The basic medical facts about a full-scale nuclear war have been clear and undisputed for decades. Hundreds of millions would be killed and injured. Massive outbreaks of disease would follow. Food supplies and water would be contaminated and the systems to deliver them destroyed. Drastic and sudden climate changes would wreak havoc on agriculture and human and animal populations. All essential services, including medical and health services, would be rendered useless. Epidemics would rage. Civil defense–the notion that there is somewhere to hide–remains a hoax.