"Our government learned its lesson," Huang said. "Their secrecy regarding the SARS epidemic damaged China's reputation as an emerging world power. Our leaders know that secrecy is not an option this time."
The Chinese government had come under international fire because it kept the first SARS epidemic secret from the world, causing a delay and slowing treatment that could have prevented a number of deaths. Song Lee was working as a teaching physician in a Beijing hospital when the epidemic broke out. She suspected it was serious and assembled the facts to make her case. When she urged her superiors to take action, they warned her to stay silent. But the World Health Organization's outbreak-alert system issued a global warning. Travel came to a halt and quarantines were enforced. An international lab network isolated a virus never before found in humans. The disease was called SARS, short for severe acute respiratory syndrome.
The virus spread to more than two dozen countries on several continents, infecting more than eight thousand people. Almost a thousand died, and a pandemic of worldwide proportions was narrowly averted. The Chinese government imprisoned the doctor who had told the world that the cases were being under-reported and that patients were being driven around in ambulances to keep them away from the World Health Organization. Others who had tried to expose the cover-up also became targets. One of them was Dr. Song Lee.
"Secrecy wasn't an option then, either," she reminded Huang, making no attempt to keep the heat out of her voice. "You still haven't told me what this has to do with me."
"We are assembling a research team and want you to be on it," Huang said.
Lee's anger spilled out.
"What can I do?" she asked. "I am simply a country doctor who treats life-threatening diseases with herbs and voodoo."
"I implore you to put your personal feelings aside," Huang said. "You were one of the first to detect the SARS epidemic. We need you in Beijing. Your combined expertise in virology and epidemiology will be invaluable in developing a response." Huang folded his hands together as if in prayer. "I will get down on my knees to beg, if you wish."
She gazed at his anguished face. Huang was brilliant. She could not expect him to be valiant as well. Softening her voice, she said, "It won't be necessary to beg, Dr. Huang. I will do what I can."
His round face lit up.
"Mark my words," he said, "you won't be sorry for your decision."
"I know I won't," Lee said, "especially after you meet my conditions."
"What do you mean?" Huang asked in a guarded tone.
"I want enough medical supplies to take care of this village for six months… No, make that a year, and expand it to encompass the villages around this one."
"Done," Huang said.
"I have established a network of midwives, but they need a trained professional to oversee them. I want a family-practice physician flown in here this week to take over my practice."
"Done," Huang repeated.
Lee chided herself for not demanding more.
"How soon do you need me?" she asked.
"Now," Huang said. "The helicopter is waiting for you. I would like you to speak at a symposium in Beijing"
She did a quick mental inventory. The hut was on loan. Her belongings could fit into a small valise. She would have to inform only the village elders and bid her aged parents and her patients a quick good-bye. Standing, she extended her hand to seal the bargain.
"Done," she said.
Three days later, Dr. Lee stood on a podium behind a lectern at the Ministry of Health in Beijing, steeling herself to address more than two hundred experts from around the world. The woman on the podium bore no resemblance to the country doctor who had delivered babies and piglets by candlelight. She wore a pin-striped business suit over a blouse of Chinese-flag red, a rose silk scarf encircling her neck. A touch of makeup had lightened the amber complexion that had been darkened by outdoor life. She was grateful that no one could see her callous palms.
Soon after she had arrived in Beijing, Lee had gone on a shopping spree, courtesy of the People's Republic of China. At the first shop, she tossed her cotton jacket and slacks in the trash. With each subsequent purchase, in some of Beijing's most fashionable boutiques, she redeemed a bit of her lost self-respect.
Song Lee was in her mid-thirties, but she looked younger. She was slender, with small hips and breasts, and long legs. While her figure was adequate but unremarkable, it was her face that inevitably turned heads for a second look. Long dark lashes shaded alert, questing eyes, and full lips alternated between a friendly smile and a slight, more serious pucker when she was deep in thought. Working in the country, she had tied her long jet-black hair in a loose ponytail and tucked it under a cap that may have belonged to a foot soldier on Mao's Long March. But now it was styled and cut short.
