by Anna Jansson
“What is it, Jonathan? You look so strange. Tell me what it is! Are you sick? You’re scaring me, tell me what it is!” said Agneta.
“I hope I’m wrong. But I don’t dare trust that. Perhaps I’m going completely crazy, getting the creeps, but right now I want us to bring out whatever breathing protection is available. Preferably P3 masks, 3M with tube filter last for eight hours, otherwise duck beaks. All personnel who go into the treatment room should have protective clothing, gloves, and the best possible breathing protection. The patient and his wife likewise, until we know what it is. Find the disease control officer for me. Now!”
“What do you think it is, Jonathan?”
“It may be bird flu. I need a register of all individuals that Petter Cederroth has seen in the past five days. Good Lord! He was in the waiting room at the ER. How long was he sitting there? I saw him give a piece of candy to the little boy with the tractor.”
Chapter 10
“A case of suspected bird flu has been discovered on Gotland. For this reason any tourists planning to go to the island are asked to postpone their travel if possible. We also want to ask any passengers who took a taxi in Visby on the evening of July 1 and the following night to please call the Infectious Disease Clinic’s new telephone line 0498-690 001. There is no cause for alarm, but to avoid lines we are asking individuals with flu-like symptoms not to visit a health center or hospital. Instead a doctor will be making house calls as needed. To get in touch with a nurse and schedule a doctor’s visit, call 0498-690 002. For general information, call 0498-690 003. The report of a case of bird flu has not yet been confirmed, and we repeat, there is no cause for alarm.”
Maria Wern turned off the radio, which continued with a broadcast from Almedalen Week and a female journalist’s complaints of sexual harassment by a number of named politicians from both sides of the aisle. Minister of Equality Mikaela Nilsson was merciless in her judgment. It reeked of a major scandal. Maria logged onto her computer. In the room next door was Tomas Hartman. She could hear him talking with his wife on the phone. Words of love.
Everyday agreements. A number of affirmations of love. I love you too. Not bad after thirty years of marriage. Happy people. Of course you think it will last the rest of your life when you promise one another eternal fidelity. But life doesn’t always turn out the way you imagined. And when it doesn’t turn out the way you imagined it, it’s just as well to drive away your self-recriminations. Pulverize them in your clenched fist and blow the dust out the window. Because they don’t lead anywhere, they only bring you grief. The most painful thing is seeing the happiness of others and thinking that you have failed. That maybe you’re never going to find someone to trust and live with. She heard Hartman hang up the phone and then whistle enthusiastically. Not the melodic line itself but a harmony he was trying out second hand, with the same effect as when someone is humming to their iPod and you hear only the naked voice and not the song itself. Now he was getting up, the chair legs scraped across the floor and a mop of gray hair became visible in the doorway.
“We’ve got a preliminary autopsy report on the man from Varsande. He was knifed in the throat sometime in the night between June 28 and 29. On his heels he has dirt-soiled scratches as if he’d been dragged on the ground. Then he has a small, barely noticeable cut on the upper left arm and an old scar on his chest. We don’t have any results on the chemical analysis yet. We don’t know more than that right now. We still have no idea who he is. In age and appearance he doesn’t tally with anyone who has been reported missing. The black hair may indicate that his ethnic origin isn’t Swedish.” Hartman glanced at the clock. “I was thinking about having my lunch on a bench by the ring wall in Ostergravar, do you want to join me? It would feel good to get away from here for a while and return to the Middle Ages.”
“Sure.” Maria was getting up to go with him when the phone rang. She asked him to wait while she took the call, and he returned to his office, still whistling, to get his lunchbox in the meantime.
“I’m looking for Maria Wern, Emil’s mom. Is this the right number?” asked a female voice.
“Yes.” Maria started feeling worried. Had something happened? Did Emil hurt himself? Hit his head? Get sick and had to be picked up at the soccer camp? Or was he just homesick? Perhaps Emil was jealous that Krister had taken Linda and not him. But that’s what he’d chosen. Maybe he’d changed his mind and wanted to be with his dad instead?
