The mother gasped as all color drained from her face. “Oh, no…”
“Don’t worry. We have a new medication for it that’s extremely effective. I’ll start her on it right away while we wait for the lab results, just to give her a head start.”
Dr. Erickson gently cradled the child’s face. “Don’t worry, honey, this will only take a second.” She swabbed a lesion before the girl had time to react and placed the sample in a glass tube, then turned to the anxious mother. “I’m quite sure we’re dealing with MRSA-II here. I’ve seen plenty of it in the last several months. It’s pretty distinctive.”
The mother’s shoulders slumped with relief. “Thank you, Doctor.”
Dr. Erickson drew the curtain closed, removed her gloves and mask, then accessed the girl’s medical record on the electronic wall panel. She tapped the touch screen to order the necessary blood tests, entered her initial diagnosis, and set up the prescription for Lucracillin.
She left the triage area to go take a little break before examining the next half dozen patients who had come in while she was examining the last two. At this rate, she’d never catch up. As she entered the break room to get some coffee, she saw Dr. Gabe Lemoli slumped in a chair at one of the tables.
“Hey, Gabe. How long’ve you been here today? You look worn out.”
“Thanks for the compliment, Lydia.”
“Anytime.”
“I’m actually in my second consecutive shift. Been here all night. I don’t think we’ve quite seen the crest of the MRSA-II problem.”
“It’s slowing some since they released the Lucracillin, don’t you think?” Lydia pressed a button on the machine and a steaming cup of fresh coffee materialized within seconds. She took the cup in both hands and savored the relaxing warmth.
“Yeah, I think so. It’s definitely decelerating, but we’ve got a ways to go before I’d call it under control. That Lucracillin is great. I haven’t lost a single patient since it came out.” Gabe rubbed his forehead with one hand as he sipped a bit of his cold coffee. “But like all wonder drugs, it sets up some bad behaviors, and I think that’s prolonging the epidemic.”
Lydia sat across from him and sipped her coffee. “How so?”
“Well, the media’s been gushing over its efficacy. And rightly so. I haven’t seen an antibiotic this effective against such a stubborn pathogen in, well, I don’t remember how long. But that’s the problem.” He extended his hand toward her, palm up, as he made his case. “The general public hears that and figures with an easy cure available, they can let their guard down. Before the drug came out, people were more careful about exposure. Now they don’t seem to care and I think that’s why the numbers haven’t tapered faster.”
“Damned good point, Gabe. Before Lucracillin came out, large public events were cancelled, people were staying home. Everybody’s acting like everything is back to normal now, and that does seem a little premature. At least we have an effective cure now, but still…prevention is always better. It’s tough on the infrastructure to admit all these patients—and tough on us, too.”
Gabe leaned back in his chair and moved his head from side to side to flex the tightness from his neck. “I think we’ll get it eradicated. It’ll just take longer this way.” He took another sip of his coffee, grimaced, and set it aside. “You know, I’ll bet everyone at Denali Labs is thrilled the public has let their guard down. Just that much more in sales for them.”
“I’m sure they’re laughing all the way to the bank. I’ll bet this single drug breaks all sales records before this is over.” Lydia finished her coffee. “Well, I’d better get back to it. You should go home, Gabe. There’ll be patients enough for you on your next shift. Get some rest.”
Gabe ran a hand through his hair. “I’ll think about it. Take care, Lydia.”
Dr. Erickson headed back to the triage area and checked the electronic status board outside the door. Another four patients had checked in just during her brief break. She took a deep breath and readied herself. This was going to be a long shift.
CHAPTER 22
President Coleridge pointed at one of the flat panels on the Oval Office wall. It displayed a real-time line graph of the number of new MRSA-II cases reported since the outbreak began. The line trended steadily downward since the peak several weeks ago.
“It’s working. Whatever Tremaine and his people at Denali did, they did it right.” He smiled and turned to his secretary of HHS, John Humphrey. It felt like the first time he’d smiled in weeks—and it probably was.
“It’s impressive, to be sure. But I think we deserve a good share of the credit. We activated widespread distribution of the drug at a speed never thought possible. Both factors in concert contributed to the launch’s success.”
“You’re right, John. Wouldn’t matter how effective Lucracillin was if we hadn’t gotten it out to even the most remote parts of the Homeland as quickly as we did.” The president leaned back in his massive leather chair. “And they say the government can’t mobilize anything effectively.” He allowed himself a smirk.
John chuckled. “This can’t hurt your re-election chances.”
“True enough. Never too early to think about that.” He gazed toward the ceiling as he considered possible themes for his next campaign. “I can run as the president who brought MRSA-II to its knees and reinvigorated the country.”
President Coleridge shifted his gaze back to John and refocused on his more immediate concern. “This thing put the Homeland in serious danger. People quit going out to buy things. The market was in the crapper. The economy can only take so much of that. Fortunately, things are back on track already. Market’s near an all-time high, in fact.”
“I don’t want to think about what would have happened if we hadn’t gotten this thing under control as quickly as we did.”
