Sheehan’s distinguished career includes postings as the Ambassador-at-Large for Counter Terrorism at the U.S. State Department as well as the New York Police Department’s Deputy Commissioner for Counter Terrorism following the 9/11 attacks. So, he should be a terrific person to speak to about citizen preparedness.

If you have a question you would like me to ask him, please send it to me at jsolomon@incaseofemergencyblog.com. I’ll put the answers on the blog.

You should be careful about what you read from the government about potassium iodide (KI). It should not be too great a surprise to learn that the current administration has politicized this issue, and once again has put politics above science.

In 2004, the US National Academy of Sciences issued a thorough and comprehensive report on KI that strongly endorsed its wide availability. But the Bush administration, earlier this year, decided to ignore the conclusions of this research group, and instead announced that a policy group (the White House Office of Science and Technology Policy) had concluded that KI offered “negligible additional value” and consequently efforts to expand its availability would not be pursued. Thus, although millions of people could need KI in a radiation emergency, almost no one would be able to get it.

Unfortunately, your optimistic assumption that “in the event of an attack KI would be distributed by the government” is incorrect since there is almost no KI to distribute. I know this, because the company I work for is the only US FDA approved manufacturer of KI tablets for radiation protection, and is the government’s sole supplier of the product.

The KI story is a classic one, where the science is unquestioned, but the government’s response is political. In order to protect the perceived best interests of the nuclear industry, current radiological emergency response plans pay little attention to KI, but instead stress the immediate evacuation of millions.

It’s like they don’t remember Katrina.

In my post, I may have sounded too optimistic and may have unintentionally been misleading about the potential availability of KI. My bigger point was that there was a need for far more guidance on this and almost all other medicine-related issues when it comes to civilian emergency preparation and response. I am concerned, and have written extensively, about the lack of discussion and advice from the government to the public about what medicines we should be storing, like KI, and others that might need to be distributed in the event of an emergency (including those for bioterror and pandemic events). Also, I didn’t want people in the listening audience to suddenly get panicked and go out to try to find KI.

But Alan is right to point out the supply constraints. And, as he mentioned in the post, it is not clear why the Administration decided earlier this year not to go ahead with a plan to distribute KI to citizens near nuclear reactors as this USA TODAY article on his company’s site points out. The bottom line for me is that we need a full public discussion on KI and other medicines that might be necessary in an emergency.

Thank you, Alan, for your input. This is exactly what I was hoping would happen with this blog — soliciting outside expertise and then using it to help me and in turn other citizens understand these issues better. I will make sure to bring up the KI issue when I speak to policymakers in the future, and I will report my findings on the blog.

As a nation, we rarely talk about citizen preparedness publicly. Based on the phone and online reaction to the shows, it is clear that there is a lot of interest and uncertainty about the subject among the population. Yet, at present, there is no place for the public to ask those questions and get them answered. So, if I can help fill that gap a bit, I’m going to try to do so on this site and through other platforms.

A post from ‘Steven from Brooklyn’ is reflective of a sentiment I heard during the series:

Consider that if it’s an event like a hurricane which you guys kept mentioning, there’s plenty of time to pack a go bag rather than grabbing the one with the stale chocolate bar in it. If it’s an event like 9-11, you probably won’t be near your go bag. And if it’s a (oh I don’t know, say) a dirty bomb or something like that, the real problem will be getting out of the city. It won’t much matter if you’ve got a “go bag” when you have nowhere to go.

On WNYC, we focused a lot of attention on making ‘go-bags’. But as Steven points out, what good is a ‘go-bag’ if you don’t have a place to go. Fair point. The reason we suggested making a ‘go-bag’ is that it is a relatively easy and tangible way for citizens to begin the preparedness process. But it is only one part.

There is a need for people to begin thinking about what they would do in the event of an emergency. That might mean ’sheltering in place’ at home or at the office, it might mean going to a shelter or in an extreme case it might mean evacuating your area.

However, in order for citizens to think about their evacuation (or stay in place) plans, they need the authorities to provide more information. There has to be some broader discussion about what are the scenarios we all might face and what would are options be. The government will not be able to provide detailed and accurate instructions for every citizen in every type of emergency, because it will depend on the situation at hand. However, that doesn’t mean that there shouldn’t be more openness about some of the most likely cases. So, when something happens, it is not the first time people are hearing about it. According to a recent New York City Office of Emergency Management survey, only 11% of New Yorkers say they know what to do in the event of a terror attack and 12% in a hurricane. The national numbers are even more anemic.

One valuable outgrowth of such a dialogue is that it would better aligh citizen expectations with the reality of government capability and put more of the responsibility with the public itself. In fact, a post from ‘Superf88′ is reflective of that public uncertainty about evacuation which needs to be addressed:

A few years ago during the power outages I was assuming that Homeland Security would be activating a system I had assumed they had established after a couple years in existence — which entailed private and government boats to evacuate folks from Manhattan to “mainland.” After all, I can’t imagine what *else* this homeland security could even do. Silly me — but do you know if such a system is yet in place?

‘Jeff from Manhattan’ posted a question that I hear a lot and asked myself at one point. In fact, it was the question that got me into this topic, the book and ultimately this blog.

Do you recommend getting potassium iodine in case of radiological attack and if so where do you recommend getting it?

After 9/11, there was a lot of discussion about Potassium Iodine (KI) as something that could be taken to deal with radiation. To learn more on the prompting of my wife, I visited Department of Homeland Security’s website Ready.Gov

“If there is a significant radiation threat, health care authorities may or may not advise you to take potassium iodide. Potassium iodide is the same stuff added to your table salt to make it iodized. It may or may not protect your thyroid gland, which is particularly vulnerable, from radioactive iodine exposure. Plan to speak with your health care provider in advance about what makes sense for your family”

So I asked my doctor about it. He told me that he didn’t suggest storing potassium iodide, because he didn’t think terrorists had the capability to deliver a nuclear attack (my italics). Now, I love my doctor but I went to him — and DHS recommended I do so — for his medical advice not his geopolitical analysis. Not making a firm recommendation will only lead to more confusion. Most experts I’ve spoken to do not think individuals should store KI less because of the possible threat and more because it will likely be misapplied without proper guidance. But it would be worth asking your doctor for his advice. It is likely that in the event of an attack KI would be distributed by the government. These are questions we need to be asking our elected officials and public health authorities so they provide us with the answers in advance rather than during an emergency.

What you should have an extra supply of is any prescription medicine that you need. However, that is not always easy to do under many insurance plans. Officials tell me that they are discussing the possibility of getting the companies to relax those restrictions if an event was imminent. That is obviously not ideal, but it would be better than the current situation.