The Perfect Pathogen (7 page)

CHAPTER 10

Rob and the kids were out
of the house shortly after 8 a.m. running a little late, but they would still
be on time, but only barely.

After dropping everyone off, Rob headed over to
the Center. He was hoping everything would be normal at work. He could use some
normal right now.

As he pulled up, the first person he saw was
Marge. Her usual smile was back.

“So, how is everything going today?” Rob asked.

“Seems to be shaping up to be a pretty good day,”
Marge replied still grinning. “You got one call already this morning from the
developer. He said the permits were signed yesterday and they will be showing
up with a back hoe later this morning to start digging. The surveyor should be
here in about thirty minutes to stake out the site, and then we just need to
get out of the way. Also, the architect was here about an hour ago. He dropped
off some new drawings on the way to his office. He said you might be interested
in seeing the full layout.”

“That’s great,” said Rob. “Mr. Shaw sure does work
fast. It probably helps that he will make some good money off the project,
particularly now that we’re expanding to the full one hundred and fifty units.”

Everything seemed to be coming together just in
time before the winter too. If all went well, they would be in the new facility
before the first snow hit. Rob looked at the plans and just smiled. With the
additional pods, the architect was able to develop the land with three groups of
five pods, with a shared outside area in the middle connected by covered
walkways. It almost looked like three wagon wheels, or three spaceships,
depending on one’s persuasion. Each circle of five pods had a boardwalk that
surrounded the circle, and then there were further boardwalks tying them with
the Learning Center and the twelve green houses, as well as a boardwalk from
each group of pods to the existing pier on the river. And to make this a “green
project,” all of the covered walkways had solar panels with micro inverters
installed to provide the electricity needed to run this operation, even with
some to spare. In addition, there were six wells and six new septic systems. It
was stunning.

Around ten., Mr. Shaw appeared in his truck towing
a trailer with a back hoe/front end loader combination. He got out of the truck
and headed in the direction of the office. Rob was already outside when he
reached the steps of the building.

“Good to see you Bill. It is fantastic that you
were able to get the permit turned around so quickly. How’d you do it?”

“Well, to be completely honest, the Commissioners
got a call from Will Walters and then it was as good as signed. Like they say,
all politics are local and if you’ve got connections you can get things done
quickly.”

“It’s great news. I saw the new plans and I can’t
tell you how impressed I am.”

“Now remember, we already had that plan in the
works before you got the increased funding. I was pretty sure you’d want to put
in the expanded infrastructure eventually.”

“So what is the schedule?  Will it take long to
get the extra Pods built for delivery?” asked Rob.

“Even more good news,” Bill replied. “The
manufacturer assembles these units ten at a time. They can deliver the first
ten in two weeks and the last five two weeks later. That should give us the
time needed to put in the wells, septic systems, electrical and communication
infrastructure. I am expecting that you can start furnishing the first five
units in about three weeks. If we were talking electronics, I would classify
these units as plug and play, they are so simple to install. They come fully
wired and plumbed too. All we have to do is hook up the electrical, freshwater,
sewage and heat pump. It is really that simple.”

As they both looked out across the meadow where
the new facility would be located, they saw a team of six surveyors laying out
the design in stakes with yellow, green, blue, red and pink flags.

“They should have everything staked out by the end
of the day,” Bill said. “In the meantime I have a team of eight with additional
heavy equipment coming to dig the septic systems and drain fields. Tomorrow we
will start in earnest with a crew of fifty men. This place will be swarming
with workers and equipment, so the noise may be a little disruptive to your
training.”

“On the contrary,” said Rob. “This will be a great
learning experience for the kids. We intend to teach them about what you are
doing and then get them out on the site to see how some of this is done. The
more we expose them to common, everyday things, the better off they will be
when they are on their own.”

“That’s a great idea,” said Bill. “Just let me
know what you want to show them and I’ll be happy to lead them through the
construction zone. I’ll bring some extra hardhats,” he added with a smile.

As they finished discussing the project, the phone
rang and Rob answered. It was Will Walter’s granddaughter. “Hello, Mr. McMann,
my grandfather wanted me to call you and let you know he is in the hospital. He
fell ill suddenly early this morning. He is alert and wanted to see you if you
could stop by.”

“Which hospital is he in?” asked Rob, deeply
concerned.

“He is in the Calvert Memorial Hospital, Room
309.”

“I’ll be there in about thirty minutes.”

“I will let him know you are on the way,” she
replied and hung up.