“I don’t, either.” The president cleared his throat and leaned forward. “So, as great as this news is, it’s not why I asked you here today.”
John straightened in his chair, ready to listen. “Yes, sir. What do you want to discuss?”
“This whole incident gives me grave concerns about Homeland Security. We don’t know where this bug came from, do we? Did it just develop, or did an enemy agency plant it? Was it meant to be just a message—or was it meant to destroy the Homeland?”
“I…don’t know. Do you have anyone at the CIA looking into that?”
“Not yet. I will, though. The crisis was too emergent to spend time looking for causes. We needed to stop the bleeding first. And it may have been a natural development, who knows?”
“Yes, it certainly could have been. We set the stage for the evolution of more and more resistant strains of bacteria years ago by using antibiotics for every little infection and in agriculture to increase production.” He shook his head. “Damned bugs just got better and better at beating our drugs.”
“But what if an enemy did plant it? The epidemic was, after all, confined to the Homeland. It could happen again.”
“I wouldn’t necessarily assume it was planted here. It could have started here from some random mutation, and just hadn’t jumped borders yet. Thank God.”
“Hard to know, but we have to err on the side of paranoia. We have many enemies. Whether naturally occurring or intentional, this could happen again. What do we do?”
“Isn’t the answer obvious? Call Tremaine up. I’m not being facetious. He’s proven he can deal with this sort of thing. And we know we can handle large-scale distribution.”
The president rubbed his temple lightly with his right forefinger as he considered how best to introduce the next topic. “This has made me think of something else, as well.”
“What’s that?”
He looked John Humphrey in the eye. “This doesn’t go beyond these doors, understood?”
John nodded. “Of course, sir.”
“Some day we might need to develop a pathological strain for our own purposes—either as a counterterrorism measure
or as a first-strike measure if the situation warranted it.”
John paled and remained silent.
“We’d need the capability to develop such an organism, as well as the capability to develop a cure that could be distributed to offer protection to the appropriate populations.”
“I…hadn’t thought about that, sir. It takes all my focus to deal with the public health issues that just naturally arise.”
“I understand this is outside your normal area of expertise. I plan to confer with those more grounded in this sort of thing as well. But if we initiate something along these lines, I’d like you to be involved because of your experience on this project. Your knowledge would be transferable and helpful to such a team.”
“Of course, sir. Whatever you need.”
“Good, John. I knew I could count on you.” The president smiled. It was good to have staff who understood the importance of cooperation.
CHAPTER 23
Sylvia tapped the command icon on the Pathosym III’s control panel and held her breath a moment as she waited for it to respond. “Jerry! We got it!”
Jerry hopped off his lab stool and rushed over to view the results. He let out a low whistle. “It worked. Thank God.”
“Wasn’t God this time, it was you. You’re far better at gene splicing than I am. That’s why I let you have the honors.”
“That’s not what I meant. You know how I feel about tinkering with that MRSA-II beast. It scares me. I’d just as soon burn all our specimens up in the autoclave so they didn’t survive another moment. I was worried that our splice might have unintended consequences. We wanted to combine the contagious nature of MRSA-II and the disease profile and sensitivity to our compound of the other pathogen.”
Jerry flopped into the other chair in front of the Pathosym console. “Can you imagine if we’d gotten it wrong and it was neither sensitive to our compound, nor to Lucracillin?”
“I see what you mean. But we were pretty confident we’d identified the correct genes to splice.” Sylvia glanced again at the display, just to make sure she’d read the results correctly. “You’re right, though. It’s tricky stuff and we could have gotten it wrong.”
Jerry’s tone took on a sarcastic edge. “Yep, we’re so damned clever, now we’ve created a whole new pathogen of our very own. We still need to run the human modeling tests to confirm the disease profile and interaction between the pathogen and our compound in the human body. I’m nowhere near ready to feel at ease yet. Not till after the human modeling results.”
“No time like the present.” Ignoring Jerry’s tone, Sylvia transferred a petri dish of the new pathogen from an incubator slot to a modeling module slot. No antibiotic had been introduced into that colony so it could be tested solely to determine the symptoms it would cause. She tapped several command icons and sat back in her chair. “All right. Let’s see what it says.”
They both waited in awkward silence for the twenty minutes it took for the Pathosym to complete the modeling analysis. As they waited, Sylvia wondered what it must have been like for Jerry and other old-school scientists to have to wait weeks to learn what symptoms a particular pathogen produced. Human trials were just so primitive.
A subdued tone sounded, signaling the test’s completion. They both locked their eyes on the display as it listed the symptoms one could expect from an infection with their newly designed pathogen.
Sylvia let out a held breath. “That’s a relief.”
“It certainly is. We couldn’t have asked for a better profile. The disease will be highly contagious, but will only cause vague, annoying flu-like symptoms, some gastrointestinal distress, and minor lesions on the skin. Nothing nearly as serious as its daddy.” Jerry pushed back his chair and rubbed his temples through his hazmat suit. “Now we just need to know if, in the human body, the compound cures without significant side effects.”
