Beloved, believe not every spirit, but try the spirits whether they are God: because many false prophets are gone out into the world.” 1 John 4:1 (King James Version)
13
Quarantine
After the CDC doctor’s call to Dan about Dr. Konrad’s death, Dan called his own doctor son Nat to report what had happened, and to ask what was likely to be next, and how to deal with the death-dealing H1N1. “Will this be the 1918-19 flu all over again, but even worse, because the huge increase in population will cause a huge increase in the number of deaths? If our goal is to stay alive, what are we meant to do to achieve that goal?”
Silence from Los Angeles.
“Are you OK? Are you there, Nat?”
“I’m here, Dad. I’m attempting to think about what you just said. This one is for experts,” Nat said. “Pros like the ones at CDC and WHO. They’ll try different vaccines, to see if they can block the growth and spread of the virus – but I don’t think they already have a wonder drug for World War I H1N1, any more than doctors did back in 1918 and 1919. Certainly Dr. Konrad didn’t come up with a magic immunizer, though he did get to play, heavily guarded, with the lethal kind of H1N1.”
“So will we all be killed by the virus?”
“I don’t think it’s going to happen to all of us. I’d bet a quarter – that’s a high bet for me – that, because of the fierceness of this virus, there will be quarantines imposed to limit its spread. I looked this one up. The federal government has empowered CDC to block epidemics on infectious diseases coming from abroad …”
“That doesn’t help here. The World War I H1N1 virus seems to have arisen in the U.S.”
“… Bear with me, Dad … and the federal government has delegated authority to part of the CDC called the Division of Global Migration and Quarantine, empowering it to detain and to medically examine individuals suspected of carrying a communicable disease. And now the list of quarantinable diseases includes influenza that is causing or has the potential to cause a pandemic. That would include what Dr. Konrad seems to have been carrying around, killing others and killing himself.”
“I don’t believe Dr. Konrad was carrying H1N1when he came into the U.S.,” Dan said. “I think Konrad Starkherz didn’t begin to play with H1N1 until he had been in America for decades.”
“Well, I think the federal authority extends to detain and medically examine persons traveling between states who are suspected of carrying a communicable disease. And most states – including the state you live in, Dad – have the power to control the spread of disease in the state by means of isolation – that is, separating people ill with a communicable disease, from people who are healthy – and also have the power of quarantine – that is, to separate and restrict the movement of well people who may have become exposed to a communicable disease, to see if they become ill. This kind of thing has been some protection to people for a long time. Way back in the 1300s, ships coming into Venice from a port that was carrying a plague – particularly if the plague being carried was the Black Death, I think – were ordered to stay at anchor for 40 days before the ships’ crew could land. According to a CDC write-up on plagues, a 40-day delay was called quarantine, coming from the Italian words ‘quaranta giorni’ – meaning 40 days.”
“Wonderful,” Dan said. He did not sound happy. “So a few rats jumped ship in Venice, and the Black Death spread through Europe, and only one-third or one-quarter of the Europeans were killed. I can’t say I look forward to quarantine, and I can’t say you’ve made my day all sunshine, Nat.”
“It’s better than nothing, Dad. Stay in Rockinam, and don’t go near any dead people, or anyone who is being quarantined or who looks sick, or any rats, living or dead. And you can be sure that the CDC and WHO, and the rest of the medical and pharmaceutical establishments in America and around the world, will be chugging hard to come up with a vaccine or a way of developing an immune defense to World War I H1N1. Huge reputation and money opportunities will be involved. That’ll get them going. That’s the kind of thing that drove the American experts when polio vaccines were finally developed. Who was going to get the Nobel Prize? The two great experts on polio used different techniques to fight that disease. Jonas Salk injected doses of inactivated (that’s fancy way of saying dead) poliovirus, a technique that was announced in 1955; Albert Sabin used attenuated live polio virus, with human trials starting in 1957. Neither of them got the Nobel Prize, but they both fought successful fights against polio.”
