we can't help," says Dallas. "Most of these people are not going to survive" there is no saving them. They'll be in intense agony." As you move out further from the site of the blast, he says, "it actually gets worse. As the damage decreases, the pain increases, because you're not numb."
In a best case scenario, there would be 1,000 critically injured victims for every surviving doctor but "it will probably be worse," according to Dallas. Whatever remains of Tehran's healthcare system will be inundated with an estimated 1.5 million trauma sufferers. In a feat of understatement, the researchers report that survivors "presenting with combined injuries including either thermal burns or radiation poisoning are unlikely to have favorable outcomes."
Iranian government officials did not respond to a request for information about how Tehran would cope in the event of a nuclear attack. When asked if the U.S. military could provide humanitarian aid to Iran after such a strike, a spokesman for Central Command, whose area of responsibility includes the Middle East, was circumspect. "U.S. Central Command plans for a wide range of contingencies to be prepared to provide options to the Secretary of Defense and the President," he told this reporter. But Frederick Burkle, a senior fellow at the Harvard Humanitarian Initiative and Harvard University's School of Public Health, as well as a coauthor of the just-published article, is emphatic that the U.S. military could not cope with the scale of the problem. "I must also say that no country or international body is prepared to offer the assistance that would be needed," he told me.
Dallas and his team spent five years working on their study. Their predictions were generated using a declassified version of a software package developed for the Defense Department's Defense Threat Reduction Agency, as well as other complementary software applications. According to Glen Reeves, the software used fails to account for many of the vagaries and irregularities of an urban environment. These, he says, would mitigate some of the harmful effects. Examples would be buildings or cars providing protection from flash burns. He notes, however, that built-up areas can also exacerbate the number of deaths and injuries. Blast effects far weaker than what would be necessary to injure the lungs can, for instance, topple a house. "Your office building can collapse" before your eardrums pop!" notes Reeves.
The new study provides the only available scientific predictions to date about what a nuclear attack in the Middle East might actually mean. Dallas, who was previously the director of the Center for Mass Destruction Defense at the Centers for Disease Control and Prevention, is quick to point out that the study received no U.S. government funding or oversight. "No one wanted this research to happen," he adds.
Rattling Sabers and Nuclear Denial
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