“He also said that not all of them would know about Marburg. It sounds like your man knows a fair amount about the subject, and he’s already up to speed on the crisis.” The tension in the air between the two men was palpable. David could practically see the arcs of electricity shoot from one man to the other. David didn’t know the man who’d made the suggestion, but he had to assume the man was somebody with some clout, to be seated at this table.
“Absolutely not,” the President said.
David remained silent. He had never entertained the idea of taking on something on this scale. He’d had the training, so he theoretically was qualified, but reading about it and doing it were quite different.
“Where else are we going to find someone”—the man looked at his watch— “in the next twenty-eight minutes?”
“I said no,” the President repeated strenuously.
“Do you want all of those people to die, Mr. President?” David was shocked at how the man was taking on Gray so effectively in a public setting.
“Of course not,” Gray shot back at him.
“Then we’ve got to go with the option that’s right in front of us. We don’t have the luxury of time to assemble the perfect operation. You know that and so does everyone around this table.”
“You need the CDC,” David repeated. “They are the number-one resource we’ve got on public health crises. I can help, but you need them in charge.”
“We need to get you on a chopper out there immediately,” one man said.
“And I said no,” Gray repeated.
David switched into ER doctor mode. “Regardless of who does what, someone needs to start calling to get tents, decontamination facilities, chlorine, as much chlorine as you can find. We’ll need shower systems, cots, blankets, pillow, meals, nurses. Call the NIH and get as many doctors and nurses as you can put your hands on. Activate the Public Health Service if you have to. Have them flown to Andrews. This isn’t something one doctor can handle.”
“Do you know anyone in the area who has the requisite knowledge?” someone asked.
David paused, realizing that, actually, he did. “Yes.” He grabbed a nearby telephone and dialed the university medical school, hoping to catch one of his colleagues.
“This is Dr. David Hammond. This is an emergency. I need Dr. Samuelson stat.”
A moment later David had the man himself on the line.
“David, what’s up?”
“Howard. I’m going to tell you something, but I need you to swear to me that what you’re about to hear will not be revealed to anyone other than you and me. I need to hear you say that.”
“All right. I swear that this conversation is off the record, between just you and me.”
“We’ve got a major health crisis looming.” He looked at his watch. “Crap, in twenty-six minutes. What is the incubation period for the Marburg virus?”
“Symptoms appear within seven to ten days of exposure.”
“Ha, so I was right,” David said. “Okay. Thanks.”
“David, what’s going on? Tell me.”
“We have a potential outbreak.”
“Here? In the United States?”
“Yes.”
“Damn! Where?”
“Right here.”
“In DC? Fuck!”
“At least. I need your help. Can I have a helicopter pick you up to take you to the site?”
“How many people exposed and how serious?”
“I don’t have a count yet.” Turning to the men around the table, he said, “Do we have a count on how many passengers? And what conditions they’re seeing?”
With his ear to a telephone, one of them reported, “Two hundred and thirty-five, and five are seriously ill. Those five are… producing a lot of bodily fluids. A number of other passengers have inadvertently been directly impacted. Wait.” He paused. “Just got word that one of the passengers died a minute ago.”
“Howard, did you hear all that?”
“Yes. It’s a plane? Where? This is beyond serious.”
“Landing in twenty-five minutes at Joint Base Andrews where we’ll need to quarantine everyone. Can you come help? I’m not an infectious-disease expert, but you are.”
“Yes, of course. I just need a couple of minutes. When and where?”
David relayed instructions.
“I’m on my way.”
“Stay where you are. Can we have him picked up by helicopter?” When he saw a nod, David went on. “Howard, get to the hospital heliport. Your helicopter will be there in four minutes,” he reported, relaying details someone had written on a piece of paper and shoved into his hands.
“Understood. I’ve just grabbed somebody else who knows more about this than anybody. Is there room on the chopper for two of us?”
When someone nodded, David said, “Yes.”
After hanging up, David turned to Gray. “Okay. I guess I need to go,” David said.
“David, no,” Gray pleaded.
“Don’t worry. It’s all right. I know what I’m doing. I don’t take chances. I follow protocol to the letter, and there is a clear protocol for this.”
“What about your security detail? I don’t like the idea of sending them into harm’s way like this. They’re not trained in how to handle hazmat conditions like this where the individual they are charged with protecting is in full isolation gear.”
“I agree. I’m going in alone.”
“Unacceptable,” the agent in the room piped up. “Where you go, we go, especially in such a dangerous situation as this. I cannot let you go in alone.”
“Why aren’t you making those phone calls? Time’s wasting, people,” David demanded of the people around the table. Many of them immediately picked up the phones in front of their spots at the table and started giving orders. He knew they were just giving orders to someone else down the line to do what he’d asked them to do, but he didn’t care. He just needed the personnel and equipment that he’d ordered.
“Sir,” the agent said. “Your chopper is inbound. We need to head upstairs now.”
“I’ve got to go, babe,” David said to Gray.
