by Judith Lucci
"How did this virus come to be at Crescent Center Medical Center? This is one of the finest hospitals in the world, and certainly the best hospital in New Orleans. I don't understand how this could have happened,” persisted Mr. Tansill. "Also, can we catch it? I know the Governor is going to have hundreds of questions. In other words, what caused it?" Mr. Tansill's voice was hesitant. He was frightened.
Alex didn't blame him. She was a bit frightened as well and suspected they all were.
Dr. Smith from Tulane interjected, "Mr. Tansill, it is hard to know where the virus came from. These attacks occur all over the world at any given time. Sometimes they are devastatingly horrific, and at other times, they do little damage. Viruses causing hemorrhagic fever are generally transmitted to humans when humans come in contact with an infected reservoir host, such as mosquitoes or ticks. The virus can also be carried by rats, and house mice. The list is limitless."
Tim Smith grinned inwardly as he noted the incredulous looks on the faces of Mayor Devries and Stuart Tansill as he continued, "The virus can also be transferred to humans through urine, fecal matter, saliva, or other body excretions from infected rodents. For instance, a human can become infected when they crush a tick or pick up a mouse from a trap if secretions are spread to the human's hand."
Mayor Devries paled.
Alex was sure he was thinking of all the roaches and enormous palmetto bugs that lived in the city. She smiled to herself. Let ‘em have it, Tim, she thought to herself as she mentally cheered for the Tulane doc.
"Oh my God, any of us can get this! This is frightening," exclaimed Stuart Tansill, his voice moving up the scale toward hysterical. "I never knew. Why are we sitting in here when those sick people are only a short distance away? This is preposterous, unsafe even." He looked accusingly at Dr. Charmaine and added, "You could be infecting us now, correct?"
Alex sneaked a peek at the Mayor. He was pallid, visibly colorless. If she were honest, she'd have to admit that she was enjoying his discomfort. Devries was a pompous ass and she really didn't think he was very bright. He struck her as being very self-serving and not in the least concerned about the people of New Orleans. She reminded herself that she probably needed to reel in the unkind, impatient side of her personality that often escaped when she was forced to tolerate people she really didn't want to.
Her grandmother, Kathryn Rosseau Lee, of Virginia had coined it during Alex's childhood as 'the other Alex, or TOA,’ that frequently escaped when Alex was frustrated, stressed, or just plain pissed off. But, Alexandra Lee Destephano, for better or worse, had inherited the intelligence, intolerance and impatience of her grandfather, Congressman Adam Patrick Lee. Fortunately, she had also inherited the grace, dignity, and kindness of her grandmother that counterbalanced her bad traits. All in all, she was a mixed bag.
For a fleeting moment, Alex felt herself homesick for her childhood home, her grandparents' horse farm in Hanover County, Virginia. I always want to escape there when things are tough here, she thought to herself. I want to go in the barn, sniff the hay and sweet feed and saddle up my horse, Dundee, and ride into the woods. Yvette Charmaine's patient voice brought Alex back to reality.
Dr. Charmaine shook her head. "No, Mr. Tansill. Very much the opposite. Very few people who are exposed become ill. The virus has to somehow get into your body through a cut, a sore, or some other portal that allows the viral organism to enter your body. It's not as desperate as it sounds. That's why we are so careful not to spread the infection. It is why all health care providers wear gloves, masks, gowns, and special air-pressure suits and are scrupulously careful when they care for these patients. The patients are isolated in two ED rooms and the utmost caution to prevent further outbreaks. If we need to expand, there are other rooms in which we can do so in the CCMC ED. We are using the best science available and all of the protocols are being employed at this hospital.”
"But there has to be more you can do," the mayor whined. "It's just not safe here and we have more than 100 politicians scheduled to arrive tonight for this weekend's summit. What am I supposed to tell people?"
Alex was grossed out as she saw the mayor rearrange his comb over in an effort to control his anxiety. It was pretty yuk.
