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Comment by perihelions | Hacker News Reader

How on earth do they expect typical governments to distribute hundreds of thousands of doses of things which are recommended to be administered within <24h? This document seems... aspirational.

Also, how do you reconcile "shelter in place" with "seek prophylactic medical care"? They're pure contradictions. If you're exposed to unknown fallout, do you run outdoors again right away to find chelators, or do you delay that and risk irreversible damage?

Maybe the most reasonable thing would be to distribute most of these things to households in advance. Like the way they distribute KI near nuclear power plants, except to everyone.

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I'm assuming this is not in case of nuclear war, because there's no way any doses of anything would get deployed to ordinary civilians in the first few weeks at least.

you also probably can't distribute cytokines and colony stimulators ahead of time.

probably the thing to do is make sure everyone has good basic PPE, bottled water, and maybe a basic rad badge, and only seek medical care if you know you've been exposed to high levels of radiation.

I'm looking particularly at KI and the chelating agents, which are ordinary shelf-stable things. The point of these is to prevent biological absorption of particular elements in fallout, so either you have them available right away, or it's a lost opportunity.

- "Time of treatment initiation: DTPA should be administered as soon as possible after exposure, ideally within the first 24h. If early administration is not possible, therapy can be initiated at any time; however, the efficacy decreases substantially when radionuclides are deposited in the bone and other organs (47, 48)."

- "The optimal period of administration of stable iodine is < 24 h before and ≤ 2 h after the expected onset of exposure."

K iodide (KI) is not completely shelf stable, it oxidizes slowly in air (into elemental iodine, which is unsuitable to be ingested as a iodine source for humans).

K iodate (KIO3) is completely shelf stable, but it can be unpleasant when taken in very large doses.

Elemental iodine in solution with iodide forms tri-iodide, which is perfectly fine to consume. This is what Lugol's solution is and it has an unlimited shelf life.

It is fine to consume, but the part of the iodide that has been converted into iodine can no longer be transformed into a useful form inside the human body.

Therefore any reserve of iodide will provide a smaller dose than expected when it is too old, unless it was stored in special conditions, e.g. in nitrogen without contact with air.

> you also probably can't distribute cytokines and colony stimulators ahead of time.

Everybody would be fine to keep a pack of iodine pills flying around their home.

I rather delay a day of colony stimulator than popping iodine when there is fallout outside.

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