“My name is Agneta and I’m a nurse at the Infectious Disease Clinic. This evening we’re having an informational meeting about bird flu. This concerns the children at the soccer camp at Klinte School. There is no cause for alarm, but we must take certain precautionary measures.”
“What do you mean by that?” Maria felt that she had to sit down while the words worked their way in and assumed their full significance.
“We’ll go into that in more detail at the meeting this evening. It will be at Warfsholm.”
“No, I want to know now.” Maria felt her face turning red and her neck flushing. The sense of an incomprehensible threat coupled with powerlessness made her agitated. “Do you think the children may have been infected by the bird flu? The cook, Berit Hoas, has it, doesn’t she? She wasn’t feeling well; I know she was taken to the hospital. Does she have bird flu? She does, doesn’t she? Answer me!”
“I have no authority to answer that. If you have any urgent questions before the meeting, you may contact Dr. Jonathan Eriksson at our information line.”
The nurse sounded stressed. Maria suspected that the situation was worse than she wanted to let on.
If she says there’s no cause for alarm again I’m going to scream, thought Maria, feeling a rush of hatred toward the woman, even though she was only doing her job according to the directives she’d been given. She could at least talk like a real person, so you felt like it was a fellow human being talking to you and not a bureaucrat. Emil, what’s going on with Emil? Maria felt worry like a clamp pressing around her neck.
“What do you intend to do? Take samples? Vaccinate them? Does the vaccine help if they’ve already been infected? Is there even any vaccine? Or medicine?”
“As I just said: If you have questions, you have to speak with our doctor. There is no reason to worry. The measures we have taken are simply to be on the safe side, if it should turn out that this is bird flu, that is. We still don’t know that.”
“But you must have a strong suspicion of that if people are being asked not to travel to Gotland. Right? That’s not a small amount of money you’re talking about, if the flow of tourists stops.” Maria felt harsh, but she did not intend to let her off that easily.
Hartman was in the doorway again, this time with his lunch in hand. He appeared to be in a marvelous mood.
“Are you coming?” He took a step into the office. “What is it, Maria? Has something happened?”
“Listen, I can’t come with you. I’ve got to make a call. It’s about Emil. I’ll explain later.” But instead of leaving the office Hartman sat in the chair by Maria’s desk with his lunch in his lap. She was glad he was sitting there; it felt like a guarantee that nothing too terrible could happen, a link to everyday reality where things such as children being infected by fatal diseases don’t exist. Maria dialed the number she’d been given to the infectious disease doctor. There was a busy signal. Most of all she wanted to go to Klinte School and make sure that Emil was doing fine. Right now. Her thoughts were whirling. What would she do if he were sick? She had to know whether he was infected, didn’t she? The line was still busy and Maria was happy that Hartman was sitting there, so there was someone to share her worry with.
“I was thinking about the neighbor to Berit Hoas, Ruben Nilsson, the one with the homing pigeons. He was found dead in his bed. This is bigger than they’re saying. What aren’t they telling us? They must understand that people will get upset and demand to find out what’s going on. This concerns my child!”
“So how contagious
is it?” asked Hartman, for lack of anything better to say. It was more like evidence that he was listening.
“I don’t know, but if it spreads like the common cold I’ve heard that a sneeze reaches ten meters. Then I guess it depends on how much resistance you have. There is medicine that stops viral infections.”
“Tamiflu. A decision was made that Sweden should buy up a million treatment rounds of ten doses a year ago, when there was an outbreak of bird flu in Southeast Asia. An emergency supply was supposed to be built up. I hope that happened.”
“Yes, I remember reading about that. The doctors had prescribed medicine on fairly shaky grounds and those who needed medicine for real afflictions had to wait, because they ran out at the pharmacy. Why doesn’t he answer? I think this shows a lack of respect! They have to set up more phone lines. They have some irritating music playing. Someone’s pounding on a piano and then there’s a catchy fiddle that stirs up the tempo even more. No doubt for a calming effect. It’s not making me calm. I’m getting mad.”