“That was Missy Walters, Will Walter’s
granddaughter,” Rob said to Bill. “Will is in the hospital in Calvert County. I
hope he doesn’t have the disease that has been killing the old people.”

“Yeah, me too,” Bill said. “I heard about that on
the news this morning. I guess the President said something about it on TV last
night. I saw the headlines in the Washington Post this morning too, “PRESIDENT
SAYS THERE IS AN UNKNOWN KILLER. CAN IT BE STOPPED?” I just took it for the
normal sensationalism you get from the press every day, figuring they need to
sell the newspapers somehow.”

“Well, I am going to have to leave you here,” said
Rob. “Will asked that I stop by to see him, so I am going to head over there
right now. He has been very generous to us and without him this project
wouldn’t be built. We owe him a lot. I will see you later today.”

On his way to the hospital, Rob sent up a prayer
that Will wasn’t stricken with the disease that was now terrorizing the
country. Will was too good a man to die like this, Rob thought. He had done so
much good for so many people. Surely God would spare him from this fate?  What
Rob did suspect, based on listening to Katie last night, was that if Will did
have the disease, he would be gone soon. Time was of the essence.

Rob entered room 309 at the Calvert Memorial
Hospital to find a host of family members encircling Will. He lay in his bed
with the left side of his body paralyzed. He was still alert and was actively
talking and joking with his family. When he saw Rob, he half smiled and then
asked him to come over to the bed. He then asked his family if he could spend a
moment alone with Rob.

“I thought I would have another good ten years in
me, but it looks as though I have contracted whatever is going around.  I know
what this means. Likely, I won’t be here tomorrow. It is a good thing I wrote
you that check when I did and that I didn’t follow your plan to wait five
years,” Will said with a chuckle. “Rob, I want to ask you a favor. Please take
good care of my great grandson. You know he has Downs just like your daughter
Hope and I know you have done such a great job with her. Please give my
grandson the same chances you give your daughter. My granddaughter will work
with you towards this goal. I have provided for him in my will, so there will
be adequate funding for him to support himself throughout his life.”

“Will, of course I will,” Rob replied. “It is the
least I can do after all the help you have given me over the years. Consider it
done.”

“Thank you Rob. This means much more than any
amount of money. I will die a happy man,” Will said with a broad smile.

As Rob left the room, he wiped tears from his
eyes. What a class act Will is, Rob thought. Down-to-earth and dignified, right
to the last breath.

Chapter 11

Dr. Brian White was the
Surgeon General’s first pick when the President asked him for someone to head
up an epidemiology task force. That task force would lead the U.S. Government’s
efforts in handling the necessary research to find the cause of the unfolding
epidemic that was now rapidly decimating the elderly population. An inwardly
shy, sensitive, bespectacled man in his late fifties, Dr. White, Director of
Pathology, Johns Hopkins University, was by far the foremost pathologist in the
United States. He was well-liked and well known for leading teams that
successfully untangled the pathology behind many previous disease outbreaks.

After his meeting with the President and the
Surgeon General, Dr. White left The White House armed with a commission to lead
the pandemic research effort, drawing upon the full resources of the U.S.
Government and a clear mandate: find the killer and figure out how to eliminate
it.

He rapidly mobilized his best colleagues from
around the world and his most promising graduate students at Johns Hopkins into
seven investigative teams, all linked into the CDC, the CIA, the Department of
Defense, and other Federal agencies equally tasked with addressing the
unfolding contagion. The seven action teams would coordinate four large regions
in the United States and three around the world, all reporting to Dr. White. In
White House briefings to the President in the days to follow, all would come to
know Dr. White and his seven teams as Snow White and the Seven Dwarfs.

In a worldwide pandemic like this, there would
already be a great deal of local research by every major hospital and pathology
lab - Coroners’ reports, death certificates, lab reports, medical charts, etc.
Data was there to be assembled, drawn from an impressive arsenal of tests and
procedures familiar to all pathologists and doctors: basic scientific testing
for infectious agents, antibody serology testing, PCR, culturing for every
infectious agent known to man -- bacterial, fungal, viral, parasite -- and
surveys for extremely rare diseases such as prions, polio, smallpox, etc. Information
on blood, urine, cerebrospinal fluid, interstitial fluid, sputum samples, and
biopsies of every major human tissue, molecular analysis of biological markers
in the individual’s genetic code, hormonal levels, immunoglobulins, and even
hair analysis on the deceased were gathered. Spectroscopy, Western blots, MRI
and CT scans, biopsy reports, biochemical tests, toxicology testing, genetic
testing, food chain surveys, and even forensic autopsy parameters were also
undertaken.

