Nuclear war and public health: preparedness, protection and the case for prevention

BACKGROUND: According to the Stockholm International Peace Research Institute, the year 2018 saw a continuing 'drift into global instability' in which 'both the USA and Russia are on a path of strategic nuclear (weapons) renewal' with 3750 nuclear bombs globally deployed 'ready to fire'. Treaties are being abrogated with increasingly aggressive language exchanged, and discredited tactics such as 'limited use' revived. These developments risk an amplifying cascade of nuclear weapon fire, whether started by intent, miscalculation or unintentionally. RESULTS: A nuclear war would cause immediate and massive loss of human life, unprecedented damage to societal infrastructures and climatic disruption resulting in a 'nuclear winter' or 'nuclear famine'. CONCLUSIONS: The systems defending national territory against nuclear warhead missiles do not guarantee protection, and neither would hastily erected domestic shelters. Any post-survival world would be utterly different and severely challenging. The only effective preventative measures require nuclear disarmament through treaty.