Key point: It's even worse today than during the Cold War.
It is no exaggeration to say that for those who grew up during the Cold War, all-out nuclear war was “the ultimate nightmare.” The prospect of an ordinary day interrupted by air-raid sirens, klaxons and the searing heat of a thermonuclear explosion was a very real, albeit remote, possibility. Television shows such as The Day After and Threads realistically portrayed both a nuclear attack and the gradual disintegration of society in the aftermath. In an all-out nuclear attack, most of the industrialized world would have been bombed back to the Stone Age, with hundreds of millions killed outright and perhaps as many as a billion or more dying of radiation, disease and famine in the postwar period.
During much of the Cold War, the United States’ nuclear warfighting plan was known as the SIOP, or the Single Integrated Operating Plan. The first SIOP, introduced in 1962, was known as SIOP-62, and its effects on the Soviet Union, Warsaw Pact and China were documented in a briefing paper created for the Joint Chiefs of Staff and brought to light in 2011 by the National Security Archive. The paper presupposed a new Berlin crisis, similar to the one that took place in 1961, but escalating to full-scale war in western Europe.
Although the war scenario was fictional, the post-attack estimates were very real. According to the paper, the outlook for Communist bloc countries subjected to the full weight of American atomic firepower was grim. The paper divided attack scenarios into two categories: one in which the U.S. nuclear Alert Force, a percentage of overall nuclear forces kept on constant alert, struck the Soviet Union and its allies; and a second scenario where the full weight of the nuclear force, known as the Full Force, was used.