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Projected US Casualties and Destruction of US Medical Services From Attacks by Russian Nuclear Forces

The number of direct, short term casualties and collateral damage to US medical services were calculated for two thermonuclear attack scenarios: 1) 2,000 Russian warheads believed to be on high alert status today; and 2) a future Russian force of 500 warheads targeted in response to the deployment of a US National Missile Defense (NMD) system. The first scenario would cause 52 million prompt fatalities, 9 million injuries, and massive destruction of US health facilities. The second scenario produces more than 100 million casualties. Even with an effective US NMD system— defined as capable of successfully intercepting more than 100 warheads—nearly 70 million fatalities would occur. 

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