Indeed, no conventional medical research stone was
left unturned. Even veterinarians, ornithologists, entomologists, and others
were included from around the world, all looking for a connection between the
outbreak and elderly humans. Dr. White’s task was to synthesize the clinical data,
coordinate world-wide efforts, and look for the unconventional stones to look
under as well. Data poured in from around the globe – Germany, the United
Kingdom, Brazil, China, Russia, India, Japan, Australia, Thailand, and
Singapore, just to mention a few. Every analytical tool and instrument was
mobilized in this all-hands on deck, around-the-clock effort. Every theory from
the best brains in the medical and pharmaceutical research business was
metaphorically thrown against the wall to see if it would stick. When no idea
seemed to hold, the teams would start over, scrutinizing the data again and
again in the hopes of a clue, a key breakthrough moment.

While the gargantuan effort went forward, the only
patterns that emerged were non-specific elevated serum sample markers (mild HDL
elevations, slightly elevated ESR, Low homocistein levels, for example), all
non-specific, normal abnormals really. For now though, it’s all that Snow White
and the Dwarfs had to point somewhere into the contagion’s dark, unknown
forest. But where? 

In the meantime, Dr. White’s cautious message back
through The White House and on to world leaders was the time has come to remind
the world community to practice measures that would prevent the spread of
communicable, community-acquired disease: frequent hand washing with soap,
minimize contact with others, drink only purified water, face masks where
necessary, and eat food only from safe sources. And again, he emphasized, wash
your hands, for deep inside something was telling him that the hands would be
key with this disease.

CHAPTER 12

Katie decided to stop by
the conference on the way back to her office. There wasn’t much she could work
on until the data started to roll in anyway. As she entered the auditorium, she
could see that only about a quarter of the people who started the week were
still here. She hoped it was due to the normal pattern of people flying home
early and not due to the illness going around. But, she knew that it was a
combination of the two because normally at least half of the people stayed to
the end.

As she arrived, Jimmy Akira, Katie’s friend from
Japan, was in the middle of his presentation, “Outlook for the future.” One of
the participants raised her hand and asked him what effect he thought this most
recent illness would have on the longevity predictions going forward?

“Once the cause has been found and a remedy
developed, I expect there will be negligible, if any, effect on the longevity
of the human species going forward,” he replied. “ In many cases we find that
the species will evolve with a new strength and immunity which may even prolong
our longevity.”

Jimmy finished his talk to a round of applause.
Out of the corner of his eye he saw Katie, and walked over to her. “I’ve missed
seeing you during the conference. I assume you have been working on some aspect
of this new bug that is going around.”

“Yes, that is a correct assumption,” said Katie.
“I’ll be working on a prediction model over the next several weeks to determine
how and where this is spreading. Have you heard anything from your home office
in Tokyo?”

“The elderly are dropping like flies,” he replied.
“Fortunately we haven’t seen many deaths among the younger generations. I think
that is because of the relatively healthy lifestyles the Japanese pursue. I saw
on the news here that the age range is mostly age 70 and above.”

“I am not sure where those figures are coming
from,” said Katie. “The CDC is still in the initial phases of data collection
and trying to figure out what is causing the deaths.”

“Well, from what I hear from Japan, the virus or
bacteria -- they haven’t determined which is causing this -- can’t be found
using normal tests. The autopsies reveal that the major organs are being
attacked systematically, causing cell damage first and then normally a stroke
or heart attack follows. This is a very strange phenomena,” said Jimmy.

Katie cringed when she heard Jimmy’s description
of the disease. It was consistent with the description given by Dr. Shah to her
only hours before. For all of the “secrecy” surrounding U.S. efforts, they were
not the only ones coming to the same conclusions. She would have to share this
with the boss. Maybe it was time for another announcement. That wasn’t her
call, but she was sure they would be interested to know what another country
had also figured out thus far.

“Does your government think they know how this is
spread or where it is coming from?” asked Katie.

“They don’t have a clue. I do think they are going
to recommend people wear surgical masks to prevent transmission through
respiration, but they have no idea if this will be effective. In our culture
that is something people will do anyway when there is any sort of community
risk. Other than that, they are at a loss on how to proceed until they can
isolate the cause. As you say in America, they have the very best and brightest
working on the problem,” Jimmy replied.

“Well, please let me know if you have a
breakthrough and I will do the same for you,” said Katie.