Robert was becoming impatient. He didn't have time for a bunch of droning politicians. As a matter, Robert, from one of the most prominent democratic families in America, rued the fact that Devries represented his party in his own home town. He glared at Devries and snapped, "You're the Mayor, you figure it out. Now, let Dr. Charmaine continue and .… " Robert stopped for a moment and checked his cell phone. He had a text. "…. It looks like we may have two more potential cases. Dr. Patterson is in need of help. Would one of you ….” Robert nodded to the infectious disease docs, “…. Tim or Dave - like to come over and help him out in ED."
"I'll go right now," Dr. Broderick volunteered, making a beeline for the door. Robert knew he couldn't wait to get out of the meeting. Broderick, like Robert, had no need for whining, complaining, self-serving politicians. Besides, Dave Broderick was a staunch conservative and it probably frosted his ass that Devries was so ineffectual and incompetent.
Robert nodded, gesturing to Yvette and said, "Please continue."
Jack felt his cell vibrate in his pocket. He extracted it carefully and read the text. It was from his administrative assistant, Jason Aldridge, better known as Jack's right arm. FRESH ONE IN THE QUARTER. NEED YOU is what the text read. Oh hell, he thought to himself, we've actually gone almost a week without a murder in his District. It was Thursday and he knew the weekend was going to be hell. A Thursday murder always predicted a hellish weekend. It never failed. He texted Jason back and said, WILL COME WHEN I CAN. PROBLEMS AT CCMC. WHO’S LEAD HOMICIDE? J.
Yvette felt they were getting nowhere fast and said briskly, "We currently have three cases, all housed in the makeshift isolation ward in the ED. This will most likely increase to five cases shortly if the two new admissions are positive for the virus. As you know, our first patient expired this morning. The patient in the ICU coded, but survived and we transferred him into our isolation unit."
"What are the symptoms of hemorrhagic viruses and how are they spread? I need some information for our press release and I want to be sure I am working within the CDC descriptions," Elizabeth asked.
Alex nodded appreciatively at the lovely dark-haired, young media relations director. Liz’s network and skills had grown exponentially since her baptism by fire during Mardi Gras this past February. Alex predicted a career in Washington as a network correspondent was in the works for Elizabeth. She was well-respected, smart and highly regarded by the national and cable network correspondents. She’d also started writing as a guest correspondent for the Times Picayune and several papers were syndicating her column. Not bad for a media communications graduate only five years out of college. Of course, she did graduate from a Virginia school - Virginia Commonwealth University.
"Good question. Oftentimes signs and symptoms vary due to the type of the hemorrhagic virus, but initial signs and symptoms often include a high fever, fatigue, dizziness, musclular aches, loss of strength, and exhaustion. Patients with severe cases of VHF often show signs of bleeding under the skin, in internal organs, or from body orifices. This is what happened to your first patient earlier today. Severely ill patient cases may also show shock, nervous system malfunction, coma, delirium, and seizures. Some types of VHF are associated with kidney failure. All three of your cases here at CCMC are exhibiting some of these symptoms. Does this help you Elizabeth? I can offer you the CDC fact sheets on hemorrhagic viral disease if you would like," Dr. Charmaine offered kindly.
"That would be great. Thank you so much," said a visibly relieved Elizabeth.
"Have you been able to isolate our virus yet," Alex inquired.
Dr. Charmaine shook her head. "No, we have not. Our mobile lab is on the way here and we have been gathering samples on all three patients. We should have a response about Ebola by
this evening as Ebola is easier to test for. Currently my assistant is data mining all of the information we have gathered. We still need to know more about the first victim, particularly his personal and travel history. We have gathered a fairly complete history about the other patients. The patient that survived in the ICU is from central Africa, Zaire, or the Congo and could potentially be the source of the outbreak although it is too soon to tell. He is a local food service worker. We are trying to locate people who know about him, how long he has been in the US and more personal information."
