The Virus
A Thriller
Stanley Johnson
Contents
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Postscript
About the Author
Also by Stanley Johnson
Copyright
About the Publisher
1
Doctor Lowell Kaplan, Head of the Bureau of Epidemiology at the National Center for Disease Control at Atlanta, Georgia, was on the telephone to Japan. He sounded worried. He was worried. He pushed back a lock of thick greying hair which had fallen over his forehead and hunched forward as he spoke, the suppressed energy visible in every line of his body.
“Okay,” he shouted into the phone. “It differs from A-Brazil, but does it have pandemic potential? That’s the question.”
Clearly dissatisfied with whatever was being said to him from the other side of the world, he slammed down the instrument and turned to his assistant, a fair-haired woman about thirty years old, who throughout the conversation had been seated patiently across the desk.
“They don’t know, Susan. They just don’t know. Or if they do, they’re not saying.”
“We’d better call a conference on this one, Lowell, hadn’t we? This is a pretty sensitive area.”
Lowell Kaplan swore out loud. “Sure,” he said bitterly. “We can call a conference. That’s what we always do. Then, if we make the right decision all the guys who were there on the day remember it and never stop patting themselves on the back because they got it right. And if we make the wrong decision, then who do you think carries the can? I do, as Head of Epidemiology. It’s my neck that’s on the line, not theirs.”
Susan Wainwright looked at him fondly. She had been working with Kaplan for over six years, in fact ever since he had been with the Center. She had, over the years, grown to admire the integrity of this man. She had seen how he handled himself during the course of a painful divorce. She had watched, without really meaning to, how he had dealt with his two children just coming into their teens at the time of the break-up of the marriage. He had shown an infinite amount of patience and tenderness. On the busiest days, he was always ready to take a call from Jimmy or Lorna.
Even so, she sometimes felt a sneaking sympathy for Martha Kaplan, whom she knew as an occasional visitor to the office. It was true that Lowell Kaplan was a “workaholic”. Sometimes she had wondered, ruefully, whether Lowell was interested in anything except work — and, of course, his kids. Many other men would not have hesitated to make a pass at her if they had spent as much time in her company as Kaplan had. Susan Wainwright knew that she was not “Miss World”. Heads didn’t turn when she walked into a restaurant. But in her heart she knew she had a great deal to offer.
Involuntarily she sighed. “I still think we ought to have a conference. Set out the facts. Examine the financial implications. Get some kind of reading on the probabilities.”
Lowell Kaplan sighed. “Okay. Go ahead and set it up. And this time, I’m going to want a record. Tape it, if you like. That’s the safest way. I want there to be a clear statement of each person’s position on this issue. That way we can nail ’em if we have to.”
Later that day, Lowell Kaplan took the chair at the hastily convened conference. He had deliberately kept the meeting small, with no outside invitees. The Center’s long-standing policy was to take as many decisions as they could on an in-house basis. Long experience had taught them that the further up the line you went, the more complicated any particular item became. It was amazing how quickly an issue could become political. Vested interests always seemed to lurk round the nearest corner. In fact, Kaplan often wondered if there were such a thing as a wholly scientific, wholly rational, wholly objective basis for action. He tried to operate as if there were, but he knew only too well that he frequently didn’t succeed.
He hung his coat behind his chair, loosened his tie and looked around the room at the half dozen men and women who were gathered there. He had been at the Center for Disease Control in Atlanta for the last six years and he could honestly say that it had been the most fascinating and rewarding period of his life. He had never before felt himself so challenged. That cluster of unpretentious buildings in an Atlanta suburb where he was privileged to work was the strategic command post in the world-wide fight against disease. Military men could count the missles ranged against them. His job, and that of his team, was to work with unseen enemies whose presence was often unsuspected.
Of course, much of the game, sometimes the most difficult part, lay in anticipation and prevention. Again the military metaphor applied. Deterrence was always the best defence. But sometimes something would slip through the net. The alarm bells would ring. When that happened, reflected Kaplan, he could count on his colleagues to rise to the emergency. They were, he thought, like some highly trained, highly mobile fire-fighting unit. Their job was to get to the scene of the blaze and to extinguish or contain the flames before the conflagration engulfed the world. Up till now they had succeeded. Somehow, thanks to skill and professionalism and a fair measure of good luck, they had managed to stay ahead. But Kaplan occasionally wondered how long the winning streak would last. He was one of the few who knew how close the world sometimes came to disaster. Already, the defences were stretched taut almost to breaking-point. And all the time, thanks to mass-travel and the continued force of urbanization, the dangers became more acute. It wasn’t plague which Kaplan feared. They knew how to deal with plague. It wasn’t cholera or typhus or any of the known diseases. What he feared was the unknown. Some sickness which would spread like wildfire among the population and against which all known remedies would prove to be of no avail.
Thank God they didn’t have that kind of problem this morning. What they were dealing with today was tricky in the extreme but not tragic. Or at least not yet. That was an important distinction.
“Okay,” he began. “Let me set out the facts, as I see them. The Japanese reckon they have found a new flu virus. They’re calling it A-Fukushima. They’ve had half a dozen cases in Fukushima already and a couple in Osaka.”