Tomas Hartman was about to say something when Maria was connected to the infectious disease specialist. She made a dismissive gesture with her hand and clamped the receiver under her chin while she reached for paper and pen.
“I want to know the truth,” said Maria when the introductions were over and she had asked about Berit Hoas.
“I have an obligation of confidentiality and I can’t say anything about a particular patient, I hope you’ll respect that. The truth is that we don’t know—and when we don’t know for sure it’s better to take precautionary measures than to stick our heads in the sand.” She heard him sigh heavily. What reason did he have to sigh? He probably didn’t have a child who was in danger. Conceited ass! Maria imitated him to herself … I hope you’ll respect that. Why did he have to hide behind such pretentious words? That way of talking creates distance. What you need is understanding and a sense that someone really cares.
“Okay. And what do you intend to do with the children if they’re infected? I want to know that now. Then I intend to bring Emil home from the camp. I don’t want him there if there’s a risk that he’ll get sick.”
“It’s not that simple. The disease control officer has decided to have the children remain at the school in quarantine. If any of them are infected we can’t risk spreading the infection further into the community. The children will be given medicine for bird flu.”
“In quarantine. What do you mean? That he can’t come home? What happens if he’s not infected now, but gets infected by someone in there? Let’s say tomorrow, because I couldn’t take him home. Do you have a legal right to do this? Otherwise this is unlawful deprivation of liberty, that’s a felony. I hope you understand the seriousness of this.” Maria felt anger suddenly flare up. She would have preferred being face-to-face with this guy so that he couldn’t escape or turn his eyes away.
“To put it in plain terms, if we don’t do this and it should turn out to be bird flu in a mutated form, which we have feared for a long time, it may mean thousands infected. The disease control officer has a legal right to hold people for taking of samples. We anticipate needing to keep them for five days if none of them become ill. So that they won’t infect each other, the children will each have their own room, where they should stay and breathing protection when it is necessary for them to leave the room. We will have healthcare personnel on site and all the children will be followed, their temperatures taken morning, noon, and evening. The children will have cell phones so that they can maintain contact with their families. I understand that this is difficult,” he added in a somewhat softer tone.
“So how long do you intend to keep my son there?” Maria sought Hartman’s eyes for reinforcement.
“In the best case we can call off the entire action as soon as tomorrow. That’s the earliest we can get a definitive answer as to whether or not this is bird flu.”
“But you believe that it is.”
“Unfortunately, yes. But I hope by all that’s holy I’m wrong.”
Chapter 11
Jonathan Eriksson was staring out the window from his desk at the Tallbacken assisted living facility in Follingbo. The magnificent rainbow arching across the sky and the expansive view did not lighten his mood, feeling like a prisoner in his office. Just like back in the day when the building was a sanitarium and the feared tuberculosis spread with awful speed, they did not want to let anyone who was infected into the hospital in town. So the residents at the Tallbacken assisted living facility had now been moved to Tingsbrogarden or evacuated elsewhere, to make room for those who had been brought in for observation and almost certainly already contagious. An observation ward was set up on the ground floor and a ward for patients with symptoms on the second floor. So far it was the taxi driver and his wife, the two policemen and the ambulance personnel who had contact with Ruben Nilsson, five homing pigeon owners who had met with Petter Cederroth on Saturday evening to go over the results of the pigeon competition, the passengers the taxi driver had reported from the night in question as well as the patients who had been in the emergency room at the same time as him, and the librarian who helped Ruben Nilsson find homing pigeon association websites on the Internet.
Rigorous arrangements, but Dr. Asa Gahnstrom, the disease control officer, did not dare take any risks in the present situation. Especially not with the healthcare personnel who had been in contact with Berit Hoas and Petter Cederroth. They had all been taken out of service and reassigned to the phone lines for information to the general public, each with a room where they had to stay night and day on the top floor in the main building of the old sanitarium. All had been given strict orders to use breathing protection if they left their rooms.