Since arriving in Beijing, Lee had attended a dizzying schedule of briefings and had been impressed at the swift reaction to the latest outbreak. In contrast to the slow response several years before, hundreds of investigators and support staff had been mobilized around the world.
China was taking the leading role in the fight against the outbreak and had invited experts to Beijing to demonstrate its robust reaction. The speedy response had revealed a silver lining to a serious situation: everyone she talked to seemed confident that basic health practices could contain the SARS outbreak while researchers continued to look for the source and develop a diagnostic test and an appropriate vaccine.
But while the mood was upbeat, Dr. Lee was unable to share their confidence. She was worried that no source of the virus had been found. The civets that had carried the original SARS strain had been wiped out, so maybe the virus had jumped to another host—dogs, chickens, insects—who knew? Also, the Chinese government's uncharacteristic transparency bothered her as well. Bitter experience had taught her that the authorities did not easily give up their secrets. Even so, she might have dismissed these qualms had not the government refused to let her visit the province that had been infected. Too dangerous, she was told, the province was under the strictest quarantine possible.
Dr. Lee had set her suspicions aside for now to focus on the daunting prospect of appearing before an audience of sharp-minded experts. Her heart thumped madly in her chest. She was nervous about speaking in public after spending years among people whose greatest concern was the rice yield. The computer programs now available to chart an epidemic not only baffled her, she was unsure of her own expertise as well. She felt like a Stone Age holdover thawed from a glacier after ten thousand years.
On the other hand, practicing medicine at its most basic level had given her a gut instinct that was more valuable than all the charts and tables in the world. Her intuition was telling her that it was too early to celebrate. As a virologist, she had respect for how fast a virus could adapt to change. As an epidemiologist, she knew from painful experience how an outbreak could quickly get out of control. But maybe she was just gun-shy. She had gone over the statistics Huang had given her, and the epidemic seemed to be on the road to being contained.
Dr. Lee cleared her throat and looked out at the audience. Some of the people waiting for her to speak were aware of and possibly responsible for her exile, but she swallowed her bitterness.
"To paraphrase the American writer Mark Twain, rumors of my professional demise have been greatly exaggerated," she said with a straight face.
She let the ripple of laughter roll over her.
"I must admit, I come to you humbled," she continued. "Since I established my rural practice, great strides have been made in the world of epidemiology. I am impressed at the way the nations of the world have come together to fight this new outbreak. I am proud of the role my country has taken in leading the effort."
She smiled at the applause. She was learning to play the game. Those wanting angry denunciations of past policy would be disappointed.
"At the same time, I must warn against complacency. Any epidemic contains the seeds of a pandemic. These pa
ndemics have come to us in the past, and human beings have always come out the worse for it."
She talked about the great plagues in history, starting with the first recorded pandemic that struck Athens during its war with Sparta. The Roman pandemic of 251 A.D. had killed five thousand people a day, the Constantinople epidemic of 452 ten thousand a day. Around twenty-five million died in Europe of the Black Death during the 1340s, and forty to fifty million worldwide in the great influenza epidemic of 1918. She repeated her warning against complacency, and repeated how pleased she was at the multinational response to the current epidemic.
Dr. Lee was stunned at the applause that her presentation received. Her acceptance back into the medical community after years of exile was unexpected, and she was overcome with emotion. She left the stage, but instead of returning to her seat she strode to the exit. Tears welled in her eyes, and she needed to compose herself. She walked along the corridor, not sure where she was going.
Someone called her name. It was Dr. Huang, hurrying to catch up to her.
"That was a fine presentation," he said, breathless from the chase.
"Thank you, Dr. Huang. I'll return to the auditorium in a few minutes. It was quite an emotional experience for me, as you can imagine. But it was reassuring to hear that a worldwide pandemic is unlikely."