“I’m going with you.”
“No, sir, Mr. President.”
“I’m the President. I get to decide,” Gray angrily shot back.
“Not on this, sir. We can’t have you anywhere near this kind of a risk and this much of an unknown.”
David hugged Gray and gave him a quick kiss. “Don’t worry. I’ll do everything in my power to keep myself and everyone else safe.”
“Sir, we need to leave immediately,” the agent reiterated.
“I’ll see you in a few hours,” Gray called after him.
David and his agent ran upstairs, exited the building, and headed across the White House lawn to the waiting helicopter. Inside were a pilot and copilot, so David and the agent got into the backseat and donned headphones with mics for communication. Almost as soon as they stepped onboard, the chopper was in the air and headed south at faster than normal speeds. It wasn’t the typical presidential helicopter, so it was more maneuverable and was able to go faster.
They headed to the hospital to pick up David’s colleagues. With all passengers onboard three minutes later, they were bound for Maryland. Before it seemed possible, David’s helicopter was landing. They were greeted by several trucks of heavily armed men, all equipped with gas masks. A truck with hazmat suits pulled up as they jumped out onto the ground. Fortunately they had also sent someone to help people get into the suits. There were more types of hazmat suits than seemed possible, so it was important that a knowledgeable person was there.
“When the plane comes to a stop, we need to go onboard to assess the situation and probably tell the passengers something,” Samuelson said, pulling on the bulk of his suit.
David was suiting up as well. His agent stopped him and said. “Sir, I need to go with you.”
“I can’t ask you to do that. This could be a deadly contagion.�
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“I’m going.”
“Please, I’m begging you. Please, don’t.”
“Where you go, I go. It’s as simple as that, sir. If I don’t go, you don’t go.”
David really did like this current agent who was assigned to him. They both had a no-nonsense approach to life and got along well.
“I’m trained in handling medical emergencies,” David argued. “I know basic emergency protocols.”
“I’m going,” the agent stated, “and I’ll follow your lead.”
They were just being sealed into their protective bio containment suits when the 747 landed near their location. Even from inside the suit, David could hear and feel the power of the 747’s engines as it came to a stop and powered down three of its four engines. They were quite removed from where most planes parked, which was precisely what David had asked for.
The suits were more elaborate than other bio containment suits David had worn in years past. These suits, for example, came equipped with cameras that recorded and transmitted everything the wearer saw and heard.
His headset crackled with the voice of a man who identified himself as the pilot, followed immediately by Dr. Samuelson’s voice.
“Captain, I’m Dr. Samuelson, chief medical officer on site. Report,” he ordered.
“Flight attendants report that there are now fifteen passengers who are seriously ill.”
“Could it be simple food poisoning?” Samuelson asked.
“It seems far more severe than that. Several of the passengers are vomiting blood,” the captain said.
“What’s the panic level onboard?”
“Serious, but at the moment contained.”
“As I’m sure you realize, no one can exit the plane just yet until we know what we’re dealing with. Military personnel are preparing decontamination facilities and medical care facilities, but they’re not quite ready yet. You can reassure everyone that we’re working as quickly as possible to get ready to get them off the plane, or I can do that when I get onboard. Several of us are going to come onboard to do a quick assessment. Inform everyone that they are to remain onboard and seated for the moment.”
Stairs affixed to the back of a truck were driven up to a door on the left side of the aircraft, a door near the front where the volume of passengers would be lighter than it would be in coach in the back. David, his agent, his two medical colleagues, as well as a base doctor started to climb the stairs, taking each step carefully because the suits were bulky.
“These things are not easy to move around in, are they?” David’s agent said to him.
David chuckled. “That’s the truth.” His levity turned suddenly serious at the top of the stairs. “This could get really ugly. Are you sure you want to do this?” David asked him.
“I have to, David.”
David noticed the agent called him by his first name. He cast a quick glance toward the man who was a foot to his right, but the suit made it next to impossible to see anything about his face. The agent had never called him by his first name before.
Another voice cut in on his headset.
“David? David?” He recognized Gray’s voice.
“I’m here, Gray. Suited up and we’re just about to enter the plane.”
“I know. We’re patched into the video feed from your suits. We’re watching and listening to everything that happens. David, please, please, please, be careful.”
“Absolutely. Personal safety is not something to play around with. We’re going in now,” David said.
“Please be safe,” Gray said. “Don’t take any chances. I want you to come back to me.”
Samuelson pounded on the door to the airplane.
“Captain, we are at the door. Can you have someone let us in?”
“Affirmative.”
The door was unlatched and slowly pushed open by a very worried-looking flight attendant, a man who easily stood six feet tall. He wore blue surgical gloves and had a linen napkin, probably from first class, tied around his face.
Dr. Samuelson raised his hand in greeting.
“Can you put me on the plane’s public-address system?” Samuelson asked.
The attendant immediately complied.