This also applied to Jonathan Eriksson. The phone call with the worried mother shook him to the core, and there were more calls coming. Maria Wern’s worry was justified. If her son isn’t infected now, but turns out to be later, who is responsible? Can you sacrifice one child to save thousands of lives? Jonathan had questioned the disease control officer’s decision, but was obliged to maintain the same line with respect to the general public and the media. It was hardest to argue with his medical colleague Reine Hammar, who was clinical director at the recently opened Vigoris Health Center at Snackgardsbaden. A schism had immediately arisen when at the request of the disease control officer Jonathan had to question him about when and where his colleague had been taken in a taxi by Petter Cederroth.
“What the hell is this? Do you think you’re some kind of policeman?”
Yes, that’s more or less how it felt to chart in detail the taxi driver’s doings during the night, as if you were the extended arm of the law. Pure investigative work to judge whether someone was guilty or not of carrying the contagion.
“Listen, I’m not interested in your personal life. I want to know what time you took a taxi and whether you were alone, that’s all.”
“I’m going to file a complaint to Social Services about this. This is abusive treatment, damn it, and not even remotely medically motivated. I’m going to laugh my head off if this isn’t bird flu. What a nuthouse!” Reine Hammar had thrown the protective mask on the desk, gone into his office, and slammed the door.
“Listen, if it’s not bird flu I’ll laugh my head off too. I’ll laugh until I puke,” Jonathan called after him behind the closed door, but was not certain that Reine heard him. A short time later he had Hammar’s wife on the phone. She was considerably more collected and seemed to grasp the seriousness of the situation.
Jonathan was dragged out of his thoughts by the phone ringing again. He collected himself briefly and picked up the receiver. It was Asa Gahnstrom, the disease control officer for the province of Gotland. He exhaled. He shouldn’t have done that.
“Just a brief bit of information. We have a problem.”
“A problem. Okay.” He tried not to sound sarcastic, but the undertone reached all the way to Asa.
“I would hope that you at least wou
ld realize the seriousness of this. I’m the one who’s responsible and I’m the one who’ll be hung out to dry. Oh well, posterity will have to judge me. The big problem right now is that we have far too little Tamiflu in the emergency supply to do any preventive treatment. Word went out to the general public that a million rounds had been procured, but not everything that was purchased is Tamiflu, far from it. Only a fraction, really. So my strategy is, treat those who have symptoms and those who are latent with the drugs we have and keep them under careful control. It’s hard to believe it’s true, but that’s how bad it is.”
“But then what’s been procured?” he asked.
“The remainder are other anti-viral drugs, without real effect on the bird flu we fear. I’ve been in contact with the procurement managers. They haven’t bought anything at all the past year. Nothing. The money is there, but they haven’t pulled the trigger and purchased any medication. Sweden has simply put itself in line.”
“What do you mean by that?” Jonathan noticed that his hand had left a damp mark on the desk pad. Suddenly the room felt stuffy and enclosed. The collar on his T-shirt was choking him, his pants felt tight.
“For a tidy sum, most other countries in Europe have already signed contracts for a place in line to purchase Tamiflu. We’re extremely late getting started. All we can do is appeal to the outside world for help—discreetly. If this leaks out to the press we’ll have a panic situation. Can you imagine what it would be like—what the terror might do to people, what a strain there would be on the healthcare system if thousands of people called at the same time or showed up at a hospital demanding treatment? Just this morning the general director of the Swedish Institute for Communicable Disease Control issued strict directives to the pharmacies that only disease control officers should be able to prescribe Tamiflu. This should have come much sooner. Unfortunately a number of doctors have been very quick with their prescription pads once the news was released. I’ve assigned someone to review the prescriptions and if possible effective immediately recall the filled prescriptions that are not medically motivated. The new system where the pharmacies register which medications are picked up isn’t so bad after all. This is a typical example. When it really counts you look after your own first.”