"Data mining? What does that mean?" questioned Stuart Tansill who was still freaked out and looking around like a germ might crawl up his arm at any moment.
"Data mining allows us to enter data in a statistical format that helps us look for patterns that can predict information to better define the outbreak. Many organizations data mine. For instance, the police data mine to predict crime patterns, marketing executive’s data mine to market their services, and so on. We will create statistical charts, histograms and prediction models once we have completed our mining. Hopefully, this will help us identify the virus and control it. We are entering information about the patients, their travel history, health history, physical symptoms, and then try to predict a pattern of the organisms."
Elizabeth had a couple more questions. "Dr. Charmaine, how long can we expect this outbreak to continue? How long will we be getting in new patients? I know the newspapers are going to ask and I just need your opinion."
Yvette Charmaine looked apologetic. "I don't have an answer for that. It could end today or last much longer. I would simply suggest to the media that we are doing everything we can to isolate the virus and are hopeful it will be contained soon. That's the best information I have available."
"Well, that's just not good enough for me," Mayor Devries retorted in an angry voice. "Surely you have a better answer than that. How do you expect me to be able to protect my city and all of those politicians if you can't tell me when this mess will end?" Mayor Devries ranted. "You've got to have a better answer that that."
Alex was alarmed by the Mayor's disrespect and Robert looked ready to throttle him. Commander Francoise looked ready to beat his ass, but that was pretty much what Jack wanted to do every day to Anthony Devries. Alex even noted that Jack's boss, Commissioner Ted Scott, was giving Mayor Devries the evil eye and looked ready to speak but the Mayor kept whining.
Commissioner Scott interrupted the peevish moaning of the mayor and said, "Mr. Mayor, I think the lady has told you everything she knows. We all have a lot of work to do. I suggest we close this meeting and get to it." The Commissioner looked around the table and noted heads nodding in agreement. He also noticed Alex had her hand raised. "Ms. Destephano, do you have another question?"
"Yes, and I agree with you, Commissioner. We all have work to do." She turned toward Dr. Charmaine and asked, "Is there an incubation period for these viruses?"
Yvette nodded, "Yes, the mean incubation period calculated currently for Ebola, and remember, we haven't determined this to be Ebola, is 12.7 days with a standard deviation of 4.3 days but can be as long as 25 days. I not saying this will be the case in New Orleans, but this is the best evidence we have on the cycle of Ebola. The incubation periods are similar for other hemorrhagic viruses. Just remember, we haven’t isolated the virus yet. It could be different from Ebola or other hemorrhagic viral diseases." Yvette voice was cautionary.
An audible gasp emerged from the conference table as the participants considered the possible month of incubation and potential outbreak. The Mayor was outraged. "You cannot possibly think this degree of uncertainty can continue in New Orleans for a month. That is preposterous. You'll have to take care of it sooner. I demand it." Devries looked around wildly at each participant at the table.
Jack detected a glimmer of anger on Dr. Charmaine's face but she covered it quickly. He did however note the telltale blush annoyance creeping up Yvette's neck and he smiled to himself. He'd seen her get mad and it really wasn't pretty. He'd known her older sister pretty well. The two of them used to antagonize the young Yvette in their youth and she would become furious with them. As Jack remembered, she was pretty spirited and had the vocabulary of a sailor. He was about to intervene, but Alex beat him to it.
"Mr. Mayor, certainly you understand Dr. Charmaine cannot actually 'control' how quickly the virus spreads, nor can she accurately predict how long this will last. Our immediate attention is centered on containing the virus and identifying exactly what kind it is. I suggest we end this meeting and I assure you all we will send email updates as we have information. Any other questions?” Alex’s voice signaled an end to the meeting.
Even though the Mayor was still flustered, he growled at Police Commissioner Scott and ordered him to be in his office at five to review security for the weekend.
After everyone finally left, Alex turned to Yvette and Robert and asked, "Well, Dr. Charmaine, welcome back to New Orleans. Has it changed much?"
