The Nightmare Scenario (8 page)

Yelena moved on to Luca Batelli, her brightest student overall. Only he was allowed to work on the core of her own research: live attenuated influenza vaccines.

“Luca, have far have you gotten?”

“Good morning, professor. I have run about a hundred sub-strains.”

“Anything interesting?”

“As expected, there are differences in pathogenicity. It’s not huge, but enough to make me feel there is something here.”

“Okay, give me the top and bottom ten.”

Luca shuffled through a series of printouts and handed Yelena the requested selection.

Yelena studied the color-coded genetic gene sequences in intense silence. After a couple of minutes she started spreading out the sheets on the desk in front of Luca.

“You see this. Look at the concentration of the positively charged amino acids. The more virulent strains have a denser concentration, here and here, while they are more spread out in the less-aggressive strains. What do you make of that?”

“Yes, that could be something. It would be a pretty significant finding if it was true.”

“I agree. Right now it’s a bit thin though. See if you can drive mutations in the strains towards higher and lower concentrations respectively, and then we’ll see what happens with the pathogenicity.”

“Sure.”

Yelena clasped her hands behind her head and stretched, arching her back. This was turning out to be a good morning. When she turned around to get coffee she found Sergei looking, no more like staring at here, intensely.

“What now?” Yelena asked.

“I have checked the data many times and I am pretty sure it is correct.”

“In that case the only explanation is contamination. Redo the experiment.”

“Professor Ivanovna! Excuse me for being so direct,” said Sergei, who had now risen to his feet, “but I have run this experiment three times already and gotten the same results each time. I know why you’re skeptical, but I’m telling you, these results are accurate.”

Yelena paused, turned around slowly and looked at Sergei, thinking, “Screwing it up three times in a row? That seems like a lot even for Sergei. There must be something else going on here.”

“Sergei,” Yelena said, “you realize what you are saying. If your analysis is correct, it means that
two patients
were infected with HIV from the same source at the same time, more or less. The only instance where we see this is with intravenous drug users. And even then it is rare, as the infection probability by exposure for that transmission type is below one percent.”

She snatched the files from Sergei. “And here you have, let’s see, a father of two and a young student, with no history of heroin abuse and living in suburbs at the opposite ends of Moscow. The two of them sharing needles feels like a bit of a stretch, Sergei, don’t you think? Maybe there was a mix-up of the samples from the original source?”

“Needle-sharing is not the only cause of matching chromatograms…”

“Oh, come on! We haven’t had contaminated blood for a decade. Both the blood and the tests are so cheap
that even the most unscrupulous black-market trader wouldn’t sell untested blood. There is no plausible explanation…” Yelena paused in mid-sentence. “Unless… Have they had surgery?” she asked Sergei abruptly.

“Yes, this one had a liver transplant, which is unusual as he is a documented alcoholic. He must have paid through the nose to get it,” added Sergei, scanning the records.

“And this one,” interjected Luca, who had started to show a sudden interest and was now peering at the other file over Yelena’s shoulder, “has had a kidney transplant.”

“
Bozje moi
…” sighed Yelena. “Infected black market organs. Unbelievable…”

“Different hospitals though,” said Sergei.

“Yes, but same owner,” came Yelena’s response as she grabbed her jacket and ran for the door.

“Where are you going, Professor Petrova?”

Yelena was already out the door and her answer trailed off. “I am going to the Ministry of Health to see the last honest man in Russia, and then rip the guts out of a certain ‘healthcare entrepreneur’.”

The excitement ran so high in the lab that no work could be done. Instead, the students shared their thoughts of how the inevitable confrontation would play out. They had occasionally glimpsed the fury of which the Professor was capable, and it was like nothing else.

Their exhilaration was interrupted by a phone’s ring. Sergei answered, “Moscow Medical Academy, Department of Infectious Diseases.”

“Yes, hello, this is Dr. Chen-Ung Loo from the Singaporean CDC. Could you please connect me to Dr. Petrova?”

“I am sorry, but Professor Petrova is unavailable at the moment. Can I take a message?”

“Yes, tell her Loo says there’s trouble in paradise.”

JULY 29
^TH
, 9 AM, WHO HEADQUARTERS, GENEVA

A
eolus hadn’t been in his office more than thirty seconds before Walt entered, obviously pre-warned by the receptionist about Aeolus’s arrival.

Aeolus sat down in his chair, took off his galoshes – a must to protect his leather shoes on rainy days – turned to Walt.

“So? Where are we?”

“Well, sir,” Walt responded, slightly short of breath, “we’ve made some progress. The Singaporeans have a sample. They’ve isolated it, grown it, and put it under a microscope. I have to agree with you, they’re amazingly efficient.”

“And what can they tell us so far?”

“First of all that you were right, it’s a strain of influenza – A, to be precise. Beyond that we don’t know much. They’re confident that it’s a new strain we haven’t seen before.

Walt handed Aeolus a printout showing a set of grainy gray balls with small filaments covering their surfaces, bunched together in groups of five and six.

“Yeah, that’s influenza, all right.”

“They have claimed the designation A/Singapore/4/2015/(HXNX) until we get the subtype, which they say should be in three days.”

“Have they started working on a diagnostic test?”

“Yes.”

“What’s their timeline?”

“Dr. Loo says there’s nothing off the shelf.”

