The blessings the United States enjoys are many, but one of the greatest has been its relative freedom from major disasters. Only twice has the United States declared a federal public health emergency—the terrorist attacks of Sept. 11, 2001, and Hurricane Katrina.

That remarkable record is likely to change. We'll consider how below, but first, let's look at how prepared the country is to deal with major disasters.

The nonprofit organization Trust for America's Health (TFAH) recently released its fourth annual "Ready or Not? Protecting the Public's Health from Disease, Disasters, and Bioterrorism" (http://healthyamericans.org/reports/bioterror06/BioTerrorReport2006.pdf). TFAH assesses health emergency preparedness of the 50 states using 10 specific indicators. Some of them are:

• Meeting the highest rating of the Centers for Disease Control and Prevention (CDC) for preparedness to distribute emergency vaccines, antidotes and medical supplies from the Strategic National Stockpile (SNS), which the CDC maintains.

• Sufficient laboratory capabilities to test for biological threats.

• Sufficient number of laboratory experts trained to test for a suspected outbreak of anthrax or the plague.

• Enough hospital bed capacity to accommodate the estimated number of people needing hospitalization within the first two weeks of "a moderate pandemic flu outbreak."

• Having a sufficient number of registered nurses.

Highlights from the report

Only one state scored a perfect 10—Oklahoma; Kansas was the only state to score nine; the rest (and Washington D.C.) scored between eight and four.

The CDC rated only 15 states at the highest preparedness level to receive and provide emergency vaccines, antidotes and medical supplies from the SNS.

A state's ability to deal with biothreats encompasses the existence of facilities, technology and equipment. Eleven states and Washington D.C. came up short in this area. An additional problem exists in that the states' laboratories can obtain reagents—diagnostic materials necessary to analyze for biological agents—only from the CDC. The CDC cannot keep up with the demand.

Only 25 states have enough hospital beds to deal with a moderately severe flu outbreak. ("Moderate" is determined by averaging the hospitalization statistics of the relatively mild 1968 flu outbreak and the severe 1918 flu epidemic.) This is truly a sobering illustration of how strained the nation's resources would be in a major disaster.

Equally disturbing is the fact that 40 states have a shortage of nurses—not just to deal with a major disaster, but to deal with present health-care demands. Moreover, a recent survey reveals that even more severe staffing shortages loom in the near future, because baby boomers are retiring and vacancies aren't being filled adequately.

What events could trigger a national health emergency?

Terrorism

Terrorism of all kinds probably comes to mind first, including agroterrorism; bioterrorism; and chemical, radiological and waterborne terrorism.

In 2004, then Secretary of Health and Human Services Tommy Thompson startled Americans from complacency with the observation, "For the life of me, I cannot understand why the terrorists have not attacked our food supply, because it is so easy to do." Agroterrorism is the "…deliberate introduction of an animal or plant disease with the goal of generating fear, costing economic losses, and/or undermining stability" (ibid., p. 5).

Bioterrorism involves the use of biological agents such as germs or biotoxins to cause disease or death in people, animals and plants. Examples in the TFAH report are anthrax, smallpox, botulism, salmonella and E. coli. The United States recently called for tighter measures to prevent even toiletries and cosmetics from being used as weapons ("Bioterrorism Experts Call for Measures to Protect Beauty Products," Dec. 13, 2006, CareFair.com).

Ominously, only 10 states have the capacity to test for chemical threats. The CDC identifies "over 60 toxic substances that could be used as chemical weapons by terrorists. Many of these are regularly used commercial and industrial chemicals that could be 'weaponized'" (TFAH report, p. 18).

Terrorism expert Richard A. Falkenrath testified last year before the U.S. Senate that chemical facilities "fly off the page" when one considers possible terrorist targets. The dual factors are those with "the greatest possibility for mass casualties and [facilities that] are the least well secured at the present time…" (Eben Kaplan, "Targets for Terrorists: Chemical Facilities," Dec. 11, 2006, Council on Foreign Relations, www.cfr.org/publication/12207 target_4_terrorists, emphasis added).

Probably radiological threats receive the most publicity today, especially the potential explosion of a "dirty bomb," which could spread radioactive material over a heavily populated area. Food and water sources are also vulnerable to this type of terrorist attack. Radiation could also be widely dispersed by destroying a nuclear facility.

Diseases

Several types of diseases could also trigger a national health emergency, including a pandemic flu, diseases spread by insects, foodborne diseases, waterborne diseases and diseases carried by animals that can spread to humans.

The Department of Health and Human Services estimates that "a severe pandemic [flu] could result in 1.9 million deaths and 9.9 million hospitalizations in the U.S." (TFAH report, p. 5).

Recent examples of diseases spread by insects include the West Nile virus, Rocky Mountain spotted fever and malaria.