“We in Japan don’t want to create mass hysteria
either, but the government is talking about this more in the news than you are
here in the U.S. I think you will start to see our news reports spill over into
the U.S. from international sources. A lot of people are staying home,
particularly those that have elderly parents living with them, to try and
prevent the spread of the illness,” he replied. “You know what we say:  Poke a
bush and a snake comes out.”

“I remember that quote Jimmy.  Let me see, let
sleeping dogs lie, right?”

Jimmy smiled.

“It has been great seeing you Jimmy.  Email me
when you get back to Tokyo with the latest news you have.”

“I sure will,” said Jimmy. They embraced and Katie
walked over to see Beth before she left for the office.

“Hi Beth,” said Katie with a sad face.

“I already know,” said Beth. “I called Melody
shortly after you left and she filled me in. She said she had talked to Sarah,
so I was sure you already knew. It is so sad, but Melody seems to be handling
it well with all of the news of dying that is going around.”

“I will have to call her later today. Was there
anything she asked for?”

“Yes, she said to find a cure for this dreaded
disease so that others would not have to suffer through what she just did. I
told her we would do our best and that you were working on a part of it so it
was bound to get solved quickly,”  Beth said with a thumbs up sign.

“Beth, you didn’t, but thanks for the confidence
builder and the pressure cooker too!  I’d better get back to the office and get
started on the model they have asked me to develop. I have some ideas that I
hope will bear fruit soon. I can’t thank you enough for taking the lead on the
conference. You have done a fantastic job!” exclaimed Katie.

“You’re welcome,” Beth replied smiling. “I will
see you in the office tomorrow morning.”

Katie turned and headed out of the building. The
task ahead seemed insurmountable to her, but she knew her limitations and she
would stay true to her mantra of working one day at a time. As she thought of
Herb, an old phrase he liked to use came to mind which seemed pertinent. “How
do you eat an elephant?  One bite at a time.”  The elephant was now clearly on
her plate.

As she pulled out of the parking lot, Katie was
shocked back into reality by a car suddenly crossing her path. She promptly
slammed on the breaks, her heart in her throat. The last thing she needed right
now was an accident. “Get your mind back in gear, girl,” she admonished
herself. “This isn’t going to be any cake walk, and when you get to the office
there will be hundreds of emails, phone calls and everyone will be pulling at
you to come up with a solution. You are under the gun, so get it together.”  Katie
always found a moment of self-chastisement helped when she started to lose
focus on a project. She was now ready to face whatever may come.

The traffic was particularly heavy this afternoon,
but twenty-five minutes later she arrived at her office.   She made a mental
note to see if something was going on that would cause more traffic.

She stopped by the cafeteria on the way to her
room and picked up a sandwich, chips, Diet Coke and a Snickers bar.  She knew
it wasn’t the healthiest choice, but her healthy lifestyle could wait a day.
Thus fortified, she was now ready to get down to business.

She opened her email to find the first batch of
data Dr. Shah had promised. Based on the configuration of the information and
the expanded number of tests, she figured it would take her three to four hours
to make the changes to her existing algorithm so that it would accept the data
and perform some meaningful analysis. She already had a lot of the variables
that she needed in her program and she was thankful for that, as it would save
a lot of time and effort.

For a start, she would be analyzing the blood
samples from the deceased against the normal blood ranges for over one hundred
and fifty tests. This would be inputted along with age, sex, ethnicity and the
location of the deceased. A comparison would then be made against the other
blood tests and the expected results, which were also adjusted for these
variables. Of course, she would be looking for a pattern immediately, but with
any luck, after three or four days of analysis she may be able to determine
one.   She knew that time was of the essence and the U.S. Government was
depending on her. She was in for some long hours, hence the Diet Coke and more
to follow.

She had so many emails she didn’t know what to do.
She quickly scanned for any from the CDC Director, the Secretary, the NSA, Dr.
Shah, Beth, and her immediate boss now, Sarah Lin.  Every time she looked at
her screen the number of unread emails increased.  When Beth gets in tomorrow,
she would ask her to organize and review the email from her contacts around the
world. But right now she had to concentrate on the task at hand.

Time was closing in on 5 p.m. and she was still
working on the modifications to her test model. She figured she would be ready
to upload the first data in about a half hour. Then she expected the algorithm
to take several hours to work through the thousands of calculations associated
with the input data. She would hopefully have data to review by 7:30 p.m. and
be ready to write a preliminary report by noon tomorrow. She didn’t expect to
have any concrete conclusions until she had more data, and though she was
receiving new data on about one hundred and fifty new deaths every hour, the
data wasn’t complete. She would have to contact Dr. Shah to see if the quality
of the data could be improved. She hoped to see something, and as unlikely as
it seemed she wasn’t convinced she would be able to spot the smoking gun that
could lead to the development of a catch-all test.