“We don’t have time to make one from scratch. If we have to inoculate ferrets it could be five weeks. He’s got to do better than that.”

“He says he might be able to, ahem… ‘cook something up.’ By adapting and combining various old PCR primers he thinks he might be able to get specificity.”

“So it’ll be two to three weeks or so?”

“Dr. Loo says he can do it in ten days.”

“I have no idea how he does these things, but let’s agree we put the right man on the job. And they’ve distributed cultures to other labs?”

“Yes, they’ will be continuously sending out samples as they become available. My office is coordinating to make sure they go out in the proper order of priority.”

“And how are things on the ground?”

“We haven’t been able to locate Rebecca Summers yet. She’s not at her office, home and isn’t answering her cell.”

“What? Then find her! Someone at the CDC must know where she is. I want her down there now!”

“Yes, sir. Also, you have a brief in front of you summarizing everything we know. It was written by two senior staffers I picked to support you. You can’t do this by yourself. You have to delegate.”

“Yes, I know,” Aeolus said, frowning. No matter how much he hated it, in this case, Walt was right. This was going to be too much for him to handle by himself. He would have to hand over the knucklehead stuff to someone else.

“How did you choose them?” he asked.

“As you know, I’m not a great judge of medical knowledge, but I do understand operational effectiveness, and in that they are capable. They have relevant experience, and they have each, on two separate occasions, stood up to you without getting fired. This means they have a rare quality, which is necessary for the job. Read the brief and see what you think.”

“Okay. I’m reading.”

Mandy entered with Aeolus’s morning coffee. Without looking up from the brief, Aeolus waved a hand toward Walt, inviting him to request any refreshments he might desire. Walt shook his head, cleared his throat and continued: “Also, if I may, this might be a good time to discuss your behavior towards the staff.”

“We’ve talked about that many times.”

“Yes, but this time you will have to lead. Your habit of not remembering their names, firing people at a whim and just generally being rude won’t work.”

Aeolus sighed, frustrated that Walt just didn’t get it. “Walt, Walt, Walt… as for the firing, you know what I’ve told you. You can’t make an omelet without breaking some eggs. Still, you do have a point. Set up an all-hands meeting in the lobby at three. And connect our regional offices via video. I agree it’s time we rally the troops. Please, stay while I read.”

Kevin Brice and Edward Moynes stood outside Aeolus’s office. Kevin was fidgeting with his pencil nervously and Edward walking around in circles. They were the two senior staffers who had written the report Aeolus was reading. Kevin was a tall, lanky man known around the office as being somewhat of an eager beaver; ambitious and always anxious to show off his knowledge. Edward, or Ed as he was usually called, was, in terms of appearance, Kevin’s polar opposite: short and stocky, with a comb-over, which failed to hide his ever-growing bald spot. He was the senior staff’s permanent cynic, always pointing out the obstacles and potential misfortunes of any proposed course of action.

Ed spoke in that high-pitched voice, which made it easy to identify him even from far away. “If he calls me an intellectual midget again, I swear to God, I’m resigning and taking up that research position at the Karolinska Institute.”

Kevin, trying to lighten the mood, responded, “At least he’s never called any of your reports ‘a grade-F college midterm paper.’ But seriously, Ed, he’s one of the
greats. Just working next to him, you learn more than you could anywhere else.”

“The only thing I’ve learned is to smile and nod gratuitously in the face of humiliating disparagement.”

As Walt opened the door and motioned the two men to enter, Aeolus started speaking. “It is not without satisfaction that I note you’ve printed this report, not on our regular eighty gram office paper, but the considerably heavier paper used for final reports, no doubt in order to try to impress me with presentation rather than content. This paper’s thickness will work far better for starting the fire in my fireplace. And that is the only thing it will be used for.”

Kevin lowered his gaze to the floor and Ed sighed inaudibly as his eyes turned to the ceiling. They both knew that if the text they had produced, with all the effort that had gone into it, was not up to par, it was unlikely that anything they wrote ever would be.

Aeolus chuckled. “Relax, I am merely jesting.”

Walt cleared his throat. “Sir, may I introduce…”

“Kevin Brice and Edward Moynes,” said Aeolus, cutting him off. “I know.”

Walt could not hide his surprise.

“This is a good brief,” Aeolus continued, tapping his finger on the folder, “It has what I need, and it’s not clogged with ephemera.”

Now Kevin and Ed were the ones who were shocked. Aeolus was not a person who gave praise. In fact, they’d never heard him be so appreciative.

“You are going to be my point-men on this,” Aeolus told them. “You will sit in on the meetings and be fully
briefed. You will lead a piece each, and you will also form a triumvirate with Walt. If, in the unlikely event that I will be indisposed at some point, a snap decision will need to be made, and you three will make it by majority vote. As you know, we have not had a Deputy Director-General since I took over. Now we have two. Consider yourselves deputized. There is going to be a staff meeting at three. I want you by my side so that everyone can see the authority I am granting you.”

Kevin and Ed stood frozen, dumbstruck. They couldn’t believe what had just transpired.

After a couple of seconds, Aeolus snapped, “What are you standing around here for? What do you think this is – a yoga class? Get going. You’ve got work to do.”

Kevin and Ed rapidly turned and left Aeolus’s office. As they walked down the corridor their pace slowed and their steps grew heavier as they gradually realized the responsibility Aeolus had placed on them.