“Maybe,” said Dan, “maybe CDC and WHO, those medical saviors, actually will find something like that kind of vaccine or other immune defense in my lifetime, but I’m already 74 years old, and I wouldn’t bet as much as a quarter on such a finding. It will be hard for me, or for others in Rockinam, not to be near people in Rockinam who cough out noxious germs, or who have gone near relatives who have died of the flu, or who are in the process of doing so, or who are working with undertakers to bury the dead. I’ve already been near such types of Rockinam citizens. Isolation of the sick may be helpful, but there’s bound to be a limit to how isolated isolation will be. I don’t look forward to the result you’re suggesting. And I would like to keep on reading and writing for a time, while I’m still alive, until my mind weakens further and my ability to recall anything has crumbled completely. But I know you’ve been trying to help, Nat, and at a time when you’re stretched in your hospital work, so it can’t have been easy for you. And I know you’ve done a lot to get the CDC people focused, and to understand what Dr. Konrad was about. Thanks to you for all of the above. I hope you’ll stay in touch, and call me from time to time on a safe long distance call. I’ll be able to cough into my house phone without infecting you. And I won’t show up at Easter or Christmas at your place, or at Michael’s. I love both you guys and your wives and your kids; I don’t want to hurt any of you. And I will follow the Memento Mori advice on the base of the bonobo skull that stares at me from my desk – I promise you I will remember to die when the time comes. I expect I may even be glad about it.”
“Do not fear those who kill the body but cannot kill the soul… . Are not two sparrows sold for a penny? Yet not one of them will fall to the ground apart from your Father. And even the hairs of your head are all counted. So do not be afraid; you are of more value than many sparrows.” (Instruction by Jesus of the twelve disciples, Matthew 10:28, 29-31, New Revised Standard Version.)
14
Birdfall
The bitter winter that year gave way reluctantly in Rockinam. For months, snow and ice covered the ground. Cars skidded and crashed on the roads. Several men of Dan’s age slipped on smooth clear ice and fell, breaking arms and hips, dislocating tailbones and other spinal bones, and causing the long-lasting pain of sciatica. Dan remained intact, though he turned 75 in late March. By April, in Rockinam, ospreys and some hawks were coming back in the marshes, as well as glossy ibises – the last being birds Dan did not remember having seen in Rockinam when he, aged 12 or 13, first began looking for birds in those marshes. By May, the temperature often broke 60 degrees Fahrenheit – a far cry from the single-digit plus or minus degrees of many days that year, between November and March.
Dan kept himself distracted – the word “busy” sounded too structured – although Dan had retired years before. He read in large amounts. He wrote – notes, poems, opening paragraphs of books, reminiscences. He listened to music – mostly show tunes written before 1955, after which time, in Dan’s view as an older man, all Broadway musical songs ceased to be beautiful. He talked once or twice a week, every week, to Nat and to Michael, to stay in touch, to be recharged by Michael’s questionable jokes, to hear from Nat how CDC doctors and their allies were doing, wrestling to come up with effective immune systems that would end the fatal powers of WH1N1. (“WHI NI is full of crap,” Michael said in one of the calls. “We’ve all heard about WHINI the Pooh.” Michael chortled at his lat
est effort at humor, until Nat told him to stifle it.) Each day a quarantine truck stopped by Dan’s house, and a driver flung to the door a metal can holding some food for Dan to eat. The streets of Rockinam clattered with the sounds of flung food cans, filled to prevent the quarantined from starving to death.
Dan also called Jimmy Madeiros on most weekdays, and the undertaker Carl Holmquist once or twice a week, to find out who was dying or had just died. Dan thanked the Almighty (together with Alexander Graham Bell, and Thomas Alva Edison) for the ability of telephones to carry information without carrying infectious diseases to or from the person at the other end of the phone. Dan also searched the Rockinam newspaper every day for information about the influenza and its spread, and for obituaries. He kept careful notes on all of this information. He was able to see that new flu infections and deaths were still increasing week by week – but at a rate that was dropping with increasing speed from the rate of growth in the month before the Christmas he had spent in Santa Barbara. Dan e-mailed his tabled information to Nat and directly to the CDC doctor who had called him to report the death of Konrad Starkherz – and Dan was pleased to receive calls or e-mails from both doctors, thanking him for his clear and helpful analysis. The messages from the doctors to Dan made it sound that effective immunity to H1N1 may have been developing, not by human endeavor, but by microbial trial and error – and by the hope of large pharmaceutical firms that they might be able to make a fortune if they managed to come up with the development of one or more effective immune systems.