"On the contrary, Dr. Lee, a pandemic is a certainty. And it will kill millions before it runs out of victims."
Song Lee glanced at the door to the auditorium. "That's not what I heard in there. Everyone seemed quite optimistic that this epidemic can be contained."
"That's because the speakers don't know all the facts."
"What are the facts, Dr. Huang? Why is this SARS epidemic any different from the last?"
"There is something I must tell you… this business about SARS… well, it's a fraud."
Lee glared at Huang.
"What are you saying?"
"The epidemic we are concerned about is caused by another pathogen, a variation of the influenza virus."
"Why didn't you tell me this? Why did you let me blather on about SARS?"
"It pained me to do so, but the presentation was intended as a smoke screen to hide the fact that the pathogen we are dealing with is much more dangerous than SARS."
"The experts speaking in the auditorium may beg to differ…"
"That's because we have been feeding them misleading information. When they have asked for specimens of the strain to help with their research, we have given them the old SARS virus. We are trying to prevent a panic."
She felt a dryness in her mouth.
"What is this new pathogen?"
"It is a mutated form of the old influenza strain. It spreads faster, and the mortality rate is much higher. Death comes more quickly and more often. It's incredibly adaptable."
Dr. Lee stared in disbelief. "Hasn't this country learned its lesson about secrecy?"
"We have learned it very well," Dr. Huang said. "China is working with the United States. We and the Americans have agreed to keep the existence of this new pathogen a secret for now."
"We saw before that delay in releasing information costs lives," Lee said.
"We also saw forced quarantine," Huang said. "Hospitals shuttered, travel and commerce interrupted, people attacked in Chinatowns around the world. We can't tell the truth now. There's no way to stop this pathogen until we've developed a vaccine."
"You're sure of this?"
"Don't take my word for it. The Americans have far more sophisticated computers. They have created models suggesting we can temporarily contain pockets of the disease, but it will eventually break out and we will have a worldwide pandemic."
"Why didn't you tell me all this back in the province?" Lee asked.
"I was afraid you might still think I had betrayed you before and wouldn't believe me," Huang said.
"Why should I believe you now?"
"Because I am telling the truth… I swear it."
Dr. Lee was confused and angry, but there was no doubt in her mind that Dr. Huang was being forthright.
"You mentioned a vaccine," she said.
"A number of labs are working on it," he said. "The most promising drug is being developed in the U.S. at the Bonefish Key lab in Florida. They believe a substance derived from ocean biomedicine will produce a vaccine that will stop this pathogen."
"You are saying that one lab has the only viable preventative?" Lee almost laughed at the absurdity despite the direness of the situation.
The auditorium doors opened, and people were starting to spill into the corridor. Huang lowered his voice.
"It's still in development," he said, "but, yes, our hopes are high. It might go even faster if you were there as the representative from the People's Republic."
"The government wants me to go to Bonefish Key?" she said.
"It seems that I have been 'rehabilitated.' I'm willing to do anything I can. But you are putting everything on this one vaccine. What if it doesn't work?"
A haunted look came to Huang's eyes, and his voice dropped to a whisper.
"Then only divine intervention can help us."
CHAPTER 3
The influenza epidemic of 1918 appeared suddenly, striking the world as it was trying to stitch itself back together after the devastating war that had ripped it apart. The epidemic raged through Spain, killing eight million people, and for that accomplishment was dubbed the Spanish flu, though it hit many other countries including America as well. Within months, it had spread around the world. There was no known cure. Victims would sicken in the morning, breaking out in the telltale mahogany-colored rash within hours, and die before nightfall. Millions died; a billion were infected. Before it petered out in 1919, influenza had killed more people than five years of brutal war had. It was worse than the Black Death.
