In a chemical attack, Smithson and Levy in their Ataxia report found there would be, "absence of awareness and standard operating procedure in 911 call centers; insufficiently equipped and trained police who are therefore likely to rush into trouble; difficulty in decontaminating large numbers of casualties rapidly; lack of chemical antidotes...uncertainty among paramedics about how to administer them; far too few hospitals ready to handle a major onrush of panicked, possibly contaminated chemical casualties; deficiencies in communications systems;...glitches in implement[ing] a large area evacuation on short notice...in most cities surveyed, hospitals plan to lock their doors after a chemical terrorist attack rather than risk compounding the problem by getting contaminated." Because U.S. hospitals are so fully occupied, there would be very few beds available.

Nuclear terrorism is another fearsome threat. The former Soviet Union had a massive stockpile of nuclear weapons, including small devices called "suitcase" bombs-at least according to Alexei Yablokov, Former Science Advisor to Boris Yeltsin, who told a subcommittee of the U.S. House National Security Committee in October 1997 that not only do these weapons exist but that some may be missing. Al-Qaeda agents have also reportedly tried to purchase nuclear weapons or material to make nuclear weapons.

In the February 9, 2002, issue of the British Medical Journal, three American physicians calculated the effect of a 12.5 kiloton nuclear explosion-the same size as the bomb dropped on Hiroshima-from a bomb concealed in a cargo container aboard a ship in New York harbor. Using software from the U.S. Federal Emergency Management Agency and the Defense Threat Reduction Agency, they estimated, "The blast and thermal effects of such an explosion would kill 52,000 people immediately, and direct radiation would cause 44,000 cases of radiation sickness, of which 10,000 would be fatal. Radiation from fallout would kill another 200,000 people and cause several hundred thousand additional cases of radiation sicknessÉthe ability to aid survivors would be very limited. About 1,000 hospital beds would be destroyed...and 8,700 more would be in areas with radiation exposures high enough to cause radiation sickness. The remaining local medical facilities would quickly be overwhelmed, and even with advance preparation outside help would be delayed."

Terrorists might also attack nuclear power plants, perhaps by crashing an airplane into the reactor building itself or into more lightly protected stores of radioactive materials in spent fuel pools at the reactor site. The watchdog group Physicians for Social Responsibility has called nuclear power plants "land mines waiting to be stepped upon." Or flown into? Though officials have publicly downplayed the possibility, recently, the Nuclear Regulatory Commission removed a study from their public reading room that graphically spells out the vulnerability of nuclear plants to an air attack.