“Ask and you shall receive.” Sylvia took another petri dish of the pathogen, introduced some of the antibiotic compound, and inserted the dish into the module that modelled drug and pathogen interactions in the human body. The Human Drug Trial in a Box, as the Pathosym marketing folks liked to call it.
Again they sat in expectant silence for the twenty minutes it took the Pathosym to complete the test. A vague feeling of superstition intruded at the edge of Sylvia’s mind as she waited. After total defeat in the competition with Denali, their work on this project had been going almost flawlessly. How long could that last before something went wrong?
Another hushed tone sounded, and they both peered at the report presented on the display. Sylvia’s sense of foreboding intensified. The results were just too good to be true.
Jerry pushed back his chair, then stood. “Time to quit while we’re ahead. A projected 99.99% efficacy rate, with a .01% chance of diarrhea as the drug’s only side effect. That’s about the best we can hope for in our first shot at playing God. I hope Phil will be pleased that the disease will be quite contagious and damned annoying to come down with, and so the drug is likely to be the blockbuster Horton needs.”
“Hey, what do you say we shut it down for the day and have a drink to celebrate? My treat.” Sylvia genuinely liked Jerry and wished he weren’t quite so disturbed by this project. She wasn’t happy about it either, but his reluctance forced her into taking the lead—which probably just added to the friction between them.
He weighed the idea for a few seconds before answering. “Well, all right. Thanks.”
CHAPTER 24
“I think the time is right now.” Dan Tremaine set aside the tiny silver tray of Stardust, rose from his chair, and paced the length of his office like a caged panther.
Vince Calhoun hated it when Dan got into this sort of mood. He’d acted like a maniac since the day he founded Denali, but whenever he had a victory under his belt—let alone a little Stardust—he became intolerable.
And with the Lucracillin triumph, Dan’s ego had burgeoned like never before.
Vince suppressed a grimace and tried to speak in a calm, rational manner, for what it was worth. “I really think we ought to hold off for a little while. The MRSA-II epidemic is only now easing off. Don’t we want to be sure things don’t take an unexpected turn before we introduce anything new?”
Dan waved a dismissive hand and kept on pacing. “Oh come on, we can rely on our enhanced Pathosym. Its models didn’t indicate any significant tendency for the MRSA-II organism to mutate, right? The distribution pipeline is in full swing, so Lucracillin is readily available for anyone contracting the disease. We’ve waited long enough.”
Vince hesitated to raise his other concern, anticipating Dan’s likely response. “There’s something else.”
Dan stopped pacing, folded his arms across his chest, and fixed a glare on Vince. “What?”
“Well, don’t you think the extreme visibility of the MRSA-II outbreak combined with the rather quick release of Lucracillin might…raise some questions?”
“About what? You think it might raise suspicions that we developed both the disease and the cure?” Dan shrugged. “Who says other BigPharma companies haven’t done it, too? Just not as well as we have.”
“There’ve been rumors floating around for some time, but no one’s ever come out and accused anyone. Until now, the pathogens we’ve been launching were relatively mild and not terribly distinctive. Their spread wasn’t constant front-page news like it’s been with MRSA-II.” He twisted his hands in his lap. “And the president didn’t get involved like he did this time. What if he started wondering if we found the cure first because we created the pathogen and had everything all set up from the outset?”
Dan stomped over to his desk and slammed down his fist, nearly knocking over the Stardust. “The president? Do you have any idea how much I’ve contributed to his campaign fund over the years—both in the name of Denali Labs and from my personal funds?” He stabbed an angry finger toward Vince. “No, he knows who his supporters are, and he knows who his best supporte
rs are. The next election is too close for him to even consider biting the hand that feeds him. We have nothing to fear from him.”
Vince considered this for a moment, and found he couldn’t refute Dan’s currency-driven logic. Money meant speech and access—even for corporations these days. Perhaps especially for corporations. “I suppose you’re right. I hadn’t thought of it that way.”
“So, we need to start working on the next blockbuster. Question is, how do we top this one?” Dan smiled as he gazed off into the distance and considered the possibilities.
“Do we really need to top this one? We could develop some other workhorse-type drug as we have in the past. That would provide good solid revenue growth without the additional risk.”
“What risk? We’ve specifically modified our Pathosym to support this business model. It provides all the analysis we could possibly need—accurately, and way faster than the base model ever could.”
“I don’t doubt the reliability of the Pathosym’s modeling. It’s not that. I’ve told you before, I think we took a terrible risk in waiting for the epidemic to reach the proportions it did just to attract the president’s attention. MRSA-II is an extremely aggressive pathogen, and it could have—and nearly did—get out of hand before the drug became generally available.”
“But look at what we got from waiting that we wouldn’t otherwise have gotten.” Dan counted on his fingers to drive home his point. “Free—and massive—distribution. No need to spend a dime on marketing. The fastest FDA approval on record—even with the new streamlined process. Sales of Lucracillin are nearly pure profit! What better scenario could you possibly want?”
“I won’t argue with you there. But what if the epidemic had gotten out of control before the distribution channels were ready? What then?”
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