By mid-June, the birds of summer had come back to Rockinam in large numbers – including hawks, bluebirds, owls, catbirds, mockingbirds, goldfinches, and warblers. Dan loved birds. He had become a birder and a member of the Audubon Society when he was only 14. Every day at noon, Dan, who by that time was in his mid-seventies, carried binoculars on his neck so he could look for birds as he walked up his driveway to the mailbox. One warm day, Dan, sweating in humid warmth, wearing a tee-shirt and tennis shorts, walked near the top of the driveway by a good-sized tree which bore in the central cup of its branches a nest that contained a group of matched birds. Through his binoculars, Dan could see that the birds were white-breasted nuthatches – a kind of bird that he knew he had not checked off as having seen in the “My Life List” in the front of his frayed copy, which he had studied and used from his childhood, of the great bird expert Roger Tory Peterson’s book A Field Guide to the Birds. As he gazed at the nuthatches, Dan talked to himself with pleasure: “Think of me as a long-life birder. I’m 75 years old, and here I am adding to my life list, not to a death list.” He enjoyed standing, looking at a nuthatch climb head down, down the tree trunk, feeding itself by pecking on bugs in the bark of the trunk. As he watched, a different nuthatch fell out of the nest and plummeted to the ground beside him. The bird stirred slightly once or twice and then lay still.
Dan bent over the unmoving bird. He admired its looks – its gray-blue cap and back, its white breast, its black eye in its white cheek. He touched the bird with his finger. It lay still on its side, not breathing. As Dan looked at the bird closely, a mosquito bit the back of Dan’s right hand. Don killed the mosquito by slapping it with his left hand. “Summer has arrived. Summer is not always delightful. Take that, you bastard bug,” Dan told himself – speaking out loud to an empty field. He picked up the dead nuthatch by the feet, and started walking back to his front door, shortening the walk by cutting across a field. On the way, about ten feet from the door of his house, Dan saw on the yard a small reddish-brown hawk lying on his back on the grass. It was a kestrel, a delicate raptor, the smallest of the American falcons, a hunter of insects and small animals. Dan found a small stick and poked the kestrel. It made no response. “Dead as a smelt,” Dan said to himself. “Michael would probably say the longer it lay there, the more it smelt. And the kestrel was already on my birds’ life list.” Another mosquito bit the back of Dan’s left hand, and was swatted flat by Dan’s right hand.
After leaving the two dead birds on the floor of the entrance to his house, Dan telephoned the Rockinam Nature Conservancy, to talk to its executive director, Kate Heisman, whom he knew well from years of birding together. “I think you’ll like this call, Kate,” he said. “I’d like to present to your Conservancy two birds that I think would enrich your museum and brighten the lives of the visitors who see them – a white-breasted nuthatch and a kestrel. They’re eye-catchingly beautiful.”
“How’d you get them?” Kate asked. “Are they in good shape? Is each of them secure, safe in a wire cage of the right size?”
“They’re both good-looking birds, but they’re both dead – no need of a cage. The nuthatch fell out of a nest that held a family of nuthatches – fell right down beside me, while I was walking up my driveway to pick up the day’s mail. The nuthatch twitched once or twice after its fall, and that was it. A beautiful bird. When I was carrying the nuthatch to my house, I almost stepped on a kestrel that was lying on its back on our front yard, motionless, maybe five yards from the door to my house. That dead small falcon was and is a beautiful bird, too. It didn’t look like any animal had gotten into it, and I didn’t see any bugs crawling on it. It must have died recently. Shall I bring the two beautiful birds around to you?”
“Did mosquitoes get you when you were with the birds?”