Examples of diseases carried by food include botulism, salmonella, E. coli, shigella (which causes dysentery) and norovirus (which causes "stomach flu" or gastroenteritis). Every year, 325,000 Americans are hospitalized and 5,000 die from such diseases, so this is already present as a health threat.

Water can carry some of the same diseases, as well as cholera, typhoid, hepatitis and polio—to name only a few. Blessed with good quality drinking water and relatively clean recreational water, Americans can easily take this benefit for granted. One has only to look at the developing world to see what life would be without it.

Avian flu is a prime example of a disease carried by animals that can spread to humans. The World Health Organization warned that the world was closer to a pandemic during 2004 (due to the avian flu) than it has been at any time since the 1968 flu. (See "Avian Influenza: Assessing the Pandemic Threat," January 2005, www.who.int/entity/csr/disease/influenza/H5N1-9reduit.pdf.) Other examples in this category include mad cow disease, rabies and SARS (severe acute respiratory syndrome). The U.S. Food and Drug Administration estimates the losses of a significant mad cow outbreak in the United States at up to $27 billion.

Natural disasters

Last (but hardly least) are natural disasters, including hurricanes, earthquakes, tornadoes, fires, drought, floods and tsunamis.

Hurricane Katrina was a disaster unlike anything the United States had seen in modern times. Early predictions for 2007 are for 14 named storms and seven hurricanes—three of them "major." At least one is predicted to make landfall.

Lessons from Katrina shocked Americans into a sober awareness of their powerlessness in the face of nature's fury, as well as of serious shortfalls in the nation's ability to manage that level of disaster satisfactorily. Among the serious shortcomings revealed was the ability to meet the needs of children, the disabled and the chronically ill.

The TFAH report highlights the dangers inherent within what it calls America's "just in time economy." That is, food, water and medicines arrive by truck and train shortly before they are consumed. There is never a large inventory on hand, especially in metropolitan areas.

Is the United States vulnerable to tsunamis? Dr. John Rundle, a scientist at the University of California, Davis, warns: "The risk for tsunamis like the one we saw in Sumatra is very real and very present and very possible" (Edie Magnus, "Could a Tsunami Hit the U.S.?" Dateline NBC, Jan. 9, 2005).

Of course, no natural disaster is precisely predictable.

There are several active volcanoes in the United States; the most active currently is Mt. St. Helens in Washington, which is growing a new lava dome. The Yellowstone caldera (the crater formed by a volcanic explosion or the collapse of its cone) is closely monitored and does not show the potential for an immediate eruption.

Scientists anticipate major earthquakes in the San Francisco Bay region anytime in the next 30 years; a major one is overdue in the Parkfield, California, area. Other U.S. regions are not exempt from earthquakes, including the Midwest, where major quakes destroyed entire towns in the early 1800s.

Flooding, drought and tornadoes can strike almost anywhere at anytime. Currently, extreme drought continues in the northern high plains states, the northern Rockies and northern Minnesota.

Think about the consequences of multiple disasters occurring simultaneously. Imagine a radiological attack by terrorists combined with a major earthquake. What about a devastating hurricane and a volcanic eruption in conjunction with localized flooding or drought? In mere days, the United States could be reduced to needing international aid to survive.

Is that an unreal scenario, the makings of only a made-for-entertainment movie?

The worst yet to come

Typically, when a major disaster occurs, many people cry, "Why did God do this?" Or "Why did God allow this to happen?" The truth is that God isn't involved in most disasters, for they are human-caused or occur in the course of natural events.

Divine intervention is rare. Yet biblical history shows that God has used disasters, sometimes stirring willing human agents and sometimes ordering nature. God used a series of disasters to humble and eventually break the spiritually wayward 12-tribe nation of Israel.

He has reconstituted a powerful modern Israel today. I refer not to the small state of Israel, but to the mightiest Israelite nation in the modern world, the United States (see our Bible study aid The United States and Britain in Bible Prophecy for the historical and biblical proof). In the same way that it came time for God to use disasters as a last measure to deal with America's Old Testament ancestors, so such a time is foretold for our world.

Much is said about the indisputable generosity of Americans, demonstrated by individual charitable donations and volunteerism, as well as by official governmental action. Yet that doesn't cancel out the behavior of those who increasingly reject any concept of a God who would restrict or control their personal choices.

There is a God—a Father—who, like a responsible human father, stipulates expected behavior for His children. Calling it "controlling" is pejorative and myopic. God's parental guidelines, summarized in the Ten Commandments, are comforting, protective, positive and healthy.

Bloated with prosperity, America feels comfortable in turning away from the God of the Bible. The time will come when God will decide with sadness that He must use the last option—a series of disasters that will virtually remove the United States' superpower status. It won't be the end of the world, but rather the restructuring of the world.

Don't take our word for it. Read the preview in Leviticus 26 and Deuteronomy 28. And read the booklet mentioned above, which brings in numerous other scriptural prophecies and combines them with history and current events.

For the United States, the worst is yet to come.