There was a map of Asia on the wall at one side of the conference room and Kaplan gestured in its general direction while Susan Wainwright pushed coloured pins into the offending cities.
“I was on the phone to the Japanese health authorities this morning and I think I should tell you they’re taking the problem seriously.”
Lowell Kaplan paused. He lowered his spectacles and looked over them. The thick greying hair on his head seemed to bristle with energy. A dark shadow covered the lower part of his face, indicating that here was a man who had shaved early in the morning and who had put in a long day’s work.
“The question is,” he continued: “Do we have a drift, or do we have a real shift? Dr McKinney, what’s your view of this one?”
Kaplan had addressed the question to a tall, good-looking man of around thirty-five who was Head of the Center’s Virology Division. Heads now turned in his direction.
James McKinney took his time and when he spoke there was still the trace of a Scottish burr which denoted his lowland ancestry. McKinney had come over from Edinburgh to do post-graduate work at the Center and had decided to stay on. The Center had been only too glad to have him. His painstaking methodical approach was precisely what was needed.
“As fa
r as we know — and we haven’t had a chance to look at all the evidence ourselves, since we haven’t had a sample set of cultures from our Japanese friends yet — there is a very fair likelihood that we are indeed dealing with an antigenic shift. The Fukushima virus appears” — he made the vowel-sound stretch out until it seemed almost as long as the Firth of Forth bridge itself — “to differ in its surface proteins from the influenza virus at present circulating in human population.”
He continued for some minutes.
“Thank you, James.”
Lowell Kaplan interrupted him at last and brought the conversation round to the essential political point.
“Our present vaccine,” he said, “is a multi-purpose unit, directed to A-Brazil, A-Texas and B-Hongkong. The first thing we have to decide is: do we simply add A-Fukushima to the existing unit or do we replace, say, A-Brazil with A-Fukushima? If we do decide to do one or other of these things, how soon and how completely can the manufacturers respond? We also have to bear in mind the liability question. Our current vaccine is well-proven and has a high degree of acceptability. If we modify it and embark on a mass campaign aimed at thirty or forty million people, or even a more modest effort aimed at twenty to twenty-five million people, we may run into a side-effects problem. In that case, the program could grind to a halt, and we could find ourselves going into the winter flu season without any protection at all.”
There was a long silence after Kaplan had finished speaking. Most of them remembered the swine flu fiasco of the mid 1970s, when the mass-vaccination campaign personally approved by President Ford got torpedoed by a host of malpractice lawsuits following the appearance of the Guillain-Barré syndrome in a small but measurable number of vaccinees. None of them wanted a repetition of that affair. This time they would move cautiously if they moved at all.
Lowell Kaplan turned to Susan Wainwright.
“What’s the word from the manufacturers on this one, Susan? How much time do we have?”
Susan Wainwright ran a hand over her hair, pushing a straying lock back into place. “If we’re going to change the vaccine, the manufacturers are going to have to rebatch. That means they have got to get the eggs together, say, twenty million eggs, and you can’t do that overnight. I’d say we have to make up our minds within the next ten days if we are to get cooperation from the manufacturers.”
“What about price?”
Susan Wainwright was hesitant. “That’s not really my province,” she said. “But I’d say if we request a new vaccine less than six months before the start of the new flu season, the manufacturers will really screw us on price.”
“You’re probably right,” said Kaplan. “So, do we adapt and pay the price, or just go along with our current vaccine? Do we just assume that A-Fukushima is a flash in the pan? Do we run that risk?”
Before Lowell Kaplan had a chance to elicit answers to his question, the bleeper in his top pocket started its urgent signalling.
“Dammit!”
He picked up the nearest phone.
The voice at the other end said: “Dr Kaplan? We have a RED ALERT here. You’re needed at once in the Data Center.”
“Gentlemen, ladies, will you excuse me?”
With quick strides, Lowell Kaplan left the room.
An hour later, the problem of next season’s influenza campaign — important though that was — had been pushed out of Kaplan’s mind. His thoughts were wholly concentrated on the call that had come in from New York. Over the past several years, he had had to deal with numerous epidemiological emergencies; that was the nature of the job. But from the brief conversation he had had with New York he knew that this particular summons was special. Deep-down, he felt supremely confident; equal to any challenge. The famous phrase came back to him: “Thou art weighed in the balance.” Well, if he was going to be weighed in the balance, he would not be found wanting.
Lowell Kaplan was met at Kennedy Airport by Dr Charles Graham, an old friend. Where Kaplan had ended up at the Center for Disease Control in Atlanta, Graham — who was a New Yorker, anyway — had gone to the Division of Tropical Medicine at Columbia University.
As they rode into the city together, Graham filled in the details.
“I don’t know how much they told you,” he began, “but I’ll begin from the beginning and try and give you the whole picture.”
“Go ahead. All I’ve had so far is a brief talk on the telephone with New York City’s Chief Medical Officer. And he sounded worried as hell. Then I left at once for the airport. Delta had to hold the plane, even then.”