“Ladies and gentlemen. I’m a medical doctor, and I have just come on board the aircraft to make an initial assessment of the situation. Until we know what we’re dealing with, we are required to wear bio containment suits, but please don’t let that alarm you. This is standard protocol for a situation like this.
“We have medical personnel flying in by helicopter from all over the DC area to get specialized care facilities set up. In the meantime, no one can leave the aircraft just yet. I know that’s probably the last thing you want to hear, but I promise we’ll do everything we can to make it as brief a time as possible. Several of us are going to move onboard now and start a variety of tasks. Please remain seated and let us do our work.”
As soon as he finished speaking, the voice of the pilot came over the public-address system.
“I just wanted to add a couple of quick comments to what you’ve just heard. There are a great many heavily armed soldiers all around this aircraft. They will shoot to kill anyone who tries to do anything stupid. I know you’re all worried. So am I. But be assured that the Americans have the world’s best medical facilities. If this had to happen, be grateful that it happened here where they are knowledgeable about these things. We will be getting the best care possible. And repeating something I told you earlier, normally onboard an aircraft such as this, cabin air is recirculated several times before being replaced. On this aircraft, we are not doing that but instead are pulling in 100 percent fresh air and venting the previously circulated air.”
“I’ll talk to the flight attendants. Carl, you check with the passengers seated closest to the affected areas. David, Major Hopkins, check the sick passengers. Let’s get to work, people.”
“Where are the affected passengers?” David asked a flight attendant.
“In the very back of the aircraft, sir.”
“Of course they are,” David muttered to himself.
Their small parade of suited figures started the trek along the length of the aircraft, starting in the first-class cabin where the aisles were wide, moving to the slightly more narrow aisles of the business class cabin, and finally to the narrow aisles of the economy section of the airplane.
David had forgotten how long a 747 was until he made this particular walk. Every step of the way, he noticed faces of very worried passengers, some in tears, all studying him intently.
The panic became more concerning the farther back in the plane they went. He noticed that every single seat was filled in this section of the aircraft. In addition to that, the other aisle was filled with people standing or sitting on the floor, apparently all intent on getting away from what was happening in the back.
The backmost cabin of the aircraft was separated from the rest of the plane by simple cloth curtains that had been pulled across the aisles. David pushed the curtain aside and was startled by what he found.
“Holy crap!” David swore softly.
“No shit,” the doctor from the base echoed.
The back of the aircraft looked like a bloodbath massacre had occurred. There was blood, vomit, and other unidentifiable stuff everywhere—the walls, the ceilings, the floor, the seats. The sick passengers were lying on seats in the center section of the plane, or in some cases even on the floor. It only took David one glance to verify that this had the characteristics of Marburg. Several passengers had bleeding around their eyes, as well as from their nose and mouth. Some were even bleeding around their fingernails.
“Initial assessment confirms that this has the appearance of some sort of a hemorrhagic fever. Massive discharge of blood and other bodily fluids evident in all of those impacted. Sick passengers contained in the rearmost compartment of the aircraft, where we are now. Pilot reports that plane is venting 100 percent of the cabin atmosphere and r
eplacing it with fresh air constantly to minimize transmission of any virus, although if this turns out to be Marburg, we’re in luck because Marburg is not transmitted through the air.”
David heard a question from some disembodied voice.
“Is it safe for them to be venting the cabin air?”
“Should be,” David answered. “If it is Marburg, the virus is not aerosolized. It can only be transmitted by direct contact with the bodily fluids of someone who is infected with the virus and is showing signs of being ill. Maybe a pilot can tell you, but isn’t air vented through the engines? If so, I’d think it’s heated before discharge, which should kill most things.”
David tried to speak to one of the sick passengers, but she didn’t seem to be able to focus or to speak. He tried another and got the same response.
“Damn,” he muttered.
“What’s wrong?” a voice asked.
“The suit makes it difficult to check for a pulse.”
David checked some of the passengers while Major Hopkins checked others. When they conferred, they realized none of the passengers were going to be able to tell them anything. Only one of them was vaguely conscious, but he wasn’t able to speak. All were exhibiting the same symptoms, the only difference being the degree of severity. All were either lethargic or unconscious.
Samuelson’s voice came over the radio. “David, Major, collect blood samples for analysis.”
“Understood,” David and the major said nearly simultaneously. David removed a few items from a pocket on his suit and set about drawing blood samples from each of the sick passengers, being very careful throughout the entire process, even down to labeling the tubes to identify which passenger he’d drawn the blood from. He used items from another pocket to take several surface swabs of various parts of the cabin that had clearly had contact with bodily fluids from the patients, handing each item to his agent so David could keep his hands free.
David and his shadow started back toward the front of the plane while the major remained with the patients in the back of the plane. They were making good progress when one of the passengers grabbed David’s arm and stopped him.
“Please, what is it? Are we all going to die?” a very worried-looking female passenger asked. David could see others craning their necks nearby, all close to panic, desperate to hear something, anything about what was happening.
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