Yvette laughed heartily shook her head, and asked, "Where in the hell did you all get that Mayor? He is a total idiot. I prefer our politicians crooked as opposed to stupid. You're going to have to keep me away from him or I'm liable to kill him!"
Robert chided her, "Now, Yvette, you know you haven't been gone that long. You know how colorful our local politicians are. Just remember back to Governor Huey P. Long to Edwin Edwards to Dutch & Mark Morial, just to name a few."
"Oh, I know. I remember very well," Yvette said, throwing her head back and laughing. Yvette Charmaine laughed with her entire body and it was an infectious laugh.
Alex loved her laugh. She smiled as well.
Yvette continued, “My favorite political crook currently is former Mayor Ray Nagin, who campaigned against fraud and corruption and was just indicted on 21 counts of fraud, money laundering and wire tapping, and God knows what else.”
"Unbelievable, isn't it." Alex commented, thinking about how honest the politicians were in Virginia compared to Louisiana. Well, most of them were honest. It had been something she had needed to get used to.
"Not really, I am beginning to think most of them are crooks. I sit in my office in Atlanta and I read the Times Picayune and I feel a bit home sick for corruption. Of course, you'll have all of those questionable politicians in the city in a few days. You're bringing them all from Washington to New Orleans. Way to go, right in the midst of a viral outbreak. Way to go, Bonnet,” Yvette quipped.
Robert smiled at his old friend and touched her hand. "Yvette, we've got to be serious for a moment. Do you think we should step up security at the hospital, particularly in view of everything that is going on?"
All traces of fun and gaiety left Yvette Charmaine’s face. She turned serious. "I absolutely think you should. And more than that, you must. By the way, do the two of you have a few extra minutes?”
Yvette's text alarm sounded as Robert and Alex nodded. "We've got more trouble. Can I get back to you all shortly? Can we reconvene?"
"Of course," Robert and Alex said in unison. Robert continued, "I want your personal take on this, Yvette."
"Well, let me get back with you after I check in at the ED. However, I will be letting the Secretary know so she can inform the White House. The President needs to know of the danger here and that we don't know yet where it is coming from. Gotta go."
Robert and Alex stared at each other, the stress evident on their faces.
Chapter 8
As New Orleans top cops Jack Francoise and Ted Scott left the hospital, the Commissioner admitted he was blown away by the Mayor's behavior. "Jack, what the hell is up with Devries? He was a total asshole in that meeting. I know he's a jerk, but he was at his absolute worst today."
Jack gave his boss a sly grin. "Why, Ted, Where's the surprise?" he answered in mock astonishment. "You know he's a SOB and every time he sees me, he's a bigger SOB. I think the sight of me raises his blood pressure 30 points." Jack grinned with some pride. "I work ha
rd to piss him off. Why would he be any different today?"
Commissioner Scott laughed and said, “His attitude was surprising to me. It was political stupidity on his part, possibly political suicide. There were a lot of very important people in that meeting. What do you think Stuart Tansill is going to tell the Governor? Tansill is pretty powerful. Some suspect he may be our next Governor. Did you see the look Tansill gave Devries?"
Jack was admiring how impressive Commissioner Scott looked in his dress blues. His brass and shoes were positively blinding in the October New Orleans sun. He shielded his eyes. "Damn, Commissioner, you could cut a rug all dressed up in your zoot suit. Your brass is hurting my eyes. Can you tone it down some?"
Scott smiled at the Commander. "You have one, too, Jack. Have you ever worn it?"
"Only at my big party, the night you all swore me in ... again." Jack rolled his eyes.
"Oh yeah, I remember, the celebration in your honor where you managed to attend for 11 minutes before you vanished, right?"
"That would be it, but don't worry, Commissioner, it's all spit shined and in my closet, ready to go. You know I hate crowds and shindigs," Jack added unnecessarily.