As they joined the stream of traffic coming into the city in the early evening, Graham reviewed the history of the case so far.
“What we’ve got is a young female student — around nineteen years old — who’s been spending the summer in Europe. She returned from Brussels a few days ago, came straight to her apartment in the city and went to bed. One morning, six days later, she had a pain in her throat and could barely swallow. She consulted her doctor, who examined her and found several blisters on her neck and yellowish ulcers in the back of her throat and inside each cheek. She had a fever and seemed unusually nervous.
“During the next three days her temperature soared; she began bleeding under the skin, there was swelling in her neck, she appeared unusually weak and drowsy, her speech grew slurred, her mouth was dry, she had great difficulty in swallowing and her face alternately flushed and turned pale. By then her doctor was extremely alarmed. He called us up and we had her brought in to Columbia-Presbyterian Hospital. That was four days ago. Since then we’ve had her in an isolation ward.”
The traffic thickened as they crossed the Triborough Bridge and waited impatiently for the line of cars to pass the toll booth. At last their driver threw his handful of coins at the basket and the light went green for them.
“And how is she now?” asked Kaplan.
“Bad. In fact, I don’t think she’s going to make it. She’s lost twenty pounds in two days and most of her hair. I could weep. She must have been a real looker before this happened.”
“I know. That’s the worst part of this job. You’re dealing with people, not just patients.”
As they passed through Harlem on their way to the hospital, Kaplan looked out at the crumbling red-brick tenement blocks, the garbage piled high on the street-corners, the tattered store-fronts. If ever there was a place ripe for the spread of disease, this was it. He shivered.
They parked in the hospital forecourt, walked down the long main corridor to the bank of elevators at the end and rode up to the isolation ward. Outside the ward they donned gowns, masks and gloves. They entered the room and stood beside the bed. For a long minute, neither of them spoke.
At last Dr Graham said: “I don’t think there’s much else we can do. We’ve tried to keep her hydrated but she loses it as fast as we put it in. She’s quiet now, but before you came she was literally writhing in agony. She was sweating so much you could have driven a steam engine.”
Kaplan looked at the wasted, shrivelled figure on the bed. It was hard to recognize what a beautiful girl she must once have been. Her blond hair had come out in handfuls, her skin had dried out and cracked, her face was contorted.
“Heart?” Kaplan asked.
“Not good. She’s been under terrific strain. Personally, I don’t think she’s going to last the night.”
“Is she sleeping now, or is she in a coma?”
“I’m not sure. She moves in and out.”
As they spoke the girl stirred on the bed. She tossed her head from side to side and mumbled a few words.
Kaplan tried to make out what she was saying.
“Mon . . . mon . . . monkeys,” the girl said, suddenly audible. “Green monkeys.” Suddenly, she rolled back her head and appeared once more to drop into a trance.
Kaplan looked at Graham with amazement. “What do you make of that?”
Graham shrugged. “She babbles quite a lot. Often about animals. I haven’
t heard her talk about green monkeys before.”
After they had scrubbed up, they went to Dr Graham’s room.
“We’ve run all the tests we can do here,” Graham said. “And there’s nothing we can pin-point as the specific cause of the disease. We don’t know what we are dealing with. We think it could be something tropical in origin, but we’re not sure.”
“Had she been to Africa before coming back to the States?”
“Not as far as we know. But maybe she was in contact with someone. We are trying to track down her family at the moment to see if we can learn anything about her movements.”
Kaplan stood up and walked over to the window. Far below, the cars were streaming northwards and out of the city. The last rays of the sun glinted on the Hudson River.
He turned back to his colleague.
“We should expect to have other reports, here or around the world, if this is a known disease. We’ve contacted the World Health Organization — WHO — in Geneva. So far, nothing.”
“What did she say to her doctor?”
“Not much, apparently. She was pretty sick by then.”
“I might go and talk to him. Do you know where he lives?”
“His office is in Washington Square, down in the Village. And we have the keys to her apartment if you wanted to visit that.”
Kaplan was in a sombre mood as he caught a cab downtown. There was something in what he had just seen that had moved him deeply. A head on a pillow; a form on a bed. Pipes and tubes. Masks. Temperature charts. All the paraphernalia of sickness. Yet once there had been an identifiable personality there, a face to be known and loved.
He went to the apartment first. Detective work was part of his job — often a large part — but he always felt awkward moving around among someone else’s possessions. The place was larger than he had imagined. Diane Verusio, as he had learned the girl was called, lived in a rather graceful house on Bank Street, a couple of blocks from the river. Her apartment was on the first floor.
The first room he entered was a spacious sitting-room, giving out onto the street. It was prettily decorated and lined with books and pictures. The dominant theme was wildlife of every kind. Over the mantelpiece was a huge photograph of Nrongoro crater at sunset, with a cheetah’s head in the foreground poking out above the grass. There was also a photograph of Treetops with a group of elephants at the waterhole. Next to it stood a smaller picture of a girl in a safari outfit. A young, attractive face with a wide smile and honest eyes. It was hard for Kaplan to link the face in the photograph with the wasted form he had seen on the bed in Columbia Presbyterian.
The Virus Page 1