By the end of the day on 20 August an area of 600 square kilometres centred on Birmingham was a scene still lit by innumerable fires burning themselves out, with pockets of activity where fire-fighting and rescue operations were going on and groups of people had formed themselves into rescue teams to try to extricate those buried beneath rubble. A small number of people had been able to obtain medical assistance but thousands were totally unable to get near a hospital because of the large numbers of injured requiring attention. By the end of the day almost all organized endeavour within the areas hit by the nuclear explosion had to be concentrated on attempting to cope with the enormous numbers of casualties. Hospitals were being inundated with requests for help and submerged by the wave of people appearing for treatment. Many were still lying where they had been injured; there was no way of collecting them up. The numbers of people appearing at hospitals were such that physical protection of the premises was required from the police. Even so, the anxiety of people to receive treatment themselves or have others treated was so great that violence began to develop and there were disturbances outside some of the surviving hospitals.
The movement of survivors out of the area, by vehicle or on foot, soon began to clog the remaining passable roads and severely hampered the emergency services. Further police effort was required to control this. The police manpower available for this task, and also for the protection of the hospitals, even with the help of reserve army units, was simply insufficient. Chaos began to develop on the roads, chiefly near hospitals and in areas which had suffered less damage than others and where people came to find food and shelter. As the night wore on the absence of electricity made matters worse, so that the day ended in a shambles of uncoordinated activity by fire-fighting and rescue teams doing what they could against the mountain of disaster facing them, in an environment where hundreds of thousands of people were seeking food and shelter and attention for severe injuries. The extent of the disaster and its aftermath was such that the local authorities were quite unable to control events.
During the day the situation in Birmingham had been in the minds of the entire country. Everyone was aware that a nuclear device had been exploded and most were convinced that it was only the first of many. This caused an element of panic everywhere as individuals sought either to protect themselves within their own homes or to move from urban areas out into the country, where they imagined they might be safer. The potential mass exodus of people was of great concern to the government, who strove to check it through broadcast messages. Fortunately no further nuclear attack took place. Nevertheless, local authorities everywhere were making preparations to ensure their own survival and might not have been receptive to requests to provide Birmingham with assistance, had these been made.
The government had ordered Headquarters United Kingdom Land Forces to take whatever action in support of Birmingham was possible without detriment to its ability to withstand further nuclear strikes. Headquarters West Midland District was ordered within minutes of the strike to provide what assistance it could in the Birmingham area.
By mid-afternoon that day twelve major units from the regular and volunteer armies, together with units of the RAF Regiment, amounting to some 10,000 men, with logistic and medical services and some fire-fighting equipment, were being deployed on emergency relief operations. Units drawn from West Midland, Eastern and Wales Districts, including the Mercian Yeomanry and men from the Light Infantry Depot at Shrewsbury, were deployed to Wolverhampton, Stourbridge, Halesowen, Solihull, Sutton Coldfield, Walsall and Brownhills. Here the local authorities had retained some semblance of local control and rescue and relief operations were therefore already under way in some form or other. The military units brought with them vehicles, communications, tentage, blankets, medical assistance, engineer equipment and fire-fighting equipment. Most important of all, they were organized bodies of men, capable and under disciplined control.