The grim statistics raced through Dr. Song Lee's mind as she covered the last leg before setting foot on Bonefish Key. She had flown into Fort Myers and caught a limo to the Pine Island Marina, where she met a colorful local character named Dooley Greene. He had taken her on his boat through the mangroves to the island. A man was waiting on the dock to greet her.
"Hi, Dr. Lee," the man said, extending his hand. "My name is Max Kane. Welcome to Fantasy Island. I'm the director of this little speck of paradise."
In his faded Hawaiian shirt and tattered denim shorts, Kane looked more like a beach bum than the respected ocean microbiologist whose impressive résumé she had perused. A Chinese scientist of his stature would not have been caught dead without his white lab coat.
"I'm pleased to meet you, Dr. Kane," Lee said, glancing around at the rippling palm trees and a whitewashed building perched on a low, grassy rise a few hundred feet back from the dock. "I've never seen a research lab in such a picturesque setting."
Kane gave her a lopsided grin. "Not half as picturesque as the island's current inhabitants. He grabbed her suitcase and headed inland. "C'mon, I'll show you to your quarters."
They climbed a stairway cut into the side of the hill and then followed a crushed-shell pathway to a row of neat cabins painted flamingo pink with white trim. Kane opened the door of one cabin and ushered Lee inside. A bed, chair, dresser, and desk had been tucked into the snug space.
"It's not the Ritz, but it has everything you need," Kane said.
Lee thought about her one-room shack in the rural countryside. "I'm sure I'll be very comfortable here."
Kane placed the suitcase on the bed.
"Glad to hear that, Dr. Lee," he said. "How was your trip?"
"Long!" she said, punctuating her reply with an exaggerated sigh. "But it's good to be back in the U.S."
"I understand you spent some time at Harvard," Kane said. "We appreciate your returning to this country to help us out."
"How could I not come, Dr. Kane?" Lee said. "The world has been lucky up to now. Despite all our medical advances, we've never developed a vaccine for the original 1918 influenza. We're dealing with a mutant s
train of that virus. Very complicated. The outcome will depend on our work here. How soon can I start?"
Max Kane smiled at Song Lee's eagerness.
"Let's get you something cold to drink," he said, "and I'll show you around, if you're up to it."
"I may fall asleep on my feet when the jet lag hits, but I'm fine for now," she said.
They walked back to the patio in front of the resort-style building. While Song rested in an Adirondack chair, Kane went into the building and brought out two glasses of mango and orange juice on ice. Sipping the delicious drink, she let her eyes wander along the shoreline. She had expected that the epicenter of secret research that had worldwide implications would be surrounded by fences and guards, and she couldn't contain her surprise that it didn't.
"It's hard to imagine that there is a lab doing vital work here," she said. "It's so tranquil."
"People would wonder if we put up barbed wire and guard towers. We've worked hard to project the image of a sleepy little research center. We decided that hiding in plain sight was the best strategy. Our website says that this is a private facility and suggests that our work is so boring to most people that no one would want to visit. You probably noticed the PRIVATE signs scattered around the island that say the same thing. We've only had a few requests to visit the center and we managed to put them off."
"Where are the lab buildings?"
"We had to get a little sneakier when it came to the research space. There are three labs farther inland. The labs are pretty well camouflaged. Google Earth would see only trees."
"What about security? I didn't see any guards."
"Oh, they're there, all right," Kane said with a tight smile. "The kitchen and maintenance staffs are all security people. There's an electronic-surveillance center that keeps track of anyone coming too close to the island twenty-four/seven. They've got cameras all over the place."
"What about the water-taxi man, Mr. Greene? Is he in on the deception?"
Kane smiled. "Dooley provides a useful cover. He worked for the old resort before Hurricane Charlie drove it into bankruptcy. We transported equipment and personnel here in our own boats when we were setting things up, but we needed someone to run people and supplies between the island and the mainland. Dooley's never been farther inland than the dock. He's a bit of a wind-bag, so if he does spout off about something he's seen out here the people who know him will figure that he's making it up."
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