Does it kill people?
The nuclear explosion does not kill people directly but imagine the electric power being out across the US indefinitely with no hope of it coming back on. All refrigerators will stop working. The electric pumps that power the public water supply and sewage treatment plants will stop. Hospitals will not be able to treat patients. Pumps at gas stations will stop so people and more importantly truckers will not be able to get fuel. The computers that run financial transactions will stop so business will also stop.
People will die of lack of water, starvation, diseases. It will be the greatest catastrophe of all time to hit this nation and the world in terms of the number of people who will die.