“More the other way around – I got them. I was out in my driveway sweating, it being a hot day, as I looked at the nuthatch, and a mosquito, bigger and darker than the ones I’m used to seeing, bit the back of my right hand. Bam! I slapped that mosquito. One down, squashed! When I was looking at the kestrel, another big mosquito bit my left hand. That nasty insect can’t bother me, or anyone else, any longer; I slapped it dead, too. What gives with your interest in bugs, Kate? I called you to talk about birds, not about insects.”
“I am a mere child of 64,” Kate said. “I would like to live longer, the way you have done so far. I don’t know whether the kind of H1N1 that has been sweeping Rockinam can be transmitted by mosquitoes from birds to people – in other words, whether it’s an avian flu – and I don’t want to be the one who finds out that it can be transmitted that way. I think that kind of avian flu has been spreading in California, thanks to all the mosquitoes they have out there. It may be coming here, as the temperature climbs with the arrival of summer and of more mosquitoes. I don’t want to encounter avian flu. Nor do I want children or parents who visit the Rockinam Nature Conservancy museum to end up dead from H1N1 or some other toxic virus. That wouldn’t reflect well on our Conservancy or on our quarantine efforts. And I’ve also heard that big mosquitoes have been spreading West Nile virus and EEE – Eastern Equine Encephalitis – sometimes with fatal results for the bug-bitten humans.”
“Say, thanks a whole lot, Kate. You’re a real day-brightener. So what would you have done, under similar circumstances?”
“Let me start with what I wouldn’t have done. I wouldn’t take a dead animal or bird into our Conservancy, if I thought there was a fair likelihood that the creature was carrying a dangerous disease like rabies or West Nile virus or EEE, or God knows what. Instead, in like cases, I have called the state university, which has a department that seemed to like to do autopsies on dead beasts, to see if they carried a flu virus or were rabid. The experts from that department took away the dead creatures, to study them. I think they were careful in wearing protective masks and spacesuits. I didn’t hear of the university doctors or students dying or falling ill.”
“Thanks, I guess, Kate. So what should I do in this situation?”
“Put your two dead birds in an intact plastic bag – a strong bag, a bird body bag, if you will – and tie it closed. If you have extra bags, I’d suggest you put each bird in double bags. The CDC has warned people who find a dead bird not to handle the bird with their bare hands. Call the CDC – it should have more expertise in this area than the state university, and certainly mor
e than our Conservancy – and have them pick up the bag and test the dead birds. I think at least a couple of CDC virologists are regularly spending time in Rockinam nowadays, checking out people in isolation or quarantine. And they seem to be getting closer to developing, or more likely to be seeing infected people’s bodies develop, some immune protection against the killer H1N1.”
“Any other consolation for me?”
“Not much. I think I’ve read that healthy youngsters and young adults have been a lot more susceptible to avian flu than older people.”
“Wonderful. Gee, thanks, Kate. I think that’s the first time I’ve heard of older people doing better against disease than younger people.”
“Well, I think oldsters – mature adults, I meant to say; I don’t mean to sound rude – haven’t often been infected or killed by influenza that moved from birds to biting bugs to people. So hang in there, Dan. You may make it just fine.”
“Great. I’m already 75. With luck, maybe I’ll reach 76.”
“Let me add something. The CDC reports say that people over 50 – that includes me, these days – are more likely than younger people to fall severely ill from West Nile virus. The common sense of it is that as we get older, our immune cells aren’t as strong and versatile as they were when we were young. Also, where you and I live, there’s a risk that people your age or mine will catch Eastern equine encephalitis – that catchy-named EEE. The name looks like a scream of terror: `EEEE.’ That scream may well be appropriate, seeing that EEE is more likely to be deadly than West Nile virus. Something like 30% of the EEE cases are fatal, and those who survive typically suffer neurological damage. What other wisdom can I impart to you? Here’s one: take a long hot shower, Dan, soon, for a scrub-down, and spray yourself with some DEET-bearing, mosquito-repelling, spray, like Off! Those sprays stink some, but the bugs don’t like them, either.”
Sometime- the Plague World Page 10