Katie called Rob at 5:30 p.m. to let him know what
she was doing, and that she couldn’t say when she would be home. Rob understood
and told her the kids had been bugging him for Mexican food, anyway, so they
would be going to the Mexico restaurant for dinner. He would wait for a call
from her later.

At 7:23 p.m. the first analysis was complete. When
Katie saw the results she didn’t know what to think. Some of the blood tests
were abnormally high, some were abnormally low, but the one thing she did
notice was that the specific abnormals were about 99% consistent among the
deceased. She figured the 1% of the deceased that didn’t follow the pattern had
either died of natural causes or that there was an error in the sample or some
of the data. There didn’t seem to be any pattern associated with sex, location
or ethnicity, but everyone in the data was over 80 years old. She would have to
let Dr. Shah make the call on which specific blood tests could provide the most
useful indicators. What she noticed immediately and found striking, given the
cause of death, was that many of the blood tests that were part of routine
blood work up for a stroke, such as LDL cholesterol or lactate, were completely
normal. She would need some help in deciphering the effect of her analysis, but
she thought she had some valuable information right out of the starting gate.

She entered all the latest data that had arrived
by email into the system and ran another test run to see how it would compare.
It would take another two hours to complete, so she started to write a report
of her initial conclusions. She was sure that Sarah and Dr. Shah would find
this information useful in preparing a strategy for moving forward.

Needing a break, she decided to look at the
headlines online for the Washington Post and see what they had to say about the
epidemic. She was stunned by what she saw. The banner across the top of her
computer read, “MILLIONS DEAD FROM UNKNOWN DISEASE.”  She quickly scanned the
article that referenced reports from Japan and Europe and criticized the lack
of comment from the U.S. Government.

At the White House, Jim Redman was reading the
same article which had just been posted. He knew it was now time to institute a
daily briefing. To deflect criticism from the White House, he was ready to have
the Secretary of Health and Human Services, Jennifer Milton, take the lead on
the reporting. Of course the President would be holding the strings, or more
accurately, Jim would. He picked up the phone and called Jennifer. “Have you
seen the latest reporting from the Post?”

“Yes, I just read the alert on my BlackBerry,”
said Jennifer.

“I want to institute daily briefings at 4 p.m.
each day and I want you to do the briefings at HHS. You can have whatever
experts you want present. We will do the first briefing tomorrow afternoon. I
will announce this to the press this evening. Have a briefing paper ready for
the President by 1:00 p.m. tomorrow. Any questions?”

“Have you cleared this with the President?” she
asked. “Earlier today he told me that he wanted to keep the lead for all public
statements at the White House.”

“Yes, I just discussed it with him,” said Jim,
cleverly disguising a lie. What he really meant was that he was going to
discuss this with him after they hung up. “I just need to remind everyone
involved that they need to stick to the script, so pick your participants with
care.”

“Of course we will. You don’t have to remind me.
We are all team players and are extremely loyal to the President. I will
contact you tomorrow morning with the information you need. Good evening,” said
Jennifer as she hung up.

Jennifer looked over at her husband and said, “The
nerve of that son of a bitch! First he bosses me around and then questions my
loyalty to the President. He has to be reined in. I’ll make damned sure of
that!”

Katie continued her work at her office, and came
to a preliminary conclusion that there were six blood tests that stood out as
possible indicators of the disease: Chloride, homocistein, HDL Cholesterol,
ALT, ESR and High B12. She wondered if any of them were due to the deceased’s
age or due to the malady, and she couldn’t be sure the data she received on the
normal test results was consistent with the data she had been using with her
longevity tests. She needed to check.

Katie did a quick review of the blood test data
she had been using over the last seven years with her longevity project. She
determined that four of the blood tests she had included were among the six
blood tests she had identified as possible key indicators for this new disease.
She identified that the levels in these four tests had slowly started to
increase about five years earlier. The change had been so gradual she concluded
it was just due to the increase in age – maybe they had been normal abnormals.
After all, who wouldn’t want higher HDL?   But she now was starting to question
her earlier hypothesis. Maybe something had changed five years earlier. Maybe
this increase was an indicator of the body trying to fight off a new disease.
Had she missed something that would now turn out to be important to the
survival of the human race?  The thought made her shudder. If she was right,
then potentially, everyone on earth could have silently been exposed to this
new disease.