“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 n
otice 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?”
The Perfect Pathogen Page 7