Karl Riecken, Riley Fisher and Steve Overman: Prevention – not preparation for nuclear war

By Karl Riecken, D.O.; Riley Fisher, D.O.; and Steve Overman, M.D., MPH

The Tri-City Herald’s recent article, “Where are targets in Washington if there’s nuclear war? See if you’re at risk,” highlights the increasing threat of nuclear war. We applaud bringing this threat to the public consciousness. World leaders are invoking nuclear weapons, and the Trump administration is calling for renewed testing and expanded pit production – fueling a new arms race that undermines international treaties. The future of Iran’s nuclear weapon’s program remains deeply uncertain.

Unfortunately, the Herald’s article leans heavily on MIRA Safety, a Texas company that profits from nuclear anxiety. Readers should know that its “expert” commentary comes bundled with product placement. The suggestion that 72 hours of supplies – plus a CM-6M Tactical Gas Mask, a Geiger Counter, and Potassium Iodide Tablets – constitutes meaningful preparation does not withstand scrutiny. We would not recommend this to our families. It’s akin to recommending a poncho to survive a hurricane.

The Tri-Cities have a long history of grappling with nuclear risk. Washington’s Columbia Generating Station is just 10 miles north of Richland. Access to credible – not commercially motivated – resources matters. U.S. DHHS Radiation Emergency Medical Management guidelines support clinicians, emergency planners, hospitals and responders on triage, decontamination, fallout and sheltering. The CDC also offers relevant public health guidance.

Speaking as physicians, we would desperately want to help after a nuclear attack. But even these resources don’t cover all radiation problems a nuclear weapon produces. The infrastructure we rely on to give care would almost certainly collapse – and that’s if we, or any physicians, nurses, medics and first responders, survive the initial blast. We would not be able to help.

The notion that personal gear provides meaningful protection distracts from reality: nuclear war is a potential extinction event. As Ronald Reagan and Mikhail Gorbachev jointly stated in 1985, “A nuclear war cannot be won and must never be fought.”

While sheltering can reduce fallout exposure outside blast zones, it cannot preserve hospitals, restore supply chains, or prevent famine and societal collapse. Supercomputer modeling in Advancing Earth and Space Sciences concludes a full-scale nuclear attack would be suicidal for the aggressor. Research in Nature as recently as 2022 found that even limited nuclear war would produce severe global famine. Annie Jacobsen’s “Nuclear War: A Scenario,” drawn from dozens of expert interviews, makes these consequences viscerally real: a single strike escalates within minutes into a civilization-ending catastrophe. As it’s been said, “the survivors will envy the dead.”

The only real answer is prevention. Treating nuclear war as a manageable emergency – like a forest fire or winter storm – normalizes the threat rather than confronting it. From our perspective as physicians, the correct response to a disease with no cure is prevention. Wouldn’t you rather your physician focus on prevention than on lessening symptoms?

There is hope. After the Reagan-Gorbachev summit, the world reduced its stockpile from 70,000 warheads to nearly 10,000. Ward Wilson’s “It Is Possible: A Future Without Nuclear Weapons,” argues convincingly that nuclear weapons are ineffective and obsolete. An article published simultaneously in 120 medical journals in 2025, “Ending Nuclear Weapons, Before They End Us,” found that 2,100 warheads in France, Russia, the U.K., the U.S. and China were on high alert – ready for launch within minutes. That is four times the number needed to decimate our biosphere and trigger mass starvation. The authors proposed four first steps:

1. Nuclear weapons countries adopt a no-first-use policy.

2. They take their nuclear weapons off hair-trigger alert.

3. All states involved in current conflicts urged to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts.

4. Join the Treaty on the Prohibition of Nuclear Weapons that has 95 states signatories, 74 of which have become legally bound.

WA Physicians for Social Responsibility and its offspring organization, Northwest Against Nuclear Weapons, are pursuing these strategies – uniting peace, labor, environmental, faith and health communities to pressure elected officials, local governments and weapons production companies toward abolition.

We must prepare for ordinary emergencies. We must organize to prevent nuclear war. We make no money doing the latter – but we get to survive on the earth we love, with the people we love. Does a company that profits from fear share that priority?

Steve Overman specializes in internal medicine and rheumatology in Seattle. Karl Riecken is a family medicine/functional medicine physician in SeaTac. Riley Fisher specializes in emergency medicine, critical care medicine